Automobile and Cycling Essay

Cycling is one of the oldest means of transport. Inventing bicycles was an enormous step in the history of transportation. Bicycles didn’t need horses or wains as a result transportation became much simpler and cheaper. Moreover the previously smelly and dirty towns turned into healthier and cleaner places. Nowadays, however, when there are several faster ways of travelling, is there any reason to ride a bicycle? Although in our more technologically developed days bicycle are rather old-fashioned way of travelling, it has certain advantages. To begin with, bicycles are much cheaper than cars and motorcycles so that a lot of people can afford to buy them. Moreover, cycling is a great, physically demanding sport. As a result it could be an essential part of a healthy lifestyle or even a balanced diet. If people used it only for go to work or school it would provide them enough movement to avoid weight problems. Finally cycling is very environmentally friendly because it doesn’t need fuel or electricity. On the other hand cycling as a mean of transport does have its disadvantages. It usually takes longer than other forms of travel. As a result it can be more tiring. In addition, riding a bicycle in the city can be a little unhealthy. Cities’ air is very polluted because cars and factories exhaust a lot fume and chemicals. Furthermore cycling can be dangerous also. In the heavy traffic violent and careless car drivers often cause accidents and if we aren’t enough careful we can easily get hurt. All things considered, although there are some disadvantages of cycling I believe it is healthier and more enjoyable than driving a car. It can be dangerous but it is a perfect method to keep ourselves fit. Furthermore, in our crowded cities travelling by bicycle often the fastest way to reach our destination.

Is Experience the Best Teacher? Essay

My whole life I’ve been told practice makes perfect. Whether it’s in the tennis court or in math class, the more you practice something, the better you become at it. In the last few years I’ve found out that practicing and doing is not the same thing. Harry Callahan once said, _†experience is the best teacher†_ and without a doubt it is. You can sit five hours taking a business class or 10 hours in a tennis practice but until you go out to the real world and start doing business with other people or play a real tennis tournament you wont _really_ LEARN. When experiencing things we all make mistakes and making mistakes, in the broad scheme of things, is good as long as we learn from them. Through the different experiences I’ve had through tennis, my musical adventures and my business deals, I’ve learned from my errors, picked myself up from the ground, and ultimately grown as a human being. On August 10, 2000 I stepped on to the tennis court for my first tennis lessons. I had previously tried to play the sport but this day I was determined to start a journey in which I could master it. After my first real tennis year, I improved at an incredible pace, and went a summer to the world-renowned Nick Bolletierri Tennis Academy in Bradenton, Florida. At merely 11 years old, I found myself without my family and in an unknown place, but that didn’t stop me from doing what I most loved, playing tennis. After that summer I fell in love with that sport and went the next two summers to Saddlebrook Tennis Academy in Tampa Bay Florida, where I polished my skills and started to play a few serious tournaments. The first tournaments that I played made me realize that no matter how much I had practiced in the tennis court, this was not practice, and at the beginning, my lack of tournament experience, hindered my ability to perform at my utmost level. In the few tournaments that I played in Florida and the dozens of tournaments I have played here, I have learned that practicing something  and doing it were two different things. The more I made mistakes and the more I was about to win a game, but then lost, were part of an experience which through time made me a better player. Everyone likes music, and everyone enjoys it, but there are some of us that absorb music and make it part of our everyday life. I have always been a huge music fan and in 2003 I decided to buy a guitar. Unlike my friends who â€Å"heard† music, I listened to it and analyzed it, taking it seriously and making it part of my life. After playing guitar for several months alone in my room I formed a band with a few friends of mine, who at the time, shared the same musical taste as me. We had a lot of trouble at the beginning adjusting, because despite the fact that we each knew had to play our instrument, playing all together was clearly not the same. After a few months of cleaning up the sound of our band, we decided to go ahead and play in front of a crowd so we signed up for the Annual School Talent Show. We were so proud and confident of ourselves that we announced it to all of our friends and made a big deal about. On May 22, 2004, a day before my fourteenth birthday, we stepped onto the stage, in front of our whole school, and started to play â€Å"Seven Nations Army† by the White Stripes, the only song we practiced for the past two months. Amid the performance we were all looking at each other realizing that everything was sounding filthy and disorganized. As we were playing we saw the faces of our friends in the crowd, who tried disguising the fact that we had played terribly. After that talent show, and several other terrible self-humiliating performances, we decided that we had enough embarrassment and we had to improve as a band. After several months of intense practicing, and the previous shameful experiences we had gone through, we started to become better and better. A year and a half after the dreadful talent show performance we found ourselves playing in front of hundreds of people, and getting paid to do what we loved the most. Months later I stepped onto another musical journey but this time in the Motion Picture field. I started to make a movie with a couple of friends that ended up receiving massive national attention. The movie started out as a project just for us to enjoy but as the Musical Director and Executive Producer, I knew we had something good in our hands and decided to make the most out of it. Eight months later it was viewed  across all the movie theaters in the capital and all the Movie Rentals in the country. The day after it was released in the movie theaters, we did over 4 newspaper interviews, over 5 live television interviews and we were reading on all major newspapers the headline â€Å"Dominican Boys Make National Movie.† After the success of the movie and my very acclaimed role as Musical Director, we received a contract from one of the biggest businessman in the Dominican Republic, to direct and produce his next upcoming movie. As of know we have just started to film that movie, but if it weren’t for all the times I humiliated myself on stage, or all the times I had to continue playing in front of people who were tired of listening and just wished for us to st op, If it weren’t for all those experiences, I wouldn’t be where I am know. Being the independent person that I am, I do not like to ask for a lot of favors or gifts. Since I was a child, my father has taught me many vital lessons and one of them is that nothing is free and money is hard to get but easy to spend. After not being able to have many of the toys that I craved as a child, I was left with this notion in my head that I had to produce money since I was young in order to have what I want and not having to ask for it. At 15 I took action and talked to one of my best friends and current business partner about the possibilities of making t-shirts and selling it among my friends. After a few months we hired a man, who has made t-shirts for a living for over a decade, and paid him to make about one-hundred t-shirts and sold them all in a period of a month. We made a good profit and decided to take our business further. After months asking for a valuable meeting in Plaza Lama, the biggest department store in the Dominican Republic, I finally received it an d after almost two hours of heavy persuasion my partner and I finally landed a contract of over 1200 t-shirts to sell in their main store. We immediately went to talk to our t-shirt manufacturer and after being to negotiate with him the prices, in order to receive a reasonable amount of profit, we got to an agreement. He was not as responsible as he seemed and took more time than promised, but we were fine since the t-shirts sold perfectly in Plaza Lama and we were just in time to receive a new contract. As we were sitting in Plaza Lama in a meeting with the manager of the clothing department, we received news that our  manufacturer was manufacturing more of our t-shirts and selling them to another department store without permission making himself a fortune and not giving us our equal pay. After a profound exchange of words with our manufacturer, we decided to part ways and take control of our own future by manufacturing our own shirts, due to the fact that we had received a new contract for over 3,200 t-shirts to sell at all their national stores. Being inspired by an â€Å"outsourcing† lesson in my economics class I talked to my partner about the possibilities of producing the shirts outside of the capital, where labor and production was cheaper, in order to increase profits. We did just that and in 6 weeks we produced all the t-shirts at half the price than before. We had to work harder since we were the ones organizing and transporting them. After a lot of hard work and effort, those t-shirts were all sold, we were paid and we realized that our companies’ profit had increased over 600% from the past set of t-shirts. Now we find ourselves selling over 3000 t-shirts a month, earning a solid amount of money, and starting to build a webpage to offer our t-shirts to anyone interested in the Caribbean. Learning from our mistakes in the past, and learning not to put too much trust on anyone, made us grow as business man and most importantly learn that money, unlike many people of my age do not know, is very hard to e arn and very easy to spend. The experiences I have been through in life, have taught me lessons more valuable than any other teacher has been able to teach me in a classroom. When you go out and experience things and make mistakes, you learn from your errors, overcome those depressing moments and ultimately become a better human being.

Capitalism and Our Society

Capitalism and Our Society Essay From the very dawn of intelligent human interaction to the present day,the concept of capitalism has dominated the way we trade goods andacquire wealth. Except for the necessity of a simple communist society inpre-modern times, or the noble humanistic notion of a socialist society,the free market has always been the most efficient way to run the economyonce the most basic needs of life have been satisfied. Only during thelast several hundred years has the idea of a modern democracy beendeveloped and applied through the modern state. These two concepts arethought by some to be interrelated, but contemporary critics of theliberal form of democracy seek to separate the two notions of capitalismand democracy. However, when examining the evidence of the relation ofthe two, let us not use the altered conceptions or versions of theseterms, but rather analyse them by their base meanings as we have come tounderstand them. After this analysis of the terms and a resultingstipulation of what the ir base meanings are, critics may say that anyfurther analysis of the relationship between the two terms would betainted by their supposed definitions. The problem with this is thatwithout a common frame of reference between the two, no comparison wouldbe logically possible without considering an infinite range of possiblemeanings. With this technical matter aside, the analysis will continuewith an investigation into arguments both for and against the separationof the two terms, and then an evaluation of the true nature ofcapitalismrsquos relationship with democracy. Specifically the freemarket economy dictating the actions of any democratic regime. After thistask of evaluation is complete, the argument will conclude withillustrating how capitalism will actually lead to a more liberal form ofdemocracy. The first step of this investigation is to make some attempt to achieve acommon frame of reference between the two terms. Literally, democracy isthe rule of the people. Specifically, it is the organization in place toallow people of a specified area, through organized elections, to givetheir uncoerced opinion on who they want to represent them in government,or what they want government to do for them. The underlyingpresupposition is that government will always obey the command of themajority of voters. There are many limitations to democracy, such as thefact that people can only vote YEA or NEA on a specific topic area, thusproducing a dichotomy of choices that may not necessarily offer asolution to a problem. Also, people must leave most decisions to thepeople they elect, since they donrsquot have enough time to continuallyvote. However, the focus of this work is not to delve into this area ofcontroversy, but rather to take this understanding of democracy as thestipulated definition for this work. One critical distinction must bemade regarding Bergerrsquos understanding of the term, and that is thatthe term democracy does not include all the civil and human ri ghtsassociated with liberal democracy. Similarly, by capitalism, this work will not use any other connotation ofthe term other than describing the free market economy, where there isprivate ownership of property, and the economic freedom to buy, sell, ortrade with whomsoever you chose. The critical element of the term is thatthere is limited government in place to enforce contracts and to providea safe trading environment. Another specific meaning given to capitalismis by Friedman, who describes capitalism as economic cooperation, whereboth parties are benefiting from the trade, provided that the trade isvoluntary and informed on both sides. READ: Freedom and Opression in Literature EssayThe next step in the investigation is to analyse some of the argumentsthat capitalism is separate from democracy. Dryzek argued that anindividualrsquos consumer preferences wereproperly expressed in the economy, while the same persons politicalpreferences were expressed in politics3. This perspective indicates thatthe capitalist economy is a separate entity form the democratic politicalsystem, because these are two different institutions into which anindividual can state his or her preferences, depending on whether theyare economically or politically motivated. On the other hand, history hasgiven many examples of how a personrsquos economic preferences have beenstated in the political forum, such as voting for a politician that haspromised to reduce taxes or to establish free trade between two states. That same person could only express those preferences in the politicalforum, because they alone would have no power to change the structure ofthe economy such that it would seem advantageous to lower taxes

Market Entry Project for CVS in Chile Essay Example | Topics and Well Written Essays - 4250 words

