Pulmonary Embolism as Manifestation of Right Atrial Myxoma

Pulmonary Embolism as Manifestation of Right Atrial Myxoma A  case report and review of literature Abstract We present a case of a 55-year-old man who suffered from shortness of breath and syncope; he was sent to our department for suspecting pulmonary embolism. We proceeded Computed tomography pulmonary angiography (CTPA) and Transthoracic echocardiogram (TTE) , confirmed the diagnosis which was caused by right atrial mass. After the surgery the patient was diagnosed as right atrial myoma (RAM) with pulmonary myoma emboli without no adverse event. The residual emboli were partially improved after one month anticoagulation. We reported this case and review of the relevent literature to help clinicians improve the understanding of diagnosis and treatment of pulmonary embolism caused by RAM. Key words: pulmonary embolism, right atrial myxoma, treatment Pulmonary embolism, most commonly originating from deep venous thrombosis (DVT) of the legs, ranges from asymptomatic, incidentally discovered emboli to massive thromboembolism causing immediate death. PTE is a life-threatening disease with a high morbidity. Annually, as many as 300,000 people in the United States die from acute PTE, which is much more common in China at present than 10 years ago (1). About 50-70% emboli of pulmonary embolism originated from deep venous thrombosis (DVT), most of which in lower extremities. Such patients without DVT should screen occult cancer. Although cancer associated venous thrombosis was widespread described, the emboli from benign tumor are less mentioned (2). Majority of the atrial myxoma complicated pulmonary emboli are tumoral, thrombotic emboli were less reported (3,4). We report a rare case of RAM with a pulmonary localization mimicking pulmonary emboli. Case presentation A 55-year-old man was admitted to emergency room with gradually increased shortness of breath for 2 months, syncope and right chest pain for 6 hours. He had a habit of long time sitting and a history of 20 pack-year smoking, and stopped smoking 10 years prior to admission. Initial assessment revealed cyanosis and right breath sound decreased. No pitting edema in lower extremities. Laboratory tests showed ALT 52IU/liter; 93IU/liter; D-Dimer >10ÃŽ ¼g/ml; NT-proBNP 3544 Ñâ‚ ¬g/ml; Troponin I 0.49 ng/ml. Arterial blood gases revealed severe hypoxemia, oxygenation index was 89mmHg; Electrocardiogram showed Sà ¢Ã¢â‚¬ ¦Ã‚  Qà ¢Ã¢â‚¬ ¦Ã‚ ¢Tà ¢Ã¢â‚¬ ¦Ã‚ ¢. CTPA revealed right main (Figure 1a), both lobar(Figure 1b,1c) and segmental (Figure 1d) pulmonary arteries(PA) multiple filling defects; right atrium irregular mass(Figure 1d). TTE showed enlargement of right chambers and a right atrial 54*47mm mass attached to the top wall, clear margin, irregular and partial rough on surface, l oose in internal structure, moving along with cardiac cycle, mild prolapse through the leaflets of the tricuspid valve and orifice of inferior vena cava, moderate regurgitation of tricuspid valves with mild pulmonary hypertension. Compressed venous ultrasonography showed negative in both lower limbs. The surgical approach was through a medial sternotomy under extracorporeal circulation. The right atrium wall was opened and a gelatinous consistency tumor with necrosis, fragile, measuring 40*50mm, adhering to the inter-atrial septum (Figure 2), a 30*20*70mm tumor embolus in the right main PA, the distal end was near right upper PA. The tumor cells expressed CD34 and calretinin, and were negative for CK and SMA. The histopathological examination confirmed myxoma (Figure 3) in right atrium and right pulmonary artery. The patient was treated warfarin (target INR, 2-3) for 1 month. Repeated CTPA showed left lower PA filling defect with no improvement after 2 months (Figure 4c), right and other left PA filling defect resolved (Figure 4a, 4b). 2 years follow-up he was asymptomatic. Discussion Cardiac tumors are less common, most of which are from metastasis. The incidence rate of primary cardiac tumors (PCTs) in autopsy ranges from 0.02 to 2.8†°. 30-50% of PCTs are myomas, 75% in the left atrium and only 10-20% arising in the right atrium, which may developing from embryonic or primitive gut rests (5,6,7). Histologically, they consist of an acid-mucopolysaccharide rich stroma. Polygonal cells arranged in single or small clusters are scattered among the matrix. The clinical manifestations of RAM may remain asymptomatic or appear with constitutional, obstructive or embolic symptoms according to the size, fragility, mobility, location of the tumor as well as body position and activity (5,8). Nonspecific constitutional signs, which present in 10-45% of patients with myxoma, are fatigue, fever, dyspnea, chronic anemia, weight loss, general arthralgia, and increase of IL-6, ESR, and CRP (8). Therefore the results of laboratory tests may mimic those for rheumatic disorders. These signs are more common for patients with large, multiple, or recurrent tumors, and usually recovered after resection (9). Pulmonary embolism of RAM fragments or thrombi from the surface may also occur, resulting in dyspnea, pleuritic chest pain, hemoptysis, syncope, pulmonary hypertension and right heart failure even sudden death. Acute abdominal pain was mentioned in two cases (10). Embolic event in cardiac myxoma is common, with the incidence ranging from 30% to 40% (5) . In the cases of RAM with pulmonary embolism, a smaller size, villous or irregular surface and multi-foci are most common factors associated with embolization (11). The duration period was ranging from 1 day to 3.5 years. The age of patients ranged from 17 to 76 years (mean age 42.8 years), with a higher incidence in women (20/35, 57%). In these cases RAMs are usually attached by a short pedicle to the inter-atrial septum (22/35), mostly in fossa ovalis, others are in free wall, crista terminalis, Koch triangle and multiple origins. Most of the patients were diagnosed with TTE (Transthoracic echocardiography), CT, transesophageal echocardiography (TEE) and magnetic resonance imaging (MRI), others were with angiography and autopsy. In almost