Expanding a U.S. based business (Shopko) into Scotland Essay

Expanding a U.S. based business (Shopko) into Scotland - Essay Example Edinburg is the capital town where the majority lives above middle class status. Geographically, the country is in the northern part of Great Britain, bordered on the Southern part by England. Most people live in the Central Lowland, which contain the three cities, Stirling, Glasgow, and Edinburgh and other large towns. Most of the other population lives in the north-eastern Lowlands in Dundee and Aberdeen. Inverness is the other populated city where majority lives and work there. The country has diverse climates ranging from temperate to tropical. However, the daytime maximum temperature in January and February is around 5 to 7 Â °C, but on rare occasions the temperature may increase to 15Â °C. Temperatures are cooler in Scotland than in Scotland. However, the country is cloudier than England because of its landscape from the Atlantic. Rainfall varies widely from 3, 000 mm per year to 800 mm in the Western Highlands and the East Cost respectively. English is the official language spoken, but some people speak different Scots dialects. The country has a strong culture that greatly influences the tourism industry. Scots are friendly, easy-going, and loving. Thus, there is no discrimination or cultural influence in the way business are conducted. The country’s economic development is largest based on the oil that remains an important element. Fishing and agriculture has also played a significant role in the country’s development. Compared to other countries, most people are living in the middle class income (Wilson, Murphy, & Lonely Planet Publications (Firm), 2008). Shopko Shopko is a company that has been growing tremendously for the past years. The reason for choosing this industry is because I work there and I have seen how the industry is important to international business. Shopko distributes various products such as clothing, jewellery, house wares, along with beauty and health products. The company has a superb reputation of referring to i ts employees from retail floor to the CEO as teammates. The company has established the need to break down barriers that hinder people to work as a team. To establish a strong teamwork, the company felt the need of referring to its employees as teammates regardless of their position. The management team works hard to collect informal feedbacks and customer surveys. The obtained feedbacks help the company to grow from one level of maturity to another. For instance, it helps in converting the first time clients to potential and frequent clients. For the past years, most clients have constantly affirmed that one of the main reasons they shop there regularly is because of the company’s ideal of friendliness and genuine teamwork. The management team and employee strive to make shopping at Shopko a more personal experience and friendly place. Specifically, feedbacks from teammates and comments posted on the social network sited confirm that Shopko is the ideal place to shop. Manage rial Implications To flourish in the tough economic times, the company should create brand ambassadors. The company should create a platform where employees are committed to the mission and understand the strategy of staying ahead of other competitors in the industry. Communication should be been the main ingredient that augments teamwork. The company shou

Written Assignments - nursing Essay Example | Topics and Well Written Essays - 750 words

Written Assignments - nursing - Essay Example ice of both the RN and the advanced practice RN and they will continue to seek federal funding for education and training and assure every nurses right to bargain for compensation and working conditions. b. ANCC certification is important because it opens doors. It validates skills and increases salaries. According to the AMA website, the certification can mean $9,000 increase over other nurse salaries. Governing boards, insurers, and military, as well as healthcare providers throughout the country see this as a testament to the competency of the nurse with the certification. www.nursingworld.org b. There are many factors affecting the nursing shortage. Many nurses that are presently working are getting ready to retire. The average age has continued to increase over the last few years. For many years the numbers of nursing schools declined as the numbers of people declined as well as hospitals. Now it is a game of catch up to get enough nursing schools, train enough instructors and improve salaries and benefits in such a way that it is attractive to enough people. c. The State of California has been increasing the numbers of RN graduates at a steady pace. They have managed that by increasing state funding to nursing programs, for equipment, and for instructional technologies. They are also studying the career paths that nurses are taking when graduating so they can begin to change patterns of education where needed. a. The RN is a dynamic member of the healthcare team, contributing to diversity an culture. The RN is able to collaborate with all of the stakeholders in the healthcare system as the advocate for her patients care and for delivery of quality healthcare. b. The goal of the education of an Associate Degree nurse is to create a well defined pathway into the field of nursing. It is a continually evolving need created by the healthcare community around them. The basic tenants that are taught are quality patient care, advocacy for

Majority Opinion Case Study Example | Topics and Well Written Essays - 1500 words

Majority Opinion - Case Study Example Since there was no evidence to the effect that students were required to profess the religious views presented in the books, then the plaintiffs, in this case, had no good basis of claiming that the requirement to read from the books amounted to the violation of the constitutional rights of the students and their parents. The basis that would well serve to make the requirement unconstitutional is if the students were compelled to do something that is against their religious belief, such as profess the religious views presented by the books (Shelly, 1994). The students were not required by any means to affirm the religious views presented or even practice such views. There was an assumption on the sides of the plaintiff that having the religious vies which was in contrast to their own belief presented in the form of poetry or fiction, entitled the children to believe in them. To indicate lack of consistency in the arguments presented by the plaintiff, one of them, Mrs. Frost held that it was all right to have their children taught other religions and philosophies, as long as such teachings did not undermine her religious beliefs, or the children had to be instructed on the error of the other religion (Fish, 1999). This serves to show that the plaintiffs believed their religion was the only one acceptable and thus, could be taught without the indication of its errors, while the other religions and philosophies had to underline this fact. This is an erroneous view of the intentions of the education system, in that it seeks to create wider knowledge, and thus cannot be limited to one religion. Another major aspect that offers support for the majority opinion by chief judge Lively is the fact that there appears an observed tendency of the plaintiff to interpret virtually everything theologically (Suber, 1987). Mrs. Frost holds that everything has to be interpreted in the Biblical perspective, arguing that there is no possible way, in which issues such as evolution a nd telepathy could be taught, without violating her religious beliefs.  

