Opera †Carmen Essay

   This was an amazing Opera, I only wish that I had the opportunity to see it in person. I have never watched anything like it, and probably would not have had it not been part of this class. Let me say Thank you for opening my eyes to this amazing experience. The theatrical performance, choreography and music were very moving and to my surprise drew me in to continue watching and trying to interpret. I have to say I was very shocked at the sexuality used in this performance, it seemed as thought it was wrote long before its time. Carmen’s sexuality was very much a large part of the performance and I found it intriguing. I decided to rent the movie Carmen to compare the performances and found them to be very similar in character however the Opera was much more captivating. The music alone is wonderful but when added to the stage performance it was absolutely mesmerizing. Carmen is a direct conflict of the expectations for women of this time period. Women were to be gentle, biddable and sinned against. However Carmen used her beauty and sexuality to her advantage. She perfectly combined her acting, singing, and dancing abilities to portray a seductive and enticing personality that even Don Jose’ could not resist. The musical transitions for each character and scene were for me the amateur at times overwhelming and difficult to take it all in. As the music and people become loud during the bullfight in the background you can hear Carmen and Don Jose’ characters in the music. In the beginning of the Opera Don Jose’ appears to be very strong and powerful with an ability to ignore Carmen. Again the music helps portray this image. Obviously he changes throughout the performance to become ravaged with lust and jealousy towards Carmen. You can hear in his voice his defeat and it leaves you to believe that although he will no longer be jealous he also will mourn Carmen forever. Although the orchestra was not shown often it appeared that it consisted primarily of men, which I found rather interesting. The sets were also incredible which made me wonder how the original sets were designed. This Opera appears to have been a monumental changes in the French Opera it is a shame that Bizet, due to his early death, was unable to realize his impact not only of his time but still today 100 years later.

Locke: Founder of British Empiricist

John Locke had a number of major influences on society in general, but his influences on education have stood the taste of time. His idea of Tabula Rasa, his introduction of empiricism, and idea of the use of all senses are all objectives that are used in schools today. The idea of Tabula Rasa is basically defined as a â€Å"blank slate.† Locke believed that everyone is born with a clean mind, a supposed condition that he attributed to the human mind before ideas have been imprinted on it by the reaction of the senses to the exterior world. â€Å"Thus the first capacity of human intellect is that the mind is fitted to receive the impressions made on it; either through the senses by outward objects; or by its own operations when it reflects on them. This is the first step a man makes towards the discovery of anything†¦Ã¢â‚¬  -John Locke (On Ideas as the Materials of All Our Knowledge) Locke considers the new mind as white paper or wax. It is to be moulded and formed as one pleases. It is up to the teacher to insure that it is formed the correct way and that there is no inate knowledge. This is incorporated into education the grade system. Children start out in kindergarten or pre-school with a blank slate; we start teaching the very basics as if they know nothing. The more information and experience they gather, the further they move along the grade continuum. Locke was considered the founder of British empiricist. He believed that all knowledge comes to us through experience. â€Å"No man's knowledge here can go beyond his experience.† Basically, all knowledge has its origin and end in experience, or perception using the senses. He says, â€Å"Experience is twofold, sensation and reflection. From both sources we obtain ideas.† Sensation is the perception of external phenomena and reflection is the perception of the operations of the mind itself. This view of empirical thinking is widely used in schools today, especially in the science fields. Concepts and skills are much easier to learn if you can experience them. The empirical way of teaching has brought about the use of the scientific method. First, students must observe a situation and decide if there is a problem. Secondly, make an educated guess, or hypothesis, of what will happen. Next, test this hypothesis. If it is true then draw a conclusion. If not, make a new hypothesis and test again. This is a very valuable way to learn. The students get to experience the whole situation and will in tern retain and understand this information better. Along with using empirical methods of learning, Locke insisted that all the senses be used when learning. It is not enough for a teacher to just stand in front of a classroom and lecture; students are only using one sense (hearing) to try to comprehend the material. Locke feels that you must hear, feel, see, smell, taste everything in order to get the full potential knowledge. This is very relative to today's teachings because we, as teachers, need to appeal to all learning styles. Some students learn better visually, others orally and so on, so we have to hit all area in order to give all students an equal chance to learn. In closing, John Locke was a very significant figure on how we educate children today. He gave us the idea of starting students with a clean slate, the use of the scientific method, and the essential use of all the senses. All these ideas are important aspects of today†s classroom and will most assuredly be a continued use in the future.

Developmental psychology Essay

Introduction The pedagogy of play can be hard to understand and part of the reason for this is it’s so difficult to explain how children learn by play because play isn’t simply; it is complex. Each child begins their early childhood education with a set of skills and prior knowledge that is influenced by their family, culture and past experiences (Fellows &Oakley, 2010). The past knowledge should become the foundation for developing an understanding of scientific concepts (Duschl, Schweingruber & Shouse, 2007). Children are naturally inquisitive, creative and aware of the world around them (Campbell & Jobling, 2012). development tool and an effective way to teach children scientific concepts while using their prior knowledge (Preston, Mules, Baker & Frost, 2007). Learning science through play shows children that science is useful and enjoyable and is a significant aspect of the real world (Bulunuz, 2013). This essay will review teaching science through play, theorists who support play and the way in which the Australian curriculum and EYLF support play pedagogy. Science and Play Play pedagogy is a context for learning through which children organise and make sense of their social worlds, as they engage actively with people, objects  and representations. Research shows that early childhood educators must use play effectively in order for children to develop contextualised knowledge about science (Bulunuz, 2013). Educators should base science experiences based on prior knowledge and interests demonstrated by the children (Moyles, 2012). Educators must acknowledge the importance of play as a platform for learning and practising the basic process skills of science (Howitt, Morris & Colville, 2007). Through play the children are learning at their own pace and children can repeat, rehearse and refine skills, displaying what they do know and practising what they  are beginning to understand. According to Campbell & Jobling (2012) there are numerous forms of play. One of which is free play. Free play is used by children to spontaneously react to their environment, and is determined by their interests. Children’s interest in the world around them usually begins with their observations, whereby they see, hear, smell, touch something that captures their interest and encourages them to explore. In order to develop contextualised knowledge about science children need to move on from free play and be involved in guided play (Campbell & Jobling, 2012).

Envirnomental Analysis Essay Example | Topics and Well Written Essays - 1000 words

Envirnomental Analysis - Essay Example First, the slow growth of houses brought a significant downturn on retail sales in terms of appliances, furniture and home furnishings. Consumer spending is also affected by stricter lending policies now being pursued by lending institutions due to default in mortgages and payments. Other economic factor affecting the industry is the high cost of gasoline which slices the consumers’ budget for household expenses and retail spending. Most likely , the following factors will pose a negative effect on the trend of industry sales and will be the trend for 20009, Punkett Research said.. The impact of high consumer debt levels will constrain spending. * The growing trend of expenditures can be influenced by lifestyles as shown in Plunkett Research. Consumers trend in spending supports healthy lifestyle with products that has more high value, long life, environment friendly, and low in consumption. The fast pace of technology has moved retail selling into new direction in selling. For instance, we are seeing now the rapid growth of on line shopping. Internet connections make shopping convenient for consumers. Report said that in 2008, internet business of retail selling have kept about 100 million consumers in their homes and business. Sales raked by Amazon in 2007 was $14.8 billion higher than in 2006 of $107 billion in 2006. A Shop.org. survey mentioned in Plunkets research t said that in 2008, on line shopping of 84.6 million consumers accounted for $ 72.0 million sales in 2006 and $ 60.7 million in 2007. Not to be outdone, Wal=Mart has joined the bandwagon in the e-commerce trading. In 1985, at the tune of $4 billion, company developed software that will give information on consumer behavior through the bar codes system. This information enabled the company to foresee demographic changes. Today, demographic changes may be seen thru the behavior of buying patterns of