Market Entry Project for CVS in Chile - Essay Example Along with this comes an online shopping portal, which also features an online prescription fulfillment system. The target market for CVS Pharmacy stores consists majorly of women (16-64) and people with medical needs. The countries in consideration are taken from the Caribbean and Latin America covering Mexico, Brazil and Chile. Mexico Mexico, which is located beside Belize and Guatemala and is 3,141 km from the U.S., is the country in Latin America. In the region of Latin America, Mexico can be regarded as the medium size country and market. Considering the FDI of CVS, we focus on people and society, government, and economy. The population of Mexico is 113,724,226 until July 2011, and the country comparison to the world is 11 (CIA - The World Factbook). Mexico has a high population growth rate which is 2%. In the whole country, 28.2% of the population is between 0-14 years, 65.2% is between 15-64 years and 6.6% is 65 years and over. The median age of Mexico is 27.1 years, for males is 26 years and for females is 28.1 years. The Urban population is 77% in 2008, 78% in 2009 and 78% 2010, which is increasing now. The poverty rate is 47.0% in 2004, 42.6% in 2006, and 47.4% in 2008. What’s more, the labor force of Mexico is 46.99 million in 2010. We can see that Mexico has a large population and the biggest part of Mexico’s population is young adults. People trend away from suburban to urban because the urban population rate is increasing. On the other hand, the poverty rate of Mexico is fluctuant, which shows the economic situation is fluctuant too, and in these years, the poverty rate is decreasing. Mexico has civil law system with US constitutional law theory, so CVS Caremark is familiar and legal system of Mexico causing smaller barrier for CVS to enter this market. And according to the World Audit, the Democracy Audit scores of the political rights and civil liberties are 2 and 3; this means the political policy of Mexico is relatively free. Mor eover, the political policies that Mexican government takes on healthcare industry really influence the pharmacy industry in Mexico. Mexican government tends to extend the healthcare services and will expand the insurance coverage to 102.0 million in 2011. Seguro Popula is introduced to increase the available resources of healthcare and cover 50.0 million people in 2011. This reform really attracts substantial foreign companies and investments to enter Mexican pharmaceuticals market. It is a great opportunity for CVS Caremark to make an entry to Mexico. The GDP of Mexico in 2008 is $1.582 trillion, $1.486 trillion in 2009, and $1.567 trillion in 2010. What’s more, the GDP per capital has the same tendency as GDP. The GDP per capital in 2008 is $14.400, in 2009 is $13,400, and in 2010 is $13,900. Another important part of the data about the economic situation of Mexico is CPI. According to Countries and Economies, using 2005 as the basic year, the CPI of Mexico is 104 in 2006, 108 in 2007, 113 in 2008, 119 in 2009, and 124 in 2010. The inflation rate of Mexico in 2009 is 5.3% and in 2010 is 4.2%. What’s more, the total labor force of Mexico is 46.99 million in 2010. Of that 46.99 million, 13.7% was occupied by agriculture, 23.4% was occupied by industry, and 62.9% was occupied by services (CIA - The World Factbook). In general, the data shows the economic downturn in 2009 of Mexico, both GDP and GDP per capital were decreased in 2009 and the inflation rate of Mexico in 2009 was also very high. In 2010, the economic situ

Systems and Operationsmanagement Coursework Example | Topics and Well Written Essays - 3000 words

Systems and Operationsmanagement - Coursework Example Various theories of operation and process management have been visited in the case study to formulate the appropriate recommendations. Since inception in 1970, Airbus has had to maintain a corporate goal of lunching a competitive fight that would enable the realisation of a sustainable market share. Despite the competitive nature of the market from major players such as Boeing and Lockheed, Airbus kept the nerve to initiate bold investment projects that enabled it to grow and reach the global status. A winning corporate combination of practices such as operations and strategy management ought to have played a major role in the rise of the company. To surpass its anticipated entry into the market, Airbus management had to venture into more challenging business that no one else had ventured into. An ambitious diversification of the organisation package of market participation was identified as the solution to keeping up with the pace of the market’s dynamic challenges. To this end, Airbus rolled out one of the most daring ventures amid internal capacity issues. Such a venture is the A380 project that became too much of a challenge along its initial implementation. Perhaps with the best operations and process realignments that corporations in this age need to armour their planning with, the success of the A380 project at Airbus would be a different story. An analysis of the project using insights postulated by systems and operations management theory has been used in the case study of the A380 project to highlight useful corporate lessons worth of sieving from the failures thereon. Airbus systems and operations logistics were evolving at an increasing rate since its founding in 1970 aiming to formulate a consortium of air transport initially covering Britain, Spain, Germany and France. As a consortium, it was not clear if the

Florida Contract Essay Example | Topics and Well Written Essays - 250 words

Florida Contract - Essay Example The handbook helps in minimizing conflict by ensuring employees are treated fairly. Therefore, the employee handbook acts as a binding contract for them. This is because it is written and not complying with what it stipulates can lead to the employer been sued. An employee has certain rights according to the handbook. Some of the rights include compensation to any employee in case of injuries acquired at the workplace. An employer would be liable to an employee in cases of sexual harassment. The laws ensure that employees are safe from discrimination, either because of sex, race, association or religion (Bush, p 42). Employers cannot discharge a female employee due to pregnancy because this is considered illegal, and the employer can be sued. Employers cannot also fire their employees because of their race, religious affiliation, age, sexual orientation, disability or nationality. It is also considered illegal for an employer to fire an employee for abiding in the set laws of the state. However, in Florida employees are ‘at will’. This means that they may be fired for any reason as long as it is not illegal. In conclusion, an employee cannot sue the employer if fired for any act that is considered illegal according to the defi nition of that term in Florida state laws (Bush, p

Federal National Mortgage Association(FANNIE MAE) and Federal Home Essay

Federal National Mortgage Association(FANNIE MAE) and Federal Home Loan Mortgage Corporation (FREDDIE MAC) and the Housing Crisis - Essay Example It allowed for banks charging low mortgage interest rates to encourage anyone interested in buying a home. It led to the creating a secondary market for mortgages. In this market, companies like Fannie Mae borrowed money from foreign markets at minimal interest rates since they were financially supported by the US Government. This enabled Fannie Mae to give fixed rate mortgage that have a very low deposit to any home buyer. Fannie Mae monopolized the secondary market for the first thirty years after its inception. In 1968, the Vietnam War created great fiscal pressure. This led to Fannie Mae’s privatization and its removal from the national budget by President Johnson. This is when it started to operate as a Government Supported Enterprise, GSE. It made profits for its shareholders and at the same time enjoyed being exempted from tax and oversight, despite being backed by the government. To prevent any further monopoly, another Government Supported Enterprise was formed in 1970. It was known as Freddie Mac. These two companies currently command a 90 per cent of the national secondary mortgage market. GSEs have experienced great growth financially over the years. Their combined asset base is currently at 45 per cent more than those of the biggest bank in the country. However, their combined debt equals 46 per cent of the present national debts. This high growth as well as over-leveraging has caused concerns in the Congress, the SEC and the Justice Department regarding their financial practices. Freddie Mac and Fannie Mae happen to be the only corporations in the Fortune 500 league that do dot abide by the requirement to furnish the public about any difficulties in finances they undergo. In case they collapse, the taxpayers will have to foot the multi-billion dollar outstanding debt. A recent probe into Freddie Mac by the SEC and the Justice Department discovered accounting errors to the tune

Agriculture Essay Example | Topics and Well Written Essays - 500 words - 1

Agriculture - Essay Example ides to kill pests instantly, and insertion of toxin genes in plants to kill feeding insects or larva (as in the case of genetically modified crops like Bt corn). There are some significant effects of modern agriculture on the environment. Extensive use of pesticides pollutes the air and causes respiratory and other health problems in humans and animals. These effects can be fatal in extreme cases of pesticide poisoning. The prolonged use of fertilizer, especially nitrogen, results in the decrease of soil pH. This means the soil becomes acidic, and therefore this will lead to subsequent yield reduction until such time that the soil becomes unfavourable for productive crop growing. Growing genetically modified herbicide tolerant crops (which is coupled with extensive herbicide use) may alter the weed population and microfauna in areas where they are cultivated. Extensive land preparation also has effects on the soil texture, soil microflora, and fauna. Agricultural pests can be insects, microbes, rodents, fungi, weeds. The primary effect of pests in agriculture is to decrease by some degree, the yield that is economically important. Extreme pest infestation can lead to famines. As an example, the potato blight, a fungus responsible for the Ireland famine in the 1800s, has resurfaced in the Andes region lately, seriously affecting potato yields (Barclay) and causing fear of famine. Locust infestation is devastating and has been responsible for famines even during biblical times. In rice growing areas, the major pests are rodents and snails that cut rice stems therefore reducing the number of productive tillers and diseases like blast and tungro. Livestock also have pests that can cause epidemics; like the bird flu which is caused by a virus. Chicken with, or suspected to have, bird flu, are killed and this results in a shortage of chicken and eggs, and consequently, increase in prices of these commodities. Another notable disease is the mad cow disease that led to

Iron deficiency anemia Annotated Bibliography Example | Topics and Well Written Essays - 750 words

Iron deficiency anemia - Annotated Bibliography Example It also explains that iron deficiency originates from poor dieting whereby one takes foods that are not rich in the nutrient. This book explains the functions of iron in the body and give in depth details about iron. It explains the biochemical functions of iron for example; it explains the role of iron in oxygen transportation and the production of energy. It further explains the reason as to why humans require an abundant supply of iron. These among other factors are behind my choice to use this book. The book is available from Google books library. By giving details about the importance of iron in the body, the book is relevant to the study of iron deficiency anemia in humans. This book reveals the effects of iron deficiency anemia in different age groups and sex as well. It provides information on how iron deficiency impacts on children, middle aged persons and persons aged 50 and above. This is particularly necessary in the quest to determine who are most prone to contracting the disease. In addition, it also explains the effects iron deficiency has on males and females. By giving a focused perspective of the effects of irons on different age groups and gender, the book proofs vital to this study. It addresses the pertinent issues regarding deficiency of iron in males and females. For example it explains that old people are prone to have a deficiency in iron as compared to children. The book was retrieved from Google books and can be accessed from there. This book by Uthman reveals the effects of iron deficiency anemia. It provides information on how iron deficiency impacts on children, middle aged persons and persons aged 50 and above. The book was retrieved from the University of Mississippi. This book is highly recommended and necessary in the quest to determine who are most prone to contracting the disease. In addition, it also explains the effects iron

Malnutrition Disease Process Essay Example for Free

Malnutrition Disease Process Essay Causes: There is a wide variety of causes of malnutrition. An elderly person with dementia may forget to eat or to buy food. Poverty may cause a lack of food or lack of nutritious food. People in third world countries often do not have access to healthy foods. Other causes may be alcoholism, excessive dieting, throat or mouth cancer, decreased mobility, malabsorption, dialysis, fistulas, corticosteroid or oral antibiotic use, hypermetabolism, burns, trauma, or a lack of oral intake for 5-10 days for a variety of reasons. Incidence: Incidence of malnutrition in America is low, thought to be as low as 10% nationwide. Death from malnutrition in our country is extremely rare. Worldwide death from malnutrition among children under age 5 is thought to be as high as 50%. Prognosis: Prognosis is very good for patients with malnutrition in America. Most incidents are temporary and are a result of another condition. The malnutrition is very treatable with food, nutritional supplements such as Ensure, or parental feedings depending on the cause.