all cases treatment was surgical with removal of the intra-atrial myxomas and the pulmonary emboli, which are usually tumoral. Majority of such patients recovered well after surgery. Four preoperative deaths, two postoperative deaths were reported. Right atrial thrombosis, transient ischemic attack (TIA), ischemic hepatitis and renal failure were the rare complication (Table 1). TTE and TEE are the most commonly used diagnostic methods in the detection and initial description of atrial myxomas (23). TTE is nearly 95% sensitive for the confirmation of cardiac myxomas, and TEE reaches nearly 100% sensitivity (45). TTE facilitated bedside test to safely detect myxomas in fatal pulmonary embolism as in our patient. TEE produces explicit images of small tumors (1 to 3 mm in diameter), especially in fat patients with poor TTE images (46). The TEE also permits a clearer picture of the attachment of the tumor and more precise characterization of the size, shape, surface, inner structure and location of the mass (47). Although TEE is a semi-invasive diagnostic test with a very low rate of significant complications, lethal pulmonary embolism during TEE procedure has been reported (22). Superior to echocardiography, multi-detectors spiral computed tomography (MSCT) and cardiac magnetic resonance imaging (CMR) are more accurate in determining the relationship to normal intra-cardiac structures and tumor infiltration into the pericardium, extension to adjacent vasculature and mediastinal structures, pulmonary arteries emboli and surgical planning (48,49). RAMs manifest as a low-attenuation intra-atrium mass with a smooth, irregular or villous surface on MSCT. Calcifications are seen in about 14% and are more common in right side lesions. Arterial-phase contrast enhancement is usually not apparent, but heterogeneous enhancement is reported on studies performed with a longer time delay (50,51). Varying amounts of myxoid, calcified, hemorrhagic, and necrotic tissue gives them heterogeneous appearances on T1 and T2-weighted images. Delayed enhancement is typical and usually patchy in nature. Steady state free preceesion (SSFP) sequences may slow prolapse through the tricu spid valve in diastole phase and can suggest the attachment point of a stalk lesion. Reconstruction of cine gradient recalled echo (GRE) images enables assessment of lesion mobility and attachment (52). 18F-FDG PET/CT can help the noninvasive preoperative confirmation of malignancy (41). Mean SUVmax was 2.8 ±0.6 in benign cardiac tumors and significantly higher in both malignant primary and secondary cases. (8.0 ±2.1 and 10.8 ±4.9). The SUVmax of myxoma is ranging from 1.6 to 4. Malignancy was determined with a sensitivity of 100% and specificity of 86% with a cut-off SUVmax value of 3.5. A weak correlation between the SUVmax and the size of tumors is found due to the partial volume effect, cardiac motion and respirtatory movement (53). Angiography is an invasive investigation that presents an additional risk of inducing migration of the tumor and only suitable for suspected acute coronary heart disease (37). Surgical removal of the RAM with pulmonary embolism is the first treatment of choice and usually curative (44,45). The crucial aspects of surgery are measures for bi-caval cannulation to prevent intra-operative embolism (27), en-bloc excision of the myxoma with a wide cuff of normal tissue, removal of fragments in pulmonary arteries, and conducted under moderate or deep hypothermia, low circulatory flow or total circulatory arrest based on the extent and sites of the emboli (44). Surgical treatment leads to complete resolution with low rates of recurrence and good long-term survival. The overall recurrence rate is about 1–3% for sporadic atrial myxoma (5,54), which grows an average of 0.24–1.6 cm per year. The risk of recurrence pulmonary embolism after resection has been reported to be 0.4% to 5.0% and interval from excision to recurrence is reported ranging from a few months to 8 years (55). The reasons of RAM recurrence include multifocal origin, incomplete surgical resection, familial disposition or abnormal DNA ploidy pattern. Postoperative annual TTE, V/Q scan for long-term observation should be followed up to detect eventual recurrence of new myxoma and pulmonary embolism. Excision of the recurrent lesions may be the only choice of treatment because of the poor role of chemotherapy and radiation (28). Pulmonary emboli from RAM are usually tumoral, although discriminating myxomas from thrombi in pulmonary arteries is difficult. Daniel T et al (56) presented the first case of paradoxical pulmonary embolism in the presence of a left atrial myxoma withouingt intra-cardiac shunting, potentially secondary to a combination of hemolysis, hemeoxygenase-1 up-regulation, systemic hypercoagulability/hypofibrinolysis, and regional venous stasis. Pulmonary thromboembolism complicated to RAM improved by coumadin therapy in a refused surgery patient (40). In our case the surgery do not remove the right side emboli, while anticoagulation was helpful for residue emboli remission, which confirmed coexistence of myxoma and thrombi. We suggest anticoagulation may be the useful in unresectable myxoma with pulmonary embolism. The duration of anticoagulation in pulmonary thromboembolism is at least three months, but the course in patients with RAM is still unknown. Conclusion According to review of the literature, RAM may not be timely diagnosed, or even totally undiagnosed. Because of the fragile consistency of RAM, pulmonary embolism are the most common comorbidity and mortality disease, usually be fatal. Surgical removal of masses from the atrium and pulmonary arteries is almost uneventful. Although the association between right atrial myxoma and pulmonary embolism has been described, the presence of thrombi was less mentioned. We suggest anticoagulation may be a choice of treatment after operation, especially in incomplete resection cases. Annual TTE and V/Q are suggested for a period of 8 years when the risk of recurrence is reported. Competing interests The authors declare that they have no competing interests.

