Tuesday, August 25, 2020
Evaluating Finances of A Non Profit Essay Example | Topics and Well Written Essays - 750 words
Assessing Finances of A Non Profit - Essay Example Casey Foundation). Headquartered in Baltimore, Maryland, the Annie E. Casey Foundation has been attempting to advance the prosperity of our nation’s most powerless youngsters for a long time. Set up in 1948 by UPS fellow benefactor Jim Casey and his kin out of appreciation for their mom, the Foundation’s first awards upheld a camp for hindered kids close to the Casey family home in Seattle (The Annie E. Casey Foundation). The Company’s subsidizing occurs through specific projects like Casey Family Programs, a free working establishment headquartered in Seattle, which gives long haul child care and other kid and family serving projects and Juvenile Detention Alternative Initiatives and so on. The Annie E. Casey Foundation makes allows that help states, urban communities, and neighborhoods make increasingly imaginative, practical reactions to these requirements. Award making is constrained to activities in the United States that can possibly exhibit imaginative arrangement, administration conveyance, and network supportsâ€especially ventures that empower long haul techniques and organizations to reinforce families and networks. As of December 31, 2006, the Foundation has endorsed award assets for installments to different associations and tasks of up to roughly $173 million, dependent upon the associations execution of commitments determined in the award understandings. The Casey Foundation’s way to deal with award making centers around making multiyear, multi-site duties that empowers them to put resources into long haul methodologies and associations that fortify families and networks. The association utilizes its assets to cooperate with and manufacture coordinated efforts among foundations, offices, chiefs, and network pioneers so they can cooperate to change intense spots to raise families.â The association likewise reserves look into, specialized help, and multi-site showings that help administration and backing
Saturday, August 22, 2020
Introduction for Currys Essay Example for Free
Presentation for Currys Essay For this task I am examining Currys and I will get data about my examination from the client support of Currys, however to do this I should realize additionally a tad about the clients profiles and what the clients consider Currys items and administrations that they give. Foundation: Currys is the main decision for families purchasing electrical gadgets for the home and different organizations. Currys likewise conveys their merchandise to their clients seven days per week to families and organizations all through the UK. While conveying new items the Group gathers 750,000 parts of the bargains products apparatuses, refrigerators, coolers, cookers, PCs, printers, radios, TVs, telephones and clothes washers, from clients homes every year, of which, until November, roughly 300,000 were ice chests. Until November 2001 these were reused or restored by a system of contractual workers, calming Local Authorities, who might somehow or another be obliged to gather or get these items, of a critical weight. Numerous units were revamped and exchanged requiring little to no effort, giving modest items to families on low pay (counting through make, a Dixons bolstered undertaking to re-train long haul jobless individuals as specialists). Others were sent out for additional utilization and the rest of and discarded following CFC gas extraction fulfilling ecological guidelines. In actuality Dixons Group gave a without cost channel to the removal of this residential waste and one which limited the age of additional excursions by householders or neighborhood authority gatherers and is in this way more earth satisfactory. This shows the amount Dixons bunch has been acting morally. Administrations that Currys gives and serious foundation: For my task, it is imperative to comprehend why retailers offer such administrations. Electrical retailing is profoundly serious, as: Currys, Comet, John Lewis, Debenhams, House of Fraser, Argos, Powerhouse, Dixons and a huge number of little autonomous retailers all go after exchange what numerous clients see as an item advertise. Low edges show the offer and that is the serious idea of the business. Since this is a serious market, value pressure is extreme and retailers will ordinarily attempt to offer the most reduced cost in the market. So the client becomes accustomed to the possibility that costs will be comparable in many outlets. Hence there is a severe strain to make distinctive either by offering restrictive items or by exceeding expectations on administration. That is the reason all retailers will offer serious assistance offers including appropriate conveyance and after deals. No retailer will need to hazard for a really long time a contender having the option to offer another help perceived. Up 'til now the leaving of reclaim has had fragmented things on deals; anyway one of the two principle tops for deals, the blistering summer months and this is the time of deals and a period that organizations hope to boost their deals. Clients profile: Most of clients of Currys are from a blended gathering old enough, sex and races. The majority of clients that I for one observe going to the store of Currys in Chadwel heath are guardians or just grown-ups who can buy items by charge cards or some other methods of installments. There are additionally different clients of Currys who are of a normal age like youngsters who can pay melodic things or games. Currys doesn't have any land clients on the grounds that their clients are more often than not locally. A few clients have their data put away into Currys framework because of their clients unwaveringness and due to Currys showcase investigates. Currys provides for its clients an assurance of buying things from their stores in the event that that the client isn't happy with the items or administrations that Currys gives to them, at that point the client can take the items back and get a substitution or if conceivable get the client can recover his/her cash back however this depends with the case. A few times if Currys can't sift through the issue that the client has with the items, they normally provide for the client the telephone number of the organization or the maker of that specific item for additional data or guidelines about the utilization of the item.
Monday, July 27, 2020
My Awesome Biology UROP florescent plants, genomes, metabolomes, big data, puzzles + more!
