Advantages of Internet Essay

Science and technology play a very important role in our life. Most of our daily activities are greatly associated with science and technology. One of the contributions of science and technology to mankind is the invention of Internet. With this invention being so widely used, it has both advantages and disadvantages. In this essay, I shall discuss the advantages and disadvantages of the Internet. The first advantage of the internet is that it provides us with leisure. This is because the Internet can provide us with various endless entertainment. For example, we can watch videos in YouTube which has millions of videos from comedy to romance and horror to suit our mood. Not only that, some television networks have their own websites. These enables us to catch up on movies or television programmes on television which we have missed. Radio channels such as Class95 and Perfect10 also have their own sites to listen to radio programmes for those who do not own a radio set. There are also many sites that enable the users especially youths to watch anime or read manga online. This is good as this enables us to save money as the cost of a manga or anime DVD can be quite expensive. These different from of online entertainment will not only gives us leisure but also provide a medium in which we can relieve the daily stress from school and work. The second advantage of the internet is E-commerce which is growing rapidly and becoming more popular. Examples of e-commerce include online shopping and e-banking. Through online shopping, we can buy many things over the net which provides a range of products from all over the world with just a click of the mouse. Examples of famous online shopping sites are Yahoo!, Amazon and e-bay which sells various products from books and furniture to electronic devices and office supplies. Doing shopping online is indeed convenient as we do not need to travel to do our shopping. As a result, time is saved.

Academic Argument Essay

Academic Argument Essay The Need for Rehabilitation Momm, like many brothel girls, had become addicted to methamphetamines. Often the brothel owners give girls meth to keep them compliant and dependent. In her village, the craving had overwhelmed her, and she was consumed by the need to go back to the brothel and get some meth. Women everyday, all over the world are being held against their will. Many of these women are bought, sold, and used for sex or labor. In the book Half the Sky by Nicholas D.Kristof and Sheryl WuDunn they focus on the prevention of sex trafficking by giving shocking statistics and first hand accounts of gruesome situations women have been through (Kristof). Sex trafficking is often seen as a non-issue because women often give consent to the sex after being involved for a long period of time. Because brothel owners are harsh and unsympathetic, women are left powerless and defenseless. Even after being rescued from brothels, women need rehabilitation in order to live a productive, successful life because they are brainwashed and drugged, have nowhere to go, and acquire no skills to maintain a normal job.On the United Nations website, it states that people participate in trafficking women â€Å"for the purpose of exploitation† (United). By exploiting women in the case of sex slavery the women are raped and brainwashed. Women often times refuse to have sex with clients at first, but after continuously being threatened, beaten, and drugged, the women have no other option but to give in to having sex. After years of this kind of mistreatment, women eventually get used to the horrible circumstance that they are in and often don’t even see it as much of a problem. At this point, the brothel owners have succeeded in brainwashing the women.Women being trafficked are rarely fortunate enough to be saved. However for the lucky ones, once rescued the women view the rescuer as a bad person for taking them away from the life that gave them food and drugs. Anywhere between 700,000 and four million women and children are trafficked around the world (Sexual). Without rehabilitation, women would just go straight back to the brothels because they no longer see a problem with what they are doing. People in support of sex trafficking view women as participating voluntarily despite the fact that they are held against their will. By keeping women in ehabilitation after being rescued, they have a much better chance of breaking their drug addiction, reversing the brainwash, and becoming educated citizens. Not only do trafficking victims have to recover from the brainwashing and drug addiction, they also have to find a place to live. Women are often held for years at a time in brothels. After being free of a life of prostitution, they have nothing and nobody to go to for help. This is where rehabilitation comes into play. It lets women get accustomed to everyday life out of the brothels and it can help them find a place to go an d people to help them.In one case, volunteers helped Neth and Momm to find their families that they had not seen in over five years (Kristof). Without these volunteers and this type of rehabilitation, these two women would have had a very slim chance of making it out of the red light district. Brothel owners may think that they are doing these women a service by providing a place to live for them, but ultimately the women could do that for themselves if they had the ability to make and income. In addition to finding women a place to go after the rape, it is vital that these victims are given the chance to be educated.With education comes opportunity. Debatably the hardest part of fighting drug trafficking is to recover the women and give them a life after the struggles of being prostituted. With education comes skills for jobs, knowledge of what happened to them, and the ability to help out with others going through the same situation. Education in third world countries is often a c hallenge for families because they don’t have the money or resources to send their children to school. However, if a woman is educated, it decreases her chance of living in poverty and being trafficked (Kristof 167-170).Although some may think the cost of education outweighs its benefits, it gives opportunities to advance in society. As volunteers assist women in escaping the brutalities of sex slavery, it is important to recall that the solution is not simply taking them from the source of the problem. Rehabilitation is also vital for the women’s success because it treats them for being brainwashed and addicted to drugs, gives them a place to live, and provides much needed education. Traffickers themselves may think that rehabilitation is not necessary, but that is for their own financial gain.So let’s give our support in every way possible to help stop the cold realty of sex trafficking and the negative side affects if brings to the women involved. The solutio n to ending trafficking lies within us all. Works Cited Kristof, Nicholas D. , and Sheryl WuDunn. Half the Sky: Turning Oppression into Opportunity for Women Worldwide. New York: Alfred A. Knopf, 2009. Print. â€Å"Sexual Trafficking Facts. † The Facts. Initiative Against Sexual Trafficking. Web. 01 June 2012. â€Å"United Nations Office on Drugs and Crime. † What Is Human Trafficking? United Nations. Web. 31 May 2012.

A Brave New World

Utopia means the idyllic state as first used by sir Thomas Moore as the title of his book in 1516 (Brave New World’s Barron’s Notes by Anthony Astrachan).The Utopia achieved by the world-state in Aldous Huxley’s A Brave New World had a terribly High price. A price which, I think is not worth it. Their citizens live in as oblivious and ignorant kind of bliss in world that is free of war, fear, violence, disease and all the other draw-backs of living in the real world (Sybille Bedford, Aldous Huxley: A Biography, 1974, cited in Brave New World’s Barron’s Notes by Anthony Astrachan).The characters from Utopia in the novel do not even know freedom. They are happy and contented in their respective occupations and are satiated by spending their free time wallowing in pleasure even though they are all alike in each class and behave in much the same way as each other save for a few idiosyncrasies Uniformity is stressed and individuality becomes like a sickn ess and all characters who had even a minor difference from other citizens in the same class were cruelly crushed into either conformity or the final escape of death in John’s case.However, if the price of such comforts would be the ignorance of the existence of freedom, an idea that many countless people have died fighting for in the real world, I think Utopia is not worth it.A. Huxley did very well in highlighting this point. John’s suicide after seeing that his beloved joined the mob to watch him suffer is a great point at rejecting the idea of Utopia in the book.Even when John found a place where he could live with all the things that he thought were necessary, including pain, he was followed by a huge crowd which had come to watch him suffer. Seeing Lenina come to watch him whip himself causes him to kill himself.In the novel, Huxley plays with the idea of how technological advances would affect society. In Utopia, humans are grown in bottles. No one has a mother. Multiple copies of a single person can be made in one go. This is a very extreme way to highlight the author’s point, completely removing the â€Å"humanity† from humanity to the point that even the genuine personal bond of parent and child is removed.The achievement of stability is attained by keeping everybody in an artificial state of perpetual happiness and contentment.   Pain and grief is removed from the realm of human emotion thereby removing all the deep feelings we associate with the feeling of being genuinely â€Å"alive†.Citizens in Utopia are encouraged to be promiscuous. Anybody can have sex with anybody they want and vice versa. Family life and the formation of intense personal relationship are obliterated so that these cannot interfere with the stability of society. Love is non-existent. Anybody who’d date or have sex with a single person for an extended period is looked on as weird.I think that the author was successful at highlighting his point. His characters were only secondary to the ideas that he proposed especially considering the time and context when he propounded them. He makes me feel as if the novel’s version of Utopia is not far from becoming a truth. Today’s culture promotes the culture of almost mindless consumption, too much indulgence in pleasure and diminishing of the family.Technology is a result of human endeavor. It allows us to live in a better world with all of our modern necessities and comforts. In this book however, a different view is illustrated. While it acknowledges the former to be true, it declares resoundingly that the opposite is possible also. Technology also has the potential to wipe out the essence of humanity. It can wipe out genuine happiness, individuality, close personal relationships, deep emotions and family.ReferencesBLTC, Brave New World? A Defence of Paradise-Engineering, Retrieved on April 13, 2008, from http://www.huxley.net/index.htmlBLTC, Brave New Wor ld’s Barron’s Notes by Anthony Astrachan, Retrieved on April 13, 2008, from http://www.huxley.net/studyaid/bnwbarron.htmlBLTC, Brave’s New World’s Monarch Notes, Retrieved on April 13, 2008 from http://www.huxley.net/studyaid/index.html   

