The American Red Cross








The American Red Cross








The American Red Cross

  1. Introduction

Marketing any product or service today ought to be done in the most strategic manner in order ensure a successful marketing. Both profit and non-profit organizations need to have a marketing plan in order to reach the target market and achieve their goals and objectives. This paper focuses on developing a marketing plan for a non-profit organization. The organization chosen in this case is American Red Cross. The rationale for choosing this firm shall be discussed in the paper. The marketing plan will involve a number of things.

One thing worth noting is that marketing a non-profit organization like American Red Cross is not just campaigning for more capital or developing donor network. It is a process used by these organizations to create a greater awareness of their activities and also to create a positive image of itself to the society by communicating in the most effective manner to their target audience. This process thus aims at showing the value of the organization to the target audience and not just to solicit funds.

  1. The Firm

American Red Cross is a non-profit organization whose history dates back to 1881. The main objective of the organization during its early years was to offer first aid to different people, to provide safe water and also to develop a number of nursing programs which would help in addressing different emerging issues. One of the notable contributions of this organization was the nationwide blood drive which it started after the Second World War where it assisted a number of war victims (The American Red Cross, 2014).

The organization today offers a number of services to different people in the world. For instance, it is estimated that over 40% of the blood supply in U.S. today is supplied by this organization (The American Red Cross, 2014). It also ensures cooperation with other related agencies like FEMA. Other activities of the organization today includes helping military families to cope with the state of living away from their beloved ones, offering community education on health issue and working in different countries to offer its services.

  • Why American Red Cross?

The choice of American Red Cross firm because of the great passion I have for the firm. The firm has done quite a lot of things in ensuring that people live better lives and that they can easily respond to the different challenges they face. The firm is also quite trusted by the public thus making it a quiet preferable company to focus on.

  • Vision

An important part of the firm’s vision is to be always there during times of need. Its vision is to be made possible by mobilizing the resources from its strong network of partners, donors and volunteers.

  • Mission

As a firm, American Red Cross has a mission with which it operates with. Its mission is to, “prevent and alleviate human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors” (American Red Cross, 2010). The organization had noticed that people used go through a lot of suffering especially during disasters and that that many people were willing to assist during such times but lacked a co-coordinating body.

  • How it respects of ethical obligations and public accountability

It is no doubt that the public in any country takes non-profit organizations as the most ethical and accountable firms (Laratta, 2009). This is due to the fact that these organizations usually receive a lot of funding from the public as donations. However, ensuring accountability and respect of ethical obligations may not be something easy. These firms are entrusted with a lot of resources which may tempt them to misuse them. However, American Red Cross operates under some ethical principles and core values which help in making it more accountable to the public in an ethical manner.

Some of these principles and values are “humanity, impartiality, neutrality, independence, voluntary service, unity and universality” (American Red Cross, 2014). These principles ensure that the organization serves all people in need without any form of discrimination. To it, all people are the same and thus they offer their services to people of any races, nations, religions and anything else. In the case of unity, the organization operates as one unified firm in the country, ensuring its openness to all people thus ensuring accountability in its service provision and financial activities. The organization also ensures a high level of credibility in its activities ensuring high integrity in matters of funds and service delivery, hence ensuring that they can be trusted by the public with its resources.

  • Why the firm needs to have a good marketing plan

American Red Cross has currently realized the need of having a clear marketing plan which would help the firm succeed in its marketing activities. For instance, the firm has a marketing department led by Peggy Dyer remaining as the Chief Marketing Officer (CMO) (American Red Cross, 2014). As a CMO, she has a responsibility of developing a marketing strategy and executing it with the aim of helping the firm achieve better results. Developing such a marketing plan would thus help in understanding the strategy she can use to marketing the firm better.

The firm needs a good marketing plan in order to ensure a higher awareness among different stakeholders, not to mention the fact that it needs to mobilize the available resources (Dolnicar & Lazarevski, 2009). There is also a great need to ensure that different people in the target area can understand how the firm can help them when faced with different problems.

In addition, the number of non –profit organizations in U.S. has increased exponentially in the last few years (Brace-Govan et al., 2011). Currently, the country has around one million non-profit organizations. To make the matters worse, most of these organizations have similar goals which make them become competitors. This clearly means that American Red Cross needs to have a good marketing plan.

In addition, there is a trend in the American society that most of the donors tend to think of the good work done by the firm only during crises. This presents a challenge to the firm hence the need to create a higher awareness at all times. Donors are also greatly concerned about the uncertain economic environment and tend to be reducing their funding hence the need to create a higher awareness (Pope, Isely & Asamoa-Tutu, 2009). However, there is new trend in the U.S. in which the young people are becoming increasingly willing to support non-profit organizations thus presenting real opportunity.

  1. Description of the market place (Target Audience)

In any given marketing plan, the target market is usually quite important. This is the population which supports a firm in its activities. In the case of American Red Cross (ARC), the target audience consists of different groups. One of the most important groups is the young urban people between the ages of 22 and 35 years. This is a very vibrant group with a lot of confidence in whatever they do. They are also well connected with each other and with different organizations, implying that they can support any firm. They live in main cities, have a high income level, values families quite much, quite conscious about the society, and also seek value for anything they do. It also consists of almost equal men and women. They are also technology users and would be glad to use the latest technology. It is the primary target because this group has a great passion on the society and is an important advocate for social justice. Despite the fact that this group is quite active in online platforms, it is quite hard to reach and generally prefer personalized approach.

Another important target audience is the American Red Cross employees, volunteers and other supporting stakeholders. This is an important group to the firm as it offers support in all activities and thus their efforts make the firm able to fulfill its promises. Being a non-profit organization, this group may be demotivated by the fact that it does not see any financial profit from their efforts. This makes the need to keep on motivating this group to keep on supporting the firm as their efforts are quite valuable. Hence, marketing aims at inciting this group and showing it the worthiness of their services. Marketing to this group is however, easier as it is influenced by peers, managers and other groups.

Other organizations such as media can also be said to be a tertiary audience to the firm. American Red Cross greatly depends on these organizations in influencing the public and ensuring that it is greatly supported. This group greatly supports the firm and its quite loyal to it hence may not need a good marketing plan.

Generally, this marketing plan will mainly focus on the young professionals as this is one of the groups which can greatly support the firm given their high income levels. It will be assumed that the firm aims at raising $100 million dollars in order to help it in ensuring that it can be in a better place to act during any disaster which may come in the future.

  1. SWOT Analysis

In order to develop an effective marketing plan, it is quite important to consider the environment of the firm. This should include both the internal and the external environmental. One of the tools which can be used to effectively study these environments is the SWOT analysis. This consists of the strengths and weaknesses in the internal environment and the opportunities and threats in the external environment. This can be summarized in table 1 below.

Table 1; SWOT analysis


  • An advanced volunteers’ network
  • Long network of volunteers
  • A high number of social work activities
  • A high trust from the public
  • Better coordination
  • Have a long history
  • Strong mission


  • Poor handling of resources
  • Great assumption that it is a government project
  • Poor connection with the primary target
  • A low transparency level
  • Not effective in marketing to its primary market


  • A great reach in the global community
  • Use of current technology to make its activities effective
  • Ever increasing ways to connect including blood drive activities
  • Millennials have a great passion to make a change


  • Huge competition
  • Uncertain global economy affecting donations
  • The young professionals are a busier target
  • Budgetary constrains


  1. The brand positioning

American Red Cross (ARC) is a well known firm in the industry. This is due to its great focus on its objectives and its effectiveness in delivering its services. In order to strengthen its brand position, the firm operates under 5Cs of collaboration, compassion, creativity, credibility and commitment. In its everyday activities, ARC works hard to ensure that it becomes better each day.

The brand position is one of the areas where the firm achieves a great marketing of itself. The simple positioning statement generally encourages people to help save lives by offering their assistance during disasters. This is quite a simple statement but it is quite encouraging and makes one to feel the urge to be part of the change and to help in assisting to save a life.

However, the current brand positioning statement fails to encourage the primary target market effectively. Encouraging people to help save the lives of others is quite appealing more to the old people but less to the younger professionals. This means that ARC should change its brand positioning statement to be more appealing to its primary target market. For instance, it should adopt the statement that, “touch someone’s life and be part of the change the world needs”. This statement can encourage them to be more encouraged to offer their donations and views on the kind of assistance they would like to be given to the different people in need of help.

ARC’s brand position is currently supported by a number of policies including being human and other humanity characteristics. However, this is a quality which may be a source of controversy with its stakeholders. Although it is true that the firm did not have any ill-motive by using this as one of its core values, it may indicate that it is open to some errors since human beings are open to a number of errors. Being human can make some volunteers question the trustworthiness of the organization and thus reduce their funding. In order to have a better picture and preserve its current image if not to make it better, the firm should change this core value to another value such as personality. This will create a better picture of the firm and thus serve to market it better. Thus, it would be important for the firm to adopt more personality characters as this would market it better to the millennials which is the primary target market of the firm.

  1. Purpose of the marketing plan

Given all these issues in the current internal and external environment, it is evident that ARC needs a good marketing plan. For instance, the firm used over $28 million only three months after the Typhoon Haiyan which implies the need to always have enough financial resources at hand (American Red Cross, 2014). In this plan, it is assumed that ARC intends to raise $100 million more funds to support its activities in the next six months and to increase its donor base by 10% in the same time period.

  1. Communication plan

It is quite evident from the above analysis that American Red Cross needs to have a strong communication plan which can help it reach its target market. The success of any market plan used by a firm depends quite much on the communication plan adopted by the firm. On the other hand, the communication plan depends greatly on the target market (Ferrell & Hartline, 2012). It should also pass the message in a clear manner which generally appeals to this target market.

The young professionals have thinking that ARC is a governmental project with the aim of offering relief to disaster victims and also to collect blood. This means that the marketing strategy used by this firm should be able to change this perception in the first place and make them see the firm as a highly trusted non-governmental organization (Arnett, German & Hunt, 2003). In this case, the firm should convey the message that it is there to help in different situations and not just disasters and blood donation activities.

Since American Red Cross’s main target market is the young professionals and the message it aims to communicate to them is the need to support the firm and be part of the life-changing process the firm is doing, the plan will use social media as one of the main communication methods (Wheeler, 2009). This is an appropriate communication tool to this population given that these young professionals are quite active in the social media. They interact quite much through sites each day. Social media has a number of platforms and each can be used to achieve a given goal or to communicate a certain point. For instance, the firm should open a Facebook page with the aim of interacting with this group in order to know their views towards the firm and hence strategize better on how to focus them. It should also have an instagram account through which it would post pictures of disaster victims in order to touch a heart of a donor. Additionally, it should use YouTube to post different videos of its volunteers in action in order to show this market that they play a great part in the society thus making them greatly encouraged to support them (Weerawardena & Mort, 2012). Instagram and the YouTube can also be usedn where the firm should post a number of pictures of its workforce in action. The need to train the volunteers and to be prepared for disasters should also be part of the message as this would help substantiate how the firm uses its resources. All in, it would be important to always create a picture of an ethical and an accountable firm at all times. Thus, the firm’s communication plan cannot be complete without incorporating the social media where its main target group is always found.

Social media aside, the firm should incorporate its websites as a medium of communicating to its target market. The young working generation has a great proficiency in surfing through the web. Whenever they wish to get some understanding on the current issues of a firm, they mainly go to the firm’s website (Mohr, Sengupta & Slater, 2010). This is made possible by the great advancement in technology and the fact that this group of people use own the latest mobile tablets which can access the internet in just a click of a mouse. This clearly means that ARC can use its website to communicate to its target market.