My Awesome Biology UROP florescent plants, genomes, metabolomes, big data, puzzles + more! When I tell people that Im majoring in Biology, they typically assume that I am pre-med, or else shudder at high school memories of endless memorization and quickly change the topic. But to me, Biology isnt either of those things. Biology is an incredibly challenging, multi-dimensional puzzle; and in our post-genomic age, it has become an INFORMATION SCIENCE. So Biology is not just anatomy and physiology, but also: biochemistry, bioengineering, bioinformatics, biomechanics, pharmacology, biophysics, biotechnology/synthetic biology, cognitive biology, developmental biology, ecology, evolutionary biology, genetics/epigenetics, molecular biology, neurobiology, population biology, structural biology, and much more! My branch is Computational Systems Biology, which can be explored at MIT from three different majors: 6-7, 7, and 20. I am fascinated by the workings of complex systems, and I love using big data to look at the big picture. Because of this, and the bonus that I get to work with plants (Arabidopsis thaliana) as the model organism, I joined the Weng Lab 8 months ago. It has been an amazing UROP experience through sophomore spring, my entire summer, and junior fall (now). In the summer, for Elizabeth C. 13s Science Out Loud series, I decided to make an episode about some things I do in the lab! It was just released to youtube, so check it out: My video doesnt really describe the specifics of what I do, but gives a general idea of why. It also shows you where I work at the wonderful Whitehead Institute for Biomedical Research, with shots from my lab and our greenhouse. Its a pretty simplified overview being aimed at the K-12 level so I wanted to include some more images as to what I actually look at and analyze: The white bands are pieces of DNA. After I have performed Polymerase Chain Reaction in order to amplify the correct fragment Im interested in, I can run it on an agarose gel which sits in an electric field, in order to separate the fragments by length. I can then extract the DNA from the gel and use it in subsequent reactions, knowing I am working with the right sequence. This is a data sample of a portion of the Arabidopsis metabolome. The rows are the variating Arabidopsis lines, and each column is a metabolite. The colors represent deviation from average blue means the metabolite is present below average, and red means it is accumulating above average, to various degrees. To understand biological big data, Ive been working closely with the Bioinformatics resources at the Whitehead, and learning everything that they do. By comparing the genomic sequences to the metabolomic data (two huge data sets with a lot of unknowns), I can start to piece together the system I am working with. Its almost like a giant puzzle, where the metabolomic data provides you with all of the blank pieces, and the genome provides you with the overall picture, but its up to you to piece them together. And this is what some of my plants look like under UV light! I love being able to work in all stages of my experiments the greenhouse, the wet lab, and the data analysis. If you have any questions or comments, always feel free to email me at [emailprotected] Huge thank you and shout out to Science Out Loud for this great opportunity! Everyone should come to the premiere of Season 2 on November 4, at 5 pm, in the Simmons MPR. I will be there, along with food, and all the other episode hosts. :)
Friday, May 22, 2020
Learning Theories And Practices Of Learning - 976 Words
provides students with different ways to learn the same material. Additionally, students learn by doing or experiencing their education, rather than through traditional methods of lectures, notes, and memorization. The experiential learning theory involves students centered learning, where students developing skills through â€Å"discovering, processing, and applying information and reflecting on what they have done†(Bower, 2013, p. 32). These theories and practices provide students with various ways to learn in the classroom that benefits various learning styles as well as creating interest in what is being learned. I believe that students are more engaged in their education when they are involved in experiential learning, when they are provided with various methods to learn the material they are being taught, and be in an environment that encourages learning. I like the idea Joseph Lancaster had in his monitorial schools in that he had stronger students teach the weaker stu dents. I have used this strategy when in a classroom where we paired stronger readers with weaker ones. The stronger readers help the weaker readers with their reading (Gutekt, 1995). However, I do not agree with the large size of his classroom and that only a few students learned the material from the teacher. I feel that students cannot solely learn from their peers and that smaller class sizes and having a teacher do the majority of the teaching provides the outcomes. Pestalozzi wanted to replace fearShow MoreRelatedConstructivist Learning Theory And Nursing Practice1520 Words  | 7 Pagesup-to-date. â€Å"Theory-based practice provides nurses with a perspective†(Parker, 2006, p.28). With the comprehension and use of educational theories, nursing educators can support student knowledge and development into practice. These theories are outlines of cohesive concepts and principals that describe, explain, or predict how people learn. Every one learns differently and a s an educator you need to be familiarized with and open to the use of one or more combinations of theories to successfullyRead MoreTheories And Practices Of Teaching And Learning Literacy1339 Words  | 6 Pagesthere have been many theories and practices of teaching and learning literacy across preschool, elementary, middle and early high school. A few of the theories and practices of teaching and learning literacy are Freebody Luke’s (1990) Four Resources Model, a cognitive-constructivist view of reading (Graves, Juel, Graves, 2007), and a complex theory of the reading process (Clay, 2013). Freebody and Luke (1990) developed what they felt were four interconnected reading practices or roles a studentRead MoreManagement Learning, Performance And Reward : Theory And Practice818 Words  | 4 Pages‘Management Learning, Performance and Reward: Theory and Practice Revisited’, from The Journal of Management Development. This article looks at the extent to which organizational learning is encouraged and recognized by performance management systems, and whether these HR tools contribute to an organization’s effectiveness and by acting as a competitive advantage. This speaks to whether the the leadership has integrated the concept of individuals learning with the organization learning and developingRead MoreManagement Learning, Performance And Reward : Theory And Practice1179 Words  | 5 Pages‘Management Learning, Performance and Reward: Theory and Practice Revisited’, from The Journal of Management Development. This article looks at t he extent to which organizational