HCAD PowerPoint Discussion 1 Essay Example | Topics and Well Written Essays - 500 words

HCAD PowerPoint Discussion 1 - Essay Example Commonly used telemedicine applications and services include bi-directional video, smart phones, email, and wireless tools among others. Within the medical field, telemedicine is not a different specialty. Instead, telemedicine is an instrument responsible for expanding traditional medical practice beyond the obvious medical practice walls to offering actual medical services remotely through technology (American Telemedicine Association, 2006, p. 3). Consequently, telemedicine promotes increased consumer participation in medical decision making, and offers novel means of sustaining healthy living. Quality patient care attainment is promoted through qualified doctors with experience in diagnostic examination using remote technologies and who work with geographically located health care delivery teams comprising of providers with varying backgrounds for coordinated health services delivery (Masys, 2002). Telemedicine health services include specialist referrals, remote patient monitoring, provision of consumer health and medical information, direct patient care, and medical mentoring and education. Increased access and cost reduction results from patient direction to monitoring centers that allow patient to retain autonomous lifestyles; use of private networks to facilitate point to point connections between hospitals and independent medical providers; interlinked programs connecting community health centers to tertiary care hospitals; and connections between health providers and homes through phone-video services (American Telemedicine Association, 2006, p. 4). Web-based e-health patient service sites offer direct services over the internet. Although health Information Technology focuses more on electronic medical records and associated information systems, it greatly enhances the use of Telemedicine. Consequently, the activities and goals of telemedicine complement synergize those of health information technology resulting

Common law and Equity Essay Example | Topics and Well Written Essays - 1000 words

Common law and Equity - Essay Example Equity is no part of the law, but a moral virtue which qualifies, moderates and reforms the rigour, hardness and edge of the law and is a universal truth. It also assists the law where it is defective and weak in the constitution. It refers to a particular set of remedies and related procedures. The role of the office of equity is to support and protect the common law from shifts and crafty devices against the justice of the law. Equity neither destroys nor creates the law but assist it. Equity is a means of preventing any unfairness which might otherwise result from rigid application of formal legal rules (Hudson, 2005, p.14,). Equity supplemented and remedied the deficiencies in the common law. The main remedy at common law is damages. Equity offers remedies other than damages such as the injunction and specific performance (Gubby, 2004, p.37). Equity will not suffer a wrong to be without a remedy, and thus equity establishes its core jurisdiction to ensure that a claimant will be entitled to acquire some redress for a wrong done to him or her or to protect some right in property (Hudson, 2004, p.9). The fundamental similarity between common law and equity is that... s a moral character to the common law and may be used synonymously with common law for the simple reason that what is legal is necessarily moral (Hamilton, Jaren, Pound, 1999, p.91). Except for different mode of administering justice in each court, it is law and reason which governs both equity and common court. Both equity and common law are 'damages'. 'Damages' at common law means a monetary response to a breach of duty. That breach of duty might be a breach of contract or it might be tort. This approach nullifies a prevalent view that 'damages' are synonymous to compensation. In common law, non compensatory monetary awards for wrongs that are acknowledged to be forms of damages namely exemplary damages, restitutionary damages and disgorgement damages. All these forms of damages have counterparts in equity. Awards of equitable compensation or 'accounts of profits', which responds to wrongs in equity, are actually different forms of damages. With the recognition that the former are simply equity's 'compensatory damages' and the later are equity's 'disgorgement damages', an understanding of rules of causation and remoteness in equity can be developed in comparison to common law counterparts. Although different sets of rules apply for different wrongs and different conducts, the nature of law is always relevant for both common law and equity. For example, the wrong of fraudulent representation in equity is identical to the tort of deceit and for that matter the same test of remoteness should apply and comparison is helpful (Robertson, 2004, p.32). Differences In case of common law, remedy is granted to a claimant who could establish a case at law, usually in proof of certain formalities and pleading a specified form of action. A common law is fairly inflexible in

Economic Analysis of Future Price Developments in the South West of Essay

Economic Analysis of Future Price Developments in the South West of England - Essay Example 2008, p. 3). The financial analysis takes account of the information that price expansions over those horizons are influenced mainly by the dealings of supply and demand in the goods, factor markets and services. GDP growth in the South West of England is likely to stay weak in the near term, before gradually intensification as households actual incomes recover, supported by sustained stimulus from monetary rule. â€Å"The South West Economic Profile is intended for all South West England partners working for the development of the regional economy. It provides a succinct, analytical account of the South West region in a way that can be related to the objectives and priorities set out in the Regional Economic Strategy† (South West Economic Profile n.d.). Following prices will be expected to increase in the near future; Domestic Price: â€Å"Domestic Pricing is a common but not necessarily accurate method of pricing exports. This type of pricing uses the domestic price of the product or service as a base and adds export costs, including packaging, shipping and insurance† (Basics of Exporting – Pricing, Quotations, Payment & Collections 2003). The considerable challenges of domestic price in South West of England faced by the euro area continue to pose an important risk to the domestic improvement. Domestic demand is prolonged relatively quickly in 2011. But much of that development was accounted for by unsustainably strong inventory accretion. But the drag on domestic expenses from tight credit situations and the economic consolidations are likely to persevere. The formidable threat posed to the euro continues as a challenge to the domestic recovery. The quantity of income saved by households remained significantly more than in the period leading up to the crisis. In the over all study, domestic price is expected to increase in high level. Market Price: Market price is the current price, as resolved by supply and demand, at which point of se rvices, goods etc., are perhaps sold or bought. â€Å"The UK power market, which has for several years lagged behind the large European markets in terms of traded volumes and churn, has seen a significant drop in churn and contraction in products traded in recent months, leading to concerns that new players are even less able to enter, and that the market is stagnating† (Broker 2012). The circumstances in London bank funding markets are better, but the costs of credit for companies and households have increased. Credit growth and financial structure remained weak. Since the present Inflation Report, the MPC has maintained bank rate about 0.5%, and market interest rates state that the expected timing of the future rise in bank rate had been increased. Oil Price: Presently, the oil prices of England are increasing slightly. â€Å"CPI inflation fell to 4.2% in December, down from 5.2% in September but still well above the 2% target. Inflation should continue to fall sharply at the start of 2012 as the impact of past rises in VAT and petrol prices drop out of the twelve-month comparison† (Overview of the Inflation Report February 2012 2012). Any major disturbance in oil and gas supply could cause an increase in energy prices. The way of price rises will depend on how firms set prices related to those expenses, and in particular the methods adopted by companies to re-establish their profit margins. The comparison of the past performance of oil price

MSc International Marketing Management Essay Example | Topics and Well Written Essays - 1000 words