Disco Music

Matt Crane 8-19-06 Music Back in the late 1960s, disco originated as a combination of many instruments played together. It was in 1969 when Jerry Butler released his latest song ‘Only the Strong Survive’ that we got our very first disco song. This was the birth of disco but then it was a form of music which hadn’t been named. Four years and many songs later on the 13th of September 1973, Vince Aletti wrote an article in the Rolling Stone Magazine which gave this music form its name â€Å"DISCO†.This soulful music is based on a number of instruments blended together to get what is known as the disco sound. The vocals are played on a steady four on the floor beat or what is known as a quaver (eighth note) or a semi- quaver (sixteenth note). Many electronic musical gadgets are used to create the background score. This form of music has more of electric bass line and the guitar is seldom used as a lead instrument. Films like Saturday Night Fever and Thank God I ts Friday made disco theque more popular than ever before.It was the Bee Gees who came to represent real Disco theque. The group till then was famous for their ballads and pop songs challenging the supremacy of The Beatles. Their success numbers were released again on the Saturday Night Fever movie soundtrack. Disco was born much earlier in the late 60’s when Jerry Butleras haunting melody was the first case of a combination of music with dance. This particular song brought about the marriage between Philly and New York soul both being evolutions of Motown Sound. The Philly sound is lavish percussion. 972 Soul Makasso is said to be one of the first disco songs. Disco spread to Europe through the jivings of Abba from the mid 70’s. Boney-M was another group of four West Indian singers and dancers who guided by West German record producer Frank Farian, soon became a great hit in Canada and Japan. The latter half of the 70’s saw clubs reverberating with Disco music. The culture centered on discotheques, nightclubs, and private parties where DJ’s played disco hits through power sound systems. Long single records kept people dancing throughout the night.Even some of the most prestigious clubs matched their lighting arrangements to swish to the beat of Disco theque. Dancing schools sprung up in some cities and candidates were taught how to touch dance hustle and cha-cha. Disco fashions then hit the market with Halston dresses for women, shiny Qiana shirts for men pointed collars and open at the chest worn with double knit jacket suits. Disco culture soon became a shelter for those on the fringes of society they found a way to express themselves. Disco managed to fulfill one of the objectives of the Civil Rights movement.It brought the races closer together for the first time where Blacks & Whites â€Å"co-mingled† freely. Although â€Å"disco's† did in fact lead to the downfall of the â€Å"inner city Funk House† a nd while a few of them practiced â€Å"racist door policies†. For the most part you could get in, dance and socialize across racial barriers. Disco was in fact one of the first forms of â€Å"voluntary integration† that American’s have seen. The music was the same & every ones attitude was the same. Different instruments and disco sounds made their way into the hearts of people in a big way.Discos became a place where there would be loud disco music, a dance floor with disco lights and of course you disco lovers dressed in the latest disco outfits having a blast of a life time. Discos have a culture of their own. The music is loud enough to make you and your heart beat a little faster. The lights keep changing colors and also help in changing you moods and shedding any inhibition you have. The clothes too are tight fitting to show off your more of the body. Shirts with slightly long and pointy collars, the Qiana shirts for the gents and the Halston dresses f or women were in fashion.Discos brought in many other cultures too. One of the main addictions that disco brought in was drugs. Cocaine and Quaalude became the main drugs for all disco lovers. While cocaine gave them a high spirit, it helped many to enjoy the loud music better. Quaalude made them feel light like jelly and helped them to move to the groove. The dance lovers enjoyed the discotheques, as there was music, dance, alcohol and fun. Discos became very popular and some of them became as popular as tourist sites too. Manhattans Studio 54 is one such place.You couldn’t miss this hangout, as you would see many celebrities and people who are both rich and famous there. In the 1970s and 80s disco and dance came together and were the craze of the time. Groups like The Jackson Five, ABBA and The BEE GEES are still bands which are famous for their great disco music. Disco, which was performed only by a few bands in the beginning spread like a forest fire. Soon disco became ma instream and all kinds of bands were performing disco numbers. Disco was the in thing and a lot of movies were made on the disco theme too.Saturday night fever starring John Travolta and Thank God It’s Friday were two big hits with disco as its mainstream idea. ABBA was a group, which took Disco beyond the borders of America and right into Europe and Asia. The songs were such big chart busters that all over the world they created many new records. Boney M a group of four West Indian singers were another group, which broke the barriers of caste, color and creed to give pure and outstanding disco music. Dalida released their hit number â€Å"J’attendrai† which topped the charts in Japan, middle and south Asia and Canada These groups made disco very popular in the 70’s.The growing craze for disco angered the fans of rock music. While some just threw out all disco records, a few took drastic steps. DJs of rock music held events like the Disco Demolition night . Many groups came together to stage anti-disco demonstrations. Slowly but steadily in the 1980s disco began to die down. Though disco kind of became obsolete but it was still very much a part of the night life in Europe. With newer forms of music and even newer groups emerging Disco was given a back seat. In 1990s and 2000 once again disco began gaining popularity again.With major singers like Madonna, Kate Ryan and Suzanne Palmer performing Disco. Disco sound is mainly based on strings and horns accompanied by reverberating vocals mixing with electric pianos and chicken-scratch guitars. Dramatic minor and major seventh chords dominate disco music. The other instruments in used are bass guitar, piano, string synth with electrocoustic keyboards. There are drum kits and electronic drums together with harp, violin, viola, trumpet, saxophone, trombone, clarinet, flugelhorn, French horn, tuba, English horn, oboe, flute and piccolo.The songs usually have a steady four-on-the floor beat. It has affinity with Dominican meringue, rumba, samba and cha-cha-cha rhythms. A synthesizer is sometimes used to replace the bass guitar. Disco branched off into regional styles during the mid70’s by many formal musicians. Keeping the same broad traits of disco the new types came to get an individual stamp of the singer and the orchestra. Notable among them were The Philadelphia Symphony Orchestra and New York Philharmonic. Disco thus came to be arranged and composed by experienced arrangers and orchestrators. It required large number of instruments and a eam, which included the conductor, copyists, record producers and mixing engineer. Disco songs used as many as 64 tracks of vocals and instrumentals. Mixing engineers thus had a very important role. They created a distinctive sounding known as disco-mix. DJ’s were important for popularizing disco and consequently its sales. I would say that disco music expresses itself by its fast beats that you dance to. Its music g ets people to be all about partying, loosing yourself to the songs, and feeling good. It lets people â€Å"groove† or â€Å"Boogie down†, just dance the night away.It’s the art of arranging sounds in time so as to produce a continuous, unified, and evocative composition, as through melody, harmony, rhythm, and timbre. To me disco music means, music that consists of several different instruments that make all sorts of rhythms and melodies. It’s a type of music that has a fast beat and just makes you want to dance. With disco music all you want to do is get down on a dance floor with a lot of people and just feeling good. Disco music is a good style of music that puts different sounds in one through the melody and rhythm of the song.