The Benefits of Using a Curriculum Within the Outdoor Environment Essay Example for Free

The Benefits of Using a Curriculum Within the Outdoor Environment Essay If education is a voyage of discovery, why not explore the opportunities to take learning outside? Chiara Pannozzo The Early Years are a time of unrivalled personal discovery, in which each day holds the potential for adventure for a child – and nowhere offers greater potential for adventure than the great outdoors. The benefits of outdoor play are really very basic, says Harry Harbottle, a consultant in play and risk management, who was formerly appointed by the EU as a child safety expert to the European Standards Organisation. If children arent allowed to engage with the elements – mud, water, air, even fire – how can they begin to understand the world that they live in? Harry argues that there is a need to move away from a culture of reluctance to let children explore outdoors. We are at last realising the consequences of children spending most of their time indoors, says Harry. There are too many children who have been adversely affected by a lack of exercise and stimulation. The outdoor environment is a rich, dynamic and natural space to enhance the school curriculum and stimulates quality learning and development in children of all ages. Its value as an essential learning resource has been recognized by many pieces of research and more recently with the ‘Eraly Uears Foundation Stage (EYFS), particularly within the principle of ‘ Enabling Environments’. Outdoor activities, whether they be core National Curriculum core subject or foundation based, can always be adapted, if necessary, for children with additional learning needs/physical disabilities by the teacher doing a reckie of the area outside which is to be used and then assessing how circumstances can be adapted for pupils with such difficulties. Also, a buddy can be placed with a child who has additional needs and assistance given when necessary. It is imperative that restrictions are only placed for health and safety reasons; otherwise, one should always endeavour to give children ownership to encourage a sense of independence and success. To give an example of how an activity could be adapted for children with additional learning needs/physical disability: Making hot chocolate drinks in Kelly Kettle †¢Children collect kindling in areas accessible to them †¢Children stay at base position to help build the waffle raft for fire †¢Children organize kindling into different sizes When the curriculum is taken into the outdoor environment, children have been observed having confidence and independence with activities they have pursued, providing them with a sense of success and raised self esteem. Children will develop relationships (PSHE) with their peers and adults. As confidence grows, children will begin to consider the needs of others (disabled/additional learning needs), as well as individually. Practitioners in the woodland have reflected that children in this environment had gained confidence in adapting to new situations and in trying new experiences. This also impacted on their ability to choose activities independently and their confidence in self initiating tasks was seen to develop dramatically. To give an example of an obvious benefit of bringing the curriculum into the outdoor environment: Child X enjoyed making shelters and would often enlist the aid of one his/her peers by sayon, â€Å"Oh – this log is heavy, can you help me ? † The other children present would the all work as a team by holding onto the large log and assist moving it into position. Child X had acquired more skill in making and strengthening friendships , the art of consideration and compromise – â€Å"Can I help you? instead of â€Å"That’s mine! †. Though these changes may be maturational, children’s experiences gave them real opportunities for practising these elementary life skills. ‘ Through their comments (the significant other), practitioners should see their role as very varied and should include: ensuring the environment is safe, allowing the children choice of equipment such as, ropes, trowels and buckets, observing and valuing their self initiated learning. Practitioners should feel by questioning, suggesting and providing propts/props, they can extend children’s self-initiated development. Dowling describes self-initiated play as spontaneous, where the practitioner can choose to be involved by participating alongside and offering a reassuring presence. Such an important aspect needs to be adopted by all adults who work with children involved in bringing the curriculum into the outdoor environment, if this is to be a successful element for children’s potential learning. â€Å"The adult needs to be aware of the potential for learning in children’s play, but this is a very different matter from predetermining the play. ’ – Dowling (1992)

Company On Cadbury

Company On Cadbury As a result of our report, we have come to discover that there are various forces that affect the environment that is Cadbury and Freddo Frog, including political, economical, socio-cultural, technological and legal. We have also discovered that there are many levels of competition which include generic competition, product competition and brand competition, as well as the situational and group influences and individual characteristics of consumers. Various market segmentation approaches were explored, and involved demographic, psychographic and behavioural market segmentation. The ways in which the brand is perceived and positioned was also explored and identified, and were illustrated through the creation of a perceptual and positioning map. Our report also explored the communication tools that were used within Cadbury for its Freddo Frog product, and evaluated the effectiveness of campaigns in reaching the consumers and communicating with the public. 2.1 Introduction: Cadbury is a multi-national corporation, which produces essentially chocolate and confectionary products and operates in more than 60 countries.(Callus Cutler). According to IBISWorld, Krafts Cadbury products have majority of confectionary market share of 49% (2010), which makes it an interesting company to study. With specific attention to the tween market of children aged 6-13 years old, Cadburys Freddo was developed and has been a great success as a childrens chocolate due to its popular brand identity, taste, and initiatives such as fundraising, interactive computer gaming and the fact that it is packaged as an appealing product. Cadburys popular brand identity and market share has such an impact on the Australian chocolate industry making the Cadbury Freddo an interesting topic to study. Part A will discuss the Cadbury brand environment and its impact on marketing initiatives for the product Freddo. That, political factors, economical forces, socio-cultural factors and legal factors all play a significant role on marketing Freddo. Part B will observe the generic, product and brand levels of competition that Cadbury has been involved in; the situational, group and individual factors that influence the consumption of the brand; and, the demographic, psychographic and behavioural characteristics of the Freddo product tween target market. This section will observe why people purchase Freddo, brand identity, the role of packaging and the changing demographics of Australian lifestyle to healthy eating choices. Part C examine how Cadbury wants its product Freddo and its associated brand perceived by its target market and how the target market perceive Freddo and Cadbury. This will include the positioning statement that: Cadbury Freddo is aimed at ‘pre-teen children and their parents who only want to spend a couple of dollars on a small chocolate as an inexpensive treat or reward for good behaviour (Cadbury 2011). This section will show positioning and perception maps for the Freddo target market. Part D will explain the various tools that Cadbury has used to communicate its desired position to its tween market and will describe a communication campaign with specific reference to this market. This report will observe, as Cadburys Australia and New Zealand Managing Director, Mark Callaghan recognises, that Cadbury has been a big part of Aussies lives for almost 90 years, and underpinning this relationship has been the unbeatable taste of our chocolate and the affinity people feel for our brands† (Ellis 2010). 