MSc International Marketing Management - Essay Example The central component is still people. All the expertise and products in the world can never substitute that one precious human resource. The Export Marketing Research has undergone a sea change in the last few decades. Since the advent of globalisation markets both domestic and international have made information gathering a vital process in establishing a business. The proposed research dissertation would analyse the differences that exists in the domestic marketing research and the international marketing research through Export Marketing Research. Export marketing research has covered a number of theoretical and practical matters such as calibration and customisation, export growth processes, barriers to exporting, export operation, etc. Rapid changes in technology, institutionalised, parliamentary, economic and attitudes throughout the globe present challenges for the future growth of export marketing enquiry. The appearance of churning and ultra-competitive business environs calls for exporters to regard the bases and sustainability of their competitive benefit to overseas markets. Specifically, future research has to concentrate on the recognition of the exact export marketing capacities that firms should build up or gain, the capacity to purchase or channelise them across markets, and the talent to continuously upgrade the aspects by using appropriate organisational learning routines. Of significant magnitude are the procedures utilised to formulate capacity-based strategies and to supervise relationships with internation al customers. The literature review of the different authors pertaining to international marketing management through export marketing research includes Bentley (1986) who defines information as "being data that are meaningful, useful to the user and which, ideally, should be comprehensive, yet concise, accurate, applicable, timely and available." As such information is rarely available in such a readily digestible form, organizations have had to develop either formal or informal methods to collect, analyse and disseminate it. Though there have undoubtedly been many successful management decisions based on experience of the management which has an inner feeling of what can be good for an organisation, the consensus among marketing theorists (Deshpande and Zaltman, 1982; Kast and Rosenzweig, 1979; Stoner, 1978), is that objective information is a prerequisite basis on which to found management decisions which will reduce risk and uncertainty. The types of marketing research information used by comp anies have been covered by Luck and Rubin (1987), Kinnear and Taylor (1991) and Churchill (1987) among others. Whilst these authors willingly prescribe the types of information which should be sought, they are not so forthcoming when discussing the types of information that companies actually collect. Similarly the international marketing research textbook by Douglas and Craig (1983) takes more of a prescriptive, rather than a

Management case Essay Example | Topics and Well Written Essays - 500 words

Management case - Essay Example Most of its offerings already had significant margins, and those that werent at this level were close or were expected to in the near future. The challenge that Newell Company faced was trying to remain the market leader for all of its industries at the same time. 2) Newell Company has many distinctive resources due to the strong credibility the brand has built up over the years. Because the company has many different product categories, a strong management style is necessary to ensure that every sector runs smoothly. In addition, Newell Company has good relationships with its supply partners, and these relationships help the company to remain number one in all areas of its business portfolio. Finally, Newell Company has access to Electronic Data Interchange (EDI), which helps the company to organize all of its purchase orders, invoices, and payments to and from its retail partners. Because most of Newell Companys orders are placed through this system, the company is able to keep track of all of its deadlines and needs. 3) Newell Company does seem to have a successful corporate level strategy because the management and administration is interlinked, which helps to build a solid kind of corporate culture. Another area that shows Newell Company is successful in the corporate area is through acquisitions. The company buys other companies that can add value and expand the operation of Newell Company. This is a very difficult process because the new acquisitions need to be the right fit. If a new acquisition is not up to the same speed of Newell Company, then that acquisition has the potential to bring the whole company down. 4) I feel that Newell Company acquiring both Calphalon and Rubbermaid are good business decisions for a variety of reasons. First of all, Calphalon is a good fit for Newell Companys housewares division because the company has access to the high end of the market where Newell Company has not been so successful. Also, Calphalon has strong