U.s. Nsa Program On Surveillance - 1789 Words

Over the last several years, cyber attacks have been continually rising. This is in response to emerging threats from rogue nations and terrorist groups. They are increasing their attacks on government, military and civilian installations. According to James Clapper (the Director of National Intelligence) these threats have become so severe. It is surpassing terrorism as the greatest challenge facing the nation. In response, the National Security Agency (NSA) began conducting surveillance on those who are involved in these activities and others which are threat to US national security interests. This program became so broad; it started continually collecting phone records and emails on ordinary Americans. This angered many, who felt that the US was acting in a way that circumvented established legal guidelines and procedures. To fully understand what is taking place requires focusing on the event, the government s response and the ways it did / did not meet our national security goal s. Together, these different elements will illustrate what occurred and the lasting impacts on everyone. (Greenwald 2014) The NSA program on surveillance began in 2001. This is when Congress authorized government officials to listen in on the phone calls and emails of those individuals suspected of engaging in terrorist activities (via the USA Patriot Act). It is designed to ensure that the intelligence community and law enforcement have the tools they need to track / monitor those suspectedShow MoreRelatedNational Security Agency Is Unconstitutional887 Words   |  4 PagesThe NSA is an unconstitutional Federal government agency established by a failed president. In 1952, the worst president in U.S. History, President Truman, established the National Security Agency (NSA). 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In October 2001, President Bush ordered the National Security Agency to commence covert monitoring of private communications through the nation s telephone companies without the requisite FISA warrantsRead MoreThe Government Places Emphasis On Freedom1382 Words   |  6 Pagesour country’s documents and beliefs, the NSA (National Security Agency) tramples what took years of bloodshed and development to circumvent its citizen’s privacy through surveillance. According to internetworldstats, 13% of American citizens don’t use the internet, meaning that 87% of our population is at risk of surveillance. Therefore, the US Government should tighten laws to restrict or stop NSA surveillance on the public. Edward Snowden, a former NSA contractor, is a hero in the eyes of manyRead MoreWhat Is Mass Surveillance?1255 Words   |  6 PagesWhat is mass surveillance? Mass surveillance is the collection of electronic data (e.g. e-mails or phone call metadata) in bulk, which means the data is being collected from many people at once instead of targeting individuals and performing surveillance on them. There are multiple methods for performing mass surveillance, but the two that are generally used by the U.S. are upstream collection and querying the data from telecom (communications) providers such as ATT under the USA Freedom Act;Read More Edward Snowden and Wikileaks744 Words   |  3 Pagesproven threat of internet surveillance was in 2001 when the NSA(National Security Agency) did a Large scale â€Å"warrantless surveillance†(Risen ‘Bush Lets U.S Spy’) of internet traffic and data streams. This surveillance program was a way to gather data and prevent terrorist attacks. However some speculated that this was not just to monitor the activities of suspected terrorists. In 2013 when Edward Snowden released data that proved that the NSA was using their surveillance on everyone it turned speculation

Saadat Hasan Manto, the Controversial Urdu Short Story Writer

PRESENTATION ON SAà DAT HASAN MANTO Of the several hundred stories, the court found only two stories in which he had transgressed the law and was liable for punishment. But his critics and the custodians of society declared Manto to be retrogressive and licentious. Even the so-called progressives betrayed him. At one strike they tarnished his entire writing career with the same dirty brush as the others... To call a writers work nothing on the basis of two stories is crass injustice. We cannot overlook the fact that Mantos masterpieces such as Toba Tek Singh, Mozel, Babu Gopinath have nothing to do with obscenity. (Jagdish Chander) 1948 to 1955 saw Manto writing most of his controversial stories. With the outcome that he†¦show more content†¦Rather they were repelled and attacked in the name of politics and religion. Manto seems to suggest the madness of the Partition and this is reflected in Toba Tek Singh as well. Perhaps even more disturbing is fact that the so-called ‘Razakars’ torment her. It is ironic as the word ‘Razakar’ is a Persian word meaning ‘a volunteer’. These were like social workers who had the reputation of ‘recovering women and children’- missing or abducted- from the other side of the border at their own risk. One realises then that there is no rational or â€Å"political explanation† of what has happened (Shashi Joshi). This also answers the question of success of Manto’s stories that have successfully shocked readers. As Alok Bhalla puts it, â€Å"What is scandalous about Manto’s partition stories is his radical erasure of all social, moral or religious reasons which normally inform civilizations. Manto’s primary argument is not only the Hobbesian one that when men are freed from responsibilities they become predators, but also that in a world which is as heartless and selfish as ours there is no reason for mercy and pity to create a safe ground for the frailty of goodness to survive.† How do we place this cynical world view of Mantos in perspective? Is it just cynical or is he doing more? Is he not reflecting what he has already seen and become aware of during the days of the

Nature vs Nurture - Depression - 818 Words

For years there has been an ongoing debate of nature versus nurture. Nature refers to genetics, inheritance and genes, and nurture refers to characteristics shaped by one’s environmental influences. For the purpose of this paper, the development of depression will be researched in terms of the nature versus nurture debate. Studies show that while some people are genetically predisposed to mood disorders, many people develop them through environmental factors. However, a different study looked at the relationship and interaction of nature and nurture. Therefore, the development of depression can not be pinpointed to one just one specific cause; it can be developed through genetics, environmental influences, or a mixture of both. Mood†¦show more content†¦(Fagnani, 2011) Some researchers believe that a difficult childhood can play a role in an early onset of depression. One theory suggests that children who go through a hard time while growing up have a more difficult t ime adjusting to changes in their. (Clouthier, 2007) Another theory is that these children may not have the proper emotional development, making them vulnerable to becoming depressed. Environmental factors often play aShow MoreRelatedChild Development: Heredity and Environment1240 Words   |  5 Pagesbetween nature versus nurture or even environment versus heredity leads to the question of: does the direct environment or the nature surrounding an adolescent directly influence acts of delinquency, later progressing further into more radical crimes such as murder or psychotic manifestation, or is it directly linked to the hereditary traits and genes passed down from that individual adolescent’s biological parents? 