learning is encouraged and recognized by performance management systems, and whether these HR tools contribute to an organization’s effectiveness by acting as a competitive advantage. An organization’s leadership needs to integrate the process of individuals learning with the idea that the organization should be learning and developingRead MoreThe Learning Theories Of Teaching Practice Within Classroom Essay1601 Words  | 7 Pagesthe main learning theories. This assessment will allow the chance to begin applying these theories in a classroom setting by using an essay that analyses teaching practice within classroom. By looking further into the statement ‘Effective teachers need a range of strategies to ensure that students learn’. Crucially using personal beliefs about learning as well as teaching to reflect on these beliefs as well as considering their influence of developmental factors within the classroom. Learning as a wholeRead MoreLearning Theories And Change Within The Practice Of Emergency Airway Management2418 Words  | 10 PagesLearning Theories and Change within the Practice of Emergency Airway Management Edward Bittner MD, PhD I. Emergency airway management as a sociocultural learning practice Learning within the practice of Emergency Airway Management (EAM) is not viewed as an individual pursuit but as something that happens through engagement in shared activities. When the EAM team members gather around the bedside to participate in patient management they are engaged in both a working and learning activity. TheRead MoreTheories of Learning and How They Can Be Used to Inform Practice in the Classroom.2277 Words  | 10 Pagesdiscusses two of the theories surrounding childrens learning and development. It further goes on to discuss how they could be used to inform practice in the classroom. The two theories to be discussed are Vygotsky’s Social Development Theory and Gardner’s Multiple Intelligences Theory. Lev Vygotsky was a Russian psychologist who lived from 1896 to 1934. He was widely involved in developing the education program of the emerging Soviet Union. At the time of his death, his theory was not known outsideRead MoreTheories That Stand Out : Adult Learning Theory, And Feedback And Its Effects On Teaching Practices Essay3095 Words  | 13 Pagesconsidered one of the top ten strategies for improving learning (Hattie, 2009). Providing feedback is considered one of the highest yielding strategies in schools (Hattie, 2009). There are many theoretical foundations that have correlations with descriptive feedback. When examining literature, there are three main theories that stand out: Adult Learning Theory, Feedback Intervention Theory, and Transformational Leadership Theory. These theories truly guide the principles of descriptive feedback makingRead MoreSimulation Of Nursing Education : A Literature Review1712 Words  | 7 PagesTeachers are champions of learning. They w ork endlessly to push students to succeed and grow. They teach them to be better readers, writers, mathematicians, scientist, historians and artists. Teachers are constantly evaluating what they can do to help their students learn and to achieve personal goals, life goals, and become productive members of society. However, not all learners have the same learning style and not all teachers have the same teaching methods. Learning styles are the result ofRead MoreDichotomy Between Theory and Practice in Education1173 Words  | 5 PagesThe interaction between â€Å"theory†and â€Å"practice†in education is a dichotomy that people have been trying to understand for over 2,000 years. The relationship between theorists and practitioners is very complicated because there are issues that surround the pace of change in theory and practice. The debates that have occurred continue to occur through today in an array of perspectives about the purpose of education and abou t how to encourage learning. Practical knowledge can be defined as knowledge
Saturday, May 9, 2020
Case Study - 6581 Words
S w 9B09M035 TALISMAN ENERGY INC.: THE DECISION TO ENTER IRAQ Natalie Slawinski wrote this case under the supervision of Professor Pratima Bansal solely to provide material for class discussion. The authors do not intend to illustrate either effective or ineffective handling of a managerial situation. The authors may have disguised certain names and other identifying information to protect confidentiality. Ivey Management Services prohibits any form of reproduction, storage or transmittal without its written permission. Reproduction of this material is not covered under authorization by any reproduction rights organization. To order copies or request permission to reproduce materials, contact Ivey Publishing, Ivey Management†¦show more content†¦Yet, despite the conflict, some analysts had seen great profit potential for Talisman in entering Sudan. One analyst had noted that the project would “â€Å"generate a lot of cash flow, and [would] be a very economic project, with a lot of exploratory upside.Ââ€Ã¢â‚¬ 1 Buckee himself ha d argued that the security situation was acceptable given that the Sudanese government protected the site and a fledgling peace treaty had recently been signed. He had felt that Talisman’’s share price would recover once investors saw the long-term potential of the project.2 Finally, the United Nations had recognized the Sudanese government, which provided legitimacy for the regime and helped reduce Talisman’’s political risks. Buckee and the board had decided that the in-country risks were manageable. For Talisman, the bet on Sudan had initially paid off. GNPOC extracted its first barrel in July 1999. Success, however, came at a cost. Shortly after investing in Sudan, numerous international nongovernmental organizations (NGOs) accused Talisman of fueling the civil war, believing the Sudanese government was using oil revenues to purchase weaponry. These NGOs accused Talisman of being complicit in the genocide that was taking place at the hands of the Sudanese g overnment.3 The brutality of the conflict in Sudan had drawn enormous media attention. Since 1983, an estimated two million people, most ofShow MoreRelatedCase Studies : A Case Study Approach Essay1157 Words  | 5 PagesA case study is a specific instance that is frequently designed to illustrate a more general principle (Nisbet and Watt, 1984). Hitchock and Hughes (1995) further suggest that the case study approach is particularly valuable when the researcher has little control over evens. Case studies strives to portray ‘what it like’ to be a particular situation, to catch up reality and ‘thick description’ (Geertz, 1973) of participants’ lives experiences of, thoughts about and feelings for a situation. TheyRead MoreCase Study887 Words  | 4 PagesCHAPTER I INTRODUCTION 1.1 Reasons choose the case 1.2 The Problems The problems of this case are: 1. How would you characterize Lincoln Electric’s strategy? In this context, what is the nature of Lincoln’s business and upon what bases does this company compete? 