3.1 Part AKaitlin Ramsay (3863803) Cadbury is a multi-national corporation that operates in more than 60 countries, and employ over 46,000 people (Callus Cutler, 2010) As such an internationally renowned and utilised company, Cadbury is thus subject to many major forces within the business environment that affect and impact upon their marketing initiatives. These forces political, economic, socio-cultural, technological and legal forces. The political factors that can affect an organisation and its initiatives are the laws and regulations that the Government can impose, as well as the political stability of a nation, or indeed, the world. (Elliot et al, 2010, pg. 48) In the case of Cadbury, forces that have affected its environment include the Childrens Television Standards 2009. This meant for Cadbury that there were now advertising restrictions in place that negated them from being able to advertise their product, in any way that may mislead or deceive children, and must be perfectly clear and understandable for a typical child (Australian Government, 2010). This means that Cadbury and their marketing initiatives of Freddo Frog must adhere to these restrictions, and be careful about that way they promote their product to children. In promoting Freddo Frogs to children, they must also not promote HFSS (High fat, salt and sugar)(Hackford, 2010). Consequently Cadbury has to focus on sensible and appropriate ways to market Freddo Frogs to kids, that doesnt infringe upon these impositions. On the other hand, parents can now be more comfortable about the fact that their children are less likely to be targeted in deceptive marketing tactics that encourage kids to consume unhealthy products. This initiative is also helping to contribute to creating a healthier lifestyle for all Australians. The Economical forces impacting upon the environment of Cadbury and its product, Freddo Frog, include interest rates, income levels, levels of inflation and the level of unemployment (Elliot et al, 2010, pg. 49) One of the foremost impacts upon all companies throughout the world was the Global Financial Crisis. This caused an increase in interest rates, a rise in inflation, high unemployment and a lower income.An increase in interest rates may lead to an increase in prices for consumers; which in turn can negatively affect sales, as people during times of financial difficulty, may be reluctant to spend more money. A rise in interest rates may also cause a change in demand for products—which in this case, would mean a decrease in demand. It also means less capital for Cadbury—which may lead to the possible retrenchment of workers due to the inability of Cadbury to support a high number of employees. The impact of these economical forces mean Cadbury needs to focus on effectively utilising their resources during times of financial obscurity. This may mean spending less money on marketing, and more on other areas of production, as there is less capital to spread around to all areas of the company. Cadbury may be more productive and efficient in these times as they are forced to consume their resources in a cost-efficient manner. An interesting fact is that although people are less likely to buy luxury goods during times of hardship, Cadburys sales increased by 2% in 2009 during the GFC, as people bought chocolate as a source of comfort food (Despuez, 2009). Looked at from this perspective, it can be concluded that Cadbury may not have to be as concerned as one would think when people are financially inadequate, as chocolate becomes a popular product during such times. The Socio-Cultural factors that affect Cadbury and its Freddo Frog include the culture, values, attitudes, beliefs and trends of the public (Elliot et al, 2010, pg. 50). In todays society, there is an increasing trend towards video games and similar technology for younger people, as well as gravitation towards initiatives that are â€Å"green† or considered ethically responsible. In addition there is an ever-increasing importance placed on the social aspect of schooling—in terms of acquiring the latest trends in order to â€Å"fit in† with the other kids, whether this is with clothing, books, toys, food and drinks. These forces that affect the youth today mean Cadbury must integrate and take into account such factors when establishing their marketing initiatives. As a result of the increasing use of technology and computers amongst young people, which is now a generational characteristic, Cadbury introduced the Internet game â€Å"The Adventures of Freddo Frog†(2010). The exciting and interactive nature of the game enticed younger people to partake in the game, and has made the product increasingly popular for young people. Modern society values the idea of contributing to a cause or initiative that helps achieve something positive. People also like the idea of being associated with something that is ethically responsible, and Cadbury has achieved this through their Fairtrade Scheme â€Å"Which seeks to address the imbalance of power in trading relationships, unstable markets and the injustices of conventional trade(Cadbury, 2010) The fact that Cadbury is so invested in their Fairtrade scheme creates a positive image for them and all of their products, including Freddo Frog. There is an element of trust that Parents value and respect, and thus are more likely to buy Cadbury products for their children, due to their belief in the brand and its ethics. The social aspect of schools also impacts upon the nature of marketing initiatives of Cadbury and their products like Freddo Frogs. The fact that a child may be considered â€Å"cool† if they are associated with a chocolate that has its own representative game (The Adventures of Freddo Frog) means social factors are important for Cadbury. Cadburys success in the creation of the game is a result of their marketing initiative in the form of Internet gaming for kids. On the other hand, the fact that importance is placed on what kids bring to school is not exactly a healthy lesson to learn for kids, and the idea that food choices is incorporated into this is also not ideal, as kids may consume more than is necessary to achieve the desired social outcome. The technological forces that may affect the company environment include whether the technology can be used for innovation, whether distribution or communication can be improved using technology, the accelerating use of technology and the better standard of quality of products due to technology (Elliot et al, 2010, pg. 50). Technology is what has allowed for the creation of the online games, and is essentially the innovative tool used to create more interaction between children and the Cadbury Freddo Frog brand. The communication improvement between children and Freddo frog is essentially due to the improvement in technology over the years (Cadbury History, 2009). Not only has the increase in computer technology been ideal for Cadbury, but also production technology, as it has allowed for considerable growth and success for Cadbury and thus, Freddo Frog. The improvement in technology has allowed Cadbury with its Freddo Frog to compete again with Kinder Surprise. For a time, Kinder was dominating the market for childrens chocolates, as the toy inside the chocolate was very popular amongst kids. The introduction of the online Freddo Frog game however, allowed Cadbury to take back its reign as the top confectionary company. The fun and interactive nature of the game is contributed to making the product so popular. The ever increasing use of technology by Generation z (otherwise known as Generation @) means that Cadbury are reaching their target market in the most ideal and popular way. And the more and more children that use the Internet, the larger the chances are they will come across the Freddo Frog Adventure Game, and the likelihood of their buying the product (or their parents for them) increases. Although, on the other hand, kids are now spending more time in the virtual world of computer games, interacting with characters that dont exist, instead of being outside playing games and interacting with real people. Legal forces are a facet of the business environment that always has a large impact upon companies, as they essentially govern and direct the actions of a company, with laws and regulations (Elliot et al, 2010, pg. 51). These come from industry bodies such as the Advertising Standards Bureau and the Australian Competition and Consumer Commission (ACCC). Companies, including Cadbury, must comply with laws and regulations such as the Fair Trading Act 1987 (NSW), the Competition and Consumer Act 2010, and the (Goods and Services Tax) Act 1999. These Acts essentially ensure that Cadbury acts in a fair manner, in relation to trade, production, workplace environment, employee treatment, taxes etc. As well as ensuring they comply with industry regulations to not deceive or mislead, or have the intention to deceive or mislead consumers, or behave in a way that does not adhere to any standards set by these regulatory bodies. The Australian Competition and Consumer Commission (2011) is responsible for dealing with matters in relation to competition, as well as the enforcement of the Competition and Consumer Act 2010. They are concerned with different areas including dealing with customers, dealing with other businesses, the running of the business in question, industry codes of conduct and professions competition. The ASB deals with issues including â€Å"use of language, the discriminatory portrayal of people, concern for children, portrayal of violence, sex, sexuality and nudity, and health and safety.