Reflection paper on a comparison of the narrative Ararat by A. Egoyan Essay

Reflection paper on a comparison of the narrative Ararat by A. Egoyan and documentary AGHET(catastrophe) - Essay Example Although they rarely take part in solving these problems, they provide an avenue of addressing these problems. Many films, targeting the social arena focus on issues such as drug abuse, crime, prostitution, child abuse among others. Further, they suggest solutions to these issues. Other films shed light on the certain important issues among us. While some are investigative, others base their ideas on research. Such are the kinds of films that either seeks to unearth certain phenomena affecting our current society. In various instances, we disregard film directors whenever they come up with a science fiction movie, creatively directed and produced to entertain us. Few are the times when we however disregard films when they address reality. This remains the biggest role played by the two films discussed in this essay, the narrative Ararat and AGHET Documentary. Based on the same idea, these two films mainly address the same topic, which is the Armenian Genocide. Approaches used by thes e films’ directors form the only difference in the films. While the Ararat is an acted narrative, the AGHET is a documentary of various accounts of witnesses during the genocide. They thus boost the human rights campaign, just as other films focusing on the social issues have done. Commonly referred to as the Armenian genocide, actions by Ottoman’s government of systematically exterminating a majority of the Armenian subjects from their historic homeland in the current State of Turkey define the genocide. The genocide took place in two phases. One of them was the mass murder of all bodied men in the region, as well as subjection to forced hard labour. The second phase was the deportation of women, children and the elderly where they were marched to the Syrian Desert, leading to numerous deaths. This was an inhumane way of dealing with these subjects. What was so important, leave along the political power and supremacy to warrant such actions to the people? For a long t ime, power hungry individuals have sacrificed innocent citizens for their individual selfish gains. Since the time of evolution, as revealed by Darwin, people and animals have had to override on others for success. This however did not warrant the Germans to treat people with the heightened levels of cruelty portrayed by the films during the genocide. Nothing justifies the actions of Ottoman Turk and his administrators to the Armenians during the genocide that claimed at least one and half people. Observers and experts describe the Armenian genocide as the first ever genocide to occur in the modern world. Owing to the organised manner in which the Ottoman’s administrators conducted the massacre to eliminate the Armenians, this is one of the most studied cases in the world so far from the holocaust. This forms the main reason why the filming of the events took place, 96 years later after their happening. They are still very significant to the world until this day. The effects of the genocide felt among the Armenians 98 years later after it took place shows the depth of the matter. The genocide started on the 24th April 1915 when Ottoman’s army arrested at least 250 Armenians and took them away from their homes. This day, commonly referred to as the Red Sunday was the night, which the interior minister Mehmed Talaat ordered the army to arrest and move to two holdings in Ankara, all notable Armenian leaders. However, the Tehcir War of 29th May 1915 led

Gender Essay Example | Topics and Well Written Essays - 500 words - 3

Gender - Essay Example From this paper, it is clear that interpretations are irrefutable since improving men and women’s status has been a pledge by the lawmakers and supported by governments as a beginning of tasks on gender. It is evident that women have suffered considerable biases since gender issues are concerned, through policies, media, literature, folk songs, and customs. However, religious teachings and mythology have played an essential role in promoting gender awareness and equity. Favoritism, double standards, and attitudes in the society are the regular reminders of inequalities experienced in the modern world (Marshall, 2000).Gender as social phenomena aroused by the differences in our biological makeup has taken by storm the public domain on major issues politicized (Hobson,2002). Nevertheless, citizens of upright religious practices consider gender as not being critical since they cherish their differences. Contrary to my opinion, gender issue has become a concern, since my childhood girls were treated more respectively compared to boys Gender has been taken lightly to some extent whereas in other cases exaggerated. Documentation of male and female in records such as the birth certificates should not be a cause for any alarm for the sake of peace. Our dressing and genetic makeup always been a problem in that ladies have always been perceived as putting on attire that is meant for men, thus a form of disrespect.To some societies like ancient Greece and Rome, cross-dressing was rampant as the norm. There is a slight difference on perceiving gender through expressing ourselves. Despite our biological differences as human beings, we have similarities that profits all (Marshall, 2000). Normally our bodies’ change as we grow towards maturity is when the difference is noticed clearly. Civilization has brought with it complications in the freedom of choice whereby people are altering their gender (Fenster & Lees, 2002). This practice has received mixed reactions from both parties involved.

Analysis Paper Essay Example | Topics and Well Written Essays - 500 words

Analysis Paper - Essay Example is their belief about the universe having to go through three eras, namely, creation, the present world where good and evil are mixed and the last era is the final state where the good and evil will be separated (Robinson , par 7). In the last era, it is believed that everything will be purified and those in hell will be released. This component relates to the universal needs and concerns in that the second era which is a world where the good and bad mix is very real to our existence today. This is the era where the world is now. Most people today believe that there is still another world, which Zoroastrians identify as the third era, where the good and the evil will be separated. The concept of hell as being a place where the evil men will ultimately go is one factor why people do good. Another religion which has captured my interest is Confucianism. I am impressed with the teachings of Confucius about morality and ethics. Although it can be considered more of a philosophy, Confucianism has a huge impact on the culture, politics, education and social structure in East Asia (Tucker , par 1). The Confucian values include promoting harmony amidst change. Unlike Zoroastrianism, Confucianism does not give emphasis in the afterlife. In Zoroastrianism, the afterlife is seen in their concept about a third era where everything will be purified and the good and evil will be separated. According to Confucius, afterlife is beyond human comprehension; thus, men should live in ways which are ideal to social relations instead of living based on rewards and punishment. Unlike Zoroastrianism, Confucianism gives emphasis on the life here on earth (FindYourFate , par 5). They believe though that the spirits are immortal and that they do not die with their bodies. Confucianism’s idea of creation is that it was brought about by the interaction of the Yin and the Yang which is generated by the Tao, the Great Ultimate. This is the counterpart of the first era of

Employee selection method Essay Example | Topics and Well Written Essays - 250 words

Employee selection method - Essay Example Additionally, the cognitive ability test evaluates the participant’s potential or aptitude to solve job-related issues by providing data about their mental abilities such as mathematical and verbal reasoning, as well as, perpetual abilities such as speed in identifying letter in the alphabet. A good example of cognitive ability test is the aptitude test that is given to prospective employees. The advantages of the cognitive ability test are that it produces various organization outcomes such as success in training and performance. Secondly, this method can be used to predict job performance, especially for complex jobs. Thirdly, the test can be administers through paper and pencil or using computerized methods. Lastly, the method is cost-effective to administer, as the participants are time (Durai, 2010). However, there are various pitfalls that are associated with this method that include that the test is likely to differ in results because of race and gender than any other type of test administers. Lastly, the method is time-consuming in case the test is purchased off- the-

How to Apply Strategic Management Skills Research Paper

How to Apply Strategic Management Skills - Research Paper Example   Designing Vision and Objectives for the Firm It is important for managers to define the purpose of the organization. The vision of a firm informs the employees and the customers about the purpose and value of the firm (Mind Tools, 2011). It is an essential part of an application of strategic management skills to design vision of a firm so as to guide employees regarding their behavior. Customers can also learn through the vision of a firm about how can they be benefitted by the firm. Usually, the vision of a firm is defined in a sentence or a statement commonly known as the vision statement. It entails the long-term purpose of the firm and how employees are supposed to operate in the company. Strategic management is all about taking strategic decisions and strategic decisions have certain characteristics. Strategic decisions are of high magnitude, they have a long-term focus, and they require the high level of commitment (Haberberg & Rieple, 2007). The vision statement is also a strategic decision because it has all of three characteristics. Objectives of the firm are more specific short-term targets. Strategic management skills are applied to define short-term targets for the firm and short-term targets are important for a firm because they serve as steps that can lead the firm to the long-term targets. Firms also require regular assessment of their position and for that short-term targets serve useful. The vision of a firm is a broadly defined purpose of the organization, on the other hand, objectives are short-term targets that can be measured empirically and are specific. Managers should always check whether the firm is treading on the right path or not, and vision and objectives help managers in this regard. Allocation of Resources An important job of a manager is to allocate resources between different departments of the firm. Allocation of resources should be done in a way so as to maximize the profits of the firm at the lowest possible costs. In tod ay’s dynamic business environment all the business functions have considerable importance and allocating resources between different function can be a daunting task. This is where strategic management skills come into play. It is vital that the resources are distributed in the best possible way so that the profits of the firm can be maximized. Allocation of resources should be done in such a way that objectives of the firms are achieved (Alkhafaji, 2003). Resources should be allocated keeping in mind the current standing of the firm in the market. For example, a newly founded firm should allocate more resources to marketing and product development while a relatively old firm should focus on customer satisfaction and better financial performance. This is how the decision of allocation of resources may differ in different types of firms. Today’s tough financial situations have made an efficient allocation of resources essential for firms. Almost all firms have limited re sources and it has to finance all its major operations in order to survive.  Ã‚  

Summary Essay Example | Topics and Well Written Essays - 5000 words

Summary - Essay Example The major question is: What is tourism education? The other important concept to consider is to establish the difference between tourism education and tourism training. The other important question that sought to be addressed by the study is: How has tourism education developed in Indonesia? More importantly, the chapter sought to explore the concepts and methods used in delivering tourism education in the learning as well as teaching process. The chapter also sought to explore the level of tourism in the Indonesian Higher education. Tourism education has rapidly developed during the past two decades in different parts of the world. For instance, the first degrees in travel and tourism were offered in the 1980s in the UK (Messenger, 1991). This trend has slowly spread to other countries both developing and developed. Research has shown that this trend is a bit similar in developing as well as developed countries. However, there has been debate about whether to consider tourism as a discipline on its own. This is mainly because it is widely viewed as an emerging discipline which has not yet fully developed. The group that argues that tourism is a discipline on its own state that there have been different distinctive concepts peculiar to the tourism industry that have developed during the recent past (Leiper, 2000). For instance, the main destination ratio is a concept specifically meant for the tourism industry (Leiper, 1981). The Australian Standard Research Classification asserts to the notion that tourism has been long identified as However, the other group argue that tourism cannot be regarded as a discipline on its own as a result of the fact that it lacks integrated frameworks that have been developed in various disciplines in different researches. In actual fact, they argue that there are few or no theories that have been specifically developed for this area of study which means that it cannot be regarded as a