2. What are the most important elements of Lincoln’s overall approach to organization and control that help explain why this company is so successful? How well do Lincoln’s organization and control mechanismsRead MoreBusiness Case Study : Business Case Studies997 Words  | 4 PagesWriting Business Case Studies How to Write Business Case Studies The objective of this part of the course is to use your case study to help you solve real company problems and to make the learning more relevant to your experience. The Business Case Study you are being asked to start today will provide information for yourself and the class to permit constructive feedback. You will have to use all of your research, writing and analytical skills to write your Company Case Study. You must give enoughRead MoreCase Study148348 Words  | 594 Pages978-0-273-73552-6 (web) All rights reserved. Permission is hereby given for the material in this publication to be reproduced for OHP transparencies and student handouts, without express permission of the Publishers, for educational purposes only. In all other cases, no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without either the prior written permission of the Publishers orRead MoreCase Studies13817 Words  | 56 PagesCASE STUDY #1 A Job Search Dilemma Eric, a second-semester senior, is looking for a job. Anxious about finding work in the worst economy in decades, he sends out scores of resumes for a wide variety of positions. The first call he gets is for a position that doesnt really interest him, but he figures he should be open to every opportunity. He schedules an interview, which he aces. In fact, the recruiter offers Eric the job on the spot. He would like Eric to start as soon as possible. Should EricRead MoreCase Study : The Angel 1089 Words  | 5 Pages Case Study #1 The Angel, 1997 Susan Meeks, an alias, woke to what she thought was the middle of the afternoon. A bright yellowish light was shining through the west window of her travel trailer. An other world being was in the room and was as tall as the ceiling of the trailer. She went to the bathroom where she washed her face with cold water and stayed in there long enough to smoke a cigarette. When she went back to the bedroom the being was still there. The being showed her futureRead MoreCase Study 8985 Words  | 4 PagesCase Study 8 Based on the January through June 2010 cash budget, what is the maximum monthly loss during the six-month planning period? What is the maximum cumulative borrowing balance? (For purposes of this question, disregard any interest payments on short-term bank loans or interest received from investing surplus funds.) Maximum monthly loss is in June: -$60,750. The maximum cumulative borrowing balance is $99,000 in February. What does the monthly cash budget reveal that indicatesRead MoreThe Case Study Of The Company1468 Words  | 6 PagesOverview of Case Study In the case study by Spector titled, Transferring Innovation Across National Boundaries, (Spector, 2012) company named Minnesota Biolabs (MB) provided laboratories with a quality test for contamination of injectable medications. This test required the use of live rabbits that led to the rabbit’s death after the test. The company was headquartered in Minneapolis, however they were organized with four, somewhat independent, national units in Europe and Japan, each run by aRead MoreLaw of Case Studies1514 Words  | 7 PagesZulfatah Arif SCM-019741 Work Psychology in Communication, Writing and Reporting COM 2153 Mr Haji Adenan Case Studies An Unmotivated Building Inspector Case Study By: Zulfatah Arif 1) Review the motivation theories discussed in this chapter. How would each one describe and explain the problems with Simon Lucas’s motivation? The theories that would be relevant to the problems with Simon Lucas’ motivation would be the McClelland’s Need Theory and Herzberg’s Two-Factor Theory.Read MoreCase Study Essay1116 Words  | 5 PagesCase Study Objective The Case will focus on issues related to the cultural aspect of international business; sustainable business practices including CSR issues; foreign investment; and the benefits of regional integration for the countries within, and companies doing business in, that region. The case study analysis will be completed on an individual basis. Instructions THE CASE: Kaizer Consulting Kaizer Consulting is an international management consulting firm that specializes in business strategy
Wednesday, May 6, 2020
Examine the view that ‘successful families need two loving heterosexual parents’ Free Essays
his statement represents the view that the typical family is a nuclear family; that is: 2 generations of parents children living together in 1 household, legally married, and that the nuclear family is the ideal. Murdock claimed that the nuclear family is universal and for any society to exist four basic functions [functional requisites] must be fulfilled. These are Reproduction – to produce the next generation. We will write a custom essay sample on Examine the view that ‘successful families need two loving heterosexual parents’ or any similar topic only for you Order Now Sexual – to control sexual behaviour, to prevent conflict between adult males over women. Socialisation – to prepare children for their wider social roles. Economic – to survive economically the male acts as breadwinner the female as carer. Functionalists would say these are essential for social life, since without the sexual and reproductive functions, there would be no members of society, without the economic function, life would cease, and without education [socialisation] there would be no culture. Human society without culture could not function. Not all families fit Murdock’s definition of family. There are examples of ‘social arrangements’ or ‘families’ that contradict Murdock’s definition. One example being the ‘new world black family’. Generally these families are Matrifocal and mother-centred and consist of a woman and her dependant children and do not include an adult male. The mother is the main carer and breadwinner and rely’s on help from female kin relatives. Another example is ‘The Nayer’ of south India. After marriage the husband did not live with his wife nor was he under any obligation to have any further contact with her. The males in the household would be either uncles or brothers but not the biological father. These male kin would serve the economical socialisation roles within the family. Gay, lesbian lone parent families also contradict Murdock’s definition. The lone parent family has only one gender role to follow, – the carer, breadwinner role, is undertaken by one adult, as well as the economic factor again undertaken by one adult. The lone parent can still maintain a sexual relationship outside of the family unit; therefore the sexual factor is still maintained. Reproduction can start without sexual contact, as the lone parent tends to rear the children in the early years, and then educational establishment assists. Even with only one gender role to be followed, socialisation prepares children for their wider social and gender roles. It would be fair to say that Murdock did not take into account the various diversities within the family, such as structural cultural diversities. The family is socially constructed and varies from one culture to another. To say that ‘successful families need two loving heterosexual parents’ is a very narrow functionalist view of the family. People are now choosing to have different types of family life, and it is more socially acceptable. Many families are no longer conventional but society still exists. How to cite Examine the view that ‘successful families need two loving heterosexual parents’, Papers