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People have tried to gain power through knowledge in determining what causes the human â€Å"mind to tick.† For centuries leaders and scientists haveRead MorePsychology, Nature Vs. Nurture971 Words   |  4 Pageswhy we are that way? The answer is found in the classic debate in Psychology, Nature vs. Nurture. Aggression is caused by learned behavior, not through genetics. There are two sides of this debate, Nature and Nurture. Nature refers to something that you’re born with and are not able to change. People that follow this are called Nativists. They believe that the traits that you have are passed down through genetics. Nurture means that your personality traits are based on your environment. For exampleRead More Twin Early Development Study: Nature versus Nurture832 Words   |  3 Pagespreference, or in more recent years, the role of gender? I believe that both nature and nurture are responsible for the way one matures. You cannot overlook the fact that some people carry the traits of their ancestors, or the fact that in many situations, people are victims of circumstance. I think the more important question is which side has a larger role in the way people turn out. When assessing the character roles that nurture creates, you must include many factors. A study called TEDS, Twin EarlyRead MoreNature Vs. Nurture Debate1427 Words   |  6 Pagesparents use authoritarian methods and punishment.† The nature Vs nurture debate has been around since 1690 created by the philosopher John Locke who believed we as humans do not have natural, inborn ideas; that our minds are a blank page, upon which experience shall write. Nurture is everything and nature is simply nothing. â€Å"Nature is what we think of as pre-wiring and is influenced by genetic inheritance and other biological factors. Nurture is generally taken as the influence of external factorsRead MoreThe Theory Of The Mind And Behavior1264 Words   |  6 Pagesthat we are born with imprinted knowledge. Aristotle, a student of Plato, theorized the concept that we were born a blank canvas and the development of our minds are sculpted by our experience, demonstrating that modern psychologi cal debates of nature VS nurture, and interests of the functions of the mind, have been discussed for centuries. Psychology as we know it today is the scientific study of the mind and behaviour. All scientists whether chemists, biologists, physicists or psychologists must employ

Women in Advertising Free Essays

Women in Advertising Irwin Allen Ginsberg; an American poet once said, â€Å"Whoever controls the media, the images, controls the culture. † The media constantly expresses images of the ideal female body. All women have their own individual set of attributes and characteristics, however, the media continuously tries to spread what they feel is the universal standard of what a woman should look like. We will write a custom essay sample on Women in Advertising or any similar topic only for you Order Now One might argue, that the images put out by the media strongly affect our generation and the way in which we perceive ourselves. Ginsberg’s statement reminded me of a television advertisement produced by Carl’s Jr. This advertisement featured swimsuit model Kate Upton eating a burger in the backseat of an old school looking car. The advertisement was exceedingly sexually suggestive and showed a substantial amount of unsuitable sex appeal. Carl’s Jr. has acquired quite the reputation of producing these overtly sexual advertisements. Advertisements such as this are damaging today’s generation’s mental and physical state of being. In America, we are surrounded by a society that is primarily consumed by sex. With that being said, there are thousands of companies that produce risky advertisements to compete for the attention of viewers such as Carl’s Jr. With regards to the Kate Upton advertisement, the first thing that caught my eye upon viewing this ad is Upton wearing lace under garments scantily covered by a short polka dot dress. The revealing dress shows off her legs and hangs loosely off her shoulder ultimately exposing her bra and cleavage. The range of positions she lies in throughout the ad goes from innocent to offensive. Upton begins removing the South West Patty Melt from its wrapping and starts to slowly consume the burger in her car. After taking the first taste, Upton starts her high-speed strip tease. For the remaining thirty seconds, the camera moves up and down the parts of her body that are revealed by her dress. She unexpectedly begins sweating all over her body, which makes a direct reference to sex. Upton’s elusive hip movements add to the theme of sex, and serve to sidetrack the viewer from the actual burger itself. Upton’s face looks incredibly pleased as if she is fulfilled with the burger she is advertising but upon close examination, you see that the burger has not been bitten into. Furthermore, this indicates that the intent of this Carl’s Jr. advertisement is to sell sex in addition to the burger itself. The content in this advertisement implies that women cannot only be healthy but also sexually fantasized individuals by purchasing the southwest patty melt. In actuality, the opposite of that implication is often true. The obvious issue in this advertisement is that women rarely consume burgers the size of the one Upton is advertising. More importantly, eating a burger of that size is filled with calories and will not make those women who do resemble Upton physically. Women are incredibly sensitive to their body image and easily perceive the body images media creates. Therefore, this advertisement may be perplexing to female viewers. In the journal Adolescent Evaluation of Gender Role and Sexual Imagery in Television Advertisements authors Donna Rouner and Michael Slater provide readers with insight on a study they conducted; the results portion states, â€Å"Exposure to advertising with idealized images of physical attractiveness will at least temporarily lower female viewers’ self perceptions of physical worth and self being. †(438) With that being said, adolescent females and adult women viewing this advertisement compare themselves to this excessively sexy yet highly idealized model and begin to feel dissatisfied with their own physical appearance. Furthermore, the fact that the feeling of temporary self-loath takes place when viewing advertisements such as the one produced by Carl’s Jr. is chilling. Many adolescent females sit in front of their television screens and are bombarded with hundreds of advertisements each day. When advertisements like this appear, the message getting out to them is, in order for you to be desirable or considered beautiful you must reveal certain parts of your body and act in an incredibly sexual manner. This corrupts the minds of young women. Thus, one might say that the targeted audience for this advertisement is men or male adolescents. According to Carol M. Sheperd, a professor at National University, â€Å"Sexiness of an advertisement causes viewers to remember the ad, and thus the product. †(2) With that being said, though Upton’s advertisement stirred up quite the controversy last year, it was successful in getting people to talk about the ad due its extreme sexual content. More importantly, it got people to go out and buy the Southwest Patty Melt. Nonetheless, Carl’s Jr. uses the pathos rhetorical appeal in this advertisement to evoke certain feelings out of viewers. Upton’s sexually suggestive