Make Better Decision Essay Example for Free

Make Better Decision Essay That the current era of economic uncertainty may have been ushered in through a series of poor government and corporate decisions is implied through the rear view mirror. Could some of the events that shaped todays crises have been avoided through better decision making processes? Thomas Davenport (2009, p. 117) presents examples of â€Å"decision making disorder† evident in both the public and private sectors and offers a framework to guide managers in making better decisions in the future. His premise lies in the ineffectiveness of the individual decision-making process resulting in dire consequences for the organization. Davenport provides a framework to guide managers in adopting a more analytical and systematic approach, resulting in greater effectiveness. He posits that the use of data, especially analytics embedded in automated systems can be powerful tools when balanced with informed human judgment. Davenport presents no new information entailing the decision making process. He does, however, raise the question of why the majority of organizations continue to rely on intuition and ignore proven tools and methods without regard for the evidence pointing to their effectiveness. The author warns that without proper prioritization and systematic review of the decision making process, success remains a gamble. Article Highlights According to Davenport (2009), allowing individual managers to make decisions without a systematic analysis has severe consequences that result in languishing profit margins. In spite of the resources available, most organizations fail to implement the recommendations that would help managers employ better decision making processes. The author notes that while these processes do not guarantee better outcomes, they certainly increase the potential (p. 118). Davenport (2009) outlines a four-step process to improve managerial decisions, the components of which are identification, inventory, intervention and institutionalization. He suggests mangers begin by prioritizing the top decisions required to achieve a goal. He states: â€Å"without some prioritization all decisions are treated as equal, which probably means that the important ones won’t be analyzed with sufficient care† (p. 118). He goes on to stress the importance of identifying key decisions in in order to examine all variables through an inventory process to determine effectiveness and lay the groundwork for organizational communication. Subsequent to identification and taking inventory, considering all parameters of the decision, the appropriate intervention should rise to the surface. The final step is the institutionalization of the decision making process, for which Davenport (2009, p. 119) recommends hiring â€Å"decision experts† in guiding managers through the process. Davenport (2009, p. 119-122) cites two examples of organizations who improved the decision making process: Educational Testing Service (ETS) and The Stanley Works. Meeting with great success, ETS has expanded the new processes to evaluate and prioritize all product changes as well as apply the methodology to handle new prospects. A center of excellence was developed at The Stanley Works that created an analytical tool for sales data and new potential sales opportunities. According to the author, due to automated decision processes created by the center of excellence, the company realized a 6% growth in gross margin. Although highly in favor of analytical tools, Davenport (2009) warns of reliance solely on automation, and cautions managers to use their expert human insight to monitor how well analytical tools are working. The decision making process should always be a human endeavor with analytics only a part of the overall toolbox. Significance of the article Davenport (2009) raises a universal concern encompassing the impact of poorly thought out organizational as well as individual decisions. The decisions of today are the realities of tomorrow, and in spite of the myriad of excellent resources available, â€Å"few organizations have reengineered their decisions† (p. 117). The author presents an excellent argument for the necessity of a systematic decision making process as well as the use of analytical tools to provide reliable information in order to make sound decisions. Corporate CEO’s exist that agree with the concepts and actively ngage in systematic decision-making processes. Donna Thompson, CEO of Access Community Health Network in the Chicago area is one example. She shares her ritual of going through the same decision-making process before taking any action, and offers â€Å"good decision making isn’t as much about having all the right answers as is using a process to ask all the right questions† (Reed-Woodard, M. A. 2006p. 164). Gully, Stainer and Stainer (2006), in their study on moral decisions within organizations, have also found a systematic process to yield the best decisions. The authors describe an organized â€Å"balance sheet† designed to prevent disordered thinking as a model of cooperative business behavior. Their findings include the need for systematic decision-making and state â€Å"the moral decision making maze needs ordered steps of asking questions and providing answers that can readily be applied to solving problems and dilemmas in business† (p. 194). Davenport’s (2009) article continues with accolades for analytical tools within automated systems as long as managers thoroughly understand the models. Jim Ciampaglio CEO of NeoSpire exuberantly claims the success of an analytical sales tool used to manage leads and store sales information and states this tool â€Å"helped us change who we are as a sales organization† (McKay, L. 2010). Executive decisions lay the foundation for business strategy: poorly thought out decisions lead to less than optimal results and systematic decision making takes the emotionality out and puts the issue in an objective framework, leading to better outcomes. Organizations integrating this type of framework reduce the risk of moving ahead with a faulty plan. Davenport (2009) states while managers are buying and most likely reading resource material providing the basis for better decision making, few actually adopt the recommendations (p. 118). Conjecture rather than interviews with key decision makers is offered to support this particular viewpoint with the implication that this may be due to the failure to connect bad outcomes to faulty decision making Conclusion Davenport (2009) does an excellent job of tying the process of decision-making to an organization’s ultimate failure or success. His thought provoking discussion as to what exactly transpires during the individual decision making process and why organizations need to gain some control over this process makes intuitive sense. The success of the author’s suggested framework for making decisions is well supported by the organizations cited in his work, with confirmations easily found in other studies such as Gully et al (2006). Further research is recommended examining the decision making processes generally employed by organizations before conclusions that support Davenport’s (2009) negative assumptions can be drawn. The author does not support his claim that only a few companies employ a systematic process and is biased in his perception of the† poor calls made in both the public and private sectors† in recent years. Overall, Making Better Decisions provides food for thought and raises the question that if Davenport’s (2009) assumptions are in fact correct, why is it that corporations continue to allow managers to use more intuition than systematic processes to arrive at decisions that impact the organization’s bottom line?

Tissue Conditioners Soft Lining Materials Health And Social Care Essay

Tissue Conditioners Soft Lining Materials Health And Social Care Essay As a briefing history of the denture lining materials, we can find that in 1942, Matthews introduced plasticized polyvinylchloride as one of the first soft lining materials used with acrylic resin dentures (Sultana, 1991) then Lammie Storer published a summary of observations on different soft denture materials and classified the processed resilient materials as follows. (1) natural rubber, (2) polyvinylchloride, (3) polyvinylacetae, (4) methyl methacrylate copolymer, (5) silicone (Lammie Storer, 1958). Furthermore, they stated that this material became hard due to loss of plasticizer after several months, and became stained and cracked in the mouth. However, we tend to examine the composition and uses of both tissue conditioners and soft lining materials in prosthetic dentistry. Basically, Tissue conditioners composed of polyethylmethacrylate and mixture of aromatic ester and ethyl alcohol and they are found in three components system: polymer (powder), monomer (liquid) and dibutyl phthalate as plasticizer flow control (liquid) when mixed together a gel is formed (Braden M 1970). The major uses of these tissue conditioners materials are: tissue treatment, temporary obturator, baseplate stabilization, to diagnose the outcome of resilient liners, liners in surgical splints, trial denture base and as a functional impression material (Nallaswamy D. 2003). Tissue treatment: the advantage of using a tissue conditioner is to prepare the selected oral structure to withstand all the stress from the prosthesis and to preserves the residual ridge. It is also used to heal irritated hyperemic tissues before denture fabrication. Temporary obturator: tissue conditioners can be added as a temporary obturator over the existing complete or partial denture and this can be done directly in the month or indirectly after an impression of surgical area has been made. Stabilization of baseplate and surgical splints or stents: when undercuts are present on an edentulous cast, an acrylic temporary denture base cannot be used as it may get locked into the undercut and break the cast during removal. In this case tissue conditioner may be used to stabilize the record base and prevent breakage of the cast. Adjunct to an impression or as a final impression material: when it is difficult to determine the extent of the denture base due to movable oral structure, tissue conditioner can be used to record the extensions of the denture in a dynamic form that will later help in preparing an impression tray for the final impression. To diagnose the outcome of resilient liners: patient with well-constructed denture sometimes develop chronic soreness and find it difficult to wear it comfortably. Tissue conditioners can be used to determine if this problem will be resolved with the use of a resilient liner. (Nallaswamy D, 2003). Commercially, there are a wide range of tissue conditioner products, for example, GC tissue conditioner and Visco-gel and more but here we will compare between these two only: Firstly, GC- tissue conditioner is composed of Polyethylmethacrylate (powder), methacrylate monomer (liquid) and dibutyl sebacate (plasticizer). Manufacturer claims that using of dibutyl sebacate as plasticizer instead of the conventional dibutyl phthalate has a merit of not being harmful to the human endocrine system. However, it is suitable for conditioning and relieving tissue (for example when there are areas of inflammation or pressure points on the inflamed alveolar ridge), but also for temporary soft relining of partial and complete dentures as well as functional impressions to fabricate new dentures or restore existing ones, for immediate dentures and as an interim solution for direct loading situations in implantology. It is manufactured by GC EUROPE, Belgium (www.gceurope.com). On the other hand, Visco-gel tissue conditioner is composed of Polyethyl methacrylate (powder), Phthalyl butyl glycolate, Ethanol (liquid). It is can be used prior to denture replacement, extension or rebasing, tissue conditioner where the denture-bearing tissues have become disturbed by either denture trauma or infection, temporary lining immediately after extraction or oral surgery, temporary soft liner when normal dentures are not tolerated, particularly for patients with impairment of general health and as functional impression material in post-operative cases or when ill-fitting dentures require replacement or rebasing. Visco-gel is manufactured by DENTSPLY DeTrey GmbH, Germany (www.dentsply.com). Regardless the trade, the following steps should be considered while applying a tissue conditioner, first, tissue part of the denture base, which crosses an undercut, should be reduced then the tissue surface of the denture, which covers the crest of the ridge, should be reduced by 1 mm to allow sufficient room for placement of the tissue conditioner (Nallaswamy D, 2003). Soft lining material is the second part of this review and here it is wise to understand the difference between the tissue conditioner and the soft lining material. The International Organization for Standardization (ISO) has issued two international standards related to liner materials: (ISO 10139-1:1991): first, lining materials for removable dentures-Part 1: short-term materials and soft lining materials for removable dentures (ISO, 1991) and the second, lining materials for removable dentures-Part 2: materials for long-term use (ISO, 1999). A short-term liner is one that is used intraorally for up to 30 days. A long-term liner is one that maintains softness and elasticity for more than 30 days (Garcia Jones, 2004). Practically, the ISO is differentiating between the temporary and the permanent soft ling material but theoretically, we can find that tissue conditioners can be used for more than 30 days depends on the loss of the plasticizer. Moreover, tissue conditioner and soft l ining have been used for the same purpose clinically. So then, what is the difference? Viscosity is that difference so whenever the material is with low viscosity and flow easily you can use it as a tissue conditioner while material with high viscosity is indicated to be used as a soft liner. There are two groups of soft lining material the first is the acrylic resin-based liner which consists of powder and liquid components. The powder has poly (ethyl or methyl) methacrylate, and sometimes copolymers, while the liquid contains methyl methacrylate monomer and plasticizers that are added to lower the glass transition temperature. The distribution of the large plasticizer molecules minimizes entanglement of polymer chains, which allows individual chains to slide by one another, keeping the liner from fully hardening. The liquids used do not contain acrylic monomers (Craig Gibbons, 1961; Anusavice, 2003). The second type of these soft lining materials is the silicone denture liners wh ich are basically polymers of dimethylsiloxane. Poly(dimethylsiloxane) is a viscous liquid, which can be cross-linked to give rubber a good elastic property. The cross-linking agent is usually an alkyl-silane (silicate) and the reaction is catalysed by an organo-metal salt such as tinoctoate or benzoyl peroxide (McCabe, 1976). Silicones are not dependent on leachable plasticizers and remain elastic for longer periods of time (Anusavice, 2003; Munksgaard, 2004). These liners cannot bind to the acrylic denture base; however, the use of an adhesive can overcome this limitation, which was shown to be a method of failure (Dogan et al., 2006). These liner materials may be selected for the treatment of the following conditions: poor stability of denture, inadequate retention of denture, reduction of vertical dimension, degradation of the denture base, improper extension of borders into the muccobuccal fold regions, mucosal irritations, atrophic ridges, bony undercuts, denture opposing natu ral teeth, reduced thickness and viscoelasticity of the mucosa, pain from gingival irritation, maxillofacial defects, traumatic or pathologic tissue loss and for reline of an existing denture (Zarb et al., 1989; Christensen, 1995; Hayakawa et al., 2000; Hill Rubel, 2011). As a conclusion then, these viscoelastic materials either tissue conditioners or soft lining materials are contributing to solve a list of dental problems that might exist in the removable prosthesis or could be used in a range of dental procedures which are related to fully or partially edentulous patients. Furthermore, these materials need a continuous care and maintenance especially, the tissue conditioner which tends to harden and roughen due to the loss of the plasticizer. However, we should not forget the primary purpose of these materials which is they are used as temporary materials during transitional situations.