† (NSW Government) There are more Commissions and Boards such as these that businesses have to be concerned about, although these are the most important and recognized. As such Cadbury has to market its product, Freddo Frog, and conduct business surrounding this product, in such a way that it does not mislead or deceive (neither parents/adults nor children), does not falsely misrepresent the product, and does not infringe upon any of the other aforementioned criteria for business conduct in relation to the Trade Practices Act, or the Fair Trading Act (ACCC, 2011). This will impact upon Freddo Frog, as they will be a legally responsible and trustworthy company, that can be relied upon by both consumers, suppliers etc. to produce a product that markets itself using only the approved methods. If a company is legally sound, they are generally thought to be an ethically/socially responsible entity as well. 3.2 References: Australian Government, 2010, Advertising to Children, accessed 26/4/11, http://www.acma.gov.au/WEB/STANDARD/pc=PC_91814 Australian Competition Consumer Commission 2011, For Consumers, accessed 28/4/11, http://www.accc.gov.au/content/index.phtml/itemId/815215 Australian Competition Consumer Commission 2011, For Businesses, accessed 30/4/11, http://www.accc.gov.au/content/index.phtml/itemId/815214 Callus, A, Cutler, D, 2010, Fact box: Cadbury vital statistics and history, accessed 26/4/11 http://www.reuters.com/article/2010/01/19/us-cadbury-factbox-idUSTRE60I1Jh30100119 Elliot, G, Rundle-Thiele, S Waller,D 2010, Marketing, John Wiley Sons Australia Ltd, Milton Queensland Cadbury 2011, Fairtrade Certified Cadbury Dairy Milk hits Australian shelves, accessed 27/4/11, http://www.cadbury.com.au/About-Cadbury/Fairtrade.aspx Cadbury History n.d., accessed 28/4/11, http://www.bizaims.com/coffee%20break/curiosities%20events%20funny/cadbury%20history Competition and Consumer Act 2010 (Cwlth) Despuez, N 2009, More People Buy Chocolate Amid Recession, Cadbury Sales Up, accessed 27/4/11, http://www.startupbizhub.com/more-people-buy-chocolate-amid-recession-cadbury-sales-up.htm Fair Trading Act 1987 (NSW) Hackford, C 2010, Sugar and Spice and All Things Nice: Advertising to Children, accessed 26/4/11, http://www.advertisingcompliancelaw.com/articles/hfss-foods/ NSW Government 2010, Fair Trading-Advertising, accessed 30/4/11, http://www.fairtrading.nsw.gov.au/Businesses/Advertising_and_marketing/Advertising.html 2010, The Adventures of Freddo and the Time Machine, accessed 27/4/11, http://www.freddo.com.au/ 4.1 Part B Madelin Robertson (3665926) Through effective marketing, Cadbury needs to make sure that they provide their target market with greater value then their opponents on different levels of competition. Cadbury works on the ‘Generic competition level by identifying that its consumers have alternative ways to meet their product needs and that this same want or need can be satisfied by substitution with quite different products (Elliot, G, et al, 2010, p.46). Today the market is highly competitive and companies are now competing against other segments of the marketplace with products such as snack foods, cakes, cereal and biscuits (IBISWorld 2010). These products are sometimes obtained at a cheaper price or offer more value for money. Cadbury aims to avoid generic competition by effective marketing of Cadbury chocolate and Freddo products to give them a prestigous and trusted image that is reasonably priced. Cadbury promote that the taste of its chocolate is superior to other common chocolate brands, that it is more enjoyable to eat compared to items such as biscuits, and that its price is similar if not reasonably priced compared to other confectionary and sweet products. ‘Product competition describes products that are broadly similar but have different benefits, features and prices that distinguish them from competing products (Elliot, G, et al, 2010, p.46). Cadbury chocolate and Freddo compete with a wide variety of confectionary products and children confectionary products in the Australian confectionary industry. Many of these products are chocolate or sweet based so they vary in flavour and product type. Some examples of products which Cadbury compete against are: Jelly lollies, hard boiled sweets, chocolate products, fine chocolate products which could all satisfy a consumer in the confectionary industry. According to IBISWorld in the confectionary industry Krafts Cadbury products have majority of confectionary market share of 49.1% (2010). Like other confectionary brands, Cadbury need to be innovative and differentiate their products, keep prices low and maintain their popular brand image to sustain consumer consumption through changing consumer tastes and dietary trends, for example, a price rise in chocolate may persuade consumers to switch to sugar-based confectionary instead (IBISWorld 2010). Cadbury contends with ‘Brand competition where many of its products are similar to other chocolate brands that offer the same benefits, features and price to the same target market. Childrens chocolate products such as Ferreros Kindersuprise, Mars Mars bar, MMs, and Nestle Smarties all target the pre-teen chocolate market in Australia. To emphasise brand image and acquire market share Cadbury works with initiatives such as supporting and sponsoring community events, fundraising initiatives and sporting groups, where Cadbury products are promoted and recognised within different communities and age groups (Cadbury 2011). Online, Cadburys Freddo interactive computer game, which children can play, helps to create demand for the product and give it a fun and prestige pre-teen confectionary brand identity over its competit ors (Cadbury 2011). Cadburys Australia and New Zealand Managing Director, Mark Callaghan recognises that Cadbury has been a big part of Aussies lives for almost 90 years, and underpinning this relationship has been the unbeatable taste of our chocolate and the affinity people feel for our brands† (Ellis 2010). Cadbury also uses individual branding of its products to give them their own identity and position in the marketplace, to reach its market segments, and to avoid confusion with other product brands. Situational influences are the circumstances a consumer finds his or herself in when making purchasing decisions. According to Elliot, principal situational influences may be classified as: physical: the characteristics of the location in which the purchase decision is made; social: the interactions with others at the time the purchase decision is made; time: the time available for a purchase decision; motivational: the reasons for the purchase; and mood: the mood of a person at the time of the purchase decision (et al, 2010, p.104). Confectionary items usually constitute an impulse purchase that is unplanned or spontaneous. The strategic presence of chocolate and confectionary in stores such as at the grocery store checkout or a vending machine signify purchases that may not have been considered or planned (IBISWorld 2010). Due to the nature of impulse buys, customers will not pay high prices for the items they did not originally intend to purchase so products such as Cadbury Freddo is relatively cheap retailing at around $1. In the current economic climate, high retail prices for children items such as toys may lead parents to buy cheaper items such as Freddo (IBISWorld 2010). When buying chocolate for children it is usually purchased as a reward for good behaviour or celebration. A retail outlet must have pleasant surroundings and be strategically placed to influence consumption. Group influences â€Å"comprise social factors (the influence of other people) and cultural factors (the influence of the values, beliefs and customs of the persons community)† (Elliot et al, 2010, p.106). The culture, subculture and social class of a group of people greatly influence buying behaviour. Increasing technology and production techniques, marketing techniques (such as interactive computer games) and environmentally friendly packaging, play a role in consumption of products and Freddo (Cadbury 2011). Cadbury has recognised the difference in generation gaps and has moved to consider this. Freddo uses modern pictures, symbols colour, packaging and a fun and happy image of Freddo to create consumer interest and to target its younger market. Cadbury promote its products as a friendly brand that is associated with family whilst being widely recognised and trusted. Freddo is also reasonably priced available to majority of the population. Many children and parents learn fr om others that Cadbury is a respected chocolate brand and identity that families enjoy and often pass this knowledge directly onto others, or indirectly by others observing use of the product. Individual factors relate to personal characteristics such as demographic factors, lifestyle and personality, and individual psychological characteristics such as motivation, perception, beliefs and attitudes and learning (Elliot et al, 2010, p.118). Individual motives such as hunger, to satisfy self with something sweet, or a treat for celebration are seen with the purchase of Freddo, however purchase of the product has been identified to impulse purchase (IBISWorld 2010). Cadbury aim to work on an individuals perception by shelving space (usually low or at eye sight where it is easy to see and reach) and packaging which shows bright and colourful tones, stylistic cartoon image of Freddo (which relates to children), legible writing, and the purple trademark colour of Cadbury which is widely acknowledged and brings consumer awareness. Cadbury ads reflect that its chocolate simply tastes good and uses this as a key element to marketing their product. The fact that Cadbury Freddo comes in a variety of flavours (strawberry, peppermint, dairy milk, top deck, white chocolate, rice crisp and caramello koala) also