actions induce emotional responses from her predominately male audience, such as feelings of arousal and even desire. The use of pathos in this ad can go either way when it comes to its effectiveness. When viewing this advertisement a consumer could be paying attention to the high levels of sex appeal and disregard all other elements of the ad, like the actual burger Upton is advertising. Conversely, the appeal of sex can heighten the chance of an advertisement succeeding because it attracts the customer’s attention. In the journal Ethics in Advertising: Sex Sells, but should it? Author Jessica Dawn Blair states: â€Å"The use of sexual appeals in the study seemed to detract from the processing and retention of message arguments. However, it did appear that the recipients would focus their attention more on the execution of ads using the type of appeal. † (112) It is our human nature to be curious about sex. Sex in addition to attractive women in advertisements often sells more than advertisements that do not use this appeal. What does that have to say about our society? The objectification of women in sexual advertisements does nothing but teach the youth of this generation that it is okay to overly sexy and in fact, it is encouraged. That is where the problem lies. These companies want to desperately appeal to their viewers and majority of them do not care if they are sending out the wrong message as long as the product gets sold. Overall, our country has based a vast majority of advertisements on sex appeal to sell their products to the targeted audience of predominately males. For the most part, women have been subjected to the role of playing â€Å"pieces of meat† to men. The objectification of women in advertising has extreme physiological consequences. It has the potential to make women think of themselves in the way in which they are portrayed and it causes them to engage in self-loath or depression. Advertisements such as Kate Upton’s put out a negative viewpoint on women. It is crucial that we reshape our own perception of how we view ourselves. Change starts from within and we have to step up as women, take the lead and reach as high as feasibly possible. Works Cited Blair, Jessica Dawn. â€Å"Ethics in Advertising: Sex Sells, but Should it? † Journal of Legal Ethical and Regulatory Issues 9. 1 (2006): 109-18. ABI/INFORM Complete. Web. 3 Mar. 2013. Carl’s Jr. Advertisement. New York Daily New. N. p. , 1 Mar. 2012. Web. 3 Mar. 2013 Rouner, Donna, Michael D. Slater, and Melanie Domenech-Rodriguez. â€Å"Adolescent Evaluation Of Gender Role And Sexual Imagery In Television Advertisements. † Journal Of Broadcasting ; Electronic Media 47. 3 (2003): 435-454. Academic Search Premier. Web. 3 Mar. 2013. How to cite Women in Advertising, Papers

Ledbury Restaurants Case Study on Business Decision Making

Questions: Scenario A restaurant chain plans to open its second restaurant in London. To ensure this is a viable move, the shareholders are keen to understand the market. Therefore you are asked to carry out a planned data collection and data analysis to help the board of directors in understanding the customer pricing preferences.(e.g. income price, age price) Task 1 Report on Data Collection and Analysis, In this report; Create a plan for primary and secondary data collection with presenting the survey methodology sampling frame used Design a questionnaire to collect data and provide a justification for its design Collect data and summarise the collected data using representative values Analyse the collected data using measures of dispersion. You must be able to use the analysis of the pricing preferences to inform and support decision making. Carry out suitable calculations to draw useful and realistic conclusions and provide valid recommendations. Your calculations must include quartile, percentiles and the correlation coefficient. Explain how these calculations helped you to draw useful conclusions. Task 2 Prepare a Business Presentation and a formal Business Report to disseminate information effectively which include; The findings which should be used to draw valid conclusions .You must use spreadsheet software for all calculations and incorporate graphs and charts(line,pie,bar chart,histogram,scatter ) to clearly and effectively present the findings. Trend lines in graphs to assist in forecasting for specified business information. For example, this may include peoples eating behaviours overtime and preferences against seasonal changes. A business presentation to disseminate information effectively Prepare a formal Business Report to be presented to the board of directors Use appropriate information processing tools to analyse the information Plan for the project, identifying relevant CRITICAL PATH, PERT, GANNT Chart, to implement a business process and the recommendations you are suggesting from your findings. For example, a business process to serve customers (It is essential to us e appropriate project managementsoftware) Different financial tools such as discounted cash flow, net present value and IRR functions to evaluate the financial viability of the proposed recommendations Answers: Introduction In the contemporary business scenario decision making is very much depend o upon the primary and the secondary form of research. As the ledbury is one of the leading restaurants who are willing on the expansion of its restaurants chain for that the study is been conducted. The study will focus on the plan for the collecting data for the opening of new chain of restaurants for the ledbury (Cleland and King, 2008). Apart from that, the study will also focuses on the various form of data collection in order specify the feasibility of the project. With the help of various graph and charts, the decision making of the opening of restaurants chain in London will be very much possible across the UK. Task 1 Plan for collecting primary and secondary data Primary data collection: For primary data collection several customers from the various restaurants and the visitors at Trafalgar square are being consider, the primary for of data will be collect via on field survey questionnaire within the London. Primary data collection is very much needed for the first hand collection of data in order to understand the need of the consumers (DeCarlo, 2010). Secondary data: Secondary forms of data are collected via internet research, blogs, social media, company annual report and the other various sources. Apart from that, secondary sources of data is very much helpful in c gathering the informations about the research which is to collect the formation about the existing restaurants and their market share within the business (Gido and Clements, 2012). Secondary data also companies of various forms of journals, newspaper and magazines. Survey Methodology Sampling the sampling here would be used as customers and the manager of the famous restaurants in London. With the help of 55 customer based the 5 manager would satisfied the primary research. The survey methodology would be sued here is quantitative and qualitative form of survey (Ferraro, 2007). For qualitative, secondary form, data would be used from the existing companies and for the quantitative data is collected on filed questionnaire. Design a questionnaire to collect the data a. How often do you visit the restaurant? Options No of respondents Total respondents Response % Last 1 week 12 55 22% Last 1 month 16 55 29% Last 1 year 8 55 15% More than 2 years 10 55 18% More than 5 years 9 55 16% Graph 1: visiting the restaurants From the above, it has been found that, with more