Lower Lip Shave for Squamous Cell Carcinoma Reconstruction

Lower Lip Shave for Squamous Cell Carcinoma Reconstruction Lower lip shave for reconstruction of lower lip squamous cell carcinoma Introduction Global estimates of the incidence of oral squamous cell carcinoma vary slightly between various sources, but it appears to be around the eighth commonest site for malignant tumours, with approximately 300,000 cases per year (Shaw, Pace-Balzan, Butterworth, 2011, Parkin et al. 2005) (Shaw et al. 2011) (Scully Bagan, 2009) (Saman Warnakulasuriya, 2009). The relative incidence of lower lip cancer is 35%, which is the highest among oral cancers sites and is most likely due to chronic exposure to sunlight (Bauer et al. 2014).Although the modifiable risk factors such as tobacco, alcohol, diet and lifestyle (S. Warnakulasuriya, 2009) have been identified in the past, only a modest decline in incidence has been reported in recent decades (Chaturvedi et al. 2008). Moreover, an increase of oropharyngeal cancer cases has been related to HPV infections, highlighting the role played by HPV 16 as well as sexual behaviour in head and neck cancer (Chaturvedi et al. 2008; Marur et al. 2010). Despit e the decline in the prevalence of smoking in industrial countries, there is no noticeable reduction in oral squamous cell carcinoma (OSCC) incidence (Shaw et al. 2011). Cancer is a disease that is perhaps more dreaded by more people than any other ailment. The prognosis, in the early stages, therefore, is favourable. The most satisfactory results are obtained when the disease is detected early and treated promptly. A sound and suggestive approach to the problem of cancer control. Patient and methods A 55-year-old patient was referred by a General Medical Practitioner (GMP) regarding a one year history of recurrent lower lip swelling and infection. The patient reported having a lump on her lower lip for approximately one year. At first it was smaller in size and eventually almost occupied the whole lower lip within the one year. The patient complained of intermittent pain and dryness with occasional suppurative discharge from the lower lip. She had had frequent courses of antibiotics and at the time of initial consultation was on a course of fluconazole. The patient had a history of biopsy previously with the diagnosis of oral lichen planus in this region. Although, there had been an improvement of the symptoms after previous treatment at that time, a significant deterioration of symptoms had recurred with advanced swelling and crusting of the lower lip. According to the GMP and the patient, the lesion was worsening and had become resistant to topical medical treatment. There was no weight loss, abdominal or other systemic features observed. The patient’s appetite, sleep and mood were good. The patient had also been diagnosed with mild asthma 5 years prior. The patient consumed minimal amounts of alcohol, did not use any tobacco products and most of her time was spent indoors. Clinical examination Extra-oral examination; there was no detectable lymphadenopathy. 20mm haemorrhagic and crusting lump present on the lower lip and tender on touch, nodular in nature. Intra-oral examination; the oral mucosa was well lubricated and mild reticular white lines were present bilaterally on the buccal mucosa with no oral mucosa speckling or ulceration evident. The patient wore upper and lower complete acrylic dentures. An incisional biopsy was performed on initial consultation. The incisional biopsy report of the sample taken showed moderate dysplasia but given the clinical examination and the nature of the long history of symptoms, it might have been that the biopsy represented only a particular part and very likely that there had been invasive components to the other parts of the lip. The patient was referred urgently to the Oral and Maxillofacial Surgery Department for further treatment even though the lip was healing well after the incisional biopsy. Method of Treatment The Oral and Maxillofacial Consultant decided to perform a lip shave of the vermilion (Kolhe Leonard, 1988) and a tumour biopsy. This method of treatment is advisable in potentially malignant and early malignancy of small lesions and where there is no metastasis present. Involvement of the lymph nodes was not observed, thus the operative removal of the lymph node was not indicated. The vermilionectomy, also and better known colloquially as the lip shave, lip peal, or lip scalp operation, refers to the elliptical, horizontal excision of the exposed mucous membrane or vermilion of the lip, generally of the lower one, with resurfacing or retreading of the surgically created defect by the advancement of the undermined labial mucosa, thereby providing fresh covering which will tolerate many more years of wear (Kurth, n.d.). This procedure is a relatively simple, well-standardised, non-deforming plastic procedure of short duration. After general anesthesia has been performed, surgical preparation of the field with colourless antiseptic solution is applied, and after appropriate draping, the exposed area of lip vermilion to be excised is first outlined with a methylene blue guide mark, after which the underlying tissues are locally infiltrated with Lignospan 2% (1:80000) solution. The outlined mark is incised throughout its entire extent while the lip is firmly immobilized with the thumb and index finger of the free hand, with care being taken to make vertical rather than oblique shelving incisions so that subsequent closure will be facilitated and hypertrophic scarring prevented. After the mucosa is first elevated by sharp dissection from one corner, it can then most conveniently be removed by curved, pointed scissors down to the muscular layer. In cases of superficial malignancy, even a deeper resection can be performed without impairing the watertight closure of the lips or jeopardizing the cosmetic result. A fter haemostasis has been secured with 3-0 Prolene, the labial mucosa is undermined for an appropriate distance down to the deep muscular plane, the surgically created defect being closed by the advancement and approximation of this mobilized flap, which is then united to the cutaneous edge. To achieve an even and symmetrical closure three key sutures are first inserted, the first in the mid-portion of the lip and the remaining two bisecting the distance between the first suture and the commissures. The continuous sutures of 6-0 Prolene can then be inserted consecutively from the wound edge. The knots should not overlay the suture line so as not to retard healing. The donor site was sutured with continuous Vicryl 3.0 suture. The excised mucosal lesion was ellipsoid in shape with the parameters of 14mm horizontally x 20mm from superior to inferior x 8mm in depth. The mucosal excision was marked with the suture material (long stitch right-sided. Short stitch lingual) and sent for histopathological examination. The patient was given broad spectrum antimicrobial (Amoxicillin 500mg) injections for at least 3 days postoperatively and advised to use the lips as little as possible. The wound was kept moist during the day with frequently changed dressings of sterile normal saline which contributed considerably to the patients comfort. At night a thick layer of Aureomycin was advised, to be applied to the suture line to prevent crusting and infection. After three days the alternate sutures could be removed, and the remaining ones on the next day following the healing having progressed satisfactorily. The patient was instructed to keep the resurfaced lip well lubricated with Vaseline, lanolin, or similar preparations for quite some time postoperatively, and was also advised to avoid undue exposure to the sun. Conclusion Although, the patient had been primarily treated for symptomatic oral lichen planus, the condition had worsened significantly within a year. A second incisional biopsy showed moderate dysplasia. Furthermore, the history of rapid symptom progression of the lesion justified the performance of a prompt excisional biopsy under general anesthesia. The most recent hisopathological report confirmed the moderately differentiated squamous cell carcinoma diagnosis, whereas moderate dysplasia was representative of only part of the lesion. Tumour thickness was about 4mm (exophytic and endophytic components) with focally non-cohesive invasion pattern. The lesion was successfully removed within excision margins from 2mm to over 5mm. Nevertheless, close follow up will be continued and the necessity of radiotherapy has been considered at a multidisciplinary meeting as margin dysplasia was found of varying grades at all margins. The lip shave is thus a non-deforming plastic operation of great value in the prophylaxis and treatment of lip cancer and in the cosmetic correction of certain congenital, neoplastic, and traumatic lip deformities. (Kurth, LIP SHAVE OR VERMILIONECTOMY : INDICATIONS AND TECHNIQUE). This is obviously not a technique suitable for all lip defects, but in selected cases it gives a very satisfactory result. Discussion Tumours are divided into two main classes; one being benign and the other, malignant. A tumour may show any degree of malignancy, which in turn has an important bearing on the prognosis and on the prospect of successful treatment. The carcinoma is a malignant epithelial tumour. It is the commonest of all malignant tumours. Among the most important carcinomas is the squamous cell carcinoma. It grows particularly on the skin, lip, tongue, larynx, cervix, and urinary bladder. Ulcers about the mouth or lips that does not heal in ten days to two weeks is a significant sign of oral cancer. If detected early and properly diagnosed, cancer is often cured or at least controlled. Incidences of oral cancer have been rising in many countries around the world (Saman Warnakulasuriya et al. 2008). The 5-year survival rate for oral cancer has not significantly improved in the past 30 years and remains at approximately 50% (Jemal et al. 2004). Many oral squamous cell carcinomas are preceded by clinically evident oral potentially malignant disorders (OPMDs) (Saman Warnakulasuriya, Mak, Mà ¶ller, 2007). It is very important to prevent malignant change in people diagnosed with OPMDs, but the hazard ratios of various OPMDs are not well known. OPMDs include hyperkeratosis or epithelial hyperplasia, epithelial dysplasia (Schepman et al. 1998, â€Å"Oral Leukoplakia and Malignant Transformation†, 1984) erythroplakia (Reichart Philipsen, 2005) and oral submucous fibrosis (Murti et al. 1985, Pindborg et al. 1984) and their clinical phenotypes are well documented. Hyperkeratosis or epithelial hyperplasia, epithelial dysplasia and OSF are the most common oral mucosal disorders in the regions where areca quid chewing is prevalent, such as India, Taiwan, and other Southeast Asian countries (Pindborg et al. 1984, Reichart Philipsen, 2005, Lee et al. 2003, Silverman et al. 1976, Kaas et al. 1994, Chung et al. 2005). The malignant potential of oral lichen planus (OLP) remains controversial because of the absence of universally accepted diagnosis criteria (Chung et al. 2005). The malignant transformation rates of OPMDs show a great variation; for example, 10–20% of hyperkeratosis or epithelial hyperplasia, epithelial dysplasia may transform to cancer and the estimated annual rate is 1.4%–7% (Schepman et al. 1998, â€Å"Oral Leukoplakia and Malignant Transformation,† 1984). In oral cavity squamous cell carcinoma (SCC) there have been many efforts to identify the factors that will allow staging in a way that accurately predicts prognosis. Many different factors have been investigated as possible predictors of outcome including patient age (Thoma et al. 2014), performance status (Rades et al. 2011) laboratory (Wittekindt P. et al. 2013) histologic grade (Arduino et al. 2008, Weijers Snow et al. 2009, Caslin R. et al. 1992, Piffkà ² et al. 