Tuesday, April 28, 2020
Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia Essay Example
Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia Paper 1.        Introduction (from World Health Organization [11]) 1.1      Asthma: Definition Asthma attacks all age groups but often starts in childhood. It is a disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. In an individual, they may occur from hour to hour and day to day. This condition is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they become easily irritated. In an attack, the lining of the passages swell causing the airways to narrow and reducing the flow of air in and out of the lungs. We will write a custom essay sample on Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia specifically for you FOR ONLY $16.38 $13.9/page Hire Writer 1.2      Asthma: Scope Between 100 and 150 million people around the globe roughly the equivalent of the population of the Russian Federation suffer from asthma and this number is rising. World-wide, deaths from this condition have reached over 180,000 annually. Around 8% of the Swiss population suffers from asthma as against only 2% some 25-30 years ago. In Germany, there are an estimated 4 million asthmatics. In Western Europe as a whole, asthma has doubled in ten years, according to the UCB Institute of Allergy in Belgium. In the United States, the number of asthmatics has leapt by over 60% since the early 1980s and deaths have doubled to 5,000 a year. There are about 3 million asthmatics in Japan of whom 7% have severe and 30% have moderate asthma. In Australia, one child in six under the age of 16 is affected. Asthma is not just a public health problem for developed countries. In developing countries, however, the incidence of the disease varies greatly. India has an estimated 15-20 million asthmatics. In the Western Pacific Region of WHO, the incidence varies from over 50% among children in the Caroline Islands to virtually zero in Papua New Guinea. In Brazil, Costa Rica, Panama, Peru and Uruguay, prevalence of asthma symptoms in children varies from 20% to 30%. In Kenya, it approaches 20%. In India, rough estimates indicate a prevalence of between 10% and 15% in 5-11 year old children. 1.3      Asthma: Causes Asthma cannot be cured, but could be controlled. The strongest risk factors for developing asthma are exposure, especially in infancy, to indoor allergens (such as domestic mites in bedding, carpets and stuffed furniture, cats and cockroaches) and a family history of asthma or allergy. A study in the South Atlantic Island of Tristan da Cunha, where one in three of the 300 inhabitants has asthma, found children with asthmatic parents were much more likely to develop the condition. Exposure to tobacco smoke and exposure to chemical irritants in the workplace are additional risk factors. Other risk factors include certain drugs (aspirin and other non-steroid anti-inflammatory drugs), low birth weight and respiratory infection. The weather (cold air), extreme emotional expression and physical exercise can exacerbate asthma. Urbanization appears to be correlated with an increase in asthma. The nature of the risk is unclear because studies have not taken into account indoor allergens although these have been identified as significant risk factors. Experts are struggling to understand why rates world-wide are, on average, rising by 50% every decade. And they are baffled by isolated incidents involving hundreds of people in a city, who suffer from allergies such as hay fever but who had never had asthma, suddenly being struck down by asthma attacks so severe they needed emergency hospital treatment. 1.4      Bronchial asthma Asthma is a chronic lung condition characterized by difficulty in breathing. People with asthma have extra sensitive or hyper responsive airways. The airways react by narrowing or obstructing when they become irritated. This makes it difficult for the air to move in and out. This narrowing or obstruction can cause one or a combination of symptoms such as wheezing, coughing, shortness of breath and chest tightness. 1.5      Asthma: Management Because asthma is a chronic condition, it usually requires continuous medical care. Patients with moderate to severe asthma have to take long-term medication daily (for example, anti-inflammatory drugs) to control the underlying inflammation and prevent symptoms and attacks. If symptoms occur, short-term medications (inhaled short-acting beta2-agonists) are used to relieve them. Medication is not the only way to control asthma. It is also important to avoid asthma triggers stimuli that irritate and inflame the airways. Each person must learn what triggers he or she should avoid. Although asthma does not kill on the scale of chronic obstructive pulmonary diseases (COPD), failure to use appropriate drugs or comply with treatment, coupled with an under-recognition of the severity of the problem, can lead to unnecessary deaths, most of which occur outside hospital. 2.        Objectives of study The objective of the study involves finding out about the incidence of bronchial asthma among children of 6-12 years in two different regions in Saudi Arabia. It also endeavors to investigate the level of awareness that the parents possess about the disease, its prevention and management. A comparative study between the socio-economic levels, and the subsequent health care facilities/awareness shall also be disused. 2.1      Importance to Saudi Arabia This study shall be of significant value to the Ministry of Health in the Kingdom. Firstly, only a scant amount of work has been done in the same realm. But more importantly, it will give an ideation into the incidence, trends and awareness of this condition in Saudi Arabia. This will help the Government to establish working patterns and future strategies into the disease that is still a potent challenge even n the developed world. Special significance would be the condition of the children, and the subsequent response of the parents to their condition. This would also give a psycho-sociological impression into the differences that two different regions in the Saudi Arabia have towards the importance that parents give towards their children. It would also help the Ministry in disseminating more information about the disease among the masses, through pamphlets as given in Appendix C. 2.2      Background Literature review Over the years and over the regions, a lot has been written and published in asthma. Interestingly, much of the work done is characteristically similar to each other, unlike some other disease of an international domain. A very brief discourse of some of the relevant works shall be mentioned hereunder, in reference in to the study in question. These are just the tip of the iceberg as far as work on asthma all over the world is concerned. However, what is most important is the fact that the facts, figures and incidence will keep changing with every region of the world. Therefore, if specified care packages are to be prepared for Saudi Arabia, ten exclusive studies of this sort must be conducted so that specialized data is made available, and subsequent strategies may be adopted. 