than 23% participants visits every week restaurants for the eatings. However, around 29% of respondents go restaurants with every month. The above scenario explains that every month every people visit the restaurant for eating. London is known for the variety of delicacies and the people are known or the quality eating and living (Barker and Chitty, 2009). With the rise in the restaurants business very shows that consumer are willing to taste the different for the delicacies and visit informal way or for occasions, which in both condition satisfies the thought of eating out. b. What are the factors that influences you towards the restaurants? Options No of respondents Total respondents Response % Service Quality 18 55 33% Brand Value 10 55 18% Ambience 13 55 24% Price 9 55 16% Others 5 55 9% Graph 2: factors that influence the consumer towards the restaurants Around 18% of respondents are very much quality preference rather than price. Secondly feels connection with ambience must be neat and clean rather than food quality with 24%. From the above , it has been found that most of the customer are being considered quality of food as their first preference among the other because the people living in London are very much known for their expensive life style and their love of quality delicacies are been known worldwide (Barlow, 2009). As the restaurants manager, it is an opportunity to offer a quality cuisine rather at value pricings. For pricing, company will be using penetration pricings. c. What type of dining do you prefer? Options No of respondents Total respondents Response % Chinese 14 55 26% French 9 55 16% Italian 11 55 20% Traditional (British) 17 55 31% American 4 55 7% Graph 3: Type of dining do you prefer Around 26% of the people of London are found of Chinese rather than other delicacies. Apart from that, the second best food, which has liked my most of people, was French in London. This shows that, rising in Chinese delicacies is been one of the major trend which has been followed by the world (Bates, 2009). The Chinese food was voted most preferable food globally by the Forbes magazines. d. What time you prefer to visit a restaurants? Options No of respondents Total respondents Response % Break fast 11 55 20% Lunch 19 55 34% Dinner 25 55 46% Graph 4: Time for visiting the restaurants From the above, around 34% of the respondents are being loved to dined out rather than having lunch or dinner. Secondly, company uses lunch as their escape route to visits the restaurants. As dining habit is very much has been known for several years. Dine out is one of the major speciality which has been followed by the generation in English (Carpenter and Fairhurst, 2009). As compare to other meals, most of the English love to have dined out because of the hectic schedules and the busy life of the Cockneys. e. How do you prefer your cuisine most? Options No of respondents Total respondents Response % Simple 14 55 25% Crafted 16 55 29% flavoured 8 55 15% Seasoned 10 55 18% Boiled 7 55 13% Graph 5: preference of your cuisine From the above, around 29% of respondents feels should, be crafter meal incorporate to other major food presenting process. Apart from that, other major restaurants goers wants their food in the simple way rather than flavoured. Summarise the data using the values For quantitative form of questionnaire, young adults with the age of 15-45 and income earning of chosen respondents from the 5000 per month has been chosen for the project at the places like Trafalgar square and various other restaurants like Bread kitchen, Heston Blumenthal and Barbeoa (Entrepreneur, 2015). Apart from that, there are two major available has been considered while collecting the data 1st Age and 2nd is Income before asserting the data. The collected data will be taken via non-probability sampling. The online sampling will be non-probability sampling. Customer participation will be based on likert scale. Analyse the results Measure of dispersions Age Population Under 18 9 18-25 21 25-35 45 35-45 19 Over 45 6 Graph 6: Total chosen population sample Mean Income = 15, 20, 21, 20, 36, 15, 25, 15 Sum of these 8 values is 167, so the mean is 167/8= 20.875 The above results shows that, the chosen age group has is 15k to 36 k. The chosen age group is being looking for the quality and cheap dinning in term of pricings. The price of the products must be lower in order to gain the differences. Measure of dispersion Standard deviations Differences SD SD2 15-20.875 -5.875 34.51 20-20.875 -0.875 0.76 21-20.875 -0.125 0.01 20-20.875 -0.875 0.76 36-20.875 15.125 228.75 15-20.875 -5.875 34.51 25-20.875 4.125 17.01 15-20.875 -5.875 34.51 By taking, the SD squares value. Sum is 35.87. The results are 350.875/7=501.25. This value is known as the variance. In order to take the Standard deviations, square root of the variance is considered. This would be (52.1235)2= 7.07. This shows that, measure of dispersion is 7.07 for the age group while selecting respondents. Analyses of percentile, quartile and the correlations coefficient Income Y Price ,X Price*Income SD 15000 128 1920000 1920000 20000 135 2700000 2700000 21000 148 3108000 3108000 25000 168 4200000 4200000 36000 179 6444000 6444000 40000 205 8200000 8200000 42000 332 13944000 13944000 44000 523 23012000 23012000 48000 928 44544000 44544000 50000 1028 51400000 51400000 mean 15947200 18116979.57 quartile 1st Quratile 22000 Median percentile 38000 43000 3rd Quarter percentile 43500 maxvalue percentile 50000 From the above, it has been found that, quartile value of the company is very much suggested that, quartile value is right side. The demand divides the data into two equal data set on income and the price offered by the various restaurants to the participants. The lower quartile is the value of the middle of the first set, where the 255 of values are very much smaller than the Q1, which is 75% larger. The quartile range of the company is shows that, restaurants and income group people are being taking high quality food with the increasing range of the price (Statista, 2015). Apart from that, it also has been found that, increasing income tend s the buyer to go for the higher price food. The taste and preference of the food is changing as per the income and age. One of the major recommendations is been identified during the research is that most of the customers are looking for quality as per their income. So the company should look to keep right quality and valued pricing instead of the using price skimmings. Besides that, extensive advertisement and the proposed quality food with right kind of quality and with right kind of approach lead the company to success in longer run (Ferraro, 2007). However, company should also look to use cost leadership strategy to gain the high market share. Task 2 Secondary research Restaurants in UK Global sales UK sales Arbys Kitchen 89.13 million 35429 Bonanza Steak house 16.301 million 13667 Yo Suhshi 9.3 million 6557 Loch Fyne 3.882 million 3522 Strdada 3.16 million 2251 Wagamama 3 million 2000 Zizzi 2.8 million 1925 Graph 7: Market share of UK Restaurants (Source: Adcock, 2010, pp-132) From the above , graph it has been found that , UK is biggest chain of the restaurants in world starting from the local cuisine to international cuisine. There has been ample evidence which shows that, market share of existing restaurant in UK (Gido and Clements, 2012). One of Arbys kitchen has highest market share of the its goodwill and the quality of food which it serves. As the compare to that, most of restaurants are been very much using the rotten or un-fresh