Moreover, the firm should use emails of this target market to communicate to it. As earlier highlighted the firm’s main target group like personalized communication and may not bother to read a message send to the masses. This means that sending a personalized message may be more effective to reach them. This is quite possible given the fact that this group has quite active email accounts which they long in almost each day. In this case, the firm should ask each of these members whenever they engage to offer their emails to be receiving messages from the firm. This would make them feel honored and respected as they would be receiving messages which would be to them quite personal. The firm would them form a team of experts which would be framing appealing messages and also sending periodic newsletters to this target market (Leroux, 2010). This would definitely catch their eye and hence be an effective communication to the firm.

As highlighted earlier, ARC also needs to focus on its secondary target, the volunteers. In order to effectively communicate to this group, it will use its website where it will create an account for each. Through this account, the volunteers will be in a position to get all the necessary information from the firm and thus remain encouraged on the need to keep offering their volunteering activities. The firm has a great competence in this case it has a very active blog where its volunteers can interact on matters of the firm (Solis, 2011). For instance, after the recent Hurricane Katrina, the firm launched a strong initiative in the social media where it aimed at not only to market itself but also to ensure that it monitors the sentiments of the public in its efforts to maintain a good relationship with them. The firm also has an active blog for volunteers, the Red Cross Flickr where they can interact (Solis, 2011). This is a good site which be used to market the firm.

  1. Conclusion

In conclusion, marketing is quite important for any firm including non-profit organizations. This paper has focused on developing a marketing plan of American Red Cross. Generally, it is clear that the firm needs such a plan in order to ensure a good relationship with the public in addition to raising enough funds to make it remain in a better position to handle any problem in the future. The plan is also important in ensuring that the firm creates higher awareness among different people in the society on the different things and ways it can help them. The target market in this case is the young professionals who have a higher income level and thus a higher ability to support the firm in its activities. In order to communicate well, it is clear that the firm should utilize current communication platforms including the social media.









Arnett, D. B., German, S. D. & Hunt, S. D. (2003). The Identity Salience Model of Relationship Marketing Success: The Case of Nonprofit Marketing. Journal of Marketing, 67(2), 89-105.

Brace-Govan, J., Brady, E., Brennan, L., & Conduit, J. (2011). Market Orientation and marketing in nonprofit organizations: Indications for fundraising from Victoria. International Journal of Nonprofit and Voluntary Sector Marketing, 16(1), 84-98.

Dolnicar, S. & Lazarevski, K. (2009). Marketing in Non-Profit Organizations: An International Perspective. International Marketing Review, 26(3), 275-291.

Ferrell, O. C. & Hartline, M. (2012). Marketing Strategy. 6th Ed. Mason, OH: South-Western Cengage Learning.

Laratta, R. (2009). Ethical climate in nonprofit organizations: a comparative study. International Journal of Sociology and Social Policy, 29(7/8), 358-371.

Leroux, M. K. (2010). The nonprofit marketing guide: High-impact, low-cost ways to build support for your good cause. San Francisco, CA: Jossey-Bass.

Mohr, J. J., Sengupta, S., & Slater, S. F. (2010). Marketing of high-technology products and innovations. 2nd ed. Upper Saddle River, NJ: Prentice Hall.

Pope, J. A., Isely, E. & Asamoa‐Tutu, F. (2009). Developing a Marketing Strategy for Nonprofit Organizations: An Exploratory Study. Journal of Nonprofit & Public Sector Marketing, 21(2), 184‐201.

Solis, B. (2011). Engage!: The complete guide for brands and businesses to build, cultivate, and measure success in the new Web, revised And updated. Hoboken, N.J: John Wiley & Sons.

The American Red Cross. (2014). About Us. Retrieved from,

Weerawardena, J. & Mort, G. S. (2012). Competitive Strategy in Socially Entrepreneurial Nonprofit Organizations: Innovation and Differentiation. Journal of Public Policy & Marketing, 31(1), 91-101.

Wheeler, R. T. (2009). Nonprofit Advertising: Impact of Celebrity Connection, Involvement and Gender on Source Credibility and Intention to Volunteer Time or Donate Money. Journal of Nonprofit & Public Sector Marketing, 21(1), 80‐107.






Obsessive Compulsive Disorder (OCD): Its Nature and Treatment









Obsessive Compulsive Disorder (OCD): Its Nature and Treatment





            It is not uncommon for virtually everyone to double check things. One may, for instance, double check to ensure that the lights are turned off before leaving the house. However, people with OCD double check things repeatedly or perform some things over and over. This behavior is referred to as obsessive compulsive disorder (OCD). OCD refers to an anxiety disorder characterized by unwanted, intrusive thoughts that cause worry, fear, uneasiness, nervousness, or apprehension (Freeman et al., 2009). The disorder usually starts somewhere between the end of childhood and start of adulthood. People with OCD have a tendency of doing things repetitively and ritualistically. These people are often aware of their compulsions, but they feel incapable of controlling or resisting them. OCD symptoms ordinarily portray themselves as obsessions – extraordinary fears, worries, and concerns (March et al., 2004). These obsessions may include fear of accident or death, disturbing thoughts about violence, the urge to remember things, and extreme consciousness about orderliness. According to Franklin et al. (2011), OCD has the potential to control one’s life and interfere with their social relationships. Due to the grave consequences it can have on one’s life, OCD is a condition whose management is critical. This paper explores this largely ignored disorder and its portrayal by various films, including OCD: The War Inside and The Touching Tree. The paper starts by defining OCD in detail and uncovering its prevalence. It then proceeds to explain its signs and symptoms, epidemiology, and how the condition can be managed.

What is OCD?

            OCD is a condition that has a neurobiological origin (Franklin et al., 2011). The brain disorder distorts how people think. It is characterized by extraordinary compulsions and obsessions that distract the normal functioning of one’s life. Obsessions refer to disturbing thoughts or impulses that result in uncontrollable fear, worry, or discomfort. To cope with the condition, an OCD victim is compelled to repetitively undertake mental or physical acts known as compulsions. Rather than anxiety, these compulsions are occasionally preceded by what is referred to as the sensory phenomenon (Jenike, 2004). Visual or auditory sensations may initiate the need to feel or sound perfect. At times, the compulsions may be triggered by an inner feeling of discomfort that causes one to repeat a certain behavior until the feeling diminishes. In other instances, ritualistic behavior is triggered by an urge rather than obsessions, feelings, or sensations.

            Like most chronic conditions, OCD can only be controlled, but not cured (Freeman et al., 2009). With appropriate treatment, people with OCD can learn how to manage the disorder. OCD is not a condition one chooses to have. When the condition is untreated, the victim often does not have any control over its effects or their reactions to it. Even though OCD patients are sometimes capable of managing or suppressing the symptoms, Kohn et al. (2004) reiterate that this may come at a significant cost. In school, for instance, students with OCD may work extraordinarily harder to the point of experiencing extreme fatigue.

            The media often offers idealized depictions of conditions such as OCD. Such depictions have increased the awareness of the public regarding such disorders (Jenike, 2004). British poet and essayist Samuel Johnson, for instance, is an ideal historical figure who was diagnosed with OCD. He had the tendency of counting his steps while he walked up and down staircases. American aerospace engineer and filmmaker Howard Hughes is also known to be a victim of OCD. Those close to him claim that he was extraordinarily afraid of germs, a phenomenon noticed in many OCD patients. Another example is renowned British footballer David Beckham, who outspokenly struggles with the condition. It is said that Beckham counts alls his clothes and that he arranges his magazines in a straight line. The list goes on and on.

            As depicted in a 2001 documentary by Mark Pancer and David Hoffert, OCD: The War Inside, OCD is actually an inside battle. Through the experiences of different people such as Trisha and Andrew, the film shows the pain and difficulties experienced by OCD patients. Given that the realities of mental illness have significantly been ignored, the movie is arguably the best description of the human face of OCD. In The Touching Tree, a film produced in 1992, OCD is also depicted as a serious mental illness, whose consequences on one’s life can be fatal. The film presents a chronology of the pain experienced by a young boy suffering from the condition, and how through the help of his elementary school teacher and a professional assistant the boy recovers gradually.  


            OCD affects one in every 30 people, or approximately 3% of the population (Freeman et al., 2009). Majority of these people experience OCD symptoms that are critical enough to interfere with their normal lives. Nevertheless, the commonness of clinically diagnosed OCD remains quite lower. In other words, most people with OCD remain undiagnosed, mainly due to lack of awareness of the condition. OCD can occur at any age, but it mainly strikes during early adulthood. In fact, statistics indicate that approximately 80% of OCD instances are seen before the age of 25 (Franklin et al., 2011). It is also important to note that the disorder is not prevalent in a specific gender: it affects men and women equally. Essentially, OCD is not discriminative – it affects people of all ages, races, ethnicities, and socio-economic levels.

Signs and Symptoms

            The major symptoms of OCD include obsessions and compulsions. Obsessions are mental pictures that replay in the mind over and over despite attempts to disregard or deal with them (Jenike, 2004). Individuals with OCD often perform acts in a repetitive manner so as to minimize obsession-related anxiety. The clarity and vividness of the obsessions vary from individual to individual, especially during the onset of the first symptoms. A mild obsession, for instance, could entail a general feeling of tension that comes with a belief that life cannot remain normal in the presence of the imbalance. A more severe obsession could entail a preoccupation with the image of someone’s death. As stated before, anyone may experience such thoughts, but some people tend to attach abnormal importance to the images, resulting in self-loathing or self-criticism. Although individuals with OCD are aware that their beliefs have no correspondence with reality, they feel an urge to behave as though the beliefs are correct (Kohn et al., 2004). For instance, an OCD patient might treat non-living matter as living matter, while still acknowledging that such a belief is irrational.

            OCD may occasionally depict itself without visible compulsions – primarily obsessional OCD. This type of OCD, which is often regarded as the most disturbing form of OCD, accounts for 50-60% of all OCD cases (Jenike, 2004). People with this type of OCD experience unwanted thoughts centered on a fear that they may behave in a manner that is prospectively fatal to themselves or others. Instead of having visible compulsions, people with primarily obsessional OCD may engage in more covert mental rituals or avoid situations that may provoke intrusive thoughts. Due to this avoidance, people experience difficulties fulfilling both their private and public roles, irrespective of the value they attach to those roles or whether they had successfully fulfilled the roles in the past (Behar, 2001). Furthermore, the constant avoidance can puzzle others who are not aware of its origin. In The Touching Tree, the elementary school boy depicts behaviors that are initially strange to his teacher. He retains his obsessions and compulsions as a secret, though his teacher discovers them later.

            In extreme instances, OCD comes out as an urge to carry out compulsive rituals in order to minimize the related anxiety and intrusive thoughts (Hill & Beamish, 2007). The person may believe that the ritualistic behavior will hinder the occurrence of a dreaded event or eliminate the thoughts from his or her mind. Whatever the case may be, the reasoning of the individual is so peculiar or irrational that it inflicts substantial stress upon the individual. Ideal examples of compulsions include: excessive nail biting, hair plucking, and skin picking; repetitively checking whether a parked car is locked; clearing the throat; sensitivity to numbers and patterns; and so on. In OCD: The War Inside, Andrew’s OCD, which began at the age of nine, results in compulsions such as gnawing on walls, streets, and even subway floors. Individuals such as Andrew are conscious that their behaviors are irrational, but the urge to comply with them is often so strong that they can’t resist it. The same case is seen in The Touching Tree ­– the young boy is aware that his behavior is both strange and distressing, but the urge to fight the compulsions overpowers him.    