The Libertarian Manifesto By John Hospers Philosophy Essay

The Libertarian Manifesto By John Hospers Philosophy Essay The Libertarian Manifesto by John Hospers is something that is equated with the ethical problem surrounding the distribution of wealth, amongst other things. Hospers (1996) argues that when it comes to the distribution of income, people should fend for themselves. He opposed arguments such as an admonition to feed the hungry because in the libertarian world, hunger simply would not happen (Hospers, 1996). Hospers (1996) begins his article by noting the definition of libertarianism, which is that people have a right to make their own decisions and lead their own lives, as long as their decisions do not interfere with anyone elses life. There is a problem as it respects the distribution of wealth, but for the libertarian it is not a problem. The individual has a right to decide what he or she wants to do. Hospers (1996) ideas, and the ideas of many libertarians, are equated with the concept that every man can fend for himself, and in the end, everyone will get exactly what they want. Hospers (1996) believes that the right to private property is basic. On some level, one might equate his ideas to natural rights ethics. Clarke Linzey (1996) write: The idea of natural rights implies that there is an essential human nature which determines this status and a moral order government the relations of human beings as such, independently of the laws of all particular societiesà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ã‚ ¦ (598). The ethical rule used by Hospers (1996) in respect to wealth distribution would be that it is permissible to follow ones desires and not to worry about others in society. This is because they have their own paths. That is, it is not an obligation for society to take care of everyone in its midst. The duty is for the individual to be accountable to himself. Yet, it is also true that there are interactions between people. Hospers (1996) provides examples of situations in respect to how one should act, and certainly, the society is accountable to the individual on some level not to influence things too much. For the libertarian, it is scant government that is the best government. Hospers (1996) writes: Government is the most dangerous institution known to man (27). The factual claims made by Hospers (1996) are associated with observational and historical facts. Nothing he says can be proven, but anecdotal evidence is used to support the authors points. A student asks whether or not Hospers position meets the fourth criteria for valid theory, which are consistency and coherence, rational justification, plausibility, and usefulness. First, it should be said that the theory is coherent, and while it is largely consistent, it is difficult to be completely consistent with the notions in libertarianism. There are exceptions. Hospers (1996) writes about freedom where people have a right to do and say as they like, but even freedom of speech has limits. He writes: Indeed, the right to property may well be considered second only to the right to life. Even the freedom of speech is limited by considerations of property (Hospers, 1996, 25). He goes on to explore other issues and provides examples of when people cannot say what they like (Hospers, 1996). While the theory is consistent, there are exceptions to everything and this muddies the waters. One can take things further by examining contemporary examples. For instance, people believe that they have the right to free speech. Hospers (1996) says that people cannot shout obscenities in a church because the property is not designated for that purpose. Enter property rights. Yet, in society today, people do have a right to their opinions. At the same time, with the political correctness movement, people are not entitled to utter certain things without their rights being challenged by the law. If someone utters a derogatory racial remark and ends up in a fight, he can be charged with a hate crime. On some level, this is thought control. As abhorrent as ones thoughts might be, the idea to outlaw certain forms of speech and not others imposes limits, thus challenging some pure libertarian notions. While this idea does not take away from the validity of the position, it certainly challenges its consistency. Is the position rational? It is a reasoned argument. In fact, the article provides much support for the premise, and the support is based on logic. Ethical criteria are included and the author does make a sound ethical arguments that are also plausible. While the points are well reasoned, the argument at the end of all of this is whether or not someone can allow poverty to exist in a world of plenty. The libertarian provides a what if argument. In other words, the libertarian claims that if things were a certain way, there would be no poverty, but the world is not completely libertarian so the point is moot. Poverty persists, so while the argument may be sound in this what if scenario, it does not address solutions for the status quo. What does one do with the poor today? Usefulness is another issue. If one is not operating in a libertarian world, the theory is only useful if the world were that way. Theoretically, Hospers (1996) provides an excellent paradigm, but it may not be possible to achieve his ideas in reality. In the United States, different ideas are supported and compromises are made. Hospers (1996) brand of libertarianism could not flourish in this sort of situation. Similarly, in totalitarian regimes, there is much too much force in play to go from such a model to one of complete freedom. Libertarianism is a sound theoretical model, but it is unknown whether or not it could ever be successfully implemented.

Alkali Aggregate Reaction Essay -- essays research papers

ASR is one example of a more general problem known as Alkali Aggregate Reaction [AAR]. ASR is a chemical process in which alkalis, usually predominantly from the cement, combine with certain types of silica in the aggregate when moisture is present. This reaction produces an alkali-silica gel that can absorb water and expand to cause cracking and disruption of the concrete. For damaging reaction to take place the following need to be present in sufficient quantities. High alkali cement Reactive aggregate [e.g. crushed greywacke type sandstone] Moisture Structures most at risk are bridges, hydraulic structures, exposed frames [e.g. open multistorey car parks] and foundations. In relation to total construction volume, the incidence of significant damage due to ASR in the UK is small. ASR was discovered in the USA in the 1940s; no case was found in the UK until 1971 [in a concrete dam in Jersey]. The problem is known to exist in at least 35 countries. Affected concrete often exhibits map cracking of the surface, known colloquially as Isle of Man cracking after that island`s three legged emblem. In heavily loaded sections the cracking will probably follow the line of the main reinforcement. An excellent overview of the phenomenon can be found in BRE Digest 330. Since the early 1980s recommendations have been produced and refined to the stage where ASR is unlikely if these are adopted. Principal methods include.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Controlling the level of available ...

Evolution and Ambiguous Communication Essay -- Biology Essays Research

Throughout the debate concerning evolution, I have noted the relative precision or imprecision of various methods of human communication. From the connotations of particular words to the emotion incited by a distinct music phrase, it is often surprising which human forms of expression are ambiguous and which seem to be universal. When considering this phenomenon, it is perhaps useful to construct a method for discussing the relative accuracy of communicating exactly what we mean when we use various ways to say it. From an evolutionary standpoint, it is relevant to our discussion to ask whether meaning(thought) pushed language into existence, or whether it was language that originated meaning. If the first is true, then mediums such as art and music are truly a product of our desire to communicate meaning in a direct sense. The meaning to be communicated first forms itself in the creator's head in some wordless nebula, and then consequently find release directly onto the painter's canvas, or the musical phrase. Hence, once the creation is added to the realm of world attention, and observers begin to interact with the creation, the meaning of the piece will undergo another translation into words as observers start to describe and recount their interaction. Only after the original meaning has traveled from the artist's mind, into a creation, and into the observer's mind, will it have it's first confrontation with language. However, if language itself created meaning, then we must understand art to be an interpretation of spoken or unspoken language; a second generation product of the human desire to communicate with self or others. This is the viewpoint endorsed by Dennett in Darwin's Dangerous Idea, as he states: "the 'lang... ... that "the idea of the original is created by the copies, and that the original is always deferred – never to be grasped." (Culler 12). This theory can be (and was originally) applied to one of the modes of human communication that is considered to be among the most precise – written language. But does this theory mean that we as humans have no hope of ever communicating exactly what it is we mean to another? Perhaps there is no hope of this, and that is why, in some more ambiguous forms of our communication, we have ceased to hope for it and admitted defeat on that front: but in doing so, we found a new realm of significance in the variety of interpretation. Works Cited 1)Culler, Jonathan. Literary Theory: A Very Short Introduction. Oxford University Press. New York, NY, 1997. 2)Dennett, Daniel C. Darwin's Dangerous Idea. Touchstone: New York, NY, 1995.

Learning from Helen Keller Essays -- Helen Keller Deaf Blind Essays

Learning from Helen Keller Facilitated Communication Institute Helen Keller is probably the most universally recognized disabled person of the twentieth century. (Others such as Franklin Roosevelt were equally well-known, but Keller is remembered primarily for her accomplishments which are disability-related.) Those of us who have grown up in the last half of this century have only known Keller as a figure of veneration. We know her primarily through popularized versions of her life such as the play "The Miracle Worker," or through her autobiographical works such as The Story of My Life (Keller, 1961 [1902]) and The World I Live In (Keller, 1908). Most of us have come away with the image of a more-than-human person living with the blessed support of an equally superhuman mentor, Annie Sullivan Macy. There is little wisdom, however, to be learned from the stories of superheroes. It is from observing the struggles, losses and compromises in both Keller and Sullivan's lives that we are likely to find parallels to the everyday experiences of ourselves and our friends. Dorothy Herrmann's recent biography of Keller, Helen Keller: A Life (Herrmann, 1998) creates a much more complete picture of the costs of Keller's celebrity and iconic status, and of the tensions present in her life-long relationship with the woman whom she always referred to as Teacher. In this paper, I will discuss two important themes from Helen Keller's life in terms of their implications for those of us who are also part of a community of people engaged in the enterprise of finding their voices in the world. The "Frost King" Incident Helen Keller was born in Alabama in 1880, and became deaf and then blind following an illness when she was 19 months old. Annie Sullivan came to Alabama to work as Helen's teacher in March, 1887. Scarcely a month later, on April 5, 1887, came the well-known moment at the water-pump, where Helen first associated the objects she experienced with the words being spelled into her hand. Within the next year, Helen began keeping a journal, and was studying the poetry of Longfellow, Whittier, and Oliver Wendell Holmes. By the time she was ten years old, Helen Keller was literally world-famous. As early as October, 1888, she was writing letters such as the following one to Michael Anagnos, the director of the Perkins' School for the Blind: Mon cher Mon... ...in facilitators, for administrators who provide access to enriched staffing resources, and for allies involved in connecting an individual with his or her broader community. The world will never see another Helen Keller. Those visible people with disabilities of our generation do not stand alone and unique -- increasingly, they are powerful members of a powerful community, in control of those who support them rather than controlled by them. Those of us who are supporters and allies of facilitated communication users can play an important role in helping our friends come into possession of their power and full citizenship in our community. The most powerful acts -- and often the most complicated and painful ones -- by which we can support movement in this direction, are those acts by which, a piece at a time, we become less and less indispensable. REFERENCES Herrmann, D. (1998). Helen Keller: A Life. New York, Alfred A. Knopf. Keller, H. (1961 [1902]) The Story of my Life. New York, Dell. Keller, H. (1908). The World I Live In. New York, Grosset and Dunlop. Shevin, M. (1993). â€Å"Editorial: Who are our Phyllis Wheatleys?† Facilitated Communication Digest 1(3): 1-2.