Certainty Essay Example for Free

Certainty Essay The Purpose of the Certainty of Objects Requirement For a Trust to exist, A must: (i) hold a specific claim-right or power; and (ii) be under a duty to B not to use that claim-right or power for A’s own benefit (unless and to the extent that A is also a beneficiary of the Trust). In other words, for a Trust to exist, A must be under the core Trust duty. The certainty requirements for a Trust simply reflect the fact that A must be under a duty to B in relation to a specific right. The certainty of objects requirement ensures that: (i) A owes a duty to a specific person; and (ii) A’s duty is certain enough to be enforced. The certainty of objects requirement can sometimes be seen as an inconvenient obstacle that can trip up a party (A0) trying to set up a Trust. However, it serves a vital purpose: a court cannot enforce a duty unless that duty is adequately defined. This point is not peculiar to Trusts. For example, an agreement between A and B can only impose a contractual duty on A to B if it is satisfies a certainty test: the nature of A’s duty to B must be adequately defined. In understanding the certainty of objects requirement, it is important to ask what information the court needs in order to enforce A’s supposed duty to B. If that information is lacking, A’s supposed duty cannot be enforced; so A will be under no duty to B; so there can be no Trust. 2. Discretionary Trusts A discretionary Trust is a form of Trust (see p 222-4 of the book): it can exist only if A is under the core Trust duty. Example 1a: A0 transfers ? 100,000 to A subject to a duty: (i) not to use that money for A’s own benefit; and (ii) to invest the money prudently; and (iii) at the end of 21 years, to pay any unspent part of the ? 00,000 and its income to Oxfam. A0 also stipulates that, during that 21 years, A can, if he wishes, pay all or any of the ? 100,000 and its income to all or any of A0’s children or grandchildren. In such a case, there is clearly a Trust: A is under the core Trust duty. And Oxfam is a beneficiary of that Trust: A owes the core Trust duty to Oxfam. A0’s children and grandchildren are not, however, beneficiaries of a Trust: A does not owe them the core Trust duty. Rather, A has a power: A can, if he wishes, give all or any of the money to all or any f A0’s children and grandchildren. 1 See eg G Scammell Nephew Ltd v Ouston [1941] AC 251. 1 A discretionary Trust is a particular form of Trust: it exists where A, in addition to being under the core Trust duty, has a power to choose how to distribute the benefit of the right A holds on Trust. Example 1b: A0 transfers ? 100,000 to A subject to a duty: (i) not to use that money for A’s own benefit; and (ii) to pay the money, in equal shares, to all of A0’s children and grandchildren. In such a case, there is clearly a Trust: A is under the core Trust duty. There is no discretionary Trust: A does not have a power to choose how to distribute the benefit of the ? 100,000. Rather, there is a fixed Trust: A is under a duty to distribute the benefit of the right held on Trust in a specific way. Example 1c: A0 transfers ? 100,000 to A subject to a duty: (i) not to use that money for A’s own benefit; and (ii) to invest the money prudently; and (iii) by the end of 21 years, to have distributed that ? 100,000 and its income, as A sees fit, amongst all or any of A0’s children or grandchildren. In such a case, there is a discretionary Trust. A does owe the core Trust duty to A0’s children and grandchildren; but A has a power to choose how to distribute the benefit of the ? 100,000. 3. Discretionary Trusts Certainty of Objects: The â€Å"Any Given Person† Test Example 2: A0 transfers ? 100,000 to A subject to a duty: (i) not to use that money for A’s own benefit; and (ii) to invest the money prudently; and (iii) by the end of 21 years, to have distributed that ? 100,000 and its income, as A sees fit, amongst all or any of A0’s relatives. In Example 2, there seems to be a problem. A0 has attempted to set up a discretionary Trust. However, such a Trust depends on A being under a duty not to pay any of the money to a person who is not a relative of A0. But can a court enforce that duty? For example, let’s say A chooses to pay out ? 5,000 to X. Is there a meaningful test the court can use to decide if X really is a relative of A0? If not, a key part of A’s intended duty cannot be enforced; in that case, the intended discretionary Trust cannot exist. And, if that occurs, A will hold the ? 100,000 on Resulting Trust for A0 (or, if A0 has died, for A0’s estate). We can sum up this point by saying that, for a discretionary Trust to exist, it must pass the â€Å"any given person† test: a court must be able to tell of any given person (eg X) whether or not that person falls within the class of those to whom A is permitted to distribute the benefit of the right A holds on Trust. 2 That â€Å"any given person† test is often referred to as the â€Å"given postulant† test. In re Baden (No 2),3 the Court of Appeal considered whether a discretionary Trust for A0’s relatives could pass that test. 2 3 See per Lord Wilberforce in McPhail v Doulton [1971] AC 424 at 456. [1973] Ch 9. Stamp LJ held that the discretionary Trust was valid. His Lordship reached that conclusion by taking a very narrow view of relatives as including only A0’s statutory next of kin (ie those close relatives specified by statute as being able to acquire A0’s rights if A0 dies without making a valid will). 4 Sachs and Megaw LJJ took a much broader approach to the term â€Å"relative†, defining it as anyone sharing an ancestor with A0. 5 That definition seems to cause a problem: if X claims that he and A0 had the same great-great-great-great-great grandmother, can the court really test that claim? Sachs and Megaw LJJ both dealt with that point by saying that the onus is on X to prove that claim; until X does so, it must be assumed that X does not share an ancestor with A0. 6 The approach of Sachs and Megaw LJJ (assuming X is out of the permitted class, unless and until X can show otherwise) seems to make the â€Å"any given person† test redundant. For example, if A0 tries to set up a discretionary Trust in which A has a power to distribute the benefit of a right to anyone who is a â€Å"good person†, we might expect A0’s attempt to fail: there is no way for a court to tell if X is or is not a â€Å"good person†. However, on the approach of Sachs and Megaw LJJ, we could instead say that the discretionary Trust is valid – it is just that, if X cannot prove he is a â€Å"good person†, it will be assumed that he is not such a person. It seems that neither Sachs LJ nor Megaw LJ wanted to leave the law in such a way as to permit there to be a discretionary Trust in favour of anyone who is a â€Å"good person†. So each judge added a further certainty requirement. Sachs LJ stated that the class of those to whom A can distribute the benefit of A’s right must be â€Å"conceptually certain†: that is, it must be possible to come up with a definition of the class. Practical, evidential problems as to whether X is or is not within that definition can be dealt with by applying the simple rule that X is out of the class until he proves otherwise. So the â€Å"good person† discretionary Trust will be invalid as there is no clear way of defining that term: it is conceptually uncertain. In contrast, whilst it may be difficult, or even impossible, to tell if X is or is not a relative of A0, that evidential uncertainty will not defeat the discretionary Trust. Megaw LJ added a different requirement, stating that a discretionary Trust can only be valid if there are a â€Å"substantial number† of people who are clearly within the class to whom A can distribute the benefit of A’s right. 8 Again, that requirement can be used to mean that a â€Å"good person† discretionary Trust is invalid, whereas a â€Å"relatives† discretionary Trust is not. The extra requirements imposed by Sachs and Megaw LJJ do not assist in fulfilling the purpose of the â€Å"any given person† test: making sure the court can tell if A distributes the benefit of the right to a person outside the permitted class. It may be that each requirement instead aims to ensure that the discretionary Trust makes some practical 4 5 [1973] Ch 9 at 28-29. Ibid at 21-22 (following the lead of the first instance judge, Brightman J). 6 Here, again, the lead of Brightman J was followed. 7 Ibid at 20. 8 Ibid at 24. 