            Although some things are done repetitively, Freeman et al. (2009) argue that they do not amount to compulsions. For instance, religious practices, bedtime routines, and acquiring a new skill are not regarded as compulsions. Whether or not a behavior is a compulsion or a mere habit is dependent upon the setting in which it is performed (Todorov, Freeston & Borgeat, 2000). For instance, arranging items everyday in an orderly manner would be expected of a person that works in a supermarket, but the same behavior would appear abnormal in other contexts. Simply, a habit makes one’s life more efficient, while a compulsion makes it complicated. In Pancer’s and Hoffert’s film, Grace’s OCD, which began at adulthood, substantially complicates her relationship with her husband and daughter. The same case applies to Marvin, whom OCD, which struck while in middle age, creates serious problems in his family. OCD is certainly an inside war.        

            OCD is also associated with other conditions such as depression, obsessive-compulsive personality disorder, hyperactivity disorder, bipolar disorder, general anxiety disorder, and social anxiety disorder. Some reports show that people with depression are at a greater risk of developing OCD in comparison to those who don’t have (Jenike, 2004). OCD patients may experience depression due to the inability to control intrusive thoughts. Other studies demonstrate some link between OCD and drug addiction (March et al., 2004; Franklin et al., 2011). In other words, people with OCD face a greater risk of developing addiction to drugs. It is important to note that demonstrating any of these symptoms does not necessarily imply that one is suffering from OCD since obsessive or compulsive behaviors can as well be seen in other conditions such as obsessive-compulsive personality disorder, autism, posttraumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD).

            Pancer’s and Hoffert’s film somehow refutes the notion that all of us experience some form of OCD. The film demonstrates that even the most moderate form of OCD is not pleasurable as commonly believed. Pancer and Hoffert illustrate that while the frequency and intensity of the symptoms associated with the condition vary from individual to individual, it is simply ignorant to argue that virtually everyone has some form of OCD. Actually, as depicted by the movie, if one walked a mile in the shoes of someone with real OCD, they would realize the laxity inherent in most conventional descriptions of the disorder.


            Though it is not precisely known what causes OCD, there is general consensus that the condition is caused by both psychological and biological factors (Hill & Beamish, 2007; Franklin et al., 2011; Jenike, 2004). From a psychological perspective, it is believed that mild versions of OCD may have had evolutionary advantages. Ideal examples in this case include persistent checking of hygiene or the surrounding for adversaries. On the other hand, biologists argue that OCD originates from abnormalities within the section of the brain that produces serotonin (Hill & Beamish, 2007). It is believed that serotonin plays an integral role in controlling anxiety. In essence, some sections of the brain in people with OCD symptoms function differently as opposed to those that don’t have. These sections include the frontal cortex, anterior cortex, striatum, and the thalamus. Compulsions or obsessions are often a result of communication difficulties amongst these sections.

            Typically, the brain produces random, strange thoughts. These thoughts are often dismissed, but in some people they get stuck in the brain (Laidlaw et al., 1999). Random thoughts can be equated to junk mail. In other words, most people are capable of ignoring the “junk mails”, but in some people the “spam filter” is simply non-operational – the junk mail keeps coming, consequently outnumbering important mails. This ultimately overwhelms the person.

            Some studies report that OCD has a genetic element (Franklin et al., 2011; Laidlaw et al., 1999). This implies that the condition may be hereditary. Simply, people from families with a history of OCD and other anxiety disorders are more likely to suffer the disorder as opposed to those that don’t. Furthermore, first-hand relatives (parents and siblings) of OCD patients are more vulnerable to developing OCD in comparison to the rest of the population. Studies of twins further support the link between OCD and genetics. Generally, studies involving twins with the condition demonstrate that genetics accounts for up to 65% of the threat for developing OCD. Family history is thus a significant predictor of OCD development. However, Mark Pancer’s and David Hoffert’s film tends to refute this argument.

            OCD has also been linked to behavioral, cognitive, and environmental factors. Behavioral theorists suggest that behavioral conditioning may accelerate the development of obsessions and compulsions (Jenike, 2004). It is actually believed that compulsions are acquired responses that assist a person minimize or prevent the nervousness associated with obsessions and urges. A person who is obsessed with germs, for instance, may repetitively wash their hands to minimize the nervousness provoked by the obsession. Since the repetitive washing momentarily minimizes the anxiety, the likelihood that the person will wash their hands as a result of the fear of contamination in future increases. Consequently, the compulsive behavior turns out to be excessive.

            Other theorists link OCD to the cognitive system. They believe that people with OCD have dysfunctional beliefs (e.g. perfectionism intolerance for uncertainty, overestimation of threat, and so on), and that their misinterpretation of intrusive thoughts generates compulsions and obsessions (Todorov, Freeston & Borgeat, 2000). This explanation holds that it is normal for anyone to experience intrusive thoughts. However, individuals with OCD misconstrue these thoughts as personally important or having grave consequences. The constant misinterpretation creates an environment for the buildup of obsessions (Hill & Beamish, 2007. Since the obsessions tend to be disturbing, the victim adopts compulsive behaviors in an attempt to neutralize or resist them.

            In addition, some environmental factors may fuel the onset and persistence of OCD. Even though some studies (e.g. Freeman et al., 2009) demonstrate that there is no connection between OCD and negative life occurrences, there is a general view that OCD, particularly during childhood, is triggered by certain events, which are often traumatic. Examples include the death of a dear one, injuries, divorce in the family, shift to a new location, or unhappiness at school. In view of the cognitive explanation of OCD, stress can add disturbing thoughts, increasing the vulnerability to obsessions. This argument is supported by some studies which maintain that one or two years before the first symptoms are seen, OCD victims undergo negative life events (March et al., 2004). Taking into account the extreme levels of stress children experience at home or school, such findings are remarkably fundamental for educators.


            There is no laboratory test that can be utilized to identify OCD, but formal diagnosis may be carried out by a psychologist, psychiatrist, social worker, or any qualified mental health professional (Jenike, 2004). During diagnosis, an evaluation is carried out to ascertain the presence of OCD. Ideally, the evaluation entails comprehensively examining the developmental, psychiatric, and medical history of the victim. A physical examination is also included sometimes. This facilitates the recognition of other disorders since OCD is often accompanied by other conditions, such as social anxiety disorder, separation anxiety disorder, depression, autism, and ADHD (Laidlaw et al., 1999). The evaluation involves a great deal of discretion since it is important to separate OCD behavior from a habit, preference, or normal development.

            Mental health professionals often utilize diagnostic interviews to screen for OCD and other related disorders. Examples include the Anxiety Disorders Interview Schedule for DSM-IV and the Schedule for Affective Disorders and Schizophrenia for School-Age Children (Freeman et al., 2009). Upon diagnosis and determining the presence of OCD, the clinician establishes the degree to which the condition is inflicting distress upon the patient. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most commonly used tool for this purpose. The tool is administered to both the parent and the child to determine the present OCD symptoms as well as their severity. A comprehensive diagnosis also entails an assessment of both medical and school records (Behar, 2001). Medical records may include physical examinations, while school records may involve grade and test scores as well as information about the child’s functioning within the school environment. Since young people spend a considerable portion of their day in school, educators together with other school personnel have an important role to play in this regard.  

            To be diagnosed with OCD, one must have obsessions or compulsions, or both (Todorov, Freeston & Borgeat, 2000). According to the guidelines provided under DSM, clinically-significant obsessions and compulsions are characterized by a number of features. First, the obsessions entail recurrent images or impulses that result in significant anxiety or distress. Second, the images or impulses are of a kind that goes beyond the ordinary spectrum of worry about typical problems (Laidlaw et al., 1999), as seen in the case of Andrew in Pancer’s and Hoffert’s film. Gnawing on walls or subway floors is certainly a behavior that falls outside normal behavior. Essentially, as mentioned earlier, compulsions become clinically significant when an individual is driven by an urge to perform them so as to suppress an obsession. As such, whereas most non-OCD people may have symptoms associated with OCD, the difference with clinically significant OCD is that an individual with OCD is innately compelled to behave in a certain manner, otherwise he or she will undergo immense psychological stress (Ladoucer & Freeston, 1995).

            Most importantly, the compulsions or obsessions must be time-consuming or detrimental to one’s social or occupational Life. In OCD: The War Inside, for instance, Grace’s OCD has impaired her relationship with her husband and daughter. Essentially, the uncontrollable nervousness she gets when she receives visitors has essentially impaired her social life. It is important to ascertain the seriousness of signs and impairment prior to and during OCD treatment.            


            As mentioned before, OCD can only be controlled, not cured. The main techniques used in the treatment and management of OCD include cognitive behavior therapy and medication. Cognitive behavior therapy (CBT), which is supported by nationally-recognized institutions such as the American Academy of Child and Adolescent Psychiatry, Harvard Medical School, and the National Institutes of Mental Health, entails gradually training the victim to handle the anxiety associated with resistance to behave ritualistically (March et al., 2004). CBT is actually the only empirically-based behavioral therapy for OCD. It is also the first intervention of choice, particularly for mild OCD and for children who have not attained puberty. CBT is also the first choice when the condition is more serious – it is combined with medication only when it doesn’t work.

            In 2004, a comparative study, dubbed the Pediatric OCD Treatment Study (POTS), was done to determine the impact of each treatment, i.e. CBT alone, medication alone, and CBT blended with medication (Freeman et al., 2009). The study established that the management of OCD should begin with CBT alone. This position resonates with that of the American Academy of Child and Adolescent Psychiatry (AACAP). These guidelines clearly advocate for the effectiveness of CBT. Nonetheless, as argued by Ladoucer & Freeston (1995), not all psychologists or psychiatrists are knowledgeable in the application of CBT. It is therefore important to get an experienced CBT therapist.

            CBT encompasses two techniques: exposure and response prevention (ERP) and cognitive therapy (March et al., 2004). In ERP, which is also known as ritual prevention, the therapist together with the patient lists the entire patient’s fears and repetitive behaviors (from the least to the most disturbing) as well as instances that can trigger these symptoms. The therapist then performs a chain of controlled ERP exercises, starting with those that induce less fear. Basically, the patient is exposed to provocative situations and is required to keep away from carrying out his or her routine compulsions for a given period of time (Franklin et al., 2011). During the exercises, the child may be required to holdup the compulsions for increasingly lengthier durations. For instance, a patient that obsessively fears germs may be asked to touch an object that he or she firmly believes is contaminated. The patient is then trained to keep away from washing his or her hands after touching the object. In the ensuing sessions, the patient is required to avoid washing his or her hands for longer durations.

            Repeated therapeutic exposures reduce the related anxiety up to the point it becomes almost unnoticeable or even diminishes completely (Franklin et al., 2011). There is no precise amount of time that one is supposed to take to gain control over the fears or disturbing images. However, ERP works by decreasing the anxiety created by provocative situations. This is referred to as habituation. It is just like swimming – when one jumps into the pool, he or she first feels uncomfortable due to coldness of the water, but with time the body gets used to the temperature of the water, even though the temperature does not change. In the context of OCD, habituation causes instances that formerly provoked OCD signs to generate reduced anxiety and a lesser desire to ritualize (Todorov, Freeston & Borgeat, 2000). With time, the patient develops the ability to tolerate more challenging exposures.  