2.2.1   Adult Asthma It has also been highlighted that â€Å"exposure to ammonia gas in the workplace is significantly associated with increase in respiratory symptoms and bronchial asthma.†[2]. To add, it is also considered that â€Å"educational programs based on self – learning in small peer groups, seem to be effective in improving asthma management†[5]. Furthermore, â€Å"the prevalence of asthma has increased in most countries since the 1970s. Levels may have plateaued in developed countries but as prevalence is associated with urbanization and a western lifestyle the problem worldwide is likely to increase over the next two decades†[17]. In a nutshell, â€Å"the prevalence of asthma in adults has increased more than twofold in 20 years, largely in association with trends in atopy, as measured indirectly by the prevalence of hay fever†[20]. 2.2.2   Child Asthma â€Å"Asthmatic school children have a higher mean period of school absenteeism compared to their non asthmatic classmates. The risk of suffering the impacts of this disease is shown to be particularly increased among questionnaire-diagnosed asthma belonging to less socio-economically advantaged families†[1]. The diagnosis age is of prime importance. â€Å"Repeated viral infections other than lower respiratory tract infections early in life may reduce the risk of developing asthma up to school age†[16]. Taking some facts of Great Britain, it can be seen that â€Å"prevalence of self reported symptoms, diagnosis, and treatment of asthma was high among 12-14 year olds throughout Great Britain with little geographical or urban-rural variation. Under diagnosis and under treatment were substantial†[14]. â€Å"The burden of self reported asthma and other allergic diseases among adolescents has changed substantially for the better in recent years throughout the British Isles. These trends correspond to those seen in the 10-14 year age group in hospital admissions, consultations with general practitioners, and parentally reported symptoms in the health survey for England†[12]. Overall, it is considered that â€Å"factors directly or indirectly related to the heating systems used in rural Bavarian homes decrease the susceptibility of children to becoming atopic and to developing bronchial hyper responsiveness†[15]. Further evidence surfaces when it is declared that â€Å"asthma, as defined by combined symptoms and test criteria, was seriously under diagnosed among adolescents. Under diagnosis was most prevalent among girls and was associated with a low tendency to report symptoms and with several independent risk factors that may help identification of previously undiagnosed asthmatic patients†[18]. But as far as the purposes of this particular study goes, the primary factor is that â€Å"a considerable proportion of children presenting to a district general hospital with pneumonia either already have unrecognized asthma or subsequently develop asthma. The high cumulative prevalence of asthma suggests that careful follow up of such children is worth while†[19]. 2.2.3   Comparison between Adult and Child Asthma While making a comparison among adults and children, some other facts come in view. â€Å"Another issue is that in both children and adults, wide variations in the prevalence of current asthma symptoms are often observed between centers within the same country. This indicates that the asthma symptom prevalence rate reported for each country is dependent to some extent on the number of centers studied†[3]. Then, there also seems to be a link among the family members. â€Å"The prevalence may actually be higher since a significant number of subjects with symptoms suggestive of asthma reported themselves as non-asthmatic subjects. As expected, positive family history was forthcoming in subjects with asthma symptoms. Most asthmatic subjects have not experienced a significant improvement in their quality of life, which could indicate sub-optimal management†[4]. Furthermore, â€Å"the parents of the asthmatic children scored significantly higher in DSSI/sAD compared to parents of the controls. Maternal anxiety reached the level of clinical disease. Maternal anxiety and left-handedness of the child were associated with asthmatic attacks 1 year later†[6]. However, â€Å"the major differences between populations found in the International Study of Asthma and Allergies in Childhood Phase One are likely to be due to environmental factors†[13].            3.        Methodology The methodology for the study entails a simple yet sequential process. Primarily, it is a comparative, cross-sectional study between two different regions in Saudi Arabia, to find out the incidence and awareness of Bronchial Asthma. It is questionnaire-based study, which shall give us demographic as well as technical data into the subject. 3.1      Study design It is a cross sectional study, which means that it shall have a sample that is representative of varying segments of the society. It is not merely a study of one group, one community or one class within Saudi Arabia. The subjects for this study shall be in two categories. Firstly, there would be children from 6-12 years from two different places; Madinah Munawara and Yanbu as industrial and non industrial city respectively. Then, the parents of the same children would also be administered with questionnaires. Questionnaires shall be devised that shall be specific for the two tiers, and would attempt to find out varying information on the subject. As the questionnaires would primarily have objective and closed-ended items, thus the statistical analyses at the end would involve item and questionnaire analysis. 3.2      Sampling frame The children would of course be from primary and lower grades. They would be belonging to two different cities, and hence would represent different living, climatic and socio-economic conditions. Similarly, their parents would possess the same difference in primary characteristics that would be taken as variables in case individual factor analysis needs to be considered at any point in time. 3.3      Sample size determination A sample of 2000 students in each city (a total of 4000), is considered as suitable to make a reasonable comparison for the sake of the study. These would be a fair enough sample of a population, to establish a trend of the incidence of Bronchial asthma among the two cities. Further, it would help in establishing the trend analysis for the disease, including its incidence and management. 