3 sense: for example, if it is not possible to give a conceptually certain definition to the class, it may well be that no-one can show he is within that class. Megaw LJ’s requirement for a â€Å"substantial number† to be within the class is of course quite vague: the point seems to be that, for a iscretionary Trust to make sense, A must have a genuine choice to make as to who will receive the benefit of A’s right. However, that point is not always correct: for example, the discretion in a discretionary Trust could come from A having a power to decide how much of the benefit of A’s right a particular individual should receive. 4. 4. 1 Discretionary Trusts Certainty of Objects: Further Tests The â€Å"full list† test? At one point, it was suggested that a discretionary trust could be valid only if the court could draw up a full list of the people to whom A is permitted to distribute the benefit of a right. On that view, in Example 2, a discretionary trust would arise only if it is possible to draw up a full list of A0’s relatives. However, in McPhail v Doulton, the House of Lords rejected that view. 9 It was based on the idea that, if A failed in his duty to distribute the benefit of the right, a court would have to step in and decide how to distribute. And, to avoid favouring any one person, the court would have to order equal division of the benefit of the right amongst all members of the class. On that view, a discretionary trust would become, in effect, like the fixed Trust in Example 1b: so a full list would be necessary. In McPhail v Doulton, Lord Wilberforce pointed out that, if A fails in his duty to distribute the benefit of a right, a court does not have to order equal division. 10 After all, such equal division could be one of the worst ways of distributing the benefit of a right: for example, splitting up a fund of ? 100,000 equally among 1,000 people would mean that no one person gains a substantial benefit from the discretionary trust. So, given the other means by which the court can step in to execute a discretionary trust, there is no need to apply the â€Å"full list† test. 4. 2 The â€Å"administrative workability† test The fact that a court may need to step in and execute a discretionary trust does not mean that a discretionary trust must pass the â€Å"full list† test. Nonetheless, it may have some impact. For example, if the terms of the attempted discretionary trust mean that there is no sensible plan a court could adopt to execute that supposed trust, then A0’s attempt to set up a discretionary trust must fail. This point may explain the (rarely relevant) â€Å"administrative workability† test. 11 9 [1971] AC 424. Ibid at 456-7. 11 That test is referred to by Lord Wilberforce in McPhail v Doulton: [1971] 1 AC 424 at 457. 10 4 For example, in one case,12 A0 (a council shortly to disappear as part of a reorganisation) attempted to set up a discretionary trust (of a large sum of money) for the benefit of all the former residents of the area covered by that council. The class of people to whom A could distribute the benefit of its right would thus include over 2 million people. It was found that the council’s attempt to set up a discretionary Trust failed: the planned Trust was â€Å"administratively unworkable†. The problem here may be that, if A fails to perform his duty to distribute, the court will have to step in. And is there any sensible way order a court could make to distribute the benefit of A’s right? We have to bear in mind the need for a court to avoid making the type of contentious political decision which it is ill-suited to make and which may cause resentment. 3 Of course, in most cases, no such problems arise: the â€Å"administrative workability† test rarely prevents an intended discretionary trust from arising. This explanation of the â€Å"administrative workability† test explains why it applies to discretionary trusts but not to attempts to give A a power (as in Example 1a). If A chooses not to exercise a power to distribute the benefit of a right then, as A is under no duty to do so, a court does not need to step in and order some form of distribution. There is thus no risk of a court facing the dilemma that would arise if an administratively unworkable discretionary trust were allowed to be valid. 4. 3 The â€Å"non-capricious† test Although the â€Å"administrative workability† test does not apply to powers, that does not mean that powers are free from certainty tests. For example if A has a power to distribute the benefit of a right to all or any of a certain class of people then, as is the case with a discretionary trust, A is under a duty not to distribute outside that class. So, with a power as with a iscretionary trust, the â€Å"any given person† test applies:14 the power is only valid if a court can tell, should A exercise the power in favour of X, whether or not X is in the permitted class. Sometimes, when accepting a power, A also comes under a duty to act loyally and responsibly when considering whether to exercise that power. In such a case, for example, A (as is the case if A holds a right on a discretionary trust) cannot simply ignore the power: he is under a duty to members of the class of potential recipients to consider periodically whether or not to exercise the power. 5 In these cases, A can be said to have a â€Å"fiduciary power†: A is not just under the negative duty not to distribute outside the permitted class; he also has some positive duties in relation to the power. It has been held that A0’s attempt to set up such a power will fail if the intended power is â€Å"capricious†: if there are no sensible criteria A can apply in considering whether and how 12 13 R v District Auditor, ex p West Yorkshire MCC [1986] RVR 24 (noted by Harpum [1986] CLJ 391). For example, would the money be better spent on paying for a new school, or a new hospital, or new sports facilities? 4 See eg re Gulbenkian [1970] AC 508. 15 For a discussion of A’s duties in such a case see eg per Megarry V-C in re Hay [1982] 1 WLR 202, esp at 210. 5 to exercise his power. 16 This does not mean that, when giving A the intended fiduciary power, A0 needs to spell out what factors A should take into account. However, it does mean that if the supposed power is â€Å"capricious† (ie there is no sensible scheme A can come up with) then A0’s attempt to give A the power must fail. Two points are worth noting about this â€Å"non-capricious† test. First, if it is linked to A0’s attempt to impose a duty on A to act loyally and responsibly when considering whether to exercise a power, it must apply to an attempt to set up a discretionary trust: such a duty is a key part of a discretionary trust. Second, in practice, it is very unlikely that this test will present a problem: people rarely go round setting up bizarre powers that cannot be considered in a sensible way. 4. 4 The â€Å"one person† test Example 3: A0, an owner of a large number of paintings, dies. In his will, he instructs A (his executor) to allow â€Å"each of my friends† to purchase one of those paintings each, at half its market value. In such a case, A0 does not attempt to set up a discretionary Trust: A has no power to choose how to distribute his rights. Rather, each friend of A has a fixed entitlement. A0 is attempting to make a conditional gift: if X satisfies a particular condition (if he is a friend of A0) he has a specific right. Nonetheless, it may seem that there is still a certainty problem: how can A (or the court) tell if X is or is not a friend of A0? However, in re Barlow, the essential facts of which were identical to Example 3,17 Browne-Wilkinson J held that the conditional gift was valid. His Lordship noted that an attempt to set up a discretionary Trust for â€Å"friends of A0† would fail: applying Sachs LJ’s test in re Baden (No 2), the term â€Å"friends of A0† is conceptually uncertain. However, a conditional gift should be treated differently: if there was just one person who could clearly show he was, on any reasonable test, a friend of A0, that person is entitled to acquire one of the paintings. 8 The test applied in re Barlow has been criticised. However, it can be defended. If an attempted discretionary Trust (eg in favour of â€Å"friends of A0†) fails a certainty test, then someone who could have benefitted from A’s power (eg a clear friend of A0) will miss out. But, in any case, that person only had a chance of receiving a benefit; he had no legal guarantee. In contrast, if a conditional gift is found to be invalid when there is a person who definitely stands to benefit from it, that person is deprived of a definite entitlement: a right given to him by A0.