Taboos: Cultures

In the world we live in there are multiple taboos. Depending on your culture, religion and beliefs many strange and bizarre things are completely normal to some people and even animals throughout the world. Taboos are what people find to be strange and unusual practices or what unique things people may do or eat in different parts of the world. Different cultures would consider strange things to eat as a delicacy in some areas or cultures and wouldn’t even dream of being eaten in other cultures. Sometimes they could even be forbidden or illegal by certain beliefs. Some religious taboos even reach to the extreme of whether or not to wear clothing. Cultures in different parts of the world believe in living in a non urban life style and not wearing any clothing, which is considered a nudist colony. Different taboos are accepted in parts of the world for traditional reasons, cultural beliefs and a variety of religion beliefs. In some parts of the world, people or cultures enjoy very different foods and consider these delicacies. In some cultures they hunt for their food. These cultures never waste any part of the animal’s body. All of the animal’s body parts are edible to them. They will even eat all the organs of the animal. These cultures actually believe that certain organs are aphrodisiacs. These delicacies are very rare and hard to locate. This is the reason why they are considered a delicacy and are so expensive. Some different examples, I found interesting in cultures throughout the world: They would include people eating insects anyway you can imagine. However, you would never find these in an American restaurant. Another is in some areas rats are like field animals and people eat them like they are a squirrel or rabbit. American on the other hand thinks that rats are dirty and disgusting animals. This is because they live in filth in city sewage and garbage dumps. Also, rats carry multiple diseases. In other countries the rats live in fields, eat grass and seeds. The rats are raised in a very different environment in other countries. The rats are sold at local village markets. Manifest functions and dysfunctions are conscious and deliberate, the latent ones the unconscious and unintended and unrecognizable. I realize that these cultures taboos are to survive and this is why they don’t waste anything. In some cultures and countries this is always the case because look at America. In our country people take advantage of just having money and being able to go buy whatever they want. Many people in our country waste things including foods. They wouldn’t even dream of eating organs or insects. They buy their food and when finished most people throw the leftovers in the garbage. Without even thinking twice about it and in other countries people and children don’t even get one meal a day let alone 3 or 4 snacks whenever they want them. Manifest functions are the consequences that people observe or expect and the latent functions are those that are neither recognized nor intended. A latent function of a behavior is not explicitly stated, recognized, or intended by the people involved. So many of these cultures are actually latent because these taboos are very important to them for the fact of survival not as a delicacy as some rich people looking for these types of foods. They hunt because they have to in order to survive. Along with eating every part of the animal because wasting any part on the animal will be less food for them to eat, especially since they may not find more food for a day or maybe a few. In my opinion, I feel that to these cultures or religions taboos are very positive to them. Because they use their surroundings and the earth to survive and they don’t waste anything because they appreciate that they actually do have whatever food they caught for that day or week. Some cultures even use the rest of the animal such as fur and bones to make things.

Essay on Suicide

In the Aftermath of Teenage Suicide: A Qualitative Study of the Psycho social Consequences for the Surviving Family Members Committing suicide in the teenage years can be perceived as the ultimate rejection of family, of significant others, and of society. This article examines the causes and effect of suicide in the youth of Sweden. In its study, topics such as the background of where signs of com/suicide-speech-outline/">suicide are visible, methods of suicide, and results of suicide.The bereavement process after a suicide may differ qualitatively from other types of losses with prolonged reactions of grief and loneliness, greater feelings of shame, and perhaps most importantly, the prolonged search for the motive behind the suicide. This study examines the topic of teenage suicide through methodical and scientific evidence. In examining this article, the psychiatry of consequences of suicide and how an outsider’s perspective can be used to benefit and heal what was once a b roken family and the people affected by the death.This study’s main purpose was to interview surviving members that had lost a teenager by suicide to increase the understanding of the circumstances that these families are living under and to generate hypotheses to be tested in future research. The study examines how the family will search for monitory signs and clues to make sense of the tragedy at hand. Studies of family reactions following teenage suicide are hampered by the psychological difficulties of approaching the families and recruiting an unbiased sample of survivors.Most interview studies involve samples that are either compromised by a high attrition rate, or based on survivors who organize and actively work through the crisis in support groups for suicide survivors. They derived their study from a larger research project on teenage unnatural deaths in which all teenage suicides were identified and the results were based on file material alone. They used another m ixed method where professionals involved in the aftermath were interviewed to investigate suicide survivors and also parents and siblings.Since all suicide victims were financially dependent on their families and none of the deceased had established a family of their own, the study’s definition of a family was the persons living in the same household as the deceased at the time of the suicide. Persons included by this definition were biological parents, stepfathers, stepmothers, and siblings. To examine the family, a mutual trust and understanding had to be established with the respondents and critical self-reflection.The family had to make it known what was allowed and where the line was so the interviewers didn’t cross it. Because the study is a hypothesis generating study, all interviews were started with broad questions and were closed with questions such as, â€Å"What do you think of this interview? † The most poignant theme of the interviews was the searc h for the â€Å"why? † which still preoccupied most of the parents. This search became more salient when the suicide had come unexpectedly.Most of the teenagers had disguised their suicidal ideation not only from their families, but from other adults and peers. Nearly all parents expressed anger at being deceived, a deception that denied them the opportunity to provide parental support. Most teenagers and their families had lived a pro-social life, which had only increased the confusion and unanswered questions. Several had been known as a â€Å"pride to any parent. † Nonetheless, they still faced problems such as a broken love affair, fear of pregnancy, or difficulties with friends.The families had trouble seeing why what seemed like such trivial teenage problems had transformed into a matter of life and death. In hindsight, they reproached themselves for their ignorance. Even long after the suicide had occurred, families were still struggling to move on. Some parents had entertained the idea of committing suicide themselves, but decided against it since they know all too well the consequences for their actions. Most teenagers who commit suicide do not express suicidal feelings or otherwise hint at forthcoming suicide.To avoid â€Å"bothering† others, many families had withdrawn from casual socializing. The sense of being deceived results in low self-esteem and nourishes feelings of inferiority and shame. Many of the bereaved appeared to be imbedded in silence. Unfortunately, younger siblings had received little help to work the crisis through. These children are more likely to be burdened than older siblings and need more time, more persistence, and an uncompromising readiness by the adult to deal with the most difficult questions.Help needs to be directed as direct help to siblings and parents, as well as to the family as a whole. A teenager suicide is a devastating trauma for the surviving family as a whole and the absence of sustainab le explanations to the suicide is a predominant issue in the grief process. The prolonged social and psychological isolation of the families in grief should be challenged. There is a need for better understanding and treatment schemes for families who have lost a teenage family member in suicide, and especially for the younger siblings who are often forgotten.