targets individual wants and taste and therefore targeting a wide range of people (Cadbury 2011). Although many people carry the belief that chocolate is not a healthy lifestyle choice, the new portion sizing and Freddo sizing is a well thought approach for children in todays lifestyle. The demographic segmentation of the target market is based on demographic variables related to the vital and social characteristics of populations such as age, education and income (Elliot et al, 2010, p.177). Cadbury Freddo are focused on the tween market segment (children aged 6-13) Generation Z and the parents of this generation, Generation X, for product consumption. Generation Z, the digital and technologic generation, present an age where children are typically focused on the internet, video games, social networking and mobile phones, hence earning the title digital natives (Elliot et al, 2010, p.177). The parents of Generation Z, Generation X, are also included in the target marketing of Freddo as these individuals are usually the ones who purchase the product. The economic climate of the Global Recession saw a dramatic fall in spending as unemployment grew, however consumption of chocolate and confectionary sustained according to IBISWorld as â€Å"consumers choose to indulg e themselves in inexpensive, ‘feel good luxuries such as candy and chocolate, in an attempt to ease more pressing concerns such as mortgage or loan repayments† (2010). The changing demographic of the average Australian household due to an ageing population and regulatory constraints are which are increasing in relation to product labelling, food safety and advertising may also put pressure on manufacturers. Psychographic segmentation is based on the psychographic variables of lifestyle, motives and personality attributes (Elliot et al, 2010, p.178). Increasing health awareness and lifestyle factors today majorly influence consumer consumption, as many people are aware that ‘junk foods are contributing to the increasing obesity rate in Australia and around the world. People are aware of the health risks and problems for themselves and their children and so aim to promote a healthy lifestyle through a balanced diet, exercise and health education. Because of the awareness between obesity and heart disease, and concerns about dental health, parents are less likely to buy chocolate products for their children, instead resorting to healthier food options or smaller portions (IBISWorld 2010). The growing popularity of low-fat diets are having an adverse effect on chocolate sales, whilst the opposite is happening for confectionary promoted on a healthy platform such as sugarless candy and gum and healthy substitute products such as snacks, cereals, nuts, yoghurt and fruit have seen a rise in demand (IBISWorld 2010). Organic products and dark chocolate are seen as a healthier option due to antioxidant content. The ethical consumer has influenced the shift towards sustainable methods of production with an emphasis on fair and equitable trading conditions and preferring fair trade chocolate brands. The behavioural market segmentation is based on actual purchase and/or consumption behaviours towards particular products and their variables, which include benefit expectations, brand loyalty, occasion, price sensitivity and volume usage (Elliot et al, 2010, p.181). As well as being the leading chocolate brand, Cadbury has been rated the most popular grocery brand of Australians in the Nielsens Company Top 100 Brands report (Ellis 2010). Many Australians are loyal to Cadbury products as they are a trusted brand with a popular identity. Parents know they can trust the quality of Cadbury products and that it will meet with their expectations. Typically parents with tweens, and tweens themselves are at the end of the purchase volume for Cadbury Freddo products (Cadbury 2011). It is a cheaper option then more expensive brands such as Lindt or Fererro products. The seasons, time of day and the scheduling of special events such as Easter, birthdays, and Christmas, influence confectionary consumption. Chocolate sales tend to be higher in cooler months (IBISWorld 2010). 4.2) References Cadbury Fundraiser accessed 04/05/11, http://www.fundraising.com.au/. Cadbury 2011, accessed 04/05/11, http://www.cadbury.com.au/. Freddo, accessed 20/04/11, http://www.cadbury.com.au/Products/Pre-teens-Confectionery/Freddo.aspx. Elliot, G, Rundle-Thiele, S Waller, D 2010, Marketing, John Wiley and Sons, Australia. Ellis, D 2010, Cadbury Named Australias Most Popular Grocery Brand, accessed 25/04/11, http://www.cadbury.com.au/About-Cadbury/News.aspx?newsID=133. IBISWorld Chocolate and confectionary manufacturing in Australia 2010, accessed 0 3/05/11, http://www.ibisworld.com.au/industryau/ataglance.aspx?indid=110. The nations favourite chocolate: Now Fairtrade Certified and on shelf throughout Australia, accessed 25/04/11, http://www.cadbury.com.au/About-Cadbury/News.aspx?newsID=134. Working together to make a difference in the community accessed 20/04/11, http://www.cadbury.com.au/Cadbury-Community.aspx. 5.1) Part C Tamara Nicol (4067137) In order for a product to be bought and ultimately perceived, evaluated and repurchased by the customer the business must first position the product so it is made available to the target market. Positioning involves how the brands name, logo, slogan and design are used to create a perceptual image of the product in the consumers mind. The product must be positioned so that customers who need, want and demand the product can have access to it and hopefully purchase it. Positioning is a very important element of target marketing as it decides how the customers will perceive the product and it requires a close understanding of the product, market and competitors. Positioning will determine whether the customers purchase the product, enjoy the product, if it meets expectations and whether they have a good experience with the product and plan of making a repurchase (Elliot et al, 2010). Perception is an outcome of the positioning. It is a psychological response to diverse stimuli. It includes the persons sensory experience, that is, smell, taste, touch, sight and hearing (Elliot et al, 2010). The consumers perception of the Cadbury Freddo would involve a variety of senses. People will evaluate this product on the grounds of, most importantly, taste but also smell and looks, if the packaging and actual product is aesthetically pleasing. Cadburys official website has the Freddo Frog filed under â€Å"Pre-Teen Confectionery† as the product is aimed at younger children, the product must be positioned towards the children as well as the parents or care givers who will most likely buy the product or give the child permission to buy it themselves (Cadbury, 2011). Cadbury implements positioning strategies in order to influence the consumers perception of the Freddo Frog. The Freddo Frog is sold in many stores country wide including supermarkets, petrol stations and corner stores (Observation). By doing the Cadbury positions the product as accessible and popular. Cadbury would like the Freddo to be perceived as at treat but also something that can be enjoyed frequently for a low cost. As a Freddo review states, â€Å"There are two reasons for cheapness; Number One so that children can afford to buy said treat with their pocket money and Number Two so that when children are harassing their mothers for sweets in the supermarket they can hold up the product and their mothers will give in because it is so cheap. Cadbury has such a product in the form of the Freddo.† (Ciao, 2004) Cadbury wishes for the Freddo Frog to be seen as a snack or treat that encourages children to buy it or pester their parents to buy it for them. As unhealthy products aimed at younger children

Strategies for the Dietary Control of Diabetes

Strategies for the Dietary Control of Diabetes A survey of the recent strategies for the dietary control of diabetes in the Middle East INTRODUCTION Significant changes in the political and socio-economic climates have been the hallmark of the last decade in the many of the countries in the Middle East especially those located in the territories of the Arabian Gulf. These changes have impacted in no small way on the demographics of the affected countries. Notable are the obvious shifts in age distribution and a perceptible increase in healthy life expectancy. Furthermore, there have been alterations in the conventional lifestyles of the people living in these countries perhaps due largely to westernization, rapid urbanization and industrialization (Abdella et al 1995). It is also worth mentioning that disease types, trends and or their prevalence have also changed dramatically. Prominent among these is diabetes. Diabetes – delineation The incidence and prevalence of diabetes have consistently increased in the last 20 years; these changes have paralleled environmental transformation as well as the adjustments to changes above mentioned (Abdella et al 1995; Zimmet et al 1977). The current projection of the World Health Organisation (WHO 2007) indicates that there will be further increases in the prevalence of diabetes in the Middle East. A working committee of the WHO on diabetes defined the disease as ‘a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both; the