Research Methodology Chapter: Communication Research

Research Methodology Chapter: Communication Research One communication-related aspect of the engagement debate concerns the fundamental nature of engagement and whether it can be considered an attitude, a psychological or motivational state, or a personality trait. The nature of engagement is a significant issue for corporate communicators since they are well-placed to influence workplace attitudes and stimulate employee motivation. Kahn (1990) presents engagement as a three-component construct influenced by three psychological states. Robinson et al. (2004) define the concept as a positive attitude. Conversely, Saks (2006) argues that engagement is not an attitude but a psychological state, while others (Sparrow and Balain, 2010) believe that engagement is an attitude. Macey and Schneider (2008a) regard engagement as a complex network encompassing trait, state, and behavioural constructs. Kahn (2010) contrasts his conception of dynamic engagement with steady-state (trait) views of motivation. Kahn describes engagement as both delicate and fragile, and quite resilient. So, Kahns view of engagement exhibits a mixture of attitudinal-type states together with more fixed steady-state predisposition traits. This complex state and trait view of engagement is useful for communicators since it highlights a need for employee communication to understand and serve internal stakeholders core (trait) communication needs, as well as surface (state and attitude) communication needs. Moreover, internal communication represents one of the organisational conditions that facilitate engagement. Pugh and Dietz (2008) consider leadership as a precursor of organisation engagement and organisational effectiveness as a consequence. The communication abilities of leadership teams are recognised as important in driving engagement (Wiley et al., 2010). Communication has been identified also as an underlying factor associated with employee engagement (Kahn, 1992). Likewise, MacLeod and Clarke (2009) highlight communication as a critical factor for enhancing performance through employee engagement. They argue that good quality internal communication enhances engagement as they emphasise that employees need clear communication from senior management to understand how their own roles fit with the organisation vision. Unsurprisingly, they cite poor communication as a barrier to engagement and a cause of disengagement. However, contributions from the professionals on communication disciplines are surprisingly meager given that internal communication is an organisational level interventio n which can positively impact employee engagement. Internal communication in any organisation has been stated to have a correlation with employee feeling of self-satisfaction and their productivity (Clampitt and Downs, 1992). High communication effectiveness is linked to better financial performance and organizational stability (Internal communication effectiveness enhances bottom-line results, journal of organizational excellence, Summer 2006, pp 71-71) Van Riel (1998, pp. 8-27) gives an overview of the elements of corporate communication as all the communication within an organisation, such as managerial communication, organisational communication, and marketing communication. This informs the employees willingness to meet the strategic mission, vision, and objectives of the organisation which creates a competitive advantage of the organisation. Research Design This section will discuss the research framework proposed for use in this study. This methodological framework is influenced by the research onion model develop by Saunders (2012) pp 128 which include general information regarding the research design and strategy, method of data collection, measurement of variable and data analysis as well as evaluate the credibility and validity of the study. There would be an examination of merits and demerits of the chosen methods use in this study, a consideration of ethical issues, as a result, the limitations. Research Design Available literature considers basically five different approaches ranging from experimental, case study, longitudinal, cross-sectional to comparative design (Bryman and Bell, 2011; Saunders et al, 2009). In view of the aim of this research, there will be a combination of approaches also known as a mixed method in the investigation of the research theme (Saunders et al, 2009). Also, a set of quantifiable data will be collected to help establish the relationship between two or more variables (Bryman and Bell, 2011). Research Strategy The strategy to be adopted for this research will be quantitative in nature, this is because will be formulation and testing of hypotheses which are tentative suppositions or proposed explanations made based on limited evidence as a starting point for further investigation which on the face of empirical evidence could hold true or false and as such be graduated to be theory or otherwise. According to Saunders et al, (2009) quantitative research is a strategy that lay emphasis on quantification in data collection and analysis that provides solid scientific fact of knowledge on the basis of positivism. Furthermore, Bryman and Bell, (2011) suggested that the application of a quantitative research strategy has the latent for statistical generalization as against qualitative research employed in many social and natural sciences academic disciplines which are more descriptive. This method of approach, therefore, is more useful to achieve the set aims and objectives of this research stated herein. Data Collection There will be the use of both primary and secondary data collection sources to collect appropriate and relevant data that will enable credible, complete and valid conclusions in accordance with the aims and objectives of the research. Primary data will include the conduct of interview of some members of the management team of the case study organisation and a questionnaire of other concerned employees. The use of these two methods is hoped to balance some of the limitations inherent in each. In addition, this research will use the content analysis approach which is a strategy for the review and analysis of relevant secondary documents from Abellio. Data Analysis All data collected for the purpose of this research will be careful analysis and tested against the theories with the aid of IBM SPSS statistical program. IBM SPSS Statistics is an integrated software product that addresses the entire analytical process, from planning to data collection to analysis, reporting, and deployment (Gaskin, J, 2012). It provides a range of statistical procedures suitable for many problems, including crosstabs, linear regression, Monte Carlo simulation, geospatial analytics, and the ability to extend built-in capabilities with Python, R, or Java code (IBM.com). I have opted for IBM SPSS statistical program for its effectiveness in data analysis and presentation quality of custom tables to help users and analysts to interpret data which could then be tested against the theoretical statements that could, in turn, lead to further generalisation statements (Bryman and Bell, 2011). Limitations of Study The following limitations are anticipated: 1. Data collected is based on interviews and questionnaires administered and as such respondents may not give the actual situation for fear that management of reprisal action against them 2. The data collected by the observation technique may be very limited. 3. The case study organisation has a large number of employees consequently, only one hundred of the affected will be sampled through the rank and file. 4. Equally important is the problem of time as the research will only be conducted within given three-month period. Frankenstein | Analysis Frankenstein | Analysis Frankenstein was a man whose ambition led to a disaster; and his actions led to evil. These are outcomes for which he is solely responsible. Is Frankenstein an innocent? In my opinion, he was not an innocent. The meaning of innocent is to free from evil or guilt. The word Frankenstein is defined in the Encarta dictionary as a creator of something that causes ruin or dest ruction, or brings about a personal downfall, this shows that his name was quite well suited. A common quotation is that One is innocent until proved guilty, If this quotation is applied to Victor Frankenstein, he would be innocent, however my argument is that he was not innocent, it was his fault his family suffered, he brought on his own destruction and was responsible for creating a human, which was morally and contextually incorrect; He would be innocent for allowing the murders of William, Justine, Elizabeth and Clerval to take place. It may be true that Frankenstein did not physically murder, however, he is the main cause, and the reason they died. Frankenstein never admitted to his families what he had done; he never took responsibility for his actions. The so called monster murdered for companionship, not to seek revenge from his victims, but to seek revenge from Frankenstein. The circumstances forced Frankensteins monster to do so, Victor was the instigator of these circumstances. My first thought was to discover what I knew of the murderer and cause instant pursuit to be made. But I paused when I reflected on the story I had to tell, this shows that Victor had the knowledge that he was the reason William was dead. He said my first thought, showing the clearness of his knowledge and that this thought had been lingering in his mind, he knew what he was doing. Frankenstein didnt need to know about the murderer, because he indirectly was the murderer, through the circumstances he created for the monster, as I mentioned briefly before. Which is why he paused half way through his thought and realised he was exactly who the murderer was, even though he blamed the creature. Frankensteins reason for creating the creature was his interest in his studies, which led him to the idea of bettering mankind. Victor thought he was doing a service to humanity by creating a new human. A new species would bless me as its creator and source; many happy and excellent natures would owe their being to me. I might in process of time (although I now found it impossible) renew life where death had apparently devoted the body to corruption. This quote shows his ego behind these plans. He wanted to conquer death, something the average human could not do. He wanted this creature to revere him highly by as he was supposedly beautiful and perfect creature. According to him, it may