3.4      Study Setting The study would be set at the schools in the two cities mentioned. Prior permission would be taken firstly from the school administration, and then from the parents. A consent form for participation of the parent and the child shall be made available before the actual questionnaires shall be administered. For ethical and secrecy reasons, the parents shall be confirmed on the consent form that no information about them or their children’s identity shall be disclosed at any point in the study. It is important to consider this, as parents may not like to share any information about their child’s health if they believe that he/she may be labeled in the future for any types of special and/or biased treatment. 3.5      Study plan Firstly, data would be collected from the population. For that purpose, personal presence would be mandatory at the institution. The parents may like to take the questionnaires home and return them the next day duly completed if physical presence is not possible. After the data is collected, then subsequent information would be tabulated and analyzed for the consequent discussion upon the study. 3.6      Questionnaire Survey There are three different types of questionnaires that have been made available. Firstly, there is the form for the parents that will seek information about their child, his life style, and incidence of asthma (Appendix A). Secondly, there is also another questionnaire that would be available to be filled by the medical health care professionals, based on the guidelines of the Medical Research Council. (Appendix B). 3.7      Data handling and statistics Once the objective data is made available through the questionnaires, then the data shall be fed to the computer software SPSS, and subsequent evaluation shall be done. Special areas of interest as far as the results are concerned shall include the incidence of asthma, the awareness about it, and the knowledge of the parents about the same. Finally, a comparison would be done on these three parameters among the two cities mentioned. 4.                 Conclusion Despite the advances made in the medical world today, bronchial asthma still possess to be a potent threat to life and living all around the world. This means that proactive steps need to be taken so that all prevention can come before cure. However, all of this can only be possible once we know what exactly the nature of the enemy is. Therefore, the epidemiology of the disease must be established in specific region so that it can be adequately tackled. Saudi Arabia is no alien to this disease, and it also needs to establish its working parameters so that it can provide its inhabitants a healthier life style. Studies like this are imperative to the cause of health care all over. It is extremely important, for the purposes of appropriate distribution of resources, and proper development of medical facilities that the true nature of the problem is found out. For that, the incidence, awareness, and management needs to develop ever more so that the people can breathe an air with the technical and administrative problems that asthma may like to offer. Parents Questionnaire (Adapted from ISAAC [9] and Asthma.org.uk [10])             Appendix A Demographic Information a)        Age of Child             _______ b)        Year of schooling      _______ c)        No. of siblings                       _______         Brothers         _______         Sisters _______ d)       Number of Child in Birth order        _______ e)        Average monthly income of parents(s) and/or other bread earners (in Riyals):            0 – 2000 ___             2000 – 5000 ___       5000 – 8000 ___       8000 + ___ f)        Any other medical condition or history of disease for the child            _____________________________________________________________________ g)        History of Bronchial Asthma in Family            _____________________________________________________________________ h)        Birth place of child (city/country)    _______________________________________ i)         Different cities/countries in which the child has lived for over 3 months till now            _____________________________________________________________________ Questions 1. Has your child ever had wheezing or whistling in the chest at any time in the past?            Yes _____                 No _____ 2. Has your child had wheezing or whistling in the chest in the last 12 months?            Yes _____                 No _____ 3. How many attacks of wheezing has your child had in the last 12 months?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 4. In the last 12 months, how often, on average, has your childs sleep been disturbed due to wheezing?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 5. In the last 12 months, has wheezing ever been severe enough to limit your childs speech to one or two words at a time between breaths?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 6. Has your child ever had asthma?            Yes _____                 No _____ 7. In the last 12 months, has your childs chest sounded wheezy during or after exercise?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 8. In the last 12 months, has your child had a dry cough at night, apart from a cough associated with a cold or chest infection?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ Adapted from Medical Research Council [8]                Appendix B Bronchial Asthma (BA) Research Strategy Questionnaire Q1      About you 1.1      Please mark the boxes next to the categories that apply to you (you may need to mark more than one) I am a†¦ person with BA                                                        researcher person who has recovered from BA                         researcher specializing in BA carer                                                                          clinician with BA patients charity representative                                               GP or nurse                                                                                          clinical specialist other (please specify)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1.2 Name†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Address†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Email†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ (This part can be left blank if you prefer) Based on your knowledge and experience, please give your opinion to the following questions:- Q2      Understanding BA 2.1      What is your understanding of the term Asthma? 2.2      What is your understanding of the term Bronchial Asthma? 2.3      In your opinion, is BA                a) a single disorder with a wide range of symptoms? OR                        b) are there distinct differences, ie subgroups or entities? 2.4      If you think that b) is true and there is a basis for subdividing it, how would you advise that it be done? 2.5      In your opinion, how could improvements in health of people with BA be measured? Q3      Research now 3.1      Which areas of research currently provide the strongest research evidence base for understanding BA? 3.2      Where are the gaps in research evidence? 