Pharmaceutical Marketing

Pharmaceutical Marketing Merck â€Å"Merck has gone beyond developing and selling prescription pharmaceuticals. It formed joint ventures in 1989 with Johnson & Johnson to sell over the-counter pharmaceuticals; in 1991 with DuPont to expand basic research, and in 2000 with Scherigng-Plough to develop and market new prescriptions medicines. In 1997, Merck and Rhone-Poulenc S. A. (now Sanofi-Aventis S. A. ) combined animal health and poultry genetics business to form Merial Limited, a fully integrated animal health company.Finally, Merck purchased Medco, a mail –order pharmaceutical distributor, in 2003, and Sirna Therapeutics in 2006† (Kotler & Keller, 2012, p. 43-44). â€Å"For branding strategies to be successful and brand value to be created, consumers must be convinced there are meaningful differences among brands in the product or service category. Brand differences often related to attributes or benefits of the product itself . . Merck has lead (its) product catego ries for decades, due in part to continual innovation† (Kotler & Keller, 2012, p. 243).Merck has donated $100 million or more to charities in a year (Kotler & Keller, 2012, p. 632). Mission Statements Ex. Japan Both pharmaceutical and biotech companies are starting to make partnership a core competency (Kotler & Keller, 2012, p. 52). Intro: Michael Dawson, author of â€Å"The Consumer Trap,† states that the business of marketing, a trillion-dollar –a-year industry, is a social, economical, environmental, and unfriendly cost on Americans today as it â€Å"continues to soak up economic and environmental resources and dominate the personal lives of citizens† (Dawson, 2005, p. ). Dawson argues that corporate America is fueled by a continuous marketing race that manipulates people’s perceptions and actions of goods into thinking the economy is out to serve one’s pleasures and happiness, when in all reality, is only out to serve the demand of busin ess today (Dawson, 2005, p. 1). â€Å"It is critical that the U. S. government recognizes that intelligently focused nutrition-related efforts are important in helping lead Americans of all ages to lead healthier lifestyles.Marketing Nutrition shows how simple solutions can save lives. â€Å"–Congressman Timothy V. Johnson, United States House of Representatives (Wansink, 2007, p. 1). There are enormous economic dividends for health care providers, public health institutions, and commercial food companies if we are successful in doing this. â€Å"–Dr. David Mela, Expertise Group Leader, Unilever Health Institute(Wansink, 2007, p. 1). Marketing = A mechanism to help pharmacy develop, communicate, and sell future pharmaceutical services to consumers (Grauer, 1981, p. ). Pharmaceutical marketing is an â€Å"element of an information continuum, where research concepts are transformed into practical therapeutic tools and where information is progressively layered and ma de more useful to the health care system† (Levy, 1994, p. 1). Provides an informed choice of carefully characterized agents (Levy, 1994, p. 1). marketing assists physicians in matching drug therapy to individual patient needs (Levy, 1994, p. 1).Pharmaceutical marketing is presently the most organized and comprehensive information system for updating physicians about the availability, safety, efficacy, hazards, and techniques of using medicines (Levy, 1994, p. 1). pharmaceutical marketing strategies can negatively affect both- the end consumers or the patients and the health care profession (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). Also, the advertising strategies included in the marketing plan of any pharmaceutical company is not ‘direct to consumer' (Need of New Pharmaceutical Marketing Strategies, 2010, p. ). Any pharmaceutical marketing strategy targets the health care professionals or the Doctors who in turn prescribe the drugs to the patients (e nd consumers) liable to pay for the products (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). However, a few countries (till date two countries- New Zealand and United States) allow Direct-to-consumer advertising (DTC advertising) for pharmaceutical products (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). Pharmaceutical Market Trends 2010. Pharmaceutical & Drug Manufacturer Resources.Retrieved from: http://www. pharmaceutical-drug-manufacturers. com/articles/pharmaceutical-market-trends-2010. html The global pharmaceutical is forecasted to make a significant growth of about 4 – 6%, exceeding $975 billion, with global pharmaceutical market sales expecting to grow at a 4 – 7% compound annual growth rate (CAGR) through 2013, based upon global macroeconomy as well the â€Å"changing combination of innovative and mature products apart from the rising influence of healthcare access and funding on market demand† (Pharmaceutical Market Trend s 2010, p. ). pharmaceutical sales are growing at a fast rate in India, China, Malaysia, South Korea and Indonesia due to the rising disposable income, several health insurance schemes (that ensures the sales of branded drugs), and intense competition among top pharmaceutical companies in the region (that has boosted the availability of low cost drugs). India – 3rd Largest Producer of Pharmaceuticals Across the World- is already a US$ 8. 2 Billion pharmaceutical market.The Indian pharmaceutical industry is further expected to grow by 10% in the year 2010. (Pharmaceutical Market Trends 2010, p. 1). The development of infrastructure and rapidly changing regulations in the Middle East are being seen as the cause of its growth. Presently South Africa, Saudi Arabia and Israel dominate the region's pharmaceutical industry due to their better infrastructure and regulatory environment. However, The Middle East pharma market depends on imported pharmaceutical drugs and therapeutics.Th e governments of countries in this region are taking measures to raise their domestic production through heavy investments in the pharmaceutical industry (Pharmaceutical Market Trends 2010, p. 1). Pharmaceutical Drugs Trends of fastest expected growth consist of anti-Diabetic Drugs and those for cardiovascular diseases, due to the changes in demographics and lifestyle with anti-hypertensives drugs will dominate the global cardiovascular market with a market share of nearly 50% (Pharmaceutical Market Trends 2010, p. 1). Strategy:The pharmaceutical companies traditionally adopt four major marketing strategies for promoting their products: Giving drugs as free samples to doctors/ Gifts that hold the company logo or details of one or multiple drugs, providing details of their products through journal articles or opinion leaders; and Sponsoring continuing medical education (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). Pharmaceutical representatives, also popularly known as medical representatives, are the major pharma marketing strategy for marketing drugs directly to the physicians.Typically, the expense of this sales force of any pharmaceutical company comprises anything ranging from 15-20% of annual product revenues (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). â€Å"Marketing Nutrition offers a ‘win-win' proposition for all concerned. Insightful companies, health professionals, and policy makers can lead the way . . . in helping people eat better and enjoy food more. â€Å"–Dr. James O. Hill, Director of Human Nutrition, University of Colorado Medical School (Wansink, 2007, p. ). Take advantage of future growth opportunities. These growth opportunities will be realized from unmet health-care needs and changing consumer life style trends and values (Grauer, 1981, p. 1). Dispensing and drug-knowledge-distribution pharmaceutical services are reviewed by a product life cycle analysis of sales profits versus time (Gra uer, 1981, p. 1). A marketing mix for new pharmaceutical services is developed consisting of service, price, distribution, and promotion strategies.Marketing can encompass those key elements necessary to meet the organizational goals of pharmacy and provide a systematic, disciplined approach for presenting a new service to consumers (Grauer, 1981, p. 1). The costs of pharmaceutical marketing are substantial, but they are typical of high-technology industries that must communicate important and complex information to sophisticated users. These costs are offset by savings resulting from proper use of medicines and from lower drug costs owing to price competition (Levy, 1994, p. 1). oint to the Food and Drug Administration (FDA) and find comfort in the fact that this agency is tasked with regulating drug advertising. â€Å"only† 8% of advertisements are in violation of regulations. at least one of the 11 advertisements in the April issue of the ARCHIVES is likely to be misleadin g and, thus, provide potentially harmful information. In fact, the FDA, according to David A. Kessler, MD, commissioner, spends most of its time developing the package insert and not, as asserted by Levy, preapproving advertising. According to Kessler, â€Å"Except under very special circumstances, the agency does not eview or approve advertising and promotional materials before their dissemination by a drug firm† Furthermore, Kessler states that an â€Å"†¦ enormous potential exists for misleading adver ¬ tisements to reach the physician and influence prescribing decisions. † (Shaughnessy, Slawson, ; Bennett, 1994, p. 1). Gifts: Giving drugs as free samples to doctors/ Gifts that hold the company logo or details of one or multiple drugs, A study was done in 1995 to gauge the outcome of a patient’s perception of pharmacy marketing regarding physician’s accepting gifts from the pharmaceutical industry.The objective of this study was to â€Å"examin e patient perceptions of professional appropriateness and the potential impact on health care of physician acceptance of gifts from the pharmaceutical industry,† via a random telephone suvey of 649 adjults living in the state of Kentucky. Through the random sampling, the outcome of the survey was that Patient awareness of officeuse gifts (eg, pens, notepads) and personal gifts to physicians from the pharmaceutical industry, patient exposure to office-use gifts, and attitudes toward physician acceptance of both office-use and personal gifts. Mainous, Hueston, ; Rich, 1995, p. 1). Eightytwo percent of the respondents were aware that physicians received office-use gifts, while 32% were aware that physicians received personal gifts. Seventy-five percent reported receiving free samples of medication from their physicians. Compared with office-use gifts, more respondents believed that personal gifts to physicians have a negative effect on both health care cost (42% vs 26%) and quali ty (23% vs 13%). After controlling for demographic variables, as well as awareness and exposure to physician gifts, individuals with at least a high school education were 2. times as likely to believe that personal gifts have a negative effect on the cost of health care and 2. 3 times as likely to believe that personal gifts would have a negative effect on the quality of health care. (Mainous, Hueston, ; Rich, 1995, p. 1). Conclusions These results suggest that the public is generally uninformed about personal gifts from pharmaceutical companies to physicians. If public perception regarding the objectivity of the medical profession is to serve as a guide, these findings suggest a reevaluation may be in order for guidelines regarding physician acceptance of gifts from the harmaceutical industry (Mainous, Hueston, ; Rich, 1995, p. 1). The World Health Organization, the American Medical Association, the American College of Physicians, and the Pharmaceuticals Manufacturers' Association have also published guidelines on perks to physicians from the drug industry. The bottom line is that all these guidelines are voluntary, and physicians have continued to vote â€Å"with their feet. † (Shaughnessy, Slawson, & Bennett, 1994, p. 1). controversial 1962 FDA amendments.Just before 1962, congress studied and concluded that because of patent protection, heavy promotion by the drug companies, consumer ignorance, and minimal incentives for physicians to be concerned with cost, drugs of dubious quality and unnecessarily high expense were being prescribed by physicians, criticisms that sound remarkably familiar even today. Up to that point, the FDA had only required â€Å"proof of safety,† which dated back to the origins of the modern drug era and the 1938 Food, Drug, and Cosmetic Act (Shaughnessy, Slawson, & Bennett, 1994, p. 1).Discussions about the influence of pharmaceutical promotion on physicians often focus on gifts and payments of relatively large economi c value. This focus is also evident in ethics guidelines addressing pharmaceutical promotion among many professional medical societies. 1 The underlying assumption is that smaller gifts are unlikely to exert influence on prescribing decisions. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). In contrast, a substantial body of marketing and psychology literature suggests that even trivial items can exert influence irrespective of economic value.For example, adding a small gift such as personalized mailing labels to a solicitation for donations has been shown to significantly increase contributions. 2 In pharmaceutical promotion, small gifts are often tethered to branding efforts, as items such as pens and coffee mugs display logos. Aside from the intrinsic value of promotional items, branded materials strengthen brand awareness and build brand equity through a variety of largely unconscious but powerful mechanisms. 3 Nonverbal information about the brand, such as symbols or logos, is o ften more influential than verbal cues. Stronger brands have a memory encoding and storage advantage over unknown brands,5 which facilitates the formation of strong positive associations with the brand. Strong branded products are more often in a â€Å"top-of-mind† set of alternatives for consumers to consider. 6 Strong brand awareness provides a justifiable reason for choosing a particular brand. 7-8 This research suggests that small branded promotional items should increase favorable attitudes for the brand being promoted.We are unaware of studies that test these effects in a clinical context with health professionals, but many physicians, because they are medical experts, believe they are not susceptible to these influences. 5, 9-10 In one survey, just 8% of physicians believed they were susceptible to influence by marketing items such as branded pens, whereas 31% of patients felt these items could influence physicians. 9 The guidelines of the American Medical Association regarding gifts to physicians from industry reflect this belief of lack of susceptibility by permitting â€Å"gifts of minimal value. â€Å"1 (Grande, Frosch, Perkins, & Kahn, 2009, p. ). The study used a randomized experimental design. Participants were third- and fourth-year medical students at the University of Pennsylvania School of Medicine (Penn) and the University of Miami Miller School of Medicine (Miami). We selected these institutions because of their differing policies regarding interactions between trainees and pharmaceutical company representatives. The University of Pennsylvania has restrictive policies in place that prohibit most gifts, meals, and samples while Miami continues to permit such marketing practices. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). 