1997, Brandwein-Gensler et al. 2005, Lindenblatt et al. 2012, Kurokawa et al. 2005), and various biomarkers (Ziober et al. 2008, Grimm, 2012). Current staging criteria from the American Joint Committee on Cancer (AJCC) for head and neck cancer rely only on tumour size, node status, and the presence of distant metastasis (TNM). Extracapsular nodal spread, positive margins, and lymphovascular invasion are used as indications for adjuvant radiation or chemotherapy but are not part of the staging criteria. Histologic grade is not included in the current staging criteria because its ability to predict a prognosis has historically been controversial (Roland et al. 1992). Although SCC staging protocol in the seventh edition of the AJCC Cancer Staging Manual seems to represent an improvement from previous editions, there are still significant shortcomings, the greatest of which is a lack of practicality. Several studies have questioned the prognostic accuracy of the TNM system for oral cancer since neither patients comorbidity, specific tumour related factors nor multimodal treatment regimens such as preoperative radiochemotherapy (RCT) are incorporated (Kreppel et al. 2013). Nevertheless, a strong association between conventional cytology grade and survival in patients has been stated by several investigators (Weigum et al. 2010, Editor Kurtycz, 2011, Thomas et al. 2014). A high histologic grade in early stage oral cavity cancer is associated with poorer survival and carries independent prognostic value, in addition to tumour size, node status, and the presence of a distant metastasis (TNM) stage. Thus, histologic grade is considered clinically when making treatment decisions, and multivariable models of survival should include grade as a covariate to improve prognostic accuracy (Thomas et al. 2014). Lip tumours are usually low grade, whereas tumours from teeth to back of tongue are increasing in malignancy as we pass back (Grade 2); tumours of pharynx-high-grade malignancy (grade 3). Grading is a useful method of communication between pathologist and surgeon and is also used as a guide to treatment. Briefly, grades 1 and 2 are usually treated surgicall y, whereas grades 3 and 4 require radiation. Furthermore, the influence of immunological parameters on the prognosis of OSCC has already been discussed in the 1970thand 1980th[References 8,9]. Despite the fact that oral cancer and its causes are well known to the medical and dental professions, and that the tissues of the mouth are accessible for early detection of any abnormal condition, intraoral cancer continues to present an important problem. Selection of early cancer diagnosis is often difficult, especially in some cases where early symptoms are not present or misleading such as in the present case. The gross appearance first presents a local induration, then a warty mass followed by deep infiltration. The malignant ulcer is slow-growing, hard, indurated, and invasive with round edges. It may or may not involve the lymphatic nodes. Furthermore, the risk factors associated with these OPMDs and oral cancers have been established. Tobacco use, alcohol abuse and areca quid chewing habits are important risk factors. The associated factors in the progression of the disease and malignant transformation of OPMDs have not been well defined in previous studies: lesion type (Schepman et al. 1998, â€Å"Oral Leukoplakia and Malignant Transformation,† 1984, Murti et al. 1985, Pindborg et al. 1984, Lumerman A. et al. 1995, Hsue et al. 2007), age (Hsue et al. 2007), lifestyle habits (Schepman et al. 1998, Hsue et al. 2007, Chen S. et al. 2000) and lesion subsites (Scully et al. 2003) were significant factors related to malignancy, but the results from different studies vary and firm conclusions cannot be drawn. Excision of the exposed mucosa or vermilion of the lips can be safely performed even under local anaesthesia and is particularly indicated in situations requiring resurfacing of the lip, notably extensive precancerous leukoplakia or chronic solar cheilitis à ¢Ã¢â€š ¬Ã¢â‚¬â„¢ the chronic sunburn of the weather-beaten farmers or sailors skin or tropical skin of the inhabitants of sunny climates. (Kurth, Lip Shave or vermilionectomy: indications and technique). Furthermore, according to the author the best results with local flaps are achieved in midline defects of the lower and upper lip. References A, M. R. L., Kaas, W., Ja, L., Nw, J. (1994). Role of areca nut in the causation of orai submucous fibrosisà ¢Ã¢â€š ¬Ã‚ ¯: a case- control study in Pakistan. Allen, E. C. M., Lumerman, H., Freedman, P., Kerpel, S. (1995). ORAL AND MAXILLOFACIAL PATHOLOGY Oral epithelial dysplasia and the development of invasive squamous cell carcinoma, 79(3), 321–329. Arduino, P. G., Carrozzo, M., Chiecchio, A., Broccoletti, R., Tirone, F., Borra, E., †¦ Gandolfo, S. (2008). Clinical and histopathologic independent prognostic factors in oral squamous cell carcinoma: a retrospective study of 334 cases. Journal of Oral and Maxillofacial Surgeryà ¢Ã¢â€š ¬Ã‚ ¯: Official Journal of the American Association of Oral and Maxillofacial Surgeons, 66(8), 1570–9. Bauer, A., Hault, K., Knuschke, P., Beissert, S., Bauer, A. (2014). These articles have been accepted for publication in the British Journal of Dermatology and are currently being edited and typeset . Brandwein-Gensler, M., Teixeira, M. S., Lewis, C. M., Lee, B., Rolnitzky, L., Hille, J. J., †¦ Wang, B. Y. (2005). Oral Squamous Cell Carcinoma. The American Journal of Surgical Pathology, 29(2), 167–178. Chung, C.-H., Yang, Y.-H., Wang, T.-Y., Shieh, T.-Y., Warnakulasuriya, S. (2005). Oral precancerous disorders associated with areca quid chewing, smoking, and alcohol drinking in southern Taiwan. Journal of Oral Pathology Medicineà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 34(8), 460–6. Editor, S., Kurtycz, D. F. I. (2011). The Role of Cytology in Oral Lesionsà ¢Ã¢â€š ¬Ã‚ ¯:, 40(1), 73–83. Grimm, M. (2012). Prognostic value of clinicopathological parameters and outcome in 484 patients with oral squamous cell carcinoma: microvascular invasion (V+) is an independent prognostic factor for OSCC. Clinical Translational Oncologyà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 14(11), 870–80. Hsue, S.-S., Wang, W.-C., Chen, C.-H., Lin, C.-C., Chen, Y.-K., Lin, L.-M. (2007). Malignant transformation in 1458 patients with potentially malignant oral mucosal disorders: a follow-up study based in a Taiwanese hospital. Journal of Oral Pathology Medicineà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 36(1), 25–9. Jemal, A., Tiwari, R. C., Murray, T., Ghafoor, A., Samuels, A., Ward, E., †¦ Thun, M. J. (2004). Cancer statistics, 2004. CA: A Cancer Journal for Clinicians, 54(1), 8–29 Kolhe, P. S., Leonard, a G. (1988). Reconstruction of the vermilion after â€Å"lip-shave†. British Journal of Plastic Surgery, 41(1), 68–73 Kreppel, M., Dreiseidler, T., Rothamel, D., Eich, H.-T., Drebber, U., Zà ¶ller, J. E., Scheer, M. (2013). The role of clinical versus histopathological staging in patients with advanced oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy followed by radical surgery. Journal of Cranio-Maxillo-Facial Surgeryà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, 41(1), 22–7. Kurokawa, H., Zhang, M., Matsumoto, S., Yamashita, Y., Tomoyose, T., Tanaka, T., †¦ Takahashi, T. (2005). The high prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma. 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R., Bhonsle, R. B., Pindborg, J. J., Daftary, D. K., Gupta, P. C., Mehta, F. S. (1985). Malignant transformation rate in oral submucous fibrosis over a 17-year period. Community Dentistry and Oral Epidemiology, 13(6), 340–1. Oral Leukoplakia and Malignant Transformation. (1984). Peter, F., Wittekindt, C., Finkensieper, M., Kiehntopf, M., Guntinas-Lichius, O. (2013). Prognostic impact of pretherapeutic laboratory values in head and neck cancer patients. Journal of Cancer Research and Clinical Oncology, 139(1), 171–8. Piffkà ², J., Bà  nkfalvi, a, Ofner, D., Bryne, M., Rasch, D., Joos, U., †¦ Schmid, K. W. (1997). Prognostic value of histobiological factors (malignancy grading and AgNOR content) assessed at the invasive tumour front of oral squamous cell carcinomas. British Journal of Cancer, 75(10), 1543–6. Pindborg, J. J., Murti, P. R., Bhonsle, R. B., Gupta, P. C., Daftary, D. K., Mehta, F. S. (1984). Oral submucous fibrosis as a precancerous condition. Scandinavian Journal of Dental Research, 92(3), 224–9 Rades, D., Seibold, N. D., Gebhard, M. P., Noack, F., Schild, S. E., Thorns, C. (2011). Prognostic factors (including HPV status) for irradiation of locally advanced squamous cell carcinoma of the head and neck (SCCHN). Strahlentherapie Und Onkologieà ¢Ã¢â€š ¬Ã‚ ¯: Organ Der Deutschen Rà ¶ntgengesellschaft [et Al], 187(10), 626–32 Reichart, P. a, Philipsen, H. P. (2005). Oral erythroplakiaa review. Oral Oncology, 41(6), 551–61 Roland, N. J., Caslin, a W., Nash, J., Stell, P. M. (1992). Value of grading squamous cell carcinoma of the head and neck. Head Neck, 14(3), 224–9. Schepman, K. P., van der Meij, E. H., Smeele, L. E., van der Waal, I. (1998). Malignant transformation of oral leukoplakia: a follow-up study of a hospital-based population of 166 patients with oral leukoplakia from The Netherlands. Oral Oncology, 34(4), 270–5. Scully, C., Bagan, J. (2009). Oral squamous cell carcinoma: overview of current understanding of aetiopathogenesis and clinical implications. Oral Diseases, 15(6), 388–99. Scully, C., Sudbà ¸, J., Speight, P. M. (2003). Progress in determining the malignant potential of oral lesions. Journal of Oral Pathology Medicineà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 32(5), 251–6. Shaw, R. J., Pace-Balzan, A., Butterworth, C. (2011). Contemporary clinical management of oral squamous cell carcinoma. Periodontology 2000, 57(1), 89–101. Shiu, M. N., Chen, T. H., Chang, S. H., Hahn, L. J. (2000). Risk factors for leukoplakia and malignant transformation to oral carcinoma: a leukoplakia cohort in Taiwan. British Journal of Cancer, 82(11), 1871–4. Silverman, S., Bhargava, K., Smith, L. W., Malaowalla, a M. (1976). Malignant transformation and natural history of oral leukoplakia in 57,518 industrial workers of Gujarat, India. Cancer, 38(4), 1790–5. Thomas, B., Stedman, M., Davies, L. (2014). Grade as a prognostic factor in oral squamous cell carcinoma: a population-based analysis of the data. The Laryngoscope, 124(3), 688–94. Warnakulasuriya, S. (2009). Causes of oral canceran appraisal of controversies. British Dental Journal, 207(10), 471–5. Warnakulasuriya, S. (2009). Global epidemiology of oral and oropharyngeal cancer. Oral Oncology, 45(4-5), 309–16. Warnakulasuriya, S., Mak, V., Mà ¶ller, H. (2007). Oral cancer survival in young people in South East England. Oral Oncology, 43(10), 982–6. Warnakulasuriya, S., Parkkila, S., Nagao, T., Preedy, V. R., Pasanen, M., Koivisto, H., Niemelà ¤, O. (2008). Demonstration of ethanol-induced protein adducts in oral leukoplakia (pre-cancer) and cancer. Journal of Oral Pathology Medicineà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 37(3), 157–65. Weigum, S. E., Floriano, P. N., Redding, S. W., Yeh, C.-K., Westbrook, S. D., McGuff, H. S., †¦ McDevitt, J. T. (2010). Nano-bio-chip sensor platform for examination of oral exfoliative cytology. Cancer Prevention Research (Philadelphia, Pa.), 3(4), 518–28. Weijers, M., Snow, G. B., Bezemer, P. D., van der Waal, I. (2009). Malignancy grading is no better than conventional histopathological grading in small squamous cell carcinoma of tongue and floor of mouth: retrospective study in 128 patients. Journal of Oral Pathology Medicineà ¢Ã¢â€š ¬Ã‚ ¯: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 38(4), 343–7. Ziober, B. L., Mauk, M. G., Falls, E. M., Chen, Z., Ziober, A. F., Bau, H. H. (2008). LAB-ON-A-CHIP FOR ORAL CANCER SCREENING AND DIAGNOSIS, (January), 111–121.