effects being long-term damage, dysfunction and failure of various organs’ (Alberti and Zimmet 1998). Diabetes is caused by a lack of the hormone insulin, which is produced by the ÃŽ ²-islet cells of the pancreas. Glucose is the primary energy source for all cells and is provided by digest ion of carbohydrates from the diet. Insulin enhances the body cells’ uptake of glucose from blood plasma. Hence, defects in insulin secretion, insulin action, or, most commonly, both leads to decreased uptake of glucose by the cells and an increase in blood glucose levels. Sustained increases in blood glucose level will lead to the excretion of glucose in the urine when such increases exceed the renal threshold of the molecule. This in turn leads to the typical symptoms of diabetes: excessive production of urine (polyuria) and extreme thirst (polydipsia). Fatty acids from fat stores are metabolized as an alternative energy source when the body senses a lack of glucose, the result is weight loss and fatigue other common symptoms of diabetes (Maitra and Abbas 2004). The clinical profile of diabetes varies minimally between the countries of the Middle East. In Kuwait for example, because of the marked disparity between individuals in their age of diabetes onset, mode of present ation, and the degree of obesity, the clinical profile of the disease is heterogeneous (Abdella et al 1995). Diabetes mellitus is not a single disease entity, but rather a group of metabolic disorders sharing the common underlying feature of hyperglycemia. Type 1 (early-onset diabetes or insulin-dependent diabetes (IDDM) and Type 2 (maturity-onset diabetes or non-insulin-dependent diabetes (NIDDM) diabetes are well known types and are characterized by the different metabolic processes of the disease (Alberti and Zimmet, 1998). Type 2 accounts for about 80% of the disease worldwide. The chronic hyperglycemia and attendant metabolic dysregulation may be associated with secondary damage in multiple organ systems, especially the kidneys, eyes, nerves, and blood vessels (Maitra and Abbas 2004). The Role of Diet in the Management of Diabetes Nutritional therapy is an integral part of the management of diabetes and plays a vital role in helping people with diabetes achieve and maintain optimal blood glucose level (United Kingdom (UK) Prospective Diabetes Study Group (UKPDS), 1990; Delahanty, 1998). The nutritional management of patients is based on evidence-based principles and recommendations for the treatment and prevention of diabetes and related complications (American Diabetes Association, 2002). These recommendations are based on evidence published in the international literature and from consensus and expert opinion as required (Ha and Lean, 1998). The benefit of tight control of both blood glucose and blood pressure in people with type 1 and type 2 diabetes has been demonstrated in several well controlled randomized large-scale studies (Diabetes Control and Complications Trial Research Group, 1993; UKPDS 1998a,1998b). Generally, the objectives of strategies for the dietary control of diabetes are complementary to the aims of medical treatment. Dyson (2002) reported that these includes but not limited to the following: Maintaining blood glucose within predetermined target range Minimizing the risk of hypoglycaemia for those patients taking insulin or oral hypoglycaemic agents Achieving weight loss in the obese patient Reducing the risk of long-term complications of diabetes Maintaining blood pressure and lipid levels within predetermined target ranges Improving and maintaining suitable quality of life. (Dyson 2002) Rationale for the project Contemporary management of diabetes places emphasis on the individual patient’s responsibility for diabetes control of blood sugars and of food consumption. The concept of self-care with regard to a recommended diet is thus considered important in order for patients to maintain normoglycaemia and reduce or prevent diabetes-related complications (Rubin and Peyrot, 1992; Rubin et al, 1997). The diabetic patient is expected to monitor his/her carbohydrate metabolism, energy expenditure and the effects of insulin or recommended medicaments on blood pressure and sugar levels. This inevitably demands a level of understanding about diabetes and of the effect of diet on the progression and or management of the disease. This survey will explore the individual patients’ approach to control or support the pharmacotherapeutic management of his/her diabetes using diet. The study will shed light on diabetic patient’s adherence to guideline dietary recommendations in the Middle East or on novel dietary strategies for the control of the disease. The results of this study is essential to health policies makers in the region and pivotal for governmental strategies to minimize the burden of the diabetic epidemics in the Middle East. Using Kuwait as First Port of Call for the Middle East Diabetes Diet Study (MEDDS) The middle east comprise a large region that covers parts of northern Africa, southwestern Asia, and south eastern Europe consisting of Bahrain, Cyprus, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Sudan, Syria, Turkey, United Arab Emirates, and Yemen. The ‘Middle East Diabetes Diet Study’ (MEDDS) will focus on Kuwait in its first phase. Implementation of the study in other countries of the Middle East will stem from its success in Kuwait following appropriate modifications to adapt the study tools to the settings and subjects of these countries. Description of First Target site: Kuwait is a relatively small country, (17, 818 km2 in surface area) and is situated in the North Eastern part of the Arabian Peninsula. Kuwait shares the north and west borders with Iraq, is bordered on the south by Saudi Arabia and on the east by the Arabian Gulf. Total population of Kuwait in 2005 was 2, 867, 000 and over 88% of these were aged 15 and over; percent Urban population out of total population was 100% during the same period (WHO 2007). The prevalence of diabetes in Kuwait was 104,000 in 2000 and the projection for the year 2030 is 319,000; this will amount to about 44% of the projected total population (WHO 2007). AIM AND OBJECTIVES Aim: The aim of this proposal is to develop a plan for the conduct of a cross-sectional survey of the recent ( Objectives: To purposely select a panel of experienced diabetes practitioners/clinicians to conceive questions assessing patients’ knowledge of their diabetes and the effects of their food types and feeding pattern on glycaemia and blood pressure control (in 11 main domains) To develop and validate a diabetes-diet questionnaire tool for the study To implement the diabetes-diet instrument during a face to face semi-structured interview designed to further explore recent dietary strategies for the control of diabetes To administer a 7-day diet dairy to respondents. Repeat the survey in other countries of the Middle East METHODOLOGY Development of Study Instruments An initial list of 11 patient’s knowledge domains as shown below will be used: Basic knowledge about diabetes Knowledge of patient’s own current management if involving pharmacotherapy Consumption of olives, fruits and vegetables, nuts and cereals in recent times. The intake of legumes in cooked foods in the last 5 years Recent intake of dairy and meat products. Consumption of alcohol/wine in the last 5 years Knowledge of other food types consumed recently Knowledge of feeding pattern in recent times Knowledge of occurrences of diabetes complications and or hospitalisations in the last 5 years Knowledge of the effect of food types and pattern of intake on control of blood pressure in the last 5 years Knowledge of the effect of food types and pattern of intake on the control of blood glucose in the last 5 years Under each domain, important points regarding each topic will be identified. To ensure content validity, a panel of 10 senior practitioners in the area of diabetes management will be identified and asked to participate in diabetes-diet (MEDDS) instrument development phase (Kline 1986; Streiner and Norman 1989). The expert reviewers will include 2 pharmacists involved in care of diabetes patients, 3 diabetes staff nurses, 3 diabetes specialist dietitians and 2 consultants in the area of diabetes. These will be identified based on their records of diabetes patient care experiences and on their knowledge of the factors impacting on the progression of the disease. The diabetes-diet (MEDDS) instrument’s content experts will rate each of the topic domains and indicate the percentage weight of each domain within the entire study tool. Between 6 and 12 multiple-choice questions will be created for each domain, with a focus on information ranked by the experts as most important for the objectives of the study. The multiple-choice question format is chosen because it is easy to administer and it will be easy to psychometrically validate the ensuing instrument (Kline 1986). Each multiple choice question will have 4 possible responses, namely one correct answer and 3 distracters. However, in order to fully capture any emerging theme, respondents will be allowed time to comment freely on the questions and the multiple choices in a semi-structured interview. These will then be transcribed for analysis. Existing questions from previous studies may