007-2008. Study participants were assigned to a control or primed condition based on their day of enrollment. Participants assigned to the â€Å"primed† condition were exposed to Lipitor (atorvastatin) br anded promotional items immediately prior to completing a computer-based study instrument. These exposures included Lipitor logos on a clipboard (used when signing in to the study room) and notepaper (used to provide participants with their study identification number). Participants assigned to the control condition completed the same procedures but with a plain (nonbranded) clipboard and notepaper.Randomization was conducted by day in order to avoid contamination of conditions. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Participants were told they were enrolling in a study about clinical decision making under varying conditions (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Our study was designed to measure the influence of exposure to branded promotional items on relative attitudes toward 2 lipid-lowering statins. We examined differences in attitudes toward Lipitor and Zocor (simvastatin) in our exposed (Lipitor promotional items) and control groups.Lipitor is among the most p romoted brand-name statins in the United States while simvastatin is available generically and considered to be nearly equally effective. The study outcomes included measures of implicit and self-reported (ie, explicit) attitudes. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Implicit attitudes were evaluated with the Implicit Association Test,11-15 a widely used tool in marketing and psychology research that is thought to be resistant to social desirability bias among research participants.Initial applications of the IAT, for example, demonstrated the persistence of racial and gender stereotypes and prejudices, even in the face of strong conscious beliefs that such attitudes do not exist and strong social norms that dictate they should not exist. 16-17 Results from the IAT are a better predictor of intergroup discrimination (eg, biased behavior against people of other races/ethnicities, gender, and sexual orientation based on existing attitudes and stereotypes) compared with osten sibly similar self-report measures. 13 In recent years, the use of the IAT has been expanded to research focused on branding and marketing. 8-19 Further details regarding application and validity of the IAT have been published elsewhere13-15; a demonstration can be found at the Project Implicit Web site (https://implicit. harvard. edu/implicit). (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Explicit attitudes were assessed by self-report. Following the IAT, participants were asked to compare Lipitor and Zocor in 5 dimensions (superiority, preference, efficacy, safety, and convenience) a follow-up anonymous Internet-based survey that assessed their attitudes toward pharmaceutical marketing.The purpose was to measure differences in attitudes among students at the 2 schools given the differing institutional policies as a possible explanatory factor(Grande, Frosch, Perkins, & Kahn, 200 Then there is the pharmaceutical industry's holy grail of marketing — the relationship between their sales representatives and medical doctors. To maintain this relationship, often called â€Å"detailing,† pharmaceutical companies spend a whopping $8,290 per doctor.The average family doctor receives 28 visits each week from drug reps, who provide free samples, explain new findings from company-sponsored drug trials, and demonstrate the latest innovation in their company’s medical devices. Some doctors, reporters and public health advocates have long decried the pharmaceutical industry's seemingly endless attempts to buy goodwill among medical professionals. But insidious marketing campaigns seeking to rebrand medical conditions as lifestyle choices, and the patients who suffer from them as consumers, have received little scrutiny. (Ebeling, 2008, p. 1). 9, p. ). providing details of their products through journal articles or opinion leaders; Worse, the trend is seriously undermining the regulatory authority of the FDA. It's not surprising that profit-driven, cu tting-edge marketing techniques have outstripped the government agency established to guide them. What is surprising is that public health advocates haven't made pharmaceutical rebranding and off-label promotions of drugs and medical devices major issues. In December, the advocacy group Consumers Union sent a letter (PDF) to the FDA requesting tighter DTC advertising regulations on medical devices. Ebeling, 2008, p. 1). The December 2007 issues of the women’s fashion magazines Allure and Harper's Bazaar both featured multi-page spreads on non-surgical cosmetic procedures, including the array of injectable wrinkle fillers. The articles outlined the pros and cons of each filler, evaluating injection pain, cost per injection (most run between $500 and $800 per shot), and how long each lasts (Ebeling, 2008, p. 1). Dermatologist and anti-aging cream entrepreneur Dr. Patricia Wexler is featured prominently in the Bazaar story.Her remarks about each injectable reflect the marketing language of the brands themselves. When she is discussing Sculptra ®, for instance, she describes how the product acts as â€Å"a trellis on which the collagen can grow† — a line marketers use to describe how the device works. She also repeatedly suggests what are off-label, unregulated product applications, such as using injectable fillers in the eye area, in the temples, in the jawline, on the cheekbones, and in the fine lines surrounding the mouth. Dr. Wexler's injectable filler romotions are especially credible among the target audience. Wexler regularly discusses non-invasive, anti-aging procedures on the â€Å"Oprah Winfrey Show,† the â€Å"Today Show,† and â€Å"Good Morning America,† and in the pages of Vogue and Marie Claire. The big pharma companies that make the injectable fillers likely dream of doctors touting their products and suggesting off-label uses for them in popular women's magazines. As the saying goes, they couldn't buy suc h good press — but they probably did. (Ebeling, 2008, p. 1). Dr. David J.Triggle, a pharmacologist at the State University of New York at Buffalo who has written about drug advertising, says a doctor’s endorsement should be scrupulously honest (Saul, 2008, p. 2). Dr. Robert Jarvik, known for the artificial heart he pioneered more than a quarter-century ago. began appearing in television ads two years ago for the Pfizer cholesterol drug Lipitor (Saul, 2008, p. 1). Skip to next paragraph The ads have depicted him, among other outdoorsy pursuits, rowing a one-man racing shell swiftly across a mountain lake. When diet and exercise aren’t enough, adding Lipitor significantly lowers cholesterol,† Dr. Jarvik says in the ad. Celebrity advertising endorsements are nothing new, of course. But the Lipitor campaign is a rare instance of a well-known doctor’s endorsing a drug in advertising — and it has helped rekindle a smoldering debate over whether it is appropriate to aim ads for prescription drugs directly at consumers. A Congressional committee, concerned that the Lipitor ads could be misleading, has said it wants to interview Dr. Jarvik about his role as the drug’s pitchman.Some of the questions may involve his credentials. Even though Dr. Jarvik holds a medical degree, for example, he is not a cardiologist and is not licensed to practice medicine. So what, critics ask, qualifies him to recommend Lipitor on television — even if, as he says in some of the ads, he takes the drug himself? (Saul, 2008, p. 1). Skip to next paragraphThe House Committee on Energy and Commerce is looking into when and why Dr. Jarvik began taking Lipitor and whether the advertisements give the public a false impression, according to John D.Dingell, the Michigan Democrat who is the committee’s chairman. â€Å"It seems that Pfizer’s No. 1 priority is to sell lots of Lipitor, by whatever means necessary, including misleading the American people,† Mr. Dingell said. Lipitor, the world’s single best-selling drug, is Pfizer’s biggest product, generating sales of $12. 7 billion last year. But as it has come under competition from cheaper generic alternatives, Pfizer has used the Jarvik campaign, introduced in early 2006, to help protect its Lipitor franchise. Wherever the Congressional inquiry leads, the controversy risks damaging Dr.Jarvik’s credibility and undermining his real medical mission. The Jarvik campaign was rolled out the same year that Zocor, Lipitor’s chief competitor, became available as a generic drug that is widely considered about as effective as Lipitor but is sold at a fraction of the cost. (Saul, 2008, p. 1). Skip to next paragraph Criticism of consumer advertising of pharmaceuticals flared as an issue back in 2004, when Merck withdrew Vioxx, a heavily advertised painkiller, after a clinical trial showed that it sharply increased the risk of heart attack s and strokes.The pharmaceutical industry adopted voluntary guidelines the next year suggesting that companies delay advertising new products for an unspecified period after they first reach the market (Saul, 2008, p. 1). In early January, the U. S. House Committee on Energy and Commerce began investigating celebrity endorsements in television ads for brand-name drugs. These direct-to-consumer (DTC) ads have been controversial since the Food and Drug Administration (FDA) loosened the rules governing pharmaceutical marketing in 1997.Before Lipitor made headlines, there was Viagra. Pfizer's â€Å"Viva Viagra! † campaign was criticized by the FDA and organizations including the AIDS Healthcare Foundation, who said the DTC ads encouraged recreational use of the erectile dysfunction drug. One print ad suggested that Viagra be used to â€Å"celebrate† events such as the Super Bowl or New Year's Eve. (Ebeling, 2008, p. 1). While troubling, DTC ads represent only 14 percent of pharmaceutical companies' marketing budgets.By the time a 30-second drug commercial airs, the company has conducted months of segmentation studies, held dozens of meetings to define the â€Å"communication target† (typically a woman, usually a mother, and of a certain income), and spent millions of dollars to develop the drug's brand and its market. This strategic marketing, which represents the remaining 86 percent of drug promotion expenses, should receive at least as much attention from regulators and lawmakers as DTC ads. (Ebeling, 2008, p. 1).While DTC ads seek to change patients' behavior, pharmaceutical companies are more interested in changing doctors' behavior. Drug marketers work hard to persuade doctors to prescribe their branded drug over generics and other competitors, and to change other medical practices that limit company profits. To cultivate medical professionals, drug companies may retain a doctor as a spokesperson, position friendly medical â€Å"thought -leaders† in the media, or organize free events at posh resorts and expensive hotels to â€Å"educate† doctors about a new disease state (think Restless Leg Syndrome) or their latest drug.In 2000, the biggest 10 pharmaceutical companies spent $1. 9 billion on promotional events alone (Ebeling, 2008, p. 1). For example, the FDA found that Eli Lilly's television broadcast advertisement for Strattera (atomoxetine) was false or misleading because it inadequately communicated the indication for the drug (attention-deficit–hyperactivity disorder) by means of competing visuals, graphics, and music presented concurrently. Similarly, serious risk disclosures were minimized for Strattera, the FDA said, by the distracting visuals and graphics (e. . , erratic camera movement, quick scene changes, and visual changes in point of view). In another case, the FDA said Pfizer's print advertisement for Zoloft (sertraline) was false or misleading because it omitted important informa tion relating to the risk of suicidality in patients, a risk stated on the product's label at the time the advertisement ran. (Donohue, Cevasco, & Rosenthal, 2007, p. 1). Drugs that are advertised to consumers are predominantly new drugs used to treat chronic conditions.Ten of the top 20 drugs, as ranked by advertising spending, were introduced in 2000 or later. Advertising campaigns generally begin within a year after the introduction of a pharmaceutical product, which raises questions about the extent to which advertising increases the use of drugs with unknown safety profiles. At least one pharmaceutical manufacturer (Bristol-Myers Squibb) recently announced a voluntary moratorium on direct-to-consumer advertising for drugs in the first year after FDA approval.And PhRMA, the industry trade group, has recommended that manufacturers delay such campaigns for new drugs until after health professionals have been sufficiently educated, although no details have been provided on how long a period was deemed necessary. 20 Finally, in a recent study of drug safety, the Institute of Medicine recommended that the FDA restrict advertising for newer prescription drugs. 8 Our data show that a mandatory waiting period on advertising for new drugs would represent a dramatic departure from current industry practices.For example, the FDA found that Eli Lilly's television broadcast advertisement for Strattera (atomoxetine) was false or misleading because it inadequately communicated the indication for the drug (attention-deficit–hyperactivity disorder) by means of competing visuals, graphics, and music presented concurrently. Similarly, serious risk disclosures were minimized for Strattera, the FDA said, by the distracting visuals and graphics (e. g. , erratic camera movement, quick scene changes, and visual changes in point of view).In another case, the FDA said Pfizer's print advertisement for Zoloft (sertraline) was false or misleading because it omitted important in formation relating to the risk of suicidality in patients, a risk stated on the product's label at the time the advertisement ran. (Donohue, Cevasco, ; Rosenthal, 2007, p. 1). direct-to-consumer advertising of prescription drugs on television. Such advertising has been criticized for encouraging inappropriate use of medications and driving up drug spending. ,2 Concern that such advertising may lead to increased use of expensive medications was amplified by the introduction of a prescription-drug benefit in Medicare in 2006 (Part D). Studies of the effect of advertising on prescribing practices have shown that such advertising increases classwide sales, helps to avert underuse of medicines to treat chronic conditions, and leads to some overuse of prescription drugs. (Donohue, Cevasco, ; Rosenthal, 2007, p. 1). Direct-to-consumer advertising has also been controversial in light of postmarketing revelations regarding problems with drug safety.Specifically, clinical trials that are requ ired for drug approval are typically not designed to detect rare but significant adverse effects, and contemporary methods of postmarketing surveillance often fail to connect adverse events that have a high rate of background prevalence with the use of particular drugs. After the market withdrawal of Vioxx (rofecoxib), a drug heavily promoted to consumers,6 critics called for the FDA to place limits on direct-to-consumer advertising, particularly for new drugs,7 a view that was reiterated in a recent report by the Institute of Medicine on the safety of medicines. (Donohue, Cevasco, ; Rosenthal, 2007, p. 1). Sponsoring continuing medical education describes the influence of sponsoring on the results, protocol and quality of drugs studies (Deutsches Aerzteblatt International, 2010, p. 1). The authors conclude that pharmaceutical companies exploit a wide variety of possibilities of manipulating study results. Apart from financing the study, financial links to the authors, such as payme nts for lectures, may tend to make the results of the study more favourable for the company.Not only the results themselves, but also their interpretation, are significantly more often in accordance with the wishes of the sponsor. (Deutsches Aerzteblatt International, 2010, p. 1). In some publications, the authors detected evidence that sponsors from the pharmaceutical industry had influenced study protocols. For example, placebos were more frequently used in drug studies than was the case with independently financed studies. On the other hand, some favourable effects were linked to financial support from the pharmaceutical industry.The methodological quality of studies with industrial support tended to be better than with independent drug studies(Deutsches Aerzteblatt International, 2010, p. 1). Most physicians must complete accredited continuing medical education (CME) programs to maintain their medical licenses, hospital privileges, and specialty board certifications. Data from t he Accreditation Council for Continuing Medical Education (ACCME) show that CME is a $2 billion per year business in the United States that earns less than half its revenue from physician learners themselves. CME is increasingly underwritten by commercial sponsors — primarily manufacturers of drugs, biologic therapies, or medical devices — that spend more than $1 billion per year in educational grants and other funding to cover more than half the costs for CME activities (Morris ; Taitsman, 2009, p. 1). In recent years, a number of studies have shown that clinical drug trials financed by pharmaceutical companies yield favorable results for company products more often than independent trials do. Moreover, pharmaceutical companies have been found to influence drug trials in various ways. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). Published drug trials that were financed by pharmaceutical companies, or whose authors declared a financial conflict of interest, were found to yield favorable results for the drug manufacturer more frequently than independently financed trials whose authors had no such conflicts. The results were also interpreted favorably more often than in independently financed trials. Furthermore, there was evidence that pharmaceutical companies influenced study protocols in a way that was favorable to themselves.The methodological quality of trials financed by pharmaceutical companies was not found to be any worse than that of trials financed in other ways. Conclusion: Published drug trials that are financed by pharmaceutical companies may present a distorted picture. This cannot be explained by any difference in methodological quality between such trials and trials financed in other ways. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). Clinical drug trials funded by pharmaceutical companies yield favorable results for the sponsor’s products more often than independent trials do.This has been demonstrated by a number of studies in recent years Various ways have been described in which pharmaceutical concerns exert influence on the protocol and conduct of drug trials, as well as on the interpretation and publication of their results. This systematic review showed widespread conflicts of interest in the shape of financial connections between scientists, academic institutions, and the pharmaceutical industry. Around one quarter of academic staff and two thirds of academic institutions had financial relationships with industry.Analysis of 8 review articles embracing a total of 1140 original articles (including randomized controlled trials [RCT], economic analyses, and retrospective cohort studies) revealed a statistically significant association between funding by biomedical companies and conclusions favorable to the pharmaceutical industry (summarized odds ratio [OR] 3. 6, 95% confidence interval [CI] 2. 6–4. 9). Industry financing was also connected with l imitations of publication rights and constraints on access to trial data. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). In the second review, a systematic analysis of 30 publications, Lexchin et al. showed that drug trials financed by pharmaceutical companies are less likely to be published, but that those published more frequently yield positive results for the sponsors’ products than do independently funded studies (8). The quality of the methods employed (analyzed in 13 publications) in trials financed by pharmaceutical companies was not inferior to that in studies with other sources of funding. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). The authors of the present systematic review set out to assess whether recently published studies reveal a connection between financing of drug trials by pharmaceutical companies and results favorable to these companies’ products. Part 1 investigates whether and, if so, how the type of fu nding affects study protocol and quality. Part 2 identifies and depicts the aspects of clinical drug trials that can be influenced by financial support from the pharmaceutical industry. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). The publications included were primarily studies performed with the expressed goal of comparing clinical trials funded by pharmaceutical companies with clinical trials that had not received financial support from such companies, e. g. , with regard to the results or conclusions. These studies were accompanied by a number of publications that investigated the consequences of financing of a study by pharmaceutical companies.These included, for example, articles in which information from the files of the US licensing authority (Food and Drug Administration, FDA) was compared with data from publications in medical journals, and case studies on individual substances. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). Conne ction between type of funding and results of drug trials Twenty-six of the 57 publications analyzed sought to ascertain whether the results and/or conclusions of drug trials depended on the type of funding or on financial conflicts of interest on the part of the authors (eTable). Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). Altogether, 23 of these 26 studies came to the conclusion that there was a positive correlation between the financing of a study by pharmaceutical companies and/or conflicts of interest on the part of the authors and results or conclusions that were favorable to the sponsor. The statistical significance of this finding was investigated in 22 cases and confirmed in 20. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. ). In 4 cases it was apparent that the findings were interpreted favorably towards the pharmaceutical concern that had funded the study, independent of the results (e5–e8). (Schott, Pachl, Limbach, Gundert-R emy, Ludwig, ; Lieb, 2011, p. 1). Another study investigated the connection between the conclusions and the source of financial support in clinical trials that had appeared in 5 influential medical journals over a period of 20 years (e10).Most trials yielded positive results for the drug in question regardless of the funding source, but this study also revealed a trend over the course of time towards more positive findings in industrially financed trials than in trials supported by non-profit organizations (e10). The third study compared the results (but not the interpretations or conclusions) of clinical trials of drugs used in pain management, some of them long available as generics (e9). (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. ). Five of the 57 studies analyzed investigated whether funding by pharmaceutical companies affected the design of the study protocol (Table 1 gif ppt). The use of placebos was shown to be significantly more common in RCTs of drugs f or psoriasis that were financed by such companies than in those with funding from other sources (e12). Moreover, several studies of treatment for premature ejaculation that were sponsored by a pharmaceutical company were found to have disregarded the relevant objective endpoint (e13).In an investigation of inhaled corticosteroids, significant differences in the frequency of adverse drug reactions (ADR) between the probands and the control group occurred only half as often when the study had been funded by the manufacturers (see also Part 2). The differences could be attributed wholly to the study design. For example, studies financed by pharmaceutical companies used lower dosages. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1).The pharmaceutical company concerned investigated the marketing effect of the study, finding that participating physicians did indeed prescribe rofecoxib significantly more often than non-participants in its first 6 months on the market. (S chott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). The results of clinical drug trials that are funded by pharmaceutical companies or whose authors have financial conflicts of interest are favorable to the products of the sponsoring company far more frequently than studies whose funding comes from other sources.Furthermore, interpretation of the data in the conclusions of industrially financed trials more often favors the sponsor. This was shown by the present systematic review and analysis of investigations, published between 1 November 2002 and 16 December 2009, into various diseases, study types (e. g. , RCTs and observational studies), and drugs. The results confirm the conclusions of 2 systematic reviews, both published in 2003, conducted with similar intent (7, 8).The principle of equipoise, i. e. , uncertainty which of the alternative approaches benefits the patient most, forms the ethical foundation of clinical studies in which the probands receive various tre atments (14). This principle seems to be violated in many studies funded by pharmaceutical companies. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). There are numerous reasons why studies financed by pharmaceutical manufacturers more often yield positive results.Four investigations found evidence that pharmaceutical companies influence the study protocol to their advantage (e12–e14, e19), e. g. , by more frequent use of placebos in control groups than in independently funded studies (e12). Although the responsible authorities sometimes demand placebo-controlled trials as a condition of licensing, they also request active controls (15). Further factors leading to higher frequency of results favorable to the sponsor in trials funded by pharmaceutical companies are described in Part 2 of this review. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). Trials financed by pharmaceutical concerns displayed no signs of poorer methodological qualit y. On the contrary, two studies showed superior quality (e16, e17). It must be taken into account, however, that some factors that serve to assess the quality of the instruments used in a study were not determined, among them the clinical relevance of the target parameters. In oncology, for instance, there are currently major defects in the protocols of industrially sponsored clinical trials, e. . , deficiencies in the definition of patient-relevant endpoints and in the selection of suitable substances for the control arm of RCTs (16–19). Moreover, clinical trials in oncology are often discontinued after preliminary analysis (20), with the result that only a short time after the licensing of a drug its additional benefits and the safety of new substances can frequently no longer be evaluated, preventing any benefit/risk analysis (21). (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, ; Lieb, 2011, p. 1). Conclusion:Wansink argues that the true challenge in marketing nutrition li es in leveraging new tools of consumer psychology (which he specifically demonstrates) and by applying lessons from other products' failures and successes. The same tools and insights that have helped make less nutritious products popular also offer the best opportunity to reintroduce a nutritious lifestyle. The key problem with marketing nutrition remains, after all, marketing. (Wansink, 2007, p. 1). New services must therefore be oriented toward consumers (i. e. , patients, health professionals, and third-party agencies) to gain acceptance (Grauer, 1981, p. ). We encourage family physicians interested in providing the best care for their patients to become educated in the advertising techniques used by the pharmaceutical industry. (Shaughnessy, Slawson, & Bennett, 1994, p. 1). | | | | | | | | | | | new challenges as well as opportunities for increasing profitability. If the pharmaceutical companies want to improve their Return-On-Investment (ROI), they have to adopt new communicat ion technologies (digital media) along with their conventional sales force of medical representatives.They really need to adopt this multi channel marketing strategies for the following reasons: The concept of blockbuster drugs is dying out for big pharmaceutical companies where 2-3 drugs were good enough to pay back the whole investment for a larger number of manufactured drugs. Now the limited prospective for blockbuster drugs (thanks to low investment on R&D and patent expiry) makes it essential to focus on more specialized drugs sold in lower volumes. And when there is low volume products, sales driven marketing strategy (with high cost of sales force) is not feasible.As far as small pharma companies are concerned, they already have small sales force. However, with the use of digital media, having a lower investment cost (both for the company and its targeted customer) they can easily get return on investment. Customer behavior (doctors behavior) is rapidly changing. Doctors, wh o are getting more and more busy with increasing patients, can be hardly seen by the medical representatives. They are more inclined towards Internet for obtaining relevant information.It is the time for pharmaceutical companies to build their marketing strategies around this digital media. Website marketing, online marketing, blogs, social media, forums, chat rooms and any other such media is an influential means to present the company's products and offers through opinion leaders (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). The right marketing strategy for any pharmaceutical company would be to build on proven strategic marketing principles, along with a focus on changing customer behavior.Use of digital media through Internet marketing plan is the best marketing strategy that can provide the basis for a changed business model. However, there should be some planning for using digital media for marketing too. It should be a multi channel marketing strategy but sho uld identify the target audience. Every digital media used for all people can not be called the right marketing strategy. The focus should be on the high value customer segment for pharmaceutical products (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1).