3.3      Why do you think this is? 3.4      If there are obstacles to closing the gaps, how can they be overcome? Q4      Research for the future and your vision for a research strategy NB A research strategy includes assessing current national and international knowledge and gaps in knowledge in a given disease/disorder. It helps to decide what further areas of research are needed and how this might be achieved. 4.1      What do you see as the most important areas for research that will increase our understanding of BA? Please list them in order of priority. 4.2      Why are they important? 4.3     What do you want a research strategy to achieve in the short term (3 years)? 4.4     What do you want a research strategy to deliver in the longer term (more than five years)? 4.5      What would make the strategy work? 4.6     If you were asked, how could you or your organization contribute to the strategy? 4.7     What do you think the barriers could be to implementing the strategy? 4.8      Is there any other advice or comment that you would like to give to MRC that will help it produce its strategy? Thank you for completing the questionnaire. Information Pamphlet (from HealthNet [7])                   Appendix C Bronchial Asthma in Saudi Arabia Although the incidence of asthma is increasing world widely, there is many voices many specialists say that asthma tends to be under diagnosed and under treated. Yet, the Bronchial Asthma (B.A.) affects 5 – 10 % of world population†¦ including Saudi Arabia. What is B.A.? This disease is defined as a reversible obstinction of large and small airways due to hyper-responsiveness to various Immunologic and non-imunologic stimuli. It is a chronic inflammatory disorder of the airway in which many cells play role in particular mast cells, eosinophils and T.lymphocytes. What are the major symptoms of B.A.? The main symptoms of this disease are: wheezing, cough, dyspnea, tachypnea and chest pain. Post tussive emesis and cough following cold air exposure or with laughter are suggestive of asthma. In susceptible individuals this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and early morning. To what extent has this disease spread in the Kingdom? In Saudi Arabia, the increased use of artificial irrigation, greenery, pollution and change of lifestyle have been cited as some of the factors that are responsible for the growing incidence of bronchial asthma. The prevalence of asthma among school children in Riyadh, for example, to be about 10%, and that range in the entire Kingdom is between 4% and 23% in different areas all over Saudi Arabia. What are the reasons behind these increased prevalence of B.A. in the Kingdom? The high and rapidly increasing in prevalence is attributed to environmental and social changes. Rapid increasing prevalence with increased exposure to indoor allergens and occupational exposure as well as indoor and outdoor pollutants are just some of the reason that tell us why prevalence and morbidity have increased. Regarding society and patient knowledge, it is notable that some patients, depending on their backgrounds, may have various misconceptions about asthma that may interfere with asthma management. These include ideas that asthma is infectious because it runs in families or affect more than a family member at a time. How can we protect our children from B.A.? To avoid asthma triggering factors one should follow certain procedures: One must avoid both active and passive smoking. Wood smoke, incense, strong perfumes, household sprays and cooking oil should be avoided. Ozone, nitrogen dioxide, and acidic aerosol might aggravate the problem. House dust mites, specially in humid areas like Jeddah and Dammam, are bad for asthma patient. Hence, one should encase mattresses and box pillows, wash blankets and beds once a week, remove carpet from time to time, and avoid stuffed toys. Animals should be removed from the home. Insects must be controlled and killed immediately. References 1.        Al-Dawood, K. Schoolboys with bronchial asthma in Al-Khobar City, Saudi Arabia: are they at increased risk of school absenteeism? Journal of Asthma. 2002 Aug; 39(5):413-20. 2.        Ballal SG, Ali BA, Albar AA, Ahmed HO, al-Hasan AY. Bronchial asthma in two chemical fertilizer producing factories in eastern Saudi Arabia. International Journal of Tuberculosis and Lung Disorders. 1998 Apr; 2(4):330-5. 3.        Clark, T. Global Initiative for Asthma. Saudi Medical Journal. 1992; 13: 521-4. 4.        Khan S, Roy A, Christopher DJ, Cherian AM. Prevalence of bronchial asthma among bank employees of Vellore using questionnaire-based data. Journal of Indian Medical Association. 2002 Nov; 100(11):643-4, 655. 5.        Veninga CC, Lagerlov P, Wahlstrom R, Muskova M, Denig P, Berkhof J, Kochen MM, Haaijer-Ruskamp FM: Evaluating an Educational Intervention to improve the treatment of Asthma in four European Countries. Au. J Respir Crit. Care Med. 1999, 160:1254-1262. 6.        Krommydas, G. et al. Left-handedness and Parental Psychopathology in the Course of Bronchial Asthma in Childhood. Pediatric Asthma, Allergy Immunology. 2002. Jun, Vol. 15, No. 3: 145-152. 7.        HealthNet. Bronchial Asthma in Saudi Arabia. 2002. 14 April, 2006. http://www.health.net.sa/english/section/full_story.cfm?catid=11type=aid=24. 8.        Medical Research Council. 2006. 14 April, 2006. http://www.mrc.ac.uk/. 9.        Ponsonby, P. et al. Exercise-induced bronchial hyperresponsiveness and parental ISAAC questionnaire responses. European Respiratory Journal. 1996, 9, 1356–1362. 10.      Asthmauk. 60-second-test. 14 April, 2006. http://www.asthma.org.uk/index.html. 11.      World Health Organization. Bronchial Asthma. 15 April, 2006. http://www.who.int/respiratory/asthma/en/. 12.      Anderson, R. et al. Trends in prevalence of symptoms of asthma, hay fever, and eczema in 12-14 year olds in the British Isles, 1995-2002: questionnaire survey. BMJ 2004;328:1052-1053. 13.      European Respiration Journal. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). 1998; 12: 315-335 14.      Kaur, B. et al. Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (international study of asthma and allergies in childhood, ISAAC UK). BMJ 1998;316:118-124. 15.      Mutius, E. et al. Relation of indoor heating with asthma, allergic sensitisation, and bronchial responsiveness: survey of children in South Bavaria. BMJ 1996;312:1448-1450. 16.      Illi, S. et al. Early childhood infectious diseases and the development of asthma up to school age: a birth cohort study. BMJ 2001;322:390-395. 17.      Rees, J. Asthma control in adults. BMJ 2006;332:767-771. 18.      Siersted, H. et al. Population based study of risk factors for under diagnosis of asthma in adolescence: Odense schoolchild study. BMJ 1998;316:651-657. 19.      Clark. C. et al. Asthma after childhood pneumonia: six year follow up study. BMJ 2000;320:1514-1516. 20.      Upton, M. et al. Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ 2000;321:88-92.
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