be harnessed and modified by the panel. The expert panel will also rank the questions within the domain in descending order based on its relative importance to patients’ diabetes diet requirement/knowledge. After the initial item bank is compiled, the expert panel members will be asked to rank the overall quality of each item on a scale of 1 to 5 (1 = poor, 5 = excellent) in terms of how well it tested each information point. These rankings will be used to eliminate questions and create a 20-30 item pilot instrument. An item bank will be developed based on this information. Questions will be written at 7th grade reading level as determined by the Flesch/Flesch-Kincaid Readability Tests calculated from Dave Taylor and Intuitive systems (2007). Respondents will also be asked to fill a 7-day diet diary. Inclusion criteria Adult volunteers aged 18-85, living in the study site with not less than 3 years diagnosis of type 1 or type 2 diabetes. Since retinal and vascular problems associated with diabetes mellitus are common, attempts will be made to administer the tools also in carers of blind diabetic patients. Exclusion criteria Anyone diagnosed with a mental illness as it may be difficult to determine the truthfulness of information collected from these patients. Patients who are deaf; this is because a researcher and the interviewee would need to be proficient in sign language for any meaningful interview to take palce Data-collection tools Three data-collection tools will eventually be used; (1) the diabetes diet questionnaire (MEDDS tool), (2) a semi-structured interview using validated questions developed by the experts group and (3) a health diary. The interview and diet questionnaire will be the main data source. The semi-structured interview will last for 20 -30 minutes and will be conducted to further explore dietary trends for the control of diabetes in the last 5 years; this will be done at any location convenient for the respondents. The MEDDS questionnaire will be self or researcher administered during the face-to-face interview. A team of 8 interviewers will be trained by the researchers for 4 days before the start of data collection. The questionnaire will be translated into the local language of the study site. The study tools will be pre-tested for about 1 week in diabetes patients across age and sex variables of the target diabetic cohort as shown by Abdella et al (1995) for diabetic Kuwaiti. Larger scal e administration of the instrument will be for 6 months following the pre-test period. Study population Based on the household registry linked to databases of diabetes organisations in Kuwait, the survey will stratify the area of Kuwait into seven strata according to the degree of urbanization, geographic location, and administrative boundaries. Townships or districts will be selected from each stratum with the selection probability being proportional to its size. Sample selection will involve the use of multi-stage cluster random sampling procedure at the district level to select sub districts and zones from where the study sample could be drawn. In each district, the area will be sub-divided into sub districts from which 3 zones will be selected based on population size. Within the selected zones, households will be randomly numbered, and houses assigned ‘even numbers’ will be selected into the final sample. . Instrument Administration Diabetes patients or their carer (as may be necessary) will be identified for face-to-face semi-structured interview, the administration of the diet questionnaire and the filling of a diet diary in the final sample population. Knowledge of dietary recommendations for the management of their diabetes will be investigated; types of food as well as feeding pattern in the last 5 years will be evaluated for each diabetes type. Answers will also be sought to questions that will provide insight into patients recent general daily energy intake and expenditure; daily amount of carbohydrate and protein in the diet, control of blood pressure and glucose levels in the last 5 years. Respondents will also provide insights into changes in local custom for dietary control of diabetes. Following the interview and administration of the diet questionnaire, each participant will be given a 7-day diet diary to complete after each meal or at the end of each day. It will be explained that the diet diary sh ould contain food types and time of eating and all dietary tactics taken to maintain normal blood glucose level (4–7 mmol/litre). The diet diary will further explore the truthfulness of information provided in the interview/ questionnaire as well as shed light on how the respondents have presented their recent self-care dietary strategies for the control of their diabetes. The Use of Interpreters Linguistic competency is central to cross-cultural studies and problems that may arise due to the researchers not understanding the local language could be overcome by the use of an interpreter (Davies, 1999). It may also be reassuring for the respondents to see someone with whom they share the same culture and language during the interview periods (Freed, 1988). Interpreters will either provide verbatim translation during the face to face interview or conduct the interview independently following adequate training (Baker, 1981). Psychometric Analysis of the Questionnaire for the Dietary Control of Diabetes Ensuring content and construct validity are appropriate methods to develop a knowledge instrument. Questionnaire validity is ideally established by comparing the new instrument being developed with an established recognized standard. There are no such standard for the target patients of this study. Reliability is also a vital attribute of a sound knowledge instrument. The diabetes-diet (MEDDS) instrument will be said to be reliable when scores are consistent over time within a site or as implementation moves from one site/country to another. The variability of the instrument’s results should in this case be due to true differences among the individuals patients that will be enrolled into the study (Streiner and Norman 1989). Content Validity Content validity refers to the extent to which a set of items reflects the intended content domain (De vellis 1991). A systematic approach to identifying important domains and developing specific items based on consultations amongst experienced practitioners in the management of diabetic patients will ensure the content validity of the ‘Middle East Diabetes Diet Survey’ (MEDDS) instrument’. This method follows those employed by Zeolla et al (2006) in determining patients’ knowledge of the management of their disease. Construct Validity Construct validity determines the instrument’s ability to function for its intended purpose (Kline 1986). The ‘contrasted group’ method will be used in this study to determine the construct validity of the MEDDS tool (Kline 1986). Reliability of the Diet Questionnaire A proportion of the diabetic patients recruited into the study will be followed-up after 4 months and urged to complete the diet questionnaire only. The time elapse is considered sufficient to reduce the impact of recall (Streiner and Norman 1989). A correlation coefficient will be calculated between the test scores from each administration. A coefficient of 0.80 or higher is considered acceptable for demonstrating test–retest reliability (Streiner and Norman 1989). Hypothesis for Construct Validity If the MEDDS instrument is a valid tool to assess the recent approaches for the dietary control of diabetes, patients managed for diabetes, should be more knowledgeable and achieve significantly higher scores than those not diagnosed or managed for the disease. To confirm this hypothesis, the response of diabetic patients to the final instrument will be compared with responses of age-matched subjects without diabetes in the same setting. Construct validity would be confirmed if the mean generated score for diabetic subjects were significantly higher than those not diagnosed or managed for diabetes. . Statistical and Data Analysis Statistical analyses will be by SPSS version 14. The results of the pre-test will be excluded from the analysis. Student’s t-test will be used to compare the differences in mean scores of patients managed and not managed for diabetes. Using chi-square (à ¯Ã‚ Ã‚ £2), demographics characteristics will be compared between patients managed and not managed for diabetes. Pearson’s correlation coefficient will be used for the test–retest reliability analysis. Descriptive statistics will be used to report patient demographics. The interview transcripts and the health diaries will be deliberated upon on more than one occasion to fully understand patients’ self care approach and identify individual patient’s dietary care strategies. Themes emerging from the interview will then be compared with dietary patterns observed in the 7-day diet diary and the diet questionnaire. Following a detailed analysis of the results of all 3 tools, perceptions of respondentsà ¢â‚¬â„¢ conformity to recommended dietary regimen or their general philosophy/strategy of managing diabetes with diet will be reached. ETHICAL CONSIDERATION The study qualitative paradigm protocol will be submitted for review and approval by the local ethics committee for the study region. A