China and Usa: a Comparison of Their Monetary Policies

University of International Business and Economics China and USA: A comparison of their Monetary Policies. Mid-term Project School of International Trade and Economics BY Rebecca Bogiri Professor: LIN GUIJIN Beijing, China 2 December 2009 China and USA: A comparison of their Monetary Policies. By: Rebecca Bogiri December 2009 Abstract The monetary policies of USA and China is analyzed here from the perspective of their implementing bodies, their choice of instruments, and their means of setting their interest rates. The analysis reveals that there are immense differences between the two countries resulting from the nature and degree of influence from their respective domestic political systems. The paper concludes that China has a complex political economy that represents a hybrid of private ownership and state control. Therefore unlike the USA, its monetary policies are subject to political influence. Keywords: Monetary policy; Monetary policy instruments; Balance Sheet; China; USA Author’s email: becky. [email  protected] com ContentsPage Abstract †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 1 Introduction †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3 USA Monetary Policy †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3 China Monetary Policy †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 7 Comparison of China and USA’s monetary policies †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 9 Conclusion †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã ¢â‚¬ ¦Ã¢â‚¬ ¦. 10 References †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 11 1. Introduction Monetary Policy is the process by which the government, central bank, or monetary authority of a country controls (1) the supply of money, (2) the availability of money, and (3) the interest rate, in order to attain a set of objectives oriented towards the growth and stability of the economy. This paper refers the above theme to two countries: China and USA. As such, there are three broad objectives. The first is to discuss monetary policy generally as carried out in the USA. The second is to discuss monetary policy generally as it is carried out in China. The third is to compare and analyze the way monetary policy is implemented in the two countries. 2. USA Monetary Policy How is the Federal Reserve structured? The Federal Reserve System (called the Fed, for short) is the nation's central bank. It was established by the Federal Reserve Act[1] and consists of the Board of Governors in Washington, D. C. , and twelve Federal Reserve District Banks. The Congress structured the Fed to be independent within the government. Therefore although the Fed is accountable to the Congress and its goals are set by law, its conduct of monetary policy is insulated from day-to-day political pressures. This reflects the conviction that the people who control the country's money supply should be independent of the people who frame the government's spending decisions. What makes the Fed independent? Three structural features give the Fed independence in its conduct of monetary policy: the appointment procedure for Governors, the appointment procedure for Reserve Bank Presidents, and funding. Appointment procedure for Governors:  The seven Governors on the Federal Reserve Board are appointed by the President of the United States and confirmed by the Senate. Independence derives from a couple of factors: first, the appointments are staggered to reduce the chance that a single U. S. President could â€Å"load† the Board with appointees; second, their terms of office are 14 years–much longer than elected officials' terms. Appointment procedure for Reserve Bank Presidents: Each Reserve Bank President is appointed to a five-year term by that Bank's Board of Directors, subject to final approval by the Board of Governors. This procedure adds to independence because the Directors of each Reserve Bank are not chosen by politicians but are selected to provide a cross-section of interests within the region, including those of depository institutions, nonfinancial businesses, labor, and the public. Funding:  The Fed is structured to be self-sufficient in the sense that it meets its operating expenses primarily from the interest earnings on its portfolio of securities. Therefore, it is independent of Congressional decisions about appropriations. How is the Fed â€Å"independent within the government†? Even though the Fed is independent of Congressional appropriations and administrative control, it is ultimately accountable to Congress and comes under government audit and review. Fed officials report regularly to the Congress on monetary policy, regulatory policy, and a variety of other issues, and they meet with senior Administration officials to discuss the Federal Reserve's and the federal government's economic programs. The Fed also reports to Congress on its finances. Who makes monetary policy? The Fed's FOMC (Federal Open Market Committee) has primary responsibility for conducting monetary policy. The FOMC meets in Washington eight times a year and has twelve members: the seven members of the Board of Governors, the President of the Federal Reserve Bank of New York, and four of the other Reserve Bank Presidents, who serve in rotation. The remaining Reserve Bank Presidents contribute to the Committee's discussions and deliberations. In addition, the Directors of each Reserve Bank contribute to monetary policy by making recommendations about the appropriate discount rate, which are subject to final approval by the Governors. Objective of Monetary policy Monetary policy has two basic goals: to promote â€Å"maximum† sustainable output and employment and to promote â€Å"stable† prices. These goals are prescribed in a 1977 amendment to the Federal Reserve Act. In the long run, the amount of goods and services the economy produces (output) and the number of jobs it generates (employment) both depend on factors other than monetary policy. These factors include technology and people's preferences for saving, risk, and work effort. So, maximum sustainable output and employment mean the levels consistent with these factors in the long run. But the economy goes through business cycles in which output and employment are above or below their long-run levels. Even though monetary policy can't affect either output or employment in the long run, it can affect them in the short run. For example, when demand weakens and there's a recession, the Fed can stimulate the economy temporarily and help push it back toward its long-run level of output by lowering interest rates. That's why stabilizing the economy, or smoothing out the peaks and valleys in output and employment around their long-run growth paths—is a key short-run objective for the Fed and many other central banks. USA Federal Reserve – Balance Sheet |ASSETS |LIABILITIES |Gold and Foreign Exchange |Currency | | |Held by public | | |Vault cash | |Federal Reserve Credit |Bank Deposits | |Loans & Discounts | | |Government Securities | | |Other credits | | Source: Federal Reserve Bulletin, May 1996. Monetary policy instruments The Federal Reserve has three instruments for controlling the money supply. They are: 1. Open Market Operations 2. The discount rate; and 3. The required reserve ratio. When using Open market operations, the Fed buys or sells government securities to affect the leve l of the money supply. For example, if the Fed wishes to increase the money supply by $2 million, it will purchase government securities worth $ 2 million. The Fed’s assets increase by $ 2 million under the securities heading. In order to pay for the government security, the Fed writes a check on itself. In return for the bond, the seller receives a check instructing the Fed to pay the seller $ 2 million. The seller then takes the check to his bank, which credits the depositor with $ 2 million, and then deposits the check at the Fed. The bank has an account with the Fed, which is now credited with $ 2 million. Thus the Fed’s liabilities increase by $ 2 million under the heading of bank deposits, as the commercial bank has just increased its reserves by $ 2 million which are held by the first instance as a deposit at the Fed. Another monetary policy instrument used to affect the level of the money supply is the Discount rate, which is the interest rate charged by the Fed to banks that borrow from it to temporary needs for reserves. Increasing the discount rate discourages banks from borrowing from the Fed, while lowering the rate encourages banks to borrow from the Fed and thus increase the money supply. The required reserve ratio refers to the percentage of total deposits that the Fed requires individual financial intermediaries to keep at the Fed as reserves. The significance of the required reserve ratio is that it affects the money multiplier, and thus the level of the money supply. For example, if the Fed wants to increase the money supply, it can do so by reducing the required reserve ratio. Because there are now less reserves and more money is available for the banks to be able to meet their customer’s demand for cash. This increases the money multiplier, which also has a positive effect on the level of the money supply. Required reserves do not pay any interest, so increases in the required reserve ration has undesirable side effects on bank profits. Open market operations are nearly always the favored tool of choice by the Fed. The Fed Open Market Operations in 2008 summarizes all monetary policies and tools used by the Fed for that year. The two tables below shows the changes in the federal funds target rate, and the primary credit rate, and the interest paid on the required reserves and excess reserve balance.. These were operational measures taken by the Fed to influence the Federal funds rate. It is evident that the Fed rapidly and continually decreased the federal funds rate and the primary credit rate throughout 2008. Furthermore, on October 8th 2008 the Fed started to pay interest on despository institutions’ required and excess reserves balances as authorized to under the Financial Services Regulatory Relief Act[2]. [pic] [pic] 3. China Monetary Policy Body in charge of Monetary Policy: Monetary policy in China is conducted by the People’s Bank of China. Article 12 of the Law of the People? s Republic of  China  on the People? s Bank of China provides † the People? s Bank of China is to establish a monetary policy committee, whose responsibilities, composition and working procedures shall be prescribed by the State Council and shall be filed to the Standing Committee of the National People? s Congress. The Monetary Policy Committee shall play an important role in macroeconomic management and in the making and adjustment of monetary policy. â€Å" Rules on Monetary Policy Committee of the People? s Bank of China stipulates that the Monetary Policy Committee is a consultative body for the making of monetary policy by the PBC, whose responsibility is to advise on the formulation and adjustment of monetary policy and policy targets for a certain period, application of monetary policy instrument, major monetary policy measures and the coordination between monetary policy and other macroeconomic policies. The Committee plays its advisory role on the basis of comprehensive research on macroeconomic situations and the macro targets set by the government. The Monetary Policy Committee is composed of the PBC? Governor and two Deputy Governors, a Deputy Secretary-General of the State Council, a Vice Minister of the State Development and Reform Commission, a Vice Finance Minister, the Administrator of the State Administration of Foreign Exchange, the Chairman of China Banking Regulatory Commission, the Chairman of China Securities Regula tory Commission, the Chairman of China Insurance Regulatory Commission, the Commissioner of National Bureau of Statistics, the President of the China Association of Banks and an expert from the academia. The Monetary Policy Committee performs its functions through its regular quarterly meeting. An ad hoc meeting may be held if it is proposed by the Chairman or endorsed by more than one-third of the members of the Monetary Policy Committee. Objective of Monetary policy: The main objective of the Chinese monetary policy is to maintain the stability of the value of the currency (the Renminbi), and thereby to promote economic growth. People’s Bank of China – Balance Sheet ASSETS |LIABILITIES | |Credits to FI |Deposits of FI | | |Central Bank Reserves | | |Excess Reserves | |Foreign Exchange Reserves |Central Bank Bills | |Securities |Deposits of Treasury | | |Currency in Circulation | Source: AE502 Macroeconomic Analysis Monetary Policy Instruments The People’s Bank of China in conducting Monetary policy has several instruments at its disposal which include: 1. The reserve requirement ratio 2. The Central Bank base interest rate 3. Rediscounting 4. Central Bank Lending 5. Open Market Operations 6. Other policy instruments as specified by the State Council In essence, the monetary instruments listed above correspond to the descriptions given under the Fed’s monetary policy heading. However, the main tool of choice for the PBC is the reserve requirement ratio. For example, in the PBC 2008 Annual Report on Monetary Policy it was reported that in order to sterilize excess liquidity in the first half of 2008, the reserve requirement ratio was decreased cumulatively by 3 percentage points on 5 occasions. Furthermore, a lower required reserve ratio was applied to rural credit cooperatives (RCCs) and financial institutions in the quake-hit areas. Furthermore, in the second half of 2008 with the heightened international turmoil and in order to ensure ample liquidity in the banking system, the PBC further reduced the required reserve ration of financial institutions on another four occasions resulting in a cumulative decrease of 2 percentage points for large financial institutions, and a cumulative decrease of 4 percentage points for smaller financial institutions. According to PBC calculations, by the end of 2008 a total of 800 billion yuan of liquidity was released into the economy. The choice of the reserve requirement ratio as the mail policy instrument is not coincidental to China which runs a high current account surplus. There is a large and growing demand for the RMB, and to maintain the RMB at the desired level the PBC issues RMB to meet this demand thereby increasing the money circulating in China. To keep inflation and economic growth under control, the PBC sterilizes its foreign exchange market interventions by buying back some of the RMB it issued to buy US dollar. In particular, it does so by selling low yield government securities to state-owned banks. So far, the banks have been able to absorb those low yield bonds in part because the interest rates paid on them bank deposits are also maintained at artificially low rates. Nonetheless, the increases in foreign reserves are not fully neutralized. Over the last five years broad money supply in China has been growing at above 15% per annum while real economic growth has averaged about 10. 5%. [3] Furthermore unlike more developed market economies, China is reluctant to raise domestic interest rates to slow its domestic growth. Doing so might mean attracting more capital inflows, which would in turn, require further money issuance to stabilize the exchange rate. That is precisely why the PBC instead changes the reserve requirement ratio on an ongoing basis to control the expansion of money and credit. 4. Comparison of China and USA’s monetary policies There are three main differences between China and the United States where monetary policy is concerned: independence of the monetary policy implementing body, choice of instruments to use in implementing monetary policy, and direct or indirect means of setting interest rates to effect monetary policy. Furthermore, these three differences are inter-related and country specific. The first major difference between the Federal Reserve System (the Fed) and the People’s Bank of China (PBC) concerns their independence from national politics. The intention of Congress when designing the Federal Reserve Act was to keep politics out of monetary politics. The Fed is totally independent of other branches and agencies of the government. Furthermore, it is self financed and therefore is not subject to the congressional budgetary process. On the other hand, the PBC is not independent from national politics in China. The PBC reports directly to the State Council which serves as China’s cabinet as well as its highest executive body. Moreover, monetary policy in China is aimed at limiting the appreciation of the renminbi (RMB), while eeping economic growth at a sustainable pace and inflation under control plus preserving a fragile banking system. The Fed in contrast implements a monetary policy that has a dual objective of maximum employment and price stabilit y. The second difference regards the choice of the monetary policy instruments used by the Fed as opposed to the PBC. The choice of instruments used in implementing monetary is essentially the same, except that the PBC has the an additional instrument; namely â€Å"additional instruments as specified by the State Council. † It is therefore no surprise that this ‘extra instrument’ arises from the lack of independence on the part of the PBC. The third difference between the Fed and the PBC lies in the way they set the interest rates. The Fed sets its federal funds rate indirectly by setting a specified target rate and then using the the tools of monetary policy (open market operations, discount window lending, and reserve requirements) to achieve that target rate. As a result, the changes in the federal fund rates trigger a chain of events that affect other short term interest rates, long term interest rates, the amount of money and credit in the economy, plus other macro-economic variables such as employment, growth and the prices of goods and services. In contrast, the PBC has a direct influence on its interest rate because of the extra instrument described above. Because there is provision for other policy instruments as specified by State Council, this allows the PBC to set interest rates directly, and thus have a direct impact on the its balance sheet. 5. Conclusion There are major differences in monetary policy and central banking in China and the USA. China has a complex political economy that represents a hybrid of private ownership and state control. Therefore, the PBC’s monetary policies, choice of instruments and methods of implementation are quite different from that of the Fed. Monetary policy in China aims at curbing the appreciation of the RMB while keeping economic growth at a sustainable pace, inflation under control, and preserving a fragile banking system. This is contrasted with the Fed’s monetary policy with the dual objective of maximum employment and price stability. Different monetary policy objectives, coupled with the degree of political independence on the part of the Fed and the PBC greatly influence the choice of instruments used and the method of implementing monetary policy in the two respective countries. 6. References Federal Reserve Bank of New York Domestic Open Market Operations During 2008 Federal Reserve Bank of New York: â€Å"Annual Report Domestic Open Market Operations during 2008† Federal Reserve Statistical Release 19 November 2009 Ian Sheldon, â€Å"US-China Trade Policy: Who gains from a rise in the Yuan? † at http://aede. osu. edu/programs/Anderson/trade Luc de Wulf and David Goldsbrough, â€Å"The Evolving Role of Monetary Policy in China†, IMF Staff Papers WP/04/125 Michael Moskow and Cathy Lemieux â€Å"China up close: Understanding the Chinese economy and financial system†, at www. chigacofed. org People’s Bank of China Monetary Policy Annual Report 2008 Peter Stella, â€Å"The Federal Reserve System Balance Sheet: What Happened and Why it matters† IMF Staff Papers WP/09/120 Financial Services Regulatory Relief Act 2006 (USA) Federal Reserve Act 1913 (USA) Law of the People’s Republic of China on the People’s Bank of China 1995 (China) http://www. frbsf. org/publications/federalreserve/monetary/structure. html http://www. pbc. gov. cn/english/huobizhengce/MPC. asp http://en. wikipedia. org/wiki/Monetary_policy ———————– [1] 1913 [2] 2006 [3] China close up (2008)