            Since every patient is different, it is important for the therapist to tailor the program to the symptoms and characteristics of the patient and his or her family (Ladoucer & Freeston, 1995). Often, children and adolescents are enrolled into weekly or bi-weekly outpatient sessions, with compulsory homework. During the sessions, the therapist may also help the patient acquire new ways of thinking. This helps patients understand that their fears are unreal and learn how to control the urges (Behar, 2001). In the example of the contaminated object, for instance, therapy helps the patient to challenge the irrational belief that coming into contact with the object can cause illness.

            It should be noted that the pace with which patients respond to CBT differs from individual to individual (Franklin et al., 2011). It is common for weeks to lapse before signs start subsiding. Even when the patient’s behavior gets better, some setbacks may be witnessed. The therapist should therefore plan additional sessions accordingly. Hospitalization is rarely required when administering CBT (Behar, 2001) – it may be required only when dealing with extreme instances of OCD, such as when one attempts suicide or when the condition is accompanied by other disorders.  

            CBT is regarded as the most effective form of intervention for OCD. This is mainly because medication is associated with various side effects and CBT is more durable (March et al., 2004). However, some people may not respond well to the therapy. Furthermore, a significant portion of OCD patients are unable to access therapy services due to either financial constraints or the long distances involved in locating a qualified therapist (Ladoucer & Freeston, 1995). There is also lack of professionals with sufficient background in the administration of CBT. In addition, some patients demonstrate unwillingness to take part in CBT. This warrants the need for medication.

            Since CBT may be administered alongside medication, it is important for the clinician to be perfectly aware of the medications appropriate for treating the condition as well as their related side effects (Jenike, 2004). The most common medications for OCD include antidepressants and selective serotonin reuptake inhibitors (SSRIs). Most antidepressants, including Anafranil, have been approved for patients aged 10 and above. Although they can effectively treat OCD, antidepressants are associated with various side effects, such as weight gain, the risk of seizures, and cardiovascular complications.

            Due to the potential side effects of antidepressants, clinicians often prefer to use SSRIs. Common SSRIs include Zoloft, Prozac, Luvox, Paxil, and Celexa. Of these, it is only Paxil and Celexa that have not received the approval of the FDA. Even though SSRIs are preferred to antidepressants, they are also associated with a number of side effects, including nausea, greater anxiety, diarrhea, and insomnia.

            A major side effect associated with antidepressants is referred to as behavioral activation (Jenike, 2004). This entails a set of symptoms, including aggression, hyperactivity, irritability, increased anxiety, agitation, suicidal thoughts, and impulsivity. As a result, the Federal Drug Administration (FDA) in 2004 issued a warning alerting healthcare providers of the risk of suicidal behavior for adolescents under antidepressants (Hill & Beamish, 2007). This is actually a risk for not only OCD patients, but also patients suffering from other disorders. As such, the physician should closely monitor the patient. Nonetheless, some reports reveal that the benefits associated with SSRIs outweigh the dangers.

            Regrettably, a significant number of OCD patients experience an acceleration of symptoms once medication is withdrawn (Todorov, Freeston & Borgeat, 2000). According to some studies, medication minimizes signs by approximately 30-40% (e.g. Freeman et al., 2009; Hill & Beamish, 2007). This implies that most people are left with residual symptoms. All in all, blending medication with CBT, whenever possible, presents the most appropriate way of enhancing treatment results.     

            According to Mark Pancer’s and David Hoffert’s film, some people can have success with cognitive behavior therapy and medication. For instance, the young woman Trisha, who attempts suicide, finds valuable help in behavioral therapy as well as SSRI medications. Andrew also finds relief after attending several behavior therapy sessions with the support of his sister and parents. In The Touching Tree, OCD is also shown to be a manageable condition. Terry, who is the main focus of the film, is successfully subjected to both behavioral treatment and medication.

Treatment Challenges

            Although OCD is a fairly widespread illness whose effective treatment is available, the conditions can at times be under-diagnosed or misdiagnosed. This happens due to a number of reasons. First, children or teenagers with the condition can be overt about their symptoms (Ladoucer & Freeston, 1995). When children keep their symptoms to themselves while at school but expose them at home, or vice versa, conflicts may arise between parents and school personnel. In such instances, it is important for school personnel to take what parents explain about their children seriously, and for parents to take what school personnel explain about the children seriously.

            Second, most victims attempt to prevent the occurrence of their signs by refraining from people or situations that provoke the anxiety, fears, or urges. For instance, one who is extraordinarily afraid of germs may refrain from drinking school water or touching shared classroom objects. As explained by March et al. (2004), such avoidance may remain undetected for long, causing any OCD symptoms to remain undetected as well. Another treatment challenge is presented by lack of adequate knowledge by physicians on how to diagnose and manage OCD, particularly amongst children and teens (Kohn et al., 2004). Moreover, OCD is not limited to the symptoms mentioned above. In other words, the condition can take less familiar signs, such as persistence reassurance-seeking, procrastination, and asking repetitive questions (Franklin et al., 2011). Such behaviors may go unrecognized. Additionally, OCD symptoms often increase or fade for no apparent reason, or may shift from one set of compulsions to another (Todorov, Freeston & Borgeat, 2000). This makes it harder to rightly diagnose the disorder. Most importantly, OCD symptoms resemble those of other disorders such as PTSD and ADHD, further complicating the process of diagnosis.


            In sum, everyone experiences intrusive thoughts at various points in their life. However, a section of the population attaches more significance to those thoughts as compared to the rest. This gives rise to what is known as obsessive-compulsive disorder. OCD, which is first seen towards the end of childhood, is mainly characterized by a strong desire to do some things repetitively. One is often aware that his or her ritualistic behavior is insensible, but they find it hard to resist the urge to behave in a certain manner. Several factors have been linked to OCD: psychological, cognitive, biological, behavioral, and environmental factors. Regardless of the cause, OCD has the potential to destroy one’s life, particularly their relationship with those around them. It is therefore important to address the condition, though it cannot be completely cured. Behavioral therapy presents the most effective intervention for OCD, though it may not work for some people, warranting the need for medications, which are associated with various side effects. A major difficulty in the treatment of OCD lies in the diagnosis of the conditions due to challenges presented by victims hiding their symptoms, the condition manifesting in less familiar symptoms, as well as the fading or waning of the symptoms with time.    



Behar, D. (2001). OCD in children and adolescents: a cognitive-behavioral treatment manual.       Community Mental Health Journal, 37(5): 462-463.

Franklin, M. et al. (2011). Cognitive behavior therapy augmentation of pharmacotherapy in           pediatric obsessive-compulsive disorder. The Journal of the American Medical          Association, 360(11): 1224-1233.

Freeman, J, et al. (2009). The pediatric obsessive-compulsive disorder treatment study II: rationale, design and methods. Child Adolesc Psychiatry Ment Health, 3: 4.

Hill, N., & Beamish, P. (2007). Treatment outcomes for obsessive compulsive disorder: a critical   review. Journal of Counseling and Development, 85(4): 504-510.

Jenike, M. (2004). Obsessive-compulsive disorder. The New England Journal of Medicine, 350:    259-265.

Kohn, R. et al. (2004). The treatment gap in mental healthcare. World Health Organization:          Bulletin of the World Health Organization, 82(11): 858-866.

Ladoucer, R., & Freeston, M. (1995). Cognitive-behavioral treatment of obsessions. Behavior       modification, 19: 247-258.

Laidlaw, T. et al. (1999). The stress of caring for people with obsessive compulsive disorders.       Community Mental Health Journal, 35(5): 443-450.

March, J. et al. (2004). Cognitive behavior therapy, sertraline and their contribution for children    and adolescents with obsessive compulsive disorder. The Journal of the American    Medical Association, 292(16): 1969-1976.  

Todorov, C., Freeston, M., & Borgeat, F. (2000). On the pharmaco-therapy of obsessive-  compulsive disorder: is consensus possible? Canadian Journal of Psychiatry, 45: 257-          263.

Aldolase (Rabbit Muscle)





Aldolase (Rabbit Muscle)


Student’s Name




Aldolase (Rabbit Muscle)



Search statement/terms








Too many general results



Aldolase (rabbit muscle)



Average number of results with satisfactory relevance



Structure of aldolase


Relevant and very precise, but less results






Need to apply effective filter strategies



Aldolase (rabbit muscle)



Average responses. A filter strategy could lead to more precise results



Structure of aldolase


Remarkable results that still require precise filter strategies


In all fields



Very high results that require to be filtered


In the title field

Aldolase (rabbit muscle)



The use of specific descriptors could refine the results further


In a precise topic

Structure of aldolase


Accurate results that provide links to relevant topics


Part 2

            The three main databases that were used included Pubmed, Ebcohost, and web of science. Since the topic was a science-based one, it was found that web of science provided the most precise results. Ebcohost also provided a list of results, but there was a lot of filtering to be done in order to get more specific results required for the topic on aldolase. Web of science database provided a list of relevant scholarly articles, but had limited results of the content from academic books. On the other hand, Pubmed results were restricted to peer reviewed journals and accessing primary information was rather challenging. During the research process, it was found out that Ebcohost was the best search engine that has a variety of primary and secondary research sources.  

            The selection of the most suitable research database mainly depends on the content of the research topic. In most of the research processes, the researcher would like to access primary and peer reviewed information. When doing a presentation paper, the use of peer reviewed sources that provide exhaustive literature review content is inevitable.

            Some of the key problems that were encountered during the search process include:

  • Difficulties in choosing the most precise source
  • Accessing primary resources
  • Detecting the discrepancies in the research results from different authors

It was quite challenging to locate primary resources from the databases as many of them required registered subscribers. The subscription fee for some of the databases was quite high, especially for academic and scientific sites such as web of science. Navigating through each site was also demanding as it required the user to access the library database before searching for specific topics. Some of the strategies that were applied in solving the above named strategies included:

  • Applying selective filter strategies
  • Use of descriptors in searching for peer reviewed content


Part 3

Annotated Bibliography

Manashi S, Dean R. Tolan, Karen N. Allen: Acta Crystallogr D Biol Crystallogr. 2008       May 1; 64 (PT 5): 543–550. Published online 2008 April 19.             doi: 10.1107/S0907444908004976: PMCID: PMC2631105.

            This resource is a peer revised scientific article that was retrieved from Pubmed database. The authors of this resource material define aldolase as an essential enzyme in gluconeogenesis and glycolysis. The resource material appropriate for research purposes as the authors provide the researcher with an in-depth analysis of the primary function and the basic structure of aldose and how it binds a variety of other proteins. The authors also provide the reader with appropriate information on how the link between noncatalytic and oligomeric cellular contribute to a stable structure of the aldose. The resource material is not biased in any way and any information borrowed from other primary and secondary resources is cited according to the required academic formats.

Russell, P. J., Williams, A., Abbott, A., Derosales, B., & Vargas, R. (2006). Characteristics of       rabbit muscle adenylate kinase inhibition by ascorbate. Journal of Enzyme Inhibition &    Medicinal Chemistry, 21 (1), 61-67. Do: 10.1080/14756360500043372.