covering letter describing the goals of the study will be provided to patients agreeing to participate. The purpose of the study will be very carefully explained to the respondents and their consent will be individually obtained before the study tools are administered. Each participant will also complete a brief demographic questionnaire. In cases of identified illiteracy, the information contained in the form will be read by the study interpreter and informed consent sought. All respondents will assured of anonymity, confidentiality and that they could withdraw from participation in the study at any time. EXPECTED OUTPUT Interventions to prevent diabetes in the Middle East should include culturally appropriate and effective ways to improve the nutritional adequacy of the diet in line with international guidelines for the dietary control of diabetes. The result of the study will indicate the knowledge gaps if any in the study population. Tight glycaemia control associated with certain food types and feeding strategies identified in the study may become basis for its recommendation and use in other parts of the world for the control of the worldwide diabetes epidemic. References Abdella Nabila A., Moustafa M. Khogalib, Amani D. Salman’, Shaker A. Ghuneimi†, Jasbir S. Bajajd (1995) Pattern of non-insulin dependent diabetes mellitus in Kuwait Diabetes Research and Clinical Practice 29.1 29-136 Alberti, K.G. Zimmet, P. Z. (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1:Diagnosis and classification of diabetes mellitus, provisional report of a WHO commission. Diabetic Medicine, 15, 539^553. American Diabetes Association (2002) Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 25: S50–S60 Baker N (1981) Social work through an interpreter. Soc Work 26:391–97 Dave Taylor and Intuitive system (2007) [Internet] [Accessed 21st April 2007] http://www.readability.info/ Davies CA (1999) Reflexive Ethnography: A Guide to Researching Selves and Others. Routledge, London Delahanty LM (1998) Clinical significance of medical nutrition therapy in achieving diabetes outcomes and the importance of process. J Am Diet Assoc 98: 28–30 Devellis RF (1991). Scale development: theory and applications. Newbury Park, CA: Sage Publications. Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of longterm complications in insulin-dependent diabetes mellitus. N Engl J Med 329: 977–86 Dyson Pamela (2002) Nutrition and diabetes control: advice for non-dietitians British Journal of Community Nursing Vol 7, No 8. 414-419 Freed AO (1988) Interviewing through an intrepreter. Soc Work 33(4): 315–97 Ha TKK, Lean MEJ (1998) Recommendations for the nutritional management of patients with diabetes mellitus. Eur J Clin Nutr 52: 467–81 Kline P. (1986) A handbook of test construction: introduction to psychometric design. New York: Methuen Co. Maitra A and Abbas A.K (2004). The endocrine system. In: Robbin’s and Cotran Pathologic Basis of Disease (edited by V. Kumar, A.K. Abbas N. Fausto). Pp. 1189-1207, 7th edn. Philadelphia, PA: Elsevier Saunders Company. Streiner DL, Norman GR. (1989) Health measurement scales: a practical guide to their development and use. New York: Oxford University Press. UKPDS (1998a) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes: UKPDS 33. Lancet 352: 837–53 UKPDS (1998b) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 317: 703–13 UKPDS (1990) Response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients: UKPDS 7. Metabolism 39: 905–12 WHO (2007) [Internet] Available: http://www.who.int/diabetes/facts/world_figures/en/ Accessed 21st April 2007 Zeolla M. M., Michael R Brodeur, Angela Dominelli, Stuart T Haines, and Nicole D Allie (2006). Development and Validation of an Instrument to Determine Patient Knowledge: The Oral Anticoagulation Knowledge Test Ann Pharmacother 40:633-8. Zimmet, P., Taft, P., Guinea, A., Guthrie, W. and Tchoma, L. (1977) The high prevalence of diabetes mellitus on a central Pacific island. Diabetologia 13, 111-115.

Internet Essay - Online Anonymity and Cyberspace Crime -- Exploratory

Online Anonymity and Cyberspace Crime The 90's internet boom gave rise to new ways of writing in through access to cyberspace. What used to be printed or handwritten on physical surfaces such as paper, cardboard, or bulletin boards has changed to 0's and 1's, bits and bytes of digitized information that can be displayed thru the projections of computer screens. Moreover, the internet has made the process of publishing one's works, writing letters, or chatting with one another much easier and convenient for everyone around the globe. The internet became a universal tool, giving much freedom and flexibility to the users; it gave them opportunity to deliver their thoughts with little or no restrictions. Since it's impossible to regulate all cyber-activities, internet users are often unrestricted by the normal laws or authorities that would set boundaries around the various online transactions. More importantly, the fact that a net user can take on different identities in cyberspace brings about several ethical and social is sues. These anonymous and unrestrictive characteristics of cyberspace often permite abusive users to easily involve themselves in serious cybercrimes such as cyberstalking, cyber-rape, and cyber-harassment through chatting services, emails, cyber communities, and other online communication. In the real world, most encounters in everyone's daily lives are anonymous ones. Chatting with a person beside you in a cafà © or talking to an assistant while shopping for a pair of pants- these are interactions between two unknown persons; however, these contacts do not affect our lives the way some of the anonymous interactions in the cyberspace does so. Chat rooms, net forums, and even the spam mails most people get u... ...sity. 10 Apr. 2004 . Diener, E., Fraser, S.C., Beaman, A. L. & Kelem, R. T. (1976). Effects of deindividuating variables on stealing by Halloween trick-or-treaters. Journal of Personality and Social Psychology 33:178- 183. Haley, Jacqueline. "Anonymity of Cyberstalkers: The Cyber-Watchdog's Tough Collar." Georgia State University College of Law May 2001. Kabay, M. E. "Anonymity and Pseudonymity in Cyberspace: Deindividuation, Incivility and Lawlessness Versus Freedom and Privacy." Conference of European Institute for Computer Anti-virus Research 8 Mar. 1998. Post, David G. "Knock Knock Who's There?" Information Week Megazine Dec. 1995. Rowland, Diane. "Anonymity, Privacy, and Cyberspace." 15th BILETA conference 14 Apr. 2000. Springer, Claudia. Electronic Eros: Bodies and Desire in the Postindustrial Age. Texas: University of Texas Press, 1996. Internet Essay - Online Anonymity and Cyberspace Crime -- Exploratory Online Anonymity and Cyberspace Crime The 90's internet boom gave rise to new ways of writing in through access to cyberspace. What used to be printed or handwritten on physical surfaces such as paper, cardboard, or bulletin boards has changed to 0's and 1's, bits and bytes of digitized information that can be displayed thru the projections of computer screens. Moreover, the internet has made the process of publishing one's works, writing letters, or chatting with one another much easier and convenient for everyone around the globe. The internet became a universal tool, giving much freedom and flexibility to the users; it gave them opportunity to deliver their thoughts with little or no restrictions. Since it's impossible to regulate all cyber-activities, internet users are often unrestricted by the normal laws or authorities that would set boundaries around the various online transactions. More importantly, the fact that a net user can take on different identities in cyberspace brings about several ethical and social is sues. These anonymous and unrestrictive characteristics of cyberspace often permite abusive users to easily involve themselves in serious cybercrimes such as cyberstalking, cyber-rape, and cyber-harassment through chatting services, emails, cyber communities, and other online communication. In the real world, most encounters in everyone's daily lives are anonymous ones. Chatting with a person beside you in a cafà © or talking to an assistant while shopping for a pair of pants- these are interactions between two unknown persons; however, these contacts do not affect our lives the way some of the anonymous interactions in the cyberspace does so. Chat rooms, net forums, and even the spam mails most people get u... ...sity. 10 Apr. 2004 . Diener, E., Fraser, S.C., Beaman, A. L. & Kelem, R. T. (1976). Effects of deindividuating variables on stealing by Halloween trick-or-treaters. Journal of Personality and Social Psychology 33:178- 183. Haley, Jacqueline. "Anonymity of Cyberstalkers: The Cyber-Watchdog's Tough Collar." Georgia State University College of Law May 2001. Kabay, M. E. "Anonymity and Pseudonymity in Cyberspace: Deindividuation, Incivility and Lawlessness Versus Freedom and Privacy." Conference of European Institute for Computer Anti-virus Research 8 Mar. 1998. Post, David G. "Knock Knock Who's There?" Information Week Megazine Dec. 1995. Rowland, Diane. "Anonymity, Privacy, and Cyberspace." 15th BILETA conference 14 Apr. 2000. Springer, Claudia. Electronic Eros: Bodies and Desire in the Postindustrial Age. Texas: University of Texas Press, 1996.