Sexual Orientation and Body Image Dysmorphia :: Sexuality Homosexuality Essays

Sexual Orientation and Body Image Dysmorphia Recent research has concluded that sexual orientation, in both men and women, may play a significant role in the feelings of dissatisfaction of one’s physical appearance and the development and onset of disordered eating habits. Numerous studies have found that homosexual men have a higher likelihood of being more dissatisfied with their overall physical appearance. It is not so clear for homosexual women. In this paper I will review a number of published research article and try to more clearly explain the contrasting results about homosexual women. ADOLESCENT SEXUAL ORIENTATION Although most of the studies look at an adult population, a study by French, Story, Remafedi, and Resnik, examined the effects of sexual orientation on an adolescent population. In their study they looked at a population based sample of about 35,000 students between the grades of seven and twelve. Each of these students completed a survey that asked questions about sexual orientation, body satisfaction, and different weight control measures. The final report included the findings from 212 heterosexual males and 182 heterosexual females for comparison with 81 self- identifying homosexual males and 38 self- identifying homosexual females, and 131 bisexual males and 144 bisexual females. They discovered that homosexual males were much more likely than heterosexual males to report having a poor body image (27.8% to 12%) and admit to frequent dieting (8.9% to 5.5%), binge eating (25.0% to 10.6%), or purging (11.7% to 4.4%). On the other side, homosexual females were more likely than heterosexual females to report that they were happy with the way that they looked (42.1% to 20.5%). Interestingly though, homosexual and heterosexual females were about equally as likely to diet, participate in binge eating, and partake in purging. PROBLEMS WITH STUDY Although the study seems to be appropriate, one must be wary about looking at a study, which was conducted through the use of surveys. This is particularly true when you are asking adolescents questions that deal with sexuality. It is possible that an adolescent’s embarrassment could be a factor in the answering of the questions. Social stereotypes could easily influence a heterosexual male to answer positively to questions about his body image because body angst is usually associated as a female behavior. This study is important to research on this topic because it shows that from the beginning of sexual orientation decisions, eating habits are a priority to some. Finicky and disordered eating problems are not something that develops later in life.

Just War Theory :: Free Essay Writer

Just War Theory Questions About The War I think the just war tradition is a great way to rate if a war is really worth fighting or is it really not worth fighting. For the first law Just Cause, yes I would say that we as the United States have just cause to end the terrorist attacks because it is really starting to get out of hand. The Second law Comparative Justice yes I would say that we have comparative justice because we have definitely suffered more than Afghanistan because we have lost many more people in their attacks than they have in any of our attacks. The Third Law Legitimate Authority is definitely being used in our country to begin our war against terrorism. Our highest rank is the president and he is the one that did declare war against terrorism. The Fourth Law Right Intention, yes I do think that right intention is being used because they killed 4500 of our citizens and all we are doing is wiping out terrorism not necessarily killing any people. We as a country just want to out do the terrorist actions and bring peace to all countries. The Fifth Law Probability of Success, yes I think that the probability of success is greater than the probability of success for the terrorists. The probability of success against terrorism is greater to prevail because the United States and Britain are just taking the initial step and if any thing goes wrong the United States has 90% of the other countries around the world to help us if we need them. The Sixth Law Proportionality is being put in effect that they keep the civilian casualties down to a minimum because that is not the purpose of the war and after the war the will have out done evil and the good and peaceful will prevail.

Health and Social Care Level Essay

3.1 Analyse why life expectancy has increase over the last century. Life expectancy in the human race has risen dramatically in the past century reaching its highest level for both male and female on record. Between 1981 and 2002 life expectancy at age 50 increases by four and a half years for men and three years for women and two years respectively. By 2002 women who were age of 65 could expect to live to the age of 84 while men could expect to live to the age of 81. The primary reason for the vast increase in life expectancy in developed countries in the 20th century is universal clean drinking water and very high level of public and personal hygiene. These two improvements account for probably 80%of the life expectancy. Overall life expectancy increased due to 6 mayor factors 1. Clean drinking water 2. Universal sanitation 3. Significantly improved nutrition, particularly during infancy and childhood 4. Vaccination against most common epidemic diseases 5. Access to high-quality trauma (accident and emergency ) care 6. Improved drugs ( particularly, antibiotic) 3.2 Examine the main causes of mortality in men aged 65- 84. The leading causes of mortality in men over the age of 65 are also among most common causes of death among the population are as a whole. Many of these conditions are also highly preventable and treatable. Here are the top six main causes of mortality in men over 65. * Heart Disease: Heart disease is the number one cause of death among adults over the age of 60. Heart disease includes conditions such as heart failure heart attack and heart arrhythmia that can cause the heart to beat ineffectively and impair circulation. Heart disease is associated with or caused by diabetes, high blood pressure , smoking, improper diet and lack of exercise. * Cancer: cancer is second leading cause of death among seniors. It includes all cancers including breast cancer, colon cancer, and skin cancer. Also include are the malignant blood and bone marrow disease that cause leukaemia .many cancers occur at a higher rate among older adult, thoug h the cause for that is not clear .cancer can also be more difficult to treat due to health condition that may also be present. * Cerebrovascular Disease: More commonly known as stroke cerebrovascular disease can be cause by either a colt or blockage that cuts off blood flow to a part of the brain or by haemorrhage. In both cases there is damage or death of the brain tissue that can cause paralysis, speech disorder, swallowing problems and immobility. People with diabetes and high blood pressure are at higher risk of stroke. * COPD: Chronic obstructive lung disease decreases the lungs ability to exchange carbon dioxide for oxygen. As the disease progress the patient has to work harder and harder to breathe often feeling as if they are suffocating. These disease are often link to a lifetime of smoking but be due to environmental factors. * Pneumonia: Pneumonia is the fifth highest killer of older adults, especially during the winter months of flu season. At high risk are seniors with chronic disease such as diabetes heart disease and reparatory conditions. The flu and pneumonia shot are recommended for all adults over the age 55 to help prevent this killer. Diabetes: Type two diabetes, also known as adult onset diabetes is a chronic that lowers the immune system and can increase risk of stroke, heart disease and other circulatory problems. Wounds take longer to heal and respiratory infections like pneumonia often are more severe. 3.3 Analyse the possible future increase or decline in life expectancy. People have been long imagining that they might individually live to old age. For most of human history, the threats to survive overwhelmed this idea. A few people lie to be old, but most of the members of any society died young. Until the early twentieth century more people died in infancy than at any other age. Reaching old age in the democratization of survival to old age in the period since about 1800. Survival and health should be distinguished. A person may be alive but not well. The different matter because disease and injury have not retreated as far as death has. Morbidity, in the sense of sickness prevalence, remains high in all societies, in some because communicable disease has taken their place. Moreover the factor state influence sickness and death seem to overlap only in part, and often to influence these two effects differently. In a future stage of the global health transition, sickness prevalence too may be forced back. Life expectancy statistical estimate of the number of years an individual is expected to live based on such criteria as sex, race, health and occupation. Average life expectancy declined from 62years in 1990 to 50 years in 2007; it is projected to fall even further by 2011, to 48 years for men and 51 for women according to the institute annual South Africa survey. The decline in life expectancy and the gap between levels in Russia and the rest of Europe l can be attributed mainly to abnormally high rates of cardiovascular disease a nd injury, for both which abuse of alcohol was a major risk factor. The guest to prolong our youth continues today, though not through lengthy field explorations, but through improvements in health, nutrition and medicine. A healthy diet regular exercise and vaccination can greatly improve an individual’s life expectancy, while an outbreak of disease, and mainly lower an individual’s life expectancy. But how life expectancy affect on a national level? While these factors are central to living longer, they alone cannot be the only facets. The social and economic conditions of each country will undoubtedly affect its citizens, their life styles and decisions. Citizens of wealthier countries have access to modern medicine and medical facilities, the leisure to exercise and meticulous regulation of sanitation and drinking water. Their life expectancies therefore, naturally should be higher than those of less developed countries. TO CONCLUDE: The future increase or decline in life expectancy is increasing by two years every decade. They show no sign of flattening out. Average life span around the world is already double what it was 200 years ago. Since the 1980s expert through the increase in life expectancy would slow down and then stop but forecaster have repeatedly been proved wrong. The reason behind the study rise in life expectancy is â€Å"the decline in the death rate of the elderly†. It is said that our bodies are evolving to maintain and repair themselves better and our genes are investing in the process to put off the damage which will lead to death. â€Å"There is no use by date when we age, ageing is not a fixed biological process† professor Kirkwood says. And with people nearly one in five currently in the uk living to see their 100th birthday in a good and better shape, it is safe to assume that this is all down to better eating habits, living conditions, education and medicine.

Body Language in Business Communication

Body Language in Business Communication Body language is a non verbal form of communication that is widely used by people in everyday environment. Alone, or in conjunction with the words, body language has a big influence on how we communicate to others. In business world it can cause both positive and negative results in communication. If used properly, body language can help create a friendly atmosphere in any conversation and can significantly enhance your verbal message. It can help win the interview, make a sale, give a successful presentation and profit from business negotiations. Therefore, today’s businesspeople more and more some time studying the different forms of the body language to achieve the maximum positive influence on people. They also do it, so they can better understand people around them as well. Body language is defined as everything what can be communicated without or in addition to words: facial expressions, physical movements (gestures), posture or silent actions. The study by UCLA (University of California in Los Angeles) showed, that words account for only 7% of the messages person conveys. The remaining 93% are non-verbal factors. As Lidia Ramse, business etiquette expert says: â€Å"In the business setting, people can see what you are not saying. If your body language doesn't match your words, you are wasting your time. † (The Sideroad: Body Language in Business by Lidia Ramse) In fact, psychologists divide body language in two categories: intentional and unintentional (subconscious). We cannot always verbally express what we feel, so our body language does it for us. At the same time, we can use our body language intentionally to express something without saying a word. It is good to understand that our body language can be also interpreted subconsciously as well. As people do not always pay close attention to what we do, certain actions can trigger a formulation of certain opinion about person. Mary-Lo use Angoujard, CEO and Founder of Rapporta Limited, gives a good example of the person, whose arms folded across the body, head down, stiff torso, hunched shoulders and crossed legs. She calls it â€Å"closed† body language that causes people think that this person is shy by nature, cold or ill or simply disagreeing strongly with something. (Raporta- Bringing Positive Energy to Business Communication) In addition to all above mentioned, nonverbal signals can suggest the attitude, understanding, empathy and ethics. That is why it is important to analyze and study your own body language and evaluate others’. Then you can learn how to use it in your own advantage and how to better understand your copartners to make your business communication process the most successful it can be. These are some tips on the most practical and common body language signals. Handshake Handshake is a form of gesture that is most commonly associated with greeting. Other common uses of it are starting the meeting, making an offer (deal) or completing an agreement. The main purpose of the handshake is to convey trust, balance and equality. In general handshake should be firm, full and supported by an eye contact. It can help convey your confidence and get a good start for further communication. Handshake can reveal your associate’s personality. The stronger the handshake the more aggressive or important the associate can be. Posture Standing tall and holding the head straight is not only a sign of a good posture. It can also show confidence, make the message come across easier and make it a subject of importance. Use of Personal Space Use of personal space is another important factor, but it is also culture oriented. Understanding of this term differs from one country to another. â€Å"For Western Europeans and Americans, a space of 14 to 16 inches is considered non-intrusive. But those from the U. K. might consider a distance of 24 inches to be more comfortable†, concludes Tatiana D. Helenius in her article about international business dealings (CNN. Money). As protocol and etiquette consultant Margaret DelVecchio said: â€Å"Awareness of the level of personal space required is crucial†¦. If not gauged properly, inappropriate proximity or distance can lead to misunderstandings and be interpreted as insult (CNN. Money). † It is also important to pay attention as to what stance your college has: is he sitting or standing? You should not take more space than other person does suggesting your bigger significance. In conclusion, it is important to mention that human body can produce over 700,000 unique movements. These movements have been divided into about 60 symbolic signals and around 60 gestures. Brenner Books: Body Language in Business). After careful examining of your own attitude you can choose and work on the most successful for the particular message body signals and correct unnecessary ones that caused you failure in the past. Nonverbal communication when coupled by good verbal skills together with knowledge of the mater ial and ethical behavior will have huge impact on others and bring successful results to any business. Works Cited Angoujard, Mary-Louise. â€Å"Is Your Body Talking Good Business? Body Language in Business – Sort it out and Communicate with Greater Impact. Rapporta – Bringing Positive Energy to Business Communication. Copyright 2006 Rapporta Ltd. Retrieved on 24 July, 2007 from: < http://rapporta. com/press07. htm> â€Å"Body Language Rules Biz Travel†. CNN. com/World. 8 July, 2003. Retrieved on 23 July, 2007 from: < http://edition. cnn. com/2003/WORLD/europe/07/08/biz. trav. body. language/index. html> Brenner, C. Robert. â€Å"Body Language in Business: How to Sell using Your Body! † BrennerBooks. com. Copyright 2001-2004, Brenner Information Group. 9 December 2004. Retrieved on 22 July, 2007 from: < http://www. brennerbooks. com/bodylang. tml> Helenius, D. Tatiana. â€Å"Body Language Savvy. † CNN Money. 2007 Cable News Network LP, LLLP. A Tim e Warner Company. 3 May, 2000. Retrieved on 22 July, 2007 from: < http://money. cnn. com/2000/05/03/career/q_body_language/> Morgan, Nick. â€Å"The Truth behind the Smile and Other Myths – When Body Language Lies. † HBS Working Knowledge. Vol. 5, No. 8, August 2002. Retrieved on 23 July, 2007 from: < http://hbswk. hbs. edu/archive/3123. html> Ramsey, Lidia. â€Å"Body Language in Business. † Sideboard. com. Blue Boulder Internet Publishing 2007. Retrieved on 23 July, 2007 from:

Living in Germany Around 1941 Essay

A) Explain why the invasion of the USSR changed the lives of those living in Germany around 1941-42. (12 Marks) The invasion of the USSR in the summer months was that of great confidence and assertiveness that they were on the ‘front foot’ from the German people. During these summer months, the Russians had been pushed back by the Germans to what many thought of as the core of the USSR; Russia. Obviously when the Germans had advanced 20 miles short of the central of the most powerful enemy they’ve faced yet, the German people had a right to be happy with their recent progress in the war. This changed their lives by giving them more confidence in that they felt they could defeat the Russians as they were pushing them back towards the capital. However, after the winter set in the attitude of the German people to the progress being made in the war changed. Before the war the Germans had demolished smaller countries such as France and Poland, meaning that the German people felt that losing was almost alien to them. But when the Russians kicked back against the Germans on the Eastern Front on December 5th 1941 outside of Moscow, the German retreat began. More and more soldiers fell, and the Germans were never able to recover the ground that they had lost. Due to the soldiers diminishing, letters had to be written back to rural Germany to notify those whom had relatives/friends in the war. When the letters started to come thick and fast, the German people now had a hint of doubt in their mind. I like to think of it as a seed that was planted- the plantation is from the initial invasion of the USSR, and when more and more letters and stories came back from the Russian lines the tree grew. Eventually, the doubt that was once a seed at the start of the invasion of Russia, had now fully flourished into a vast tree of doubt, showing us how the German lives had changed through doubt and anxiety that gradually built up through the invasion of Russia, from going and destroying France and Poland to being pushed back from the Russians. Some historians could say that the battle of Stalingrad had the biggest effect of the German people around 1941. I would say that it was the turning point in the entire war, as it caused the realization from the German people that they were not going to win the war. This contrasts to before the war, where, as said, the German people didn’t have many qualms about minor losses because they believed they knew they were going to win in the first pl ace. However during Stalingrad this changed; where a quarter million Germans were surrounded, field marshaled, and eventually forced to surrender- this continued on to 1942 where the German soldiers were freezing, and running low on ammunition. The news of this was tried to be kept ‘under wraps’ by some of the hierarchy in the German army, as it would prove low for morale. However the word spread through the press and a flurry of letters of death being sent home. This fully confirmed to the German citizens that the Germans were now on the ‘back foot’ changing their lives, as they now had to be preparing for a loss, instead of a victory. Although it is not directly coherent to the invasion of the USSR, it could be said that the bombings that partly came about from the invasion of Russia changed the lifestyles and actions of the German people. Before the bombings, William L Shirer reported â€Å"The atmosphere was so peaceful and calm. The bathing beach at Wannsee jammed with thousands. Hundreds of sailboats and canoes on the Havel. Families picnicking under the trees† this tells us that the German people were once not bothered as much by the war, and it continued to be ‘business as usual’ for the German citizens. I can contrast this when the bombings continued to develop on 16th and 17th of January 1943. The German people were now saying that the â€Å"English are clearly superior in the air, and that the German Luftwaffe is ‘impotent’ at the moment and has no possibility of retaliating appropriately† I think that this is a perfect example of the change from the Germans being confident and carrying on with their ‘normal day’ to then beginning to doubt the German superiority in the war, showing us how much their attitude has changed from pride to dread in a matter of three years. Even though the bombings weren’t as connected to the Germans invading Russia, it could be said that had not the Germans invaded Russia then the bombings may not have been present/ been less relentless.

Research Proposal on Banking Essay

Introduction Over thirty-five years have passed since academics began speculating on the impact that information technology (IT) would have on organizational structure. The debate is still on-going, and both researchers and managers continue to explore the relationship between IT and organizational structure. As organizations need to process more information under these uncertain conditions, IT is one possible way for organizations to increase their information processing capability. We are conducting a research in HBL bank that, how bank increase the number of account holders using Internet banking among its Current Account holders. IT has a dramatic effect on both people’s personal and professional lives. IT is also changing the nature of organizations by providing opportunities to make fundamental changes in the way they do business. The technology is changing rapidly, with computing speeds and the numbers of transistor equivalents available in a given area of a microprocessor chip both doubling in very short time. Organizations are acquiring more and more technology systems to assist in everything from manufacturing to the management of information to the provision and improvement of customer service. Harnessing and coordinating this computing power is the challenge. New tools and innovative perspectives with which to examine, interpret, and comprehend these rapidly evolving environments are always needed and sought. Background / Literature View: IT is transforming the way that business is conducted. Computers prepare invoices, issue checks, keep track of the movement of stock, and store personnel and payroll records. Word processing and personal computers are changing the patterns of office work, and the spread of information technology is affecting the efficiency and competitiveness of business, the structure of the work force, and the overall growth of economic output. Many people believe that the primary driving force behind this information revolution is progress in microelectronic technology, particularly in the development of integrated circuits or chips. Thus, the reason that computing power that used to fill a room and cost $1 million now stands on a desk and costs $500 or that pocket calculators that used to cost $1000 now cost $10 is that society happens to have benefited from a series of spectacularly successful inventions in the field of electronics. But fewer people understand why the introduction of information technology occurred when it did or took the path that it did, why data processing came before word processing or why computers transformed the office environment before they transformed the factory environment. Because this technology oriented view of the causes of the information revolution offers little guidance to the direction that technological developments have taken thus far, it offers little insight into the direction that they will take in the future. Electronic banking is one of the first things that come to mind when one thinks about the future of banking. It is generally assumed that electronic banking is new and that it will replace or supplement many channels of delivery of retail banking services. The term electronic banking as used here refers to any banking activity accessed by electronic means. It includes Online Banking, Automated Teller Machines (ATMs), Automated Call Centers, Digital Cash, Internet Banking, Screen Telephones, E-Utility Bills and so on. These channels of delivery can be used for presenting and paying bills, buying and selling securities, transferring funds, and providing other financial products and services. Electronic banking can be used for retail banking and business-to-business (B2B) transactions, as well as for facilitating large-amount transfers. Equally important, electronic banking is a worldwide phenomenon. As the term is used here, it involves transactions. Web sites that are transactional are considered electronic banking. Electronic banking and the Internet in general are forcing a shift in the way banks and other businesses organize and the way they think of themselves. A shift is taking place from vertical integration to virtual integration. Banks and other financial intermediaries must realize that they are in the financial information industry. The Internet makes it possible to bring both customers and suppliers together to share critical business information. E-banking helps banks relay and show to their clients how good their services are, how many services we are providing and that the services they offer are of better standards. Through E-banking the company can show the clients that they are better than competitors and can give them satisfaction guaranteed. Statement of the problem The internet and the different things it can do to uplift business procedures, products and services is a current necessity for business. One of internet’s products is Electronic banking. Electronic banking is a faster way for clients to transact with the banks personnel. Clients can still transact with banks while on the comfort and safety of their homes and Offices. The main purpose of this proposed research is to determine, how we will increase Internet Banking Users among their present Account holders. Theoretical Framework: Increase Internet Banking Users Quality Products (websites) A Bank Manager observed that, if he provides the better Quality Products (Websites) and Low Bank Charges on Internet-Banking to his Account holders. This will increase the number of Customer of Internet Banking. But it will not affect on those Account holders with less qualification and do not use internet. Qualification of account holder and use of internet Low Bank Charges on Internet Banking Research Objectives: This Research intends to find out, If Bank updates its website and gives quality products, easy use and as well as reduce its transaction charges on Internet banking will increase the number of users using Internet Banking among its Account holders. However, according to the literature review, the qualification of account holder is plays an important part in this relationship. Our objective is if we increase quality products and reduce its transaction charges on Internet banking will increase the Internet Banking users. Research Question: * If we increase quality products and reduce its transaction charges on Internet banking will increase the Internet Banking users or not? * Qualification of customer and use of internet is effect on internet banking users or not? Research Design/Methodology: Type of research This research will use the descriptive type of research. Descriptive method of research is to gather information about the present existing condition and solving the problem. The descriptive approach is quick and more practical financially. Moreover, this method will allow for a flexible approach, thus, when important new issues and questions arise during the duration of the study, a further investigation may be allowed. The study opted to use this kind of research considering the goal of the study to obtain first hand data so as to formulate rational and sound conclusions and recommendations for the study. Research Strategy For this research data will be gathered through collating published studies from different books, articles from different related journals and studies, and other literary instruments. Afterwards make a content analysis of the collected documentary and verbal material. The study will then summarize all the necessary information. The study will then make a conclusion based on the said information and provide insightful recommendations on how to solve the said problem. Sample and Sampling Technique The respondents of the research came from the different branches of bank mentioned from Karachi. Due to time constraint and also, for the convenience of the researcher, only hundred (100) respondents were considered for the study. The convenience sampling technique was imposed in the study to pick up the hundred respondents, mainly because the availability of the respondents from the different branches was considered. This part of the study is important because the most important data needed to fulfill the objectives and aims of this study will only be supplied by the respondents from the Branches of HBL bank Karachi. Primary and secondary data collection The primary source of data will come from a survey using questionnaire and interviews that will be conducted by the researcher. The primary data frequently gives the detailed definitions of terms and statistical units used in the survey. These are usually broken down into finer classifications. The secondary source of data will come from research through the internet; books, journals, related studies and other sources of information. Acquiring secondary data are more convenient to use because they are already condensed and organized. Moreover, analysis and interpretation are done more easily. Validation of the instrument For validation purposes, the researcher pre-tested a sample of the set survey questionnaires. This was done by conducting an initial survey to at least five respondents from the different banks from Karachi. After the respondents answered, the researchers then asked them to cite the parts of the questionnaire that needs improvement. The researcher even asked for suggestions and corrections from the respondents to ensure that the survey-questionnaire is effective. Automatically, these five respondents were not included as respondents for the study. Data analysis Data gathered will be analyzed through frequency distributions. These will give way to reviewing the data categories and the number of referrals in each category. The data acquired will be analyzed according to the different categories and importance. The information that will be gathered and analyzed will be important to achieve the objectives desired by the study.