            This resource material is a peer reviewed article retrieved from the web of science database. The authors of this research resource provide a comprehensive comparison of the different results that previous academic researchers have documented regarding the structure and scientific characteristics of the rabbit muscles. The authors mainly concentrate on the skeletal muscle glycogen and elaborate on how ascorbatte facilitates the general storage of the muscles. The research material provides a unique analysis son how glycogen is inhibited when the rabbit muscles are at rest. This content is not easily available in other resource materials. The authors further provide the researcher with an depth description on how the RMAK concentration becomes important to the inhibition process, especially when there is a need to increase the level of sensitivity in the muscles. The resource material is not biased and is thereby recommended for research purposes.

Sherawat, M., Tolan, D. R., & Allen, K. N. (2008). Structure of a rabbit muscle fructose-1,6-        bisphosphate aldolase A dimer variant. Acta Crystallographica Section D, (5), 543.          doi:10.1107/S0907444908004976.

            This research material is a peer reviewed journal that was retrieved from Ebcohost scientific database. The authors of this research materials document a comprehensive analysis of a primary laboratory experiment that was conducted using ascorbic acid in an effort to detect the scientific characteristics of the rabbit muscle. The study in this research material mainly concentrates on the possibility of the reversal of the ascorbate inhibition that facilitates the overall storage of glycogen in the skeletal rabbit muscles. The resource material is suitable for research purposes as it contains primary and secondary data and the content is not biased.



Manashi Sherawat, Dean R. Tolan, Karen N. Allen: Acta Crystallogr D Biol Crystallogr. 2008      May 1; 64(Pt 5): 543–550. Published online 2008 April 19.     doi: 10.1107/S0907444908004976: PMCID: PMC2631105.

Russell, P. J., Williams, A., Abbott, A., Derosales, B., & Vargas, R. (2006). Characteristics of       rabbit muscle adenylate kinase inhibition by ascorbate. Journal Of Enzyme Inhibition &   Medicinal Chemistry, 21(1), 61-67. doi:10.1080/14756360500043372.

Sherawat, M., Tolan, D. R., & Allen, K. N. (2008). Structure of a rabbit muscle fructose-1,6-        bisphosphate aldolase A dimer variant. Acta Crystallographica Section D, (5), 543.          doi:10.1107/S0907444908004976.

Little People

Speech presentation


All the protocol observed, ladies and gentlemen, good morning, we all gathered here for a mission and a vision. Who are the little people everybody keeps talking about? Listen to these dear classmates “The little people is less offensive than dwarf or midget, and those words should be banned. Justice in this case is a concern, for justice, peace, and genuine respect for people” Dwarfs, midgets, smurfs and many other disrespectful names are used for the little people of our society. I am not speaking about short people like pannunz, I am talking about the Tryon Lannisters and Mini me’s of the world. Hello, Miss Roirden and my fellow classmates, it comes to my attention that many individuals do not know how to refer to the little people and they end up “be-little-ing” them to the new ‘low’. Little people is the plural term for the bellow height citizens and the little person for one singular being Is proper and less offensive than the words ‘ dwarfs’ or midgets to denote them by.
Listen to the call and the voice of the little people who are outraged and are calling for justice, they are tired of being referred to with very bad, humiliating terms. Look at the media, listen to it carefully, when referring to this group of people, how do they call them, how do they feel about them? What is the government doing about it, nothing, it does not give justice to the little people. The society looks at them as less important people, even the jobs they give them. Despite the height, they are human too, they have the talents to explore, come on, fellow citizens, where do we find justice? The ‘Dwarfs’ want to ban word midget from being broadcasted on TV and other media sources, like the internet, social media, newspapers, among others. It is the cry of the little people that the media keeps referring to them as dwarfs, making them feel less important than who they are, they also want to be appreciated, they want to look important.
However, justice does not recognize them at all; it cannot hear their cry. Where is justice, then, they justice is there for every citizen, but is this justice my fellow colleagues? Where is justice? I wonder what justice is then, if it cannot open its ears and listen to the cry of the minority, the little people. They refer to them as pigmies, dwarfs, even some people go to the extend of calling them that the developing people, meaning they have not yet finished developing into human beings. How sad is this, I too feel it, my people, how do you feel if you were in their shoes? The cry of the little people still haunts justice, what can be done to change these offensive words from the media, and the society? They call the terms euphemism, the words that sound more polite and respectful, are there no other good and appreciative words that can be used instead of little, dwarfs, smurfs and the likes. Come on my fellow classmates, listen, and listen carefully to the cry of the innocent “short or little people” they are equally important and they would wish to be referred to in a more respectful manner with good terms.

Peffley, Mark. (2010). Justice in America. Cambridge University Press.

Is Scrooge the True Hero of a Christmas Carol?


Is Scrooge the True Hero of a Christmas Carol?
A Christmas Carol focuses on the spirit of Christmas. Ebenezer Scrooge is a hero in the story because he allows the reader to understand the value of Christmas. He is a miserable old man that fails to see the value of Christmas. However, through it all he remains the hero of the story(Dickens, 2009). This is because he proves that there is a bit of good in everybody, regardless of how miserable a person will be. In addition, he proves that the spirit of Christmas lives within us all even though it is masked by misery and unhappiness. Therefore, Ebenezer Scrooge is a hero based on his ability to illustrate kindness beyond his unhappy life.
In the First Stave (Marley’s Ghosts and the Three hundred Spirits), Ebenezer Scrooge is reluctant to give Bob a break on Christmas day. The rationale behind his reasoning is the value of ensuring that the business keeps operating during the holidays. “What good is Christmas that it should shut down bus-iness”(Dickens, 2009). However, even with the thought of losing business on the day, Scrooge allows Bob the day off on Christmas. He chooses to do his part and at the expense of his happiness (of making money and not working too much). It illustrates that Scrooge is willing to make sacrifices even though he remains a miserable man.
Though Scrooge is not willing to embrace the spirit of Christmas in the same vein as Fred and Bob, he is a symbol of practicality(Dickens, 2009). There is no doubting that Ebenezer Scrooge is a sad man and lacks any sense of compassion; however, he has business sense. For example, his refusal to purchase or add an additional lump of coal to add extra heat to the office ensures that Bob is not complacent in his manner of working because of the heat. Extra warmth would reduce concentration, which is a valid aspect of business. Therefore, the lack of extra heat in the workplace may appear mean or portrays Scrooge as a miser, but the reality is that it is good for productive purposes.
Bob Cratchit and Tiny Tim are heroes in their own right based on the unfortunate aspects that negatively affect their lives(Dickens, 2009). Bob is a kind-hearted man who seeks to do the right thing at any opportunity. Inaddition, he is subjected to unfair treatment for Scrooge who is his boss. To a certain degree, Bob is the depiction of an employee in the modern; underpaid, overworked, and making an effort to make ends meet through the problems. He is a hero because he remains positive even though the various problems that occurthrough his life and to his family. He even manages to remain cheerful and optimistic that Scrooge would give him Christmas day off even though he knows that his boss is cruel and a miserable man.
Tiny Tim is Bob’s son who is a cripple. He was crippled at birth and he embodies the aspects of hardship and struggles of life. His is the image of sympathy because his helpless was not his fault and his parents could do nothing to avert the problem. He is a hero because he takes his situation in stride and is willing to make something of his life regardless of his problem. He is a source of inspiration for Bob who works towards providing a better life for his family(Dickens, 2009). Tim is essential for the story because he embodies the ideology that even through the various problems in life, a person can enjoy life, which was the case at Christmas day. Though the premise is to look down on him, Tim illustrates his willingness to rise above his problems, which is a source of motivation for a reader.
Scrooge and Fred illustrate the nature of extremes in the story. While Scrooge is a bitter and miserable person, Fred is an up-beat person who is always willing to enjoy the holidays(Dickens, 2009). He always makes the effort to invite Scrooge for the Christmas, even though Scrooge always rejects his invitations. Fred is Scrooge’s nephew, and is a positive individual always willing to celebrate the festivities to the extreme. He is a hero based on his likeable character. He can inspire joy based on his demeanor and his approach to socializing.
In contrast, Scrooge is a symbol of hope for humanity in that goodness is within us all. Scrooge endures a period of speaking to ghosts to realize that it is important to be kind. Though he rejects the notion of the ghosts, his hallucination serves as a means of awakening the good in him and embraces the aspects of Christmas. This suggests that Scrooge has always had well in him, but he chose to be miserable out of his own accord. Therefore, Scrooge proves that being miserable is a choice and good resides in everyone regarding of the situation (Dickens, 2009). Therefore, the nature of the characters in the story presents how happiness exists. In the case of Scrooge, his aspect of good is introverted and he extenuates the misery in people. However, majority of the other characters exude happiness. This illustrates the various elements of social values and perspectives.

Dickens, C. (2009). A Christmas Carol. London, UK: Cricket House Books.

Sugar Cube Production Feasibility Study





Sugar Cube Production Feasibility Study


Student’s Name



Table of Contents

Executive Summary. 3

Company Description and Products and Services. 3

Market research. 4

Business Strategy. 4

Operation. 5

Others. 6

Machines. 6

References. 7



Sugar Cube production feasibility study

Executive Summary

Sugar cube is a six sided piece of sugar which can be put in a hot drink like coffee or tea. It is simply sugar; the only difference is the shape and size. A small sugar particle makes-up the sugar cube (Chen, 2010). There are many companies that are involved in production of sugar and sugar cubes. These factories have different standards according to the country they are located. Governing rules and standards of production differ according to the regulations of each country. The population that consumes the sugar accounts for the profits a company makes from its produce. However, some produce in mass since they have markets outside their countries.

The company for producing the sugar cubes is located in UK. The main financier is the Barclays bank. They are interested in sugar production business, since it promises huge profits. Therefore, they are ready to partner with the company in order to make the product at a shared cost and profit (Brenton, 2010). That is the best way to ensure that the construction and machine purchasing processes are effected immediately. Also, needed is the money to market the product with a new brand to the market. The estimation of sales should be reached for the success of the new company. It is better to share profits and losses than to bear the loss alone.

Evaluation of production cost, availability of raw materials and the rules and regulations set by other countries is important. The company can extend its production capacity to other countries, or try to compete with other factories in foreign markets. That is why it is of great significance to analyse the condition of a similar business in other countries (Broad berry, 2005). For informed decision making, it is important to have enough data. It also helps in future arrangements and investments decisions. To study the competition in the market is another reason that makes it important to study what is in other countries. For more success, the company must be aware of the competitors. The dangers the competitors have in the local and international markets. It also helps in pricing the products in order to offer a competitive brand and price (Srivastava, 2004). Affordability is another asset that guides consumers. For this to be achieved, the production costs must be minimised. Taking advantage of the available opportunities propels the company higher and higher.

Company Description and Products and Services

The company is a sugar cubes production company. It has a CEO who is the head of the company and oversees all the departments and processes of the company. Then there is an assistant CEO who is the second in command an helps the CEO in carrying out company management duties. Below the assistant CEO are the mangers. These include the regional mangers, production managers, supply and marketing manager, chief accountant, human resource manager and the operations manager. The management work as a team for the welfare of the whole company (Charmin, 1990). They contribute in creating the goals of the company and work hard to meet the set goals.

Under the management team are the foremen. These are close to the workers and help in achieving the set goals by managing the employees. They are the link between the employees and the management (Emmett, 2006). They handle small crises and forward any contribution from the employees to the management. The distribution of work among the employees and overseeing quality production is also their responsibility.