have been acceptable to play the role of god; maybe his being a scientist is why he didnt think of what was morally correct, and he didnt think of how the society would react to his actions. However, having said that, he didnt admit his doings to his family, perhaps he knew they wouldnt accept it, or the deaths in the family could have a higher weightage in terms of being more important than letting his parents know the truth. If they did know the truth, they wouldnt be happy with him creating the creature. The quote does show that right from the start, Victor had an idea of how he would somewhat be stepping into the shoes of a godlike figure, he outlines the fact that he would be superior, and he would have the power to renew the dead. This proves that he had no innocence, or naivety in terms of knowing precisely what he was doing and what it would lead to. I, the miserable and the abandoned, am an abortion, to be spurned at, and kicked, and trampled on. Is what the creature says after being shunned, on the basis of aesthetics. This shows his faults, and how he was wrong to shun the creature. He may have shunned it because he already conquered death, so in his view, he may have already obtained the status of god, or a superior power, something no one had achieved. He didnt think about anything past the ugliness of the creature, or his personal benefits. His selfishness is what ultimately destroyed him and others as well. The creature he created is more like a project to Frankenstein, his aim is to conquer death, and once he has done so, the project is over. Not once does he consider the fact that he has simply given birth to a new human being, with feelings and emotion, a live creature who has to be taught the ways of life as if it is a baby. Frankensteins abandonment of the creature is another factor that proves him guilty, and not an innocent, as shown in the quote I previously mentioned, with the creatures emotions towards being shunned. Its his own fault that the creature comes back saying I may die; but first you, my tyrant and tormentor, shall curse the sun that gazes on your misery. Beware; for I am fearless, and therefore powerful. The creature was deprived of the companionship, which he could only get from his creator. The creature figures that the only way he can get some attention, is by threatening his creator. This could be compared to a situation with a child and a parent. Frankenstein is somewhat the parent of his creature. His job is to nurture him, but because of his own ego, he runs away. If it were a parent and a child, the child would be defenceless because it hasnt even developed physically, however the creature is an example where he is an uneducated child, with a higher physical strength. Frankensteins creature thinks through intuition, as any child who hasnt learnt anything would do. He doesnt know whats right and wrong, so he doesnt know its wrong to threaten; he doesnt know its wrong to kill. Blaming him is like blaming a child for breaking a valuable, such as a vase. You cant blame the child because their knowledge hasnt developed, they havent yet learnt. However in the childs case, after making such a mistake, the child would be taught not to do so again, creating a basis of how it is wrong, this does not take place for the creature. It could be argued that the creature shou ld know through Victors fear, but does a child learn anything when it senses fear? No, it anything, it will only learn to keep intimidating. Frankensteins faults of his creation, or you could say his faults in parenting, were completely his responsibility. Frankensteins creature is described as having dark black hair, yellow skin, black lips and eyes sunk into his sockets (Shelly 56). Its quite ironic that Frankenstein feared his own creation, he is the one who hand-picked the features his so called perfect man would have. For him to say breathless horror and disgust filled my heart(56), towards a creation of his own, just shows his tendency towards aesthetics, and how backward he is in terms of being accepting, yet how forward he is in terms of doing something new. He is responsible for the way the creature turned out. This once more, proves his irresponsibility, and his view to the creation as a project. His attitude towards the creature is why he was incapable of acting the right way. He wasnt serious enough, or perhaps he wasnt ready to face negative consequences, seeing as he was a perfectionist. The background Frankenstein created in terms of nurture is what caused his creature to murder. Victor admitted to creating the monster, but he denied that he drove the monster to commit murder. He wouldnt admit to anyone; not himself, not his family, that he was the one who allowed the murders to take place. He allowed Clerval, his wife Elizabeth, his brother William and Justines death to take place because he didnt take the blame for his actions. If he had admitted to his actions earlier, less deaths would have been caused, if he had been responsible, and given the creature what it needed, he would not be guilty of four murders. In the end, Frankenstein was at loss of everything close to him, he blamed the monster, but it was his fault. He had a faint idea that it was his fault, although no one could possibly be able to admit to murdering the people close to them. The only way he could be innocent, is for not literally taking a knife and stabbing his relatives. However the pain he got from his creature was his own fault. Innocence lies in having no sense of guilt for any action of yours, this, Victor did clearly not have. The creature couldnt stop himself from destroying Victor, because Victor couldnt stop himself from creating the creature. The creature was an innocent; it only reacted to the actions of society. Victor was guilty in every way. Arrhythmogenic Right Venticular Dysplasia | Case Report Arrhythmogenic Right Venticular Dysplasia | Case Report Arrhythmogenic Right Venticular Dysplasia – A Rare case report from tribal zone of Central India Dr. Prakash Khunte, Dr. P. Beck, Dr. K. Yadav ABSTRACT Arrhythmogenic right ventricular dysplasia (ARVD) is under diagnosed cardiomyopathy which commonly presents in young adults with ventricular tachycardia or sudden death. It is characterized pathologically by progressive fibrofatty replacement of the myocardium, primarily of the right ventricular free wall. Clinically, it presents with life-threatening malignant ventricular arrhythmias which may lead to sudden death, most often in young people and athletes. ARVD/C is difficult to diagnose, although standardized diagnostic criteria have been proposed, based on the presence of major and minor criteria encompassing electrocardiographic, arrhythmic, morphofunctional, histopathologic, and genetic factors. Case report A 30 year male patient named Heeralal Diwakar R/o Baloda Bazar (C.G.) was admitted in department of Medicine, Intensive cardiac Coronary Unit at Pt. J. N. M. Medical College Dr .B.R.A.M. Hospital Raipur with the complain of palpitation ,dizziness, dyspnoea on exertion and left sided chest pain, cough with expectorant distension of abdomen since 8 days.patient having severe palpitation and dizziness in recent hours. Patients having similar complain and admitted two time in hospital in last two year and patient had episode of PSVT and had given DC shock and patient on aspirin,amidaron,metoprolol. There is no family history of sudden cardiac death and any heart disease. Patient was former by occupation and having addiction to tobacco and occasionally alcoholic. On admission patient on general examination pulse -100/min regular.blood pressure was 100/70 mmhg, height -161 cm,weight 58 kg,BMI- 22.39,Iteric ,no cyanosis, oedema were present .on systemic examination bilateral crepitatition present in infrascapular area ,apex beat present on 5 th intercosta space on midclavicular lines,s1 soft.s2 present,s3,s4 absent .No thrill ,murmur,parasternal heave were present. On investigation E.C.G. ST segment elevation seen in lead II,III,aVf, ST segment depression in lead I,Avl,Twave inversion in v1-v6, epsilon wave in V1-v3. Troponin card test was positive and patient diagnosed as acute inferior wall Myocardial Infraction with congestive cardiac failure. Other investigation were random blood sugar was 120 mg/dl, urea 90 mg/dl, creatinine 2 mg/dl,s.billirubin 3.7 mg/dl , direct billirubin 2.3 mg/dl,S.G.O.T S.G.P.T were high,alkaline phosphatase 12877 mg/dl ,sodium 130 mg/dl, potassium 4.9 mg/dl.s. protein 7 g/dl,serum albumin 4 gm/dl,s. cholesterol 114 mg/dl, triglyceride 64 mg/dl,LDL 84 MG/DL,VLDL 13 mg/dl,HDL-17 mg/dl. TLC count were 34000/cumm,Hb 14.5 gm/dl, platelet 222000 /cumm X ray chest cardiomegaly was present. On echocardiography Right ventricle dilated ,RV wall thickness 4 mm. Right Atrium dilated, severe non hypertensive TR , Right ventricle thinned out ,normal LV systolic function suggestive of Arrhythmogenic right ventricular dysplasia. Patient was advised to continue amiodarone ,aspirin ramipril and has been asymptomatic ever since. DISCUSSION The name arrhythmogenic right ventricular dysplasia(ARVD) was coined for the first time in 1978 by Frankand Fontaine. Arrythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a cardiomyopathy characterized pathologically by fibrofatty replacement primarily of the RV and clinically by life-threatening ventricular arrhythmias in apparently healthy young people. The prevalence of the disease has been estimated at 1 in 5,000 individuals, although this estimate will likely increase as awareness of the condition increases among physicians. Arrythmogenic RV cardiomyopathy is recognized as a cause of sudden death during athletic activity because of its association with ventricular arrhythmias that are provoked by exercise-induced catecholamine discharge. Diagnosis may be difficult because many of the electrocardiographic abnormalities mimic patterns seen in normal children, and the disease often involves only patchy areas of the RV. he prevalence of ARVC in the general population is approximately 1 in 5,000 , but the disease is not widely recognized because of the difficulty in making the diagnosis . A familial predilection of the disease has been recognized since 1982 when Marcus et al. described 24 cases of ARVC, two in the same family. Subsequently, several groups have reported familial ARVC, and families with two or more affected individuals have been recognized in Asian, Japanese, Northern European, African and North American populations . Genectics The disease is typically inherited as an autosomal dominant trait with variable penetrance and incomplete expression. The genes responsible for ARVC have not been identified, but seven loci have been mapped to chromosomes 14 (14q23 to q24 and 14q12 to q22), 1 (1q42 to q43), 2 (2q32.1 to q32.2), 3 (3p23) and 10 (10p12 to p14) . The genetic products of these sites have not been easily identified because of incomplete penetrance and expression, age-related expression and difficulties with accurate diagnosis of the disease. Recently, plakoglobin has been identified as the first gene responsible for autosomal recessive ARVC . The gene was identified in Naxos disease where greater than 90% cosegregation of ARVC with cutaneous manifestations, woolly hair and keratodermia, facilitated case identification. Plakoglobin participates in forming cell-to-cell junctions. It is postulated that inadequate cell adherence damages the cardiac cell membranes leading to cell death and fibrofatty replaceme nt. The cardiac ryanodine receptor gene (RyR2) has also recently been implicated in ARVC and offers potential insight into the association of adrenergically mediated ventricular arrhythmias with this disease. The ryanodine receptor induces calcium release from the sarcoplasmic reticulum into the cytosol . The cardiac ryanodine receptor has also been identified as being responsible for catecholamine-induced ventricular tachycardia . Its skeletal muscle counterpart has been implicated in malignant hyperthermia and central core disease , a congenital myopathy, but the mechanisms by which mutations in the cardiac ryanodine receptor might mediate fibrofatty myocardial changes are not clear and will likely be the focus of future studies. Despite these advances, genetic analysis for ARVD is not clinically available and is restricted to research laboratories. Histopathology Characteristically, the RV in ARVC is replaced with a fibrofatty tissue. Morphologic alterations of ARVC usually begin in the subepicardium or mediomural layers of the RV and progress to the endocardium with fibrofatty replacement of myocytes and thinning of the wall. The regions of RV most frequently involved are the RV inflow area, the apex and the infundibulum. These three areas form â€Å"the triangle of dysplasia† . However, small amounts of fat are present in the epicardial layer and within the RV myocardium in normal subjects. Etiology In addition to a genetic cause of ARVC, disontogenetic, degenerative, infectious or inflammatory ( apoptotic and myocyte transdifferentiation theories have been proposed either as the cause of or as environmental factors facilitating gene expression. The disontogenetic theory is largely historical but suggests that ARVC is a milder form of â€Å"parchment RV† or Uhl’s anomaly a congenital hypoplasia of the RV myocardium, which presents in infancy as congestive heart failure (CHF) . The degenerative theory suggests that ARVC is a consequence of myocyte death due to an inherited metabolic or ultrastructural defect. A possible defect has been mapped to chromosome l4q23 to q24 . This area encodes for the alpha actinin gene, which shares structural homology with the amino terminal domain of dystrophin. This finding supports the concept of a genetically determined atrophy similar to that in patients with Duchenne’s or Becker’s muscular dystrophy. Some have suggested that ARVC should be considered as a â€Å"myocardial dystrophy† Furthermore, skeletal muscle involvement has been reported in a Swedish family with ARVC, and the defect has been tentatively localized to chromosome 10q22.3 The infectious or inflammatory theory maintains that the disease results from previous myocarditis. Inflammatory infiltrates are common in histologic specimens from patients with ARVC ECG The ECG in patients with ARVD/C usuallyshows sinus rhythm, QRS duration 110 ms in lead V1, a terminal deà ¯Ã‚ ¬Ã¢â‚¬Å¡ection within or at the end of the QRS complex (called epsilon wave) in leads V1–V3 (30% of patients), and inversion of T waves in the right precordial leads (50%–70% of patients). Complete right bundle branch block is found in approximately 15% of patients and incomplete right bundle branch block in 18% of patients with ARVD/C. In the presence of right bundle branch block pattern, selective prolongation of the QRS duration in leads V1–V3 compared with lead V6 (25 ms, parietal block) is an important hallmark of ARVD/C. . Additional ECG markers have been reported, such as the ratio of QRS duration in leads V1V2V3 vs V4V5V6 >1.2 and a prolonged S wave upstroke in V1–V3 >55 ms in the absence of right bundle branch block. Arrhythmia Left bundle branch block type VT on ECG, Holter monitoring, or during exercise testing Extrasystoles of more than 200 over a 24-h period. Echocardiography mild to Severe dilatation and reduction of right ventricular ejection fraction with no (or only mild) left ventricular impairment Localised right ventricular aneurysms (akinetic or dyskinetic areas with diastolic bulging) Severe segmental dilatation of the right ventricle. Radioisotope techniques Radionuclide angiography, by showing abnormal right ventricular function with left ventricular involvement, is usefulfor predicting subsequent cardiac death in ARVD/C.Myocardial perfusion scintigraphy allows noninvasive assessment of right ventricular damage in patients with arrhythmias due to ARVD/C This technique may distinguish patients with ARVD/C from those with idiopathic right ventricular outà ¯Ã‚ ¬Ã¢â‚¬Å¡ow tract tachycardias Cardiovascular magnetic resonance imaging This modality allows visualization of the right ventricle, not only anatomically and morphologically but also in functional and à ¯Ã‚ ¬Ã¢â‚¬Å¡ow dynamic terms. Functional ab normalities consist of right ventricular aneurysms, regional thinning, right ventricular dilation, failure of systolic thickening, and impaired global and diastolic right ventricularfunction. Clinical presentation The clinical presentation varies widely because ARVD/C includes a spectrum of different conditions rather than a single identity. Different pathologic processes may manifest a diversity of symptoms, such as fatigue, atypical chest pain, syncope, or acute coronary syndrome .ARVD/C is a disease that may have a temporal progression, and the disease may present differently according to the time of presentation There may be (1) a symptomatic form with transient or sustained ventricular tachycardia of left bundle branch block configuration, although right bundle branch block configuration also can be observed; (2) an asymptomatic form consisting of ventricular ectopic beats (1,000/24 hours); (3) right ventricular failure with or without arrhyth mias; and (4) a masked form in which sudden death, usuallyduring exercise, is the first clinical presentation. Overall, judging the accurate position of the patient on the time scale of the spectrum is difficult, and some patients may remain stable for several decades. Diagnosis A definite diagnosis of ARVD/C is based on histologic demonstration of transmural fibrofatty replacement of right ventricular myocardium at either autopsy or surgery. In 1994, McKenna et al established the criteria for diagnosing ARVD/C in a Task Force report on ARVD/C Criteria for Diagnosis of ARVD/C 1. Family history Major Familial disease confirmed at necropsy or surgery. Minor Family history of premature sudden death (,35 years of age) due to  suspected ARVD/C. Family history (clinical diagnosis based on present criteria). 2. ECG depolarization/conduction abnormalities Major Epsilon waves or localized prolongation (.110 ms) of QRS complex in  right precordial leads (V1–V3). Minor Late potentials on signal-averaged ECG. 3. ECG repolarization abnormalities Minor Inverted T waves in right precordial leads (V2 and V3) in people. 12  years of age and in absence of right bundle branch block. 4. Arrhythmias Minor Sustained or nonsustained left bundle branch block–type ventricular  tachycardia documented on ECG or Holter monitoring or during  exercise testing. Frequent ventricular extrasystoles (.1000/24 h on Holter monitoring). 5. Global or regional dysfunction and structural alterations* Major Severe dilatation and reduction of RV ejection fraction with no or mild  LV involvement. Localized RV aneurysms (akinetic or dyskinetic areas with diastolic  bulgings). Severe segmental dilatation of RV.   Minor Mild global RV dilatation or ejection fraction reduction with normal LV. Mild segmental dilatation of RV. Regional RV hypokinesia. 6. Tissue characteristics of walls Major Fibrofatty replacement of myocardium on endomyocardial biopsy. *Detected by echocardiography, angiography, magnetic resonance imaging,  or radionuclide scintigraphy. Modified from McKenna et al. Therapy Because clinical findings that predict long-term outcomeof patients with ARVD/C are incompletely known, no precise guidelines exist to select patients who should be treated with b-blockers, antiarrhythmic drugs, or a Implantable cardioverter-defibrillator. r. Management of patients with ARVD/C is individualized, and strategies are based on local experience of the different centers. References Siddiq I. Khalil), Amjad Kamal, Shakeel Ahmad Department of Medicine and Cardiology, Almana General Hospital, PO Box 10366,Jubail 31961, Saudi Arabia. Eur J Echocardiography (2004) 5, 394e398. Carol Gemayel, MD*; Antonio Pelliccia, MD† ; Paul D Thompson, MD J Am Coll Cardiol. 2001;38(7):1773-1781.doi:10.1016/S0735-1097(01)01654-0. Cristina Basso, Domenico Corrado, Frank I Marcus, Andrea Nava, Gaetano Thiene Lancet 2009; 373: 1289–1300 University of Padua Medical School, Padua, Italy. Philippine Kià ¨s, MD, Marianne Bootsma, MD, PhD, Jeroen Bax, MD, PhD,  Martin J. Schalij, MD, PhD, Ernst E. van der Wall, MD, PhD Heart Rhythm, Vol 3, No 2, February 2006,Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands. Domenico Corrado, Guy Fontaine, Frank I. Marcus, William J. McKenna, Andrea Nava, Gaetano Thiene and Thomas Wichter, Circulation. 2000;101:e101-e106, doi: 10.1161/01.CIR.101.11.e101 Frank R, Fontaine G. Electrocardiologie de quatre cas de dysplasia ventriculaire droite arythmogene. Arch Mal Coeur Vaiss 1978;71:963–972. Rampazzo A, Nova A, Malacrida S, Beffagua G, Bauce B, Rossi V, et al. Mutation in human desmoplakin domain binding to plakoglobin causes a dominant form of arrhythmogenic right ventricular dysplasia. Am J Hum Genet 2002;71(5):1200e6 Bauce B, Rampazzo A, Basso C, Bagattin A, Daliento L, Tiso N, et al. Screening of ryanodine receptor type 2 mutations in families with effort induced polymorphic ventricular rhythmias and sudden death: early diagnosis of asymptomatic carrier. JACC 2002;40(2):341e9.