vegetable and fruits which is why quality is lacking. For Global sales Graph 8: Global sales of UK restaurants chain (Source: (Carpenter and Fairhurst, 2010, pp-257) The global sales of Arby are highest because of the name and high brand in London. However, at recently junk food companies like McDonalds and Subway has been very popular and highest market share in worldwide including the UK. Growth of the restaurants chain Types of Restaurants Percent growth in UK (2013) Multi cuisine 38.9% Limited cuisine 20.1% Fixed cuisine 17.33% Seasonal cuisine 19.25% Quick cuisine 21.09% Graph 9: Growth of the restaurants chain (Source: Coviello and Winklhofer, 2008, pp-85) As per the above graph , it has been found that , cockney are very fond of multi cuisnie restaurants who serves world delicacies . Majority of the people are looking to switch to the multi cuisine restaurants with 38% in compare to the fixed or rather tropical based restaurants (Danaher and Johnston, 2009). The survey was conducted by the heath London chamber of commerce in order to help the new age entrepreneur. Forecasting the eating habits of the UK customer base Eating habit of consumers in UK 2005 2009 2013 Growth Salad 28.09% 39.08 48.09% Fresh Sandwiches 28.18% 34% 37.02% Boiled dinner 14% 19.08% 24% Fired Snacks 40.18% 29.09% 19.09% Sweets 44.09% 35% 38.11% Oily food 38.02% 18% 11.09% Graph 10: Forecasting the eating habits of the UK consumers (Source: Heylen et al. 2007, pp-54) In London, most of locales are being very much heath sensitive rather than price sensitive. Most of the people are found of the eating salad which has been increasing from the year 2009 (Bates, 2009). However, decrease in oily food and junk food id decreased from 40% in 2005 to 195 in 2013. This shows that demand of the food oily food is decreasing. Refer to PPT Prepare business Plan In order to open a restaurants business venture various forms of data feasibility study should be considered which also include the market feasibility and financial feasibility. With the help of primary research it has been found that, most of the customer in London is very much acquitted with the quality rather than price. Apart from that, another major factors would be pricing and ambience of the restaurants which is very much considered before moving to the restaurants (Entrepreneur, 2015). On the other hand, secondary research helps the organisations to cater large customer base. From the above research , it has been found that, most of restaurant are using fresh and quality form of food which is served within the London and global with rise in Abey restaurants because of its quality and the rest known for using low pricing strategies to gain the market base. However, rise in salads in UK market and the rise in boiled food rather than junk food is one of the major reason of concern for the ledbury restaurants (Hellman, 2005). Using appropriate tool for the restaurants business Activity Description Activity duration (days) Depends on A Preparing the business plan 10 - B Primary and secondary research plan 25 A C Hiring personnel 3 B D Work orders 60 C E Supply of equipments Assemble measure ingredients 20 C F Sources of funds 10 C G Renting a building 15 C H Installations of equipments 5 E,FG I Furntur fittings 10 DH J Monitoring 2 I Project plan Activity Depends on Normal time Crash time Normal cost Crash cost A - 10 8 4900 6000 B A 25 24 3000 6000 C B 3 2 2000 3300 D C 60 58 1600 3000 E C 20 19 5000 6000 F C 10 9 1800 4000 G C 15 13 6000 8000 H E,FG 5 4 8000 9000 I DH 10 9 3000 4000 J I 2 1 1000 2000 Figure 1: CPM of new restaurants business (Source: created by author) Table 1: Gantt chart (Source: Created by author) Financial tools NPV for new Restaurants business project Year Cash flow Present value 0 -500000 -500,000 1 200,000 181,818.18 2 300,000 247,933.88 3 200,000 150,262.96 NPV=80,015,02 Payback period of the restaurants chain business Payback period for 3 years Year Cash flow 0 -500000 1 200,000 2 300,000 3 200,000 Payback period =3+ (50, 0000/200,000) =5.5 years NPV is one of the major financial tool which shows that highest is the NPV higher chance of the choosing the project. In this case NPV is 80, 015,02. NPV considers time value of money which is most effective. Another major method is payback period which shows that lower would be year rate larger will be chance of according the project (DeCarlo, 2010). Since the investor will be restaurants within the 5 years, the project of restaurant business must be chosen. Conclusion From the above , study in has been found that , in order to open restaurants chain then the company need prepare primary research and secondary form research for decision making the market conditions. The primary research has helped the companies to gather the primary form of data which shows people of London are eager to prefer quality than price. Apart from that ambience and payment options are other major attractions for the customers. From the secondary research it has been found that, rising competition between the existing firms within the London and UK will be one of the major problems. People of London are very much narrowed towards the salads rather than fried food habits. Reference list Books Cleland, D. I. and King, W. R. (2008) Project management handbook, 4th ed. New York: Van No strand Reinhold. DeCarlo, D. (2010) EXtreme Project Management: Using Leadership, Principles, 4th ed. London: Kogan Page Limited Ferraro, J. (2007) The Strategic Project Leader: Mastering Service-Based Project Leadership, New York: Taylor Francis Gido, J. and Clements, J. P. (2012) Successful Project Management, 5th ed. London: McGraw-Hill Education. Adcock, D. (2010) Marketing: Principles and practice. 4th ed. London, Thousand Oaks CA: Sage Publication. Barker, N., and Chitty, W., (2009). Integrated Marketing Communications Asia Pacific Edition. 6th ed. New York, London: Routledge. Barlow, J. (2009) Excel models for business and operations management. 6th ed. New Jersey: John Wiley Sons Inc. Journals Bates, T. (2009) Analysis of Survival Rates among Franchise and Independent Small Business Startups, Journal of Small Business Management 33(2): 2636. Carpenter, J. M. and Fairhurst, A. (2009) Consumer shopping value, satisfaction and loyalty for retail apparel brands. Journal of Fashion Marketing and Management, 9 (3), 256-269. Connell, S. (2008) Travel broadens the mind The case for international research. International Journal of Market Research, 44 (1), 97106. Corstjens, M. and Lal, R. (2008) Building store loyalty through store brands. Journal of Marketing Research, 37 281-291. Coviello, N. E. and Winklhofer, H. (2008) Contemporary Marketing Practices Research Program: A Review of the First Decade, Journal of Business Industrial Marketing, 23 (2), 84-94 Danaher, P. J. and Johnston, W. J. (2009) How Firms Relate to Their Markets: An Empirical Examination of Contemporary Marketing Practices, Journal of Marketing, 66 (3), 33-46. Hellman, K. (2005) "Strategy-driven B2B promotions", Journal of Business Industrial Marketing, 20(1), pp.4 - 11 Heylen, J. P., Dawson, B. and Sampson, P. (2007) An Implicit Model of Consumer Behaviour. Journal of the Marketing Research Society, 37(1), 51-67. Websites Entrepreneur, (2015). Entrepreneur - Start, run and grow your business.. [online] Available at: https://www.entrepreneur.com/ [Accessed 21 Jan. 2015]. Statista, (2015). Healthy eating habits when dining out U.S. 2014 | Statistic. [online] Available at: https://www.statista.com/statistics/327004/healthy-eating-habits-of-consumers-in-restaurants-us/ [Accessed 21 Jan. 2015].