Upon completion, the company will offer many jobs to the community. Skilled and non-skilled people are needed to offer their services in exchange for money. Therefore, job creation is a major feedback to the society (Daleep, 2008). They are also producing one of the most consumed products in the society. People can have a new brand offering a quality product at an affordable price. They are also contributing huge income to the government through taxation. Therefore, they are of great benefit to the public and the government. They are also offering an affordable product to the public. For processing sugar cubes, there are many raw materials needed, these can be supplied from the country. The sugarcane farmers for example, will get a new market for their products.

Market research

It is the process through which the end users are linked to the market through information. They get to know about the new product and the benefits. The information offered helps the company in analysing the market, and thus make an informed decision (Kroschwitz, 2004). The marketing research defines ways of collecting information, analysing, and helps in finding the implications of the findings. It helps in getting quantitative and qualitative data concerning the market nature towards the give product or service. Therefore, the organisation gets prior information about the condition of the market on their product. The most important thing is getting the required process information and then analysing the results.

The company has realised that there are people who do not take sugar. These people are increasing each day due to health implications. Some companies that use sugar are also reducing their products due to the negative developments (Humphries, 2006). The taxation also is high, which makes the production expensive. The effects of taxes have to be reflected in the prices. In order to conquer that problem, the company has to reduce the amount of packages. Reducing the portions packed in order to lower the price caters for the low income earners (Ramos, 2014). They can afford to purchase small packages for a fair price. Then to cater for the rich big packages offered at a discount can attract their attention. Through negotiations, the government can reduce taxation (Mitchell, 2006). However women and youths have to be involved in management of the company. Therefore, the management are willing to introduce equal gender distribution and engage youths for government considerations. Reduction in tax helps in offering a competitive price in the market.

Business Strategy

Business strategy is the process in which the company sets major goals to meet within the set time. The management sets these goals by considering the available resources. They also analyse the external and internal environments the organisation is competing. The plan offers the way of monitoring the progress towards the set goals (Mark, 2003). According to changes in the market, the management changes some strategies in order to fit in the competition. They should always aim at propelling the company towards the set goals. The employees should be motivated in order to work efficiently for the welfare of the company. Failure to recognise the role of workers slows down the development process.

The company aims at making one billion pounds at the end of the first year and addition of 250 million pounds in the preceding years. The competitors are tough but the organisation has to make it through. By studying what other competitors do and what the market is lacking is one of the strategies (Niall, 2008). It is important to recognise what the market needs and work hard to fill that gap. That is the way in which new products and services can be developed for higher profits. New services are essential in creating the uniqueness of the company from other competitors. Therefore specialised research group has been set aside to study the market and develop new products (Tanner, 2010). The company also has a plan of buying agricultural land where they can plant the raw materials. In future, it can help in reducing the raw materials purchase cost. The company is also aiming at adopting new machinery after every five years. New technology helps in improving the quality of the product. It also reduces the costs due to integration of several activities.


The company has the top management made-up of CEO and the assistant CEO. Then there are other departmental managers who oversee the execution of the organisation’s goals. The foremen control the employees in their task areas (Nsouli, 1995). The process begins with buying the raw materials. The acquired raw materials are kept in the receiving store. Then from the receiving stores, they are taken to the processing plant where they undergo various processes. There are several machines which have been set-up to control these processes. They only require low supervision for the whole production process. Most of them have programmed microchips which control these processes through the installed commands. These machines help in reducing the number of human labour needed, and also increase accuracy (PSwaminathan, 2007). It may create a negative image to the society, but it will also ensure mass production at a fair cost. The aim is to produce 24 tons every day.

The other process is branding the packaging paper. People go for brand, and the quality of the brand wins more customers. Quality control is another process in which the quality of the product is accessed. It must meet the required quality for it to be released for human consumption. Packing is another important process, where the product is packed in different sizes. Then the packed product is labelled the retail price to avoid customer extortion. The finished product is then transported to the market (Poona, 2005). Some of the excess is stored as back-up. There are various promotion activities that assist in developing and selling the brand of the organisation. The public need to know about the brand for them to gain interest. A customer feels in control when they make informed decisions and the go for what they think is the best. Advertisement has been the favoured method. In television at peak hours when most of the people are watching news has been preferred. Awareness plus affordable price and high quality products, the company is set for high performances.


According to the research carried out, there is enough market in the stores and other outlets. Young people are the biggest consumers of sugar. Therefore, the young people and middle aged people are the targeted groups (Jackson, 2007). People of all classes us sugar cubes in their homes. To enter the market, the brand needs proper market and promotion. People have to know about the new brand before it reaches the market. Prior knowledge about the product can give it warm welcoming to the market. Through recognised distributors, wholesalers and retailer channels, the company is hoping to supply the product closer to the consumer.

There are many jobs that the company creation will create. These are well paying jobs for the most skilled and competent people. The CEO of the company earns £4200 per month; the assistance earns £4000 per month. The management team requires ten people each earning a monthly salary of £3700. The skilled foremen for various operations each earn a monthly salary of £2900. Permanent employees are many, estimated to one thousand and each earns £2000 per month. The subordinates for the cleaning jobs and security; estimate of two hundred workers each earning £1000 per month.


The machinery supplier is the CFS and the Zhengzhou Longer Machinery Co., Ltd.. The two companies are responsible for supplying the sugar cubes forming machines, sugar cube press machine, coffee sugar cube processing machine, cone making machine, and sugar cubing line (Broad berry, 2005). Other machines are packaging machines, branding machines, processing machines and quality testing machines. With these machines, the company is set for the best in the sugar cube business.


Brenton, P. J. (2010). Carbon footprints and food systems do current accounting     methodology disadvantage developing countrie. Washington, D.C: World Bank. .

Broad berry, S. (2005). The productivity race: British manufacturing in international          perspective,. Cambridge, U.K. New York: Cambridge University Press.

Charmin, P. (1990). The making of the sugar giant: Tate and Lyle. Chur New York: Harwood       Academic Publishers.

Chen, J. &. (2010). Chen-Chou sugar cane handbook a manual for cane sugar manufacturer        and their chemist . New York: J. Wiley.

Daleep. (2008). Francophone Africa, 1905-2005 century of economic and social change.   New Delhi: : Allied Publishers.

Emmett, D. &. (2006). understanding street drug a handbook of substance misuse for         parents, professionalsand teachers. London Philadelphia: J. Kingsley. .

Humphries, S. &. (2006). the making of modern London. London.

Jackson, S. &. (2007). Sugar Policy Reform in the European Union and World Sugar         Markets . Paris: OECD Publishing.

Kroschwitz, J. &. (2004). Kirk-Othmer encyclopedia of chemical technology. Hoboken: N.J:          Wiley-Interscience. .

Mark, J. &. (2003). the food industrie. London: Chapman & Hall. .

Mitchell, H. (2006). Sweeteners &sugar alternatives in food technologyOxford Ames. Iowa:           Blackwell Pub.

Niall, M. (2008). Sweet! : From gave to turbinado, home baking with every kind of natural             sugar and sweetener, with more than 100 recipes. United States: Da Capo Lifelong .

Nsouli, S. (1995). Resilience and growth through sustained adjustment: the Moroccan        experience. . Washington, DC: International Monetary Fund. .

Poona. (2005). Economic botany. New Delhi: Discovery Pub. House.

PSwaminathan, M. (2007). Agriculture cannot wait: new horizons in Indian agriculture. New        Delhi : Academic Foundation.

Ramos, R. M. (2014). Mass production of beneficial organism’s invertebrates and entomopathogenic . London: Elsevier Science.

Srivastava, P. N. (2004). Plant biotechnology and molecular markers. Boston New Delhi:             Kluwer Academic Publishers Anamaya Publishers.

Tanner, A. (2010). Batch craft, design and product. London: A & C Black Publishers .



Paper Review on “Under Pressure: How the Density of Exoplanets’ Atmospheres Weighs on the Odds for Alien Life”

Paper Review on “Under Pressure: How the Density of Exoplanets’ Atmospheres Weighs on the Odds for Alien Life”
The article “Under Pressure: How the Density of Exoplanets’ Atmospheres Weighs on the Odds for Alien Life” explorers how atmospheric pressure on earthlike planets would leads to the planets being habitable. Anyone who would wish to estimate habitability according to Giovanni Vladilo of the Trieste Astronomical Observatory in Italy and lead author of the paper published in the Astrophysical Journal should put atmospheric pressure into consideration as atmospheric pressure affects the liquid water temperature that is used to define habitability (Hadhazy, 2013).
Atmospheric pressure is the air molecules that weigh heavily on us at around one kg per square centimeter, but as humans, we cannot feel it as we have adapted to live in these conditions. Atmospheric pressure impacts water boiling point when it changes from liquid to gas. At higher attitudes, the atmospheric pressure is lower than at sea levels and water boils at lower temperatures and vice versa. According to Vladilo, this happens because temperature is an indicator of how fast molecular motion is, boiling point occur only when the molecules are fast enough to allow other molecules to escape from each other. Pressure keeps the molecules tight and at high pressures, high temperatures are needed to allow evaporation (Hadhazy, 2013).
In Vladilo’s paper, he and his colleagues modeled a planet similar to earth in terms of atmospheric pressure then run computer simulations which varied the planets atmospheric pressure from 100 to 6 times more than earths. The distance from the planets sun like star was also varied from two thirds to an additional third. The habitability of these planets were gauged on the latitudes that could have surface the atmospheric pressure increased the habitable zone increased in width. When the atmospheric pressure was lowered to about a tenth that of earth, the outer edge of the habitable zones reached two percent further than earths but as the atmospheric pressure were increased to thrice that of earth the habitable zone increased to 18 percent (Hadhazy, 2013).
These results indicate that a planet similar to earth with a higher atmospheric pressure and closer to the sun by 5 percent would be habitable but a lower pressure planet would not be habitable. Higher pressure is denser and so they transport heat better and thus promote a greenhouse effect where atmospheric gases absorb heat. Plants that are further from their stars than how the earth is from the sun receive less sunlight than earth. They trap heat better at higher atmospheric pressures and their polar zones retain water than freezing it. Thus, this planet will remain warm though it is far from its star. On the hand, exoplanets with lower atmospheric pressure and closer to their star will have its water boil as at lower atmospheric pressure water boils at a lower temperature (Hadhazy, 2013). At higher atmospheric pressure where the planet is closer to its star, the water will not boil and the planet could still be habitable.
Although these planets that are closer to their star with higher atmospheric pressure are habitable, the temperatures are too high for humans and other thermophiles to survive. What would survive in such a planet are bacteria that thrive in temperatures higher than 45 degrees Celsius. Humans would survive in a planet that is further from the sun. Atmospheric pressure also affects biodiversity. High temperature exoplanets would have almost similar surface temperatures due to efficient transfer of heat among their latitudes and the life forms living in these exoplanets would be few as they would need to be adapted to the similar temperatures. On the other hand, low pressure exoplanets will have more varied temperatures than earth and they would have many more life forms than earth with organisms more adapted to their varied temperatures (Hadhazy, 2013).
Habitable zones that depend on pressure are only studied academically as the zones of exoplanets being studied do not have atmospheric pressure as one of their components but Vladilo believes that working with super earths which are planets larger than earth is where the atmospheric pressure insights could be applied. Atmospheric pressures of planets through observations can only determine the chemical properties of these pressures. The major reason for this is that exoplanets development of pressures and the densities they develop is not well understood (Hadhazy, 2013). Different planets with different atmospheric pressures have different densities. Vladilo and his colleagues plan to do a follow up of this model.
The information in this article is relevant to astrobiology as it adds to the knowledge of the subject. Terrestrial life is believed to exist in an environment where there is water and in modern day, astrobiologists concentrate on the habitual zone where the water in this zone does not freeze or boil away. Such a zone according to the article can be achieved by increasing atmospheric pressure in an earthlike planet. The fact that earth like planets with higher atmospheric pressures could be habitable will lead to more astrobiologists doing more research on this subject. The article also goes on to explain the kind of environment that would be necessary for life to survive in high atmospheric pressures and explains the extremes that would lead to life dying in this environment. Another area of astrobiology that the article looks into is the kind of life that can survive in high atmospheric environment (Hadhazy, 2013). The writer also explains how far the habitable environment would stretch and areas not habitable under these circumstances.
It is obvious that following this article more astrobiologists will research more on the possibility of habitable environment in higher atmospheric pressures. The writer also asserts that the atmospheric pressure properties are not well known and the formation of atmospheric pressures and their densities are not well understood as different planets have different densities. The area of atmospheric pressure has not been extensively studied and it will be exciting to see what other astrobiologists can research and tell the general public on this topic (Hadhazy, 2013).
One of the critic of the article is that the writer use of planets similar to earth in terms of humidity, size and all other aspects is not rational this kind of planet would be difficult to find out there in the space as all the other planets that have been discovered are not similar to earth.
Another critic of the article is that atmospheric pressure cannot be controlled or predicted and we don’t know the source of atmospheric pressure very little has been studied or known about atmospheric pressure. Vladilo and his colleagues do not include density that comes with atmospheric pressure in his theory. Different atmospheric pressures come with different densities and this can affect the habitability of the planet even with the right atmospheric pressure at the right distance from the sun.
Hadhazy, A. (2013). Under Pressure: How the Density of Exoplanets’ Atmospheres Weighs on the Odds for Alien Life, accessed 26 March 2014,

What the student does teaching for enhanced learning by John Biggs

What the student does teaching for enhanced learning by John Biggs

In today’s larger and more diversified classes, many teachers encounter many difficulties in maintaining academic standards. The problem becomes even more tactical if the learning outcomes are seen as a function of student’s activities than of the teachers’ characteristics. John Biggs asserts that the job of a teacher is to organize the teaching context that the students can use in their learning processes. This can be achieved if all components are aligned according to the teaching and learning objectives (Biggs, 2012). The teaching methods adopted by the teachers encourage the students to undertake the learning activities that are likely to achieve their understanding. Assessment tasks determine how the learning objectives can be met.
Learning provides a base camp of enquiry among the students. Despite the fact that technology has brought learning closer to the people, it is very important for the student to go to school as it give them an opportunity to enquire what they don’t understand while at the same time share what they know. In the current 21st century, the concept of learning is more important than the idea education because things are changing dramatically and quickly as a result of availability of the advanced technology (Biggs, 2012). Innovation in education environment has continuously altered the means at which the information is shared and transferred from one direction to another. This has therefore necessitated psychological change of how individuals passed the information in the past in order to match with the current trend.
Basically, the reason as to why the concept of learning has become more vital it is because nowadays the students are learning through meaningful projects. What I regard to be good teaching, and how one teaches depends on what conception of teaching and learning that is at hand. John Biggs argued that based on two strategies of teaching such as teacher focus and student focus learning can be able to transform learning environment. My experience in learning came into my sense when I finished my high school overseas in Middle East that education is dependent and self learning (Biggs, 2012). This is because in order for the students to be successful in school, their success will depend on their relationship with the teachers and their self motivation because their personal effort contributes to a greater extent towards their success. I realized that learning is based on teacher focused strategies theories of teaching that asserts that knowledge is conceived as transmitted from expert teacher to inexpert learner. The role of the teacher is to get the concepts across. I also realized that the lowest conceptions see learning as concepts of understanding the discipline. The student focus strategies sees the focus as bringing the conceptual change in student’s understanding of the world and it is their efforts of understanding what the teachers teach that is important in determining their success rather than what the teacher do.
In conclusion, my experiencing in learning institution helped me to understand that learning outcomes are determined by a whole complex of factors such as fixed student related factors and teaching related factors such as methods of teaching, assessment, curriculum and approaches of learning while engaging in a particular task (Biggs, 2012). This therefore calls for an interactive system of learning between the teacher and the students. Just like any other system, learning has to be understood as a whole and its components have to be understood as they affect each other. I was encouraged to focus on learning as the teachers focus on what they teach, and then I will eventually obtain my desired results.

Biggs, J. (2012). What the student does: teaching for enhanced learning. Higher Education Research & Development, 31(1): 39-55

Does breastfeeding reduce the effects on Neonatal Abstinence Syndrome in neonates exposed to methadone or Subutex inutero


Problem statement 3

Research question. 3

Hypothesis. 4

Operational definitions and variables. 4

Significance of the problem.. 4

Introduction to the literature review.. 5

Literature review.. 5

Conclusion to the literature review.. 11

Theoretical framework. 11

Methods, design, sampling data collection procedures. 12

What statistical tests can be applied to analyze the data and why?. 13

Ethical considerations. 14

Limitations of the study. 14

Conclusion. 15

References. 16






Problem statement

The question as to whether or not breastfeeding can reduce the effect on neonatal abstinence syndrome in neonates exposed to methadone or subutexinutero has not been fully explored (Kenner 2007). This makes the issue emotionally charged and this, therefore, prompts a scientific bearing in order to resolve it. This is because infants’ babies are usually exposed to methadone in utero which makes them to physically depend on it but then it is abruptly withdrawn at birth yet they are incapable of continuing using drugs despite negative consequences. Methadone maintenance is an important treatment modality when administered under medical supervision which is recommended for opioid dependent women. A baby who is borne of mother who abuses drugs starts life with a handicap. Her intra-uterine life which is compromised affects her nutritional status, her growth and in some cases her intellectual capability. After birth, she goes through withdrawal symptoms that affect her health and adaptation to extra-uterine life.

Previous research has shown that 55% to 94% of babies prenatally exposed to drugs such as buprenorphine and methadone will at least experience some withdrawal indicators after birth which causes neonatal abstinence syndrome. Late withdrawal can occur at 2-3 weeks of age.

Research question

Does breastfeeding reduce the effect on neonatal abstinence syndrome in neonates exposed to methadone or subutexinutero?


  • Breast feeding reduces the effect on neonatal abstinence syndrome in neonates exposed to methadone or subutexinutero
  • Breastfeeding reduces withdrawal
  • Neonatal abstinence syndrome-a group of problems that occur in a new born who was exposed to addictive illegal or prescriptive drugs while in the mother’s womb (Aronson 2012)
  • Neonates-an infant in the first 28 days after birth
  • Methadone-A drug used in the health sector as an analgesic, maintenance anti-addictive as well as a reductive preparation that is used by patients who suffer from opioid dependence
  • Subutexinutero-medication approved for the treatment of opiate dependence
  • Drug withdrawal-is a group of symptoms that occur upon abrupt discontinuation or increase in intake of medication or recreational drugs

Operational definitions and variables

Significance of the problem

Previous studies and research has revealed that breast feeding can reduce the effect of neonatal abstinence syndrome. It is also not always necessary for a pregnant woman to avoid using drugs because not all drugs have side effects


Introduction to the literature review

This section covers the identification, location as well as the analysis of documents that contain information which is related to the research problem, the purpose of this review is to determine what has already been done regarding the research subject. It also forms the framework on which the research subject will be interpreted. Literature review further helps in revealing the strategies, procedures, variables and measuring instruments found useful in investigating the research problem. It also makes the researcher familiar with previous studies and thus facilitates the interpretation of the results of the study. It, therefore, pulls together, integrates and summarizes what is known in the area of study revealing gaps in information and areas where major questions still remain the call for further research. Sources to be reviewed will be secondary sources.

Literature review

This review investigated the relationship between maternal drug abuse and the symptoms, the effectiveness with which pharmacologic agent control the symptoms as well as the length of stay by inpatients. The study confirmed that polypro abuse is the commonest type of drug abuse in Dublin. The duration of symptoms is noted for infants exposed to benzodiazepines, the experience would favor the use of morphine’s Sulphate to treat pure opiate withdrawal symptoms, and there was an average occupancy of 3 beds per day in pediatrics departments.

Therapeutics and Toxicology (2012) vol 24.The ARTICLE discussed the complex nature of factors that could affect the infant’s display of neonatal abstinence syndrome, clinical presentation and treatment of neonatal abstinence syndrome and the impact of recent findings on future directions for research. It was found that recent findings have advanced the understanding of the NAS disorders (Bolget 2010). Other substances that are psychoactive such as the serotonin reuptake inhibitors which are increasingly prescribed may produce independent discontinuation syndromes.

Interest is developing in the interplay of the generic as well as the prenatal environmental factors that scanty information is available (Riodarn 2010) on the long-term effects of exposure to utero methadone. This paper is a description of the neurobehavioral and the somatic findings of children between 1 and 18 months of life that were borne of methadone-maintained mothers as well as to a matched comparison group of mothers who are drug-free. During the neonatal period, the findings were (1) a 75 percent prevalence of narcotic abstinence syndrome which ranges from moderate-to-severe, (2) a significant prevalence of head circumferences that are below the 3rdpercentile, and (3) is the systolic blood pressure that is elevated. In the follow-up, children with methadone had (1) significantly increased incidence of otitis media; (2) higher incidences of head circumferences which are below the 3rd percentile; (3) developmental delays, neurologic results of tone discrepancies, as well as poor fine motor coordination; (4) a higher incidence of eye findings that are abnormal; and (5) a relatively lower score on the motor developmental and mental indices.

These neurobehavioral outcomes in children who are borne of methadone-treated mothers at the age of 18 months could be predictors of future learning as well as behavioral problems (Riordan 2010). Exposing infants to methadone via the breast milk of their mothers is very minimal. Women who use methadone to treat opioid dependence shouldn’t get discouraged to breastfeed their babies. The benefits that come with breastfeeding by a large margin surpass any theoretical minimal risks. In fact, methadone is an opioid analgesic that is used to treat narcotic dependency. Its utility is related to its serum half-life that is very long, an onset of action that is slow, and lower rates of the euphoric effect compared with the other opiates. Methadone’s long elimination half-life allows for a gradual reduction in the dose. Indeed, methadone has been confirmed to reduce the illegal use of opiates and related crime. Maintenance programs have as well been confirmed to reduce the risks of contracting STIs, including HIV/AIDs. It is acceptable to prescribe and legally dispense methadone for outpatient use, which helps to facilitate the management of the patients.

Maternal methadone use and the neonate Jonathan Rampono a1c1, Stephen Proud a1, L. Peter Hackett a2, Judith H. Kristiansen a3andKenneth F. Ilett, may 2003 A cohort of 450 women who are drug-dependent and whom substitute methadone had been prescribed and also those that had given birth to singletons were monitored in a large maternity unit in United Kingdom. The research noted a strong link between drug misuse and social deprivation during pregnancy.

Besides the authorized dose of methadone a large number of women continue using illicit drugs in their pregnancies including heroin, cannabis, benzodiazepines, to a lesser degree, cocaine. Of those infants that were born to these women, close to half of them needed pharmacological treatment for baby withdrawals or Neonatal Abstinence Syndrome (NAS). This is more likely when a woman has continued to take other drugs. The most common factor however that determines the likelihood of an infant requiring treatment is the maternal dose of methadone that is prescribed (Lawrence 2010).

One finding of this study is that when a woman breastfeeds her baby for more than three days the baby is significantly less likely to require treatment for NAS. Researchers have opined that this could be because of the combined effects of the value of breast milk, the manner in which breastfeeding soothes disturbed babies and the small traces of the drugs that are taken by the mother who may find their way into the mother’s breast milk, therefore lessening the withdrawal symptoms of the baby. On the grounds of their findings, researchers’ have recommended that mothers who misuse drugs should be encouraged to continue breastfeeding their babies. A protracted postnatal stay has been recommended to assist professionals in the health-care in observing the for symptoms of NAS carry out social work assessment as well as arranging for community and parenting support for the mothers before they are discharged (Zaoutis 2007).

Methadone, which is a full mu-opioid agonist, is the best recommended drug for the treatment of opioid dependence when one is pregnant. Neonatal abstinence syndrome has a characteristic of hyperirritability and automatic nerves system dysfunction and it often needs medication and further treatment. This is usually due to exposure to methadone. Though buprenorphine has not been fully studied in pregnancy, it is seen as an optional treatment for opioid dependence.

The study involved a double-blinded, double-dummy and flexible-dosing which were conducted randomly and the study was also controlled. Buprenorphine and methadone were used in a comprehensive care of 175 pregnant women with upload dependency at eight international sites. The results were then comprehensively compared and the results were that the number of neonates requiring treatment for NAS, the peak of NAS score, the total amount of morphine required treating NAS, the length of the hospital stay of neonates and neonatal head circumference (Ruiz 2011). The treatment was stopped by sixteen of the eighty nine women in the methadone group and twenty eight of the eighty six women in the buprenorphine group..131 neonates whose mothers were monitored to the end of their pregnancy according to the treatment group were monitored with fifty eight exposed to buprenorphine and seventy three exposed to methadone. The outcome showed that that the initial group required less morphine(mean dose,1.1 mgs vs. 10.4 mgs;p<0.0081) and it had a shorter duration of hospital stay(10.0 days<0.0091) and had a shorter time of treatment for the neonatal abstinence syndrome(4.2 days vs. 9.8days,p<0.003325) The p value in this case are calculated in accordance with specific thresholds for importance. There was very little difference between groups in other primary and secondary outcomes or in the rates of maternal or neonatal adverse events. These results are in line with the use of obuprenorphine as an acceptable treatment for opioid dependence in pregnant women.

Drug Abuse; number, Published online August 26, 2013Pediatrics Vol. 132 No. 3 September 1, 2013 pp. e796 -e809 (doi: 10.1542/peds.2013-1985),Most mothers are usually advised wrongly to stop breastfeeding or avoid taking important medication because of fear of the negative side effects on their infants. This fear is usually unnecessary in some cases due to a small number of medications that may be contraindicated in breastfeeding mothers or associated with adverse effects on the infants.

Information which can inform physicians about the extent of excretion for a specific drug in human milk is very important yet unavailable. The American academy of pediatrics has provided data concerning known excretion of specific medications in breast milk (Blackburn 2013). Concerned individuals and organizations can now access more current information on the internet and as an application for mobile devices, at LactMed. This is where the reader can obtain the most current data on individual medication except information of radio active compounds reacquiring temporary cessation of breastfeeding. This report discusses many topics of interest that surround lactation like the use of therapies that are psychotropic, drugs to treat substance abuse, galactagogues, narcotics and herbal products, as well as breastfeeding and immunization of women. The discussion relating to global effects of maternal medications and lactating in second and third world countries has not been discussed this report. The world health organization however offers many programs as well as resources that address the value of breastfeeding.

How drugs and therapeutics are transferred into mother’s breast milk: An over view of specific topics pediatrics September 1, 2013132: e796-e8: The positive and negative effect of buprenorphine (BUP) in breast milk is not clearly known (Pollin 2013). This study is thus aimed at doing an investigation to the transfer of both buprenorphine and its main active metabolite, norbuprenorphine (n-BUP) in human milk while attempting to identify the specific effect of the drug on infants when taken in doses. Seven breastfeeding mothers were maintained on the BUP treatment due to previous opiate addiction and this was studied in an open observed study. The study revealed that all mothers were willing to breastfeed their newborns. Buprenorphine samples were collected for analysis from the urine of 6 infants together with their urine, breast milk and blood from their mothers during a 24 hour period in the week after birth. One mother and her infant were studied when the infant was 9 months.

After the study, Buprenorphine and n-BUP were analyzed by liquid chromatography/mass spectrometry method was the most suitable for handling different matrices. The results were that the buprenorphine and n-BUP dose per one kg bodyweight less than 1 percent with a mean milk/plasma area under the curve of 1.9(range,1.1-2.8) for BUP AND 0.7(range,1.1-2-80 for BUP and 0.8(range,0.5-1.3) for n-BUP. It is however recommended that the new borne should be monitored closely

FACEB J.March 1, 2013 27; 1275-1284: A maternal junk-food diet lowers sensitivity to the opioid antagonist naloxone in newborns after weaning. Newborn who is exposed to maternal junk food has been seen to increase the preference for palatable diets in adult off springs. The study was aimed at determining whether changes in preference could be due to changes in u-opioid receptor expression within the mesolimbic reward pathway. The report showed that Mrna expression of the u-opioid receptor in the ventral segmental area (vta) at weaning was 1.4-fold who were males and 1.9- fold for females lower in offspring junk food’s administration the opioid antagonist naloxone to offspring given a palatable diet after the weaning period reduced the fat intake in control offspring and the total energy intake also reduced. The treatment of naloxone had no effect in the intake of standard rodent feed in control or JF offspring. The findings indicate that the exposure to maternal junk food diet leads to early desensitization (Riodard 2010) of the opioid system which may explain the increased preference for junk food in these off springs (Watson 2013).

Conclusion to the literature review

Previous studies and research has revealed that breast feeding can reduce the effect of neonatal abstinence syndrome. It is also not always necessary for a pregnant woman to avoid using drugs because not all drugs have side effects


Theoretical framework

Despite this widespread use of benzodiazepines when one is pregnant and lactating, there is little information about their effects on the developing fetus as well as on nursing of the infants. The researchers review what is today known about the effect of benzodiazepine therapy on nursing infants and the fetus. Medline search of the literature from 1966 to 2000 was conducted with terms like “clonazepam,” “benzodiazepines,” “alprazolam,” “fetus,” “diazepam,” “chlordiazepoxide,” “lorazepam,” “pregnancy,” “lactation,” and “neonates.” Today, available information is not sufficient to determine whether potential value of benzodiazepines to the mother supersede the risks to the fetus. Therapeutic benefit of a given drug should be weighed against the concept of adverse outcomes on the fetus both after and before birth. Literature suggests that there is safety in taking diazepam during pregnancy as opposed to during lactation due to associated risk of causing lethargy, weight loss and sedation in infants. Using chlordiazepoxide during pregnancy as well as in lactation is seemingly safe. Avoiding alprazolam would be prudent during pregnancy and lactation. To avoid the risk of defects in the congenital, physicians ought to use those benzodiazepines with long safety records and must give a prescription of a benzodiazepine as immunotherapy for the shortest duration possible at the lowest effective dosage. High peak concentration must be avoided by dividing the day to day dosage into 2 or 3 doses.


Methods, design, sampling data collection procedures

There will be two sets of questionnaires containing structured and unstructured questions which will be administered on residents of areas to be specified. The sampling method to be employed for the purpose of the study will be purposive sampling which will be used to select the newborn suffering from neonatal abstinence syndrome and subsequent test conducted at an interval of two weeks of continuous breastfeeding. Interviews will also be conducted on breast feeding mothers to determine whether they use methadone or subutexinutero drugs both before and after delivery. Direct observations shall be made while in the field.

Data collection methods

The choice of data collection methods is largely based on the efficiency and accuracy of the data collected. On deciding on the method, one must decide on the extent to which the method would provide precise and adequate information on the variables. Bearing this in mind, the method that will be used to collect data will be primary data collection method which includes face-face interviews, questionnaires and direct observation method in the field. This will be preceded by acquisition of the necessary introduction and permission letter from the authorities. The researcher will also collect secondary data from relevant libraries.

Data collection procedure

The researcher will get a letter from the university to show the research he or she is carrying out is legal. This will enable the researcher to obtain data from the respondents without any doubts and the respondents will also be willing to answer the questions accurately.

What statistical tests can be applied to analyze the data and why?

The researcher should consider the input that bears a medical intervention or exposure to toxic compounds and outputs which have a measure of health that the study is required to effect. The researcher may also consider conducting prospective studies and the paradigm of using randomized controlled trials during the study where subjects with the syndrome are randomized to one or two treatments one of which may bear controlled treatment. The researcher can also conduct clinical trials on human subjects of the study so as to enable him answer specific questions about biomedical or behavioral interventions with regard to the drugs under study. This will enable the researcher to craft conclusions that are valid from a study in which data is collected through experimentation, observation or survey. The success of a medical study will depend on the proper statistical analysis of data emanating from the study. The researcher should be extremely keen with regard to monitoring the weight of the infants who are identified to be suffering from asp especially with regard to establishing whether the weight of such babies differs from the general average weight for that age comparing the efficacy of the effect of the methadone drug to those babies who don’t suffer from the syndrome.

The researcher should also monitor the changes in the health of the baby who is breastfed to reduce the effect of methadone. In the course of solving this problem, researchers need to collect data from the subjects involved in the study. Information should be collected from sample members representing the population. Opinions regarding data should be avoided at this stage but instead inferential statistics should be applied to draw conclusions with regard to the rest of the population with regard to sample data analysis each data collection method should be based on certain assumptions.

The findings of statistical analysis should be interpreted precisely and the researcher should state clearly the interpreted probabilities of specific outcomes which should be clearly stated.. In data related medical studies, it’s quite reasonable to convert a medical problem into a statistical problem. The data should be collected using the most relevant experimental design and the most appropriate statistical method chosen. It should then be applied properly with attention to the underlying theory and requirements of the selected statistical method. A proper and complete statistical analysis will lead to reliable and valuable conclusions.

Ethical considerations

The researcher will have to cope with three value systems which include society, nursing and science. These values may conflict the values and subjects, communities and societies and create dilemmas. The following ethical considerations must be met

  • Respect for privacy of personal information
  • The researcher has a duty of beneficence (doing good)
  • The duty of non-malfeasance (preventing or mitigating harm)
  • Duty of fidelity and trust


Limitations of the study

The researcher anticipates the following problems in carrying out research

  • Unwillingness to reveal sensitive information by the respondents
  • Low response rate to the survey
  • Inaccurate information



Reducing the risks that come with benzodiazepine therapy in women that are pregnant or lactating involves the use of drugs that have clear safety records at the lowest dosage within a very short duration, avoiding them in the first trimester, as well as avoiding regimens that are multidrug. Benzodiazepine is one of the commonly used group of anxiolytic drugs in America and is among the drug most frequently recommended to women who are at their reproductive age as well as to those who are pregnant for minimize anxiety and manage eclampsia or preeclampsia in the latter part when one is pregnant. These agents are indicated for the treatment of general anxiety disorder, to treat panic disorder with agoraphobia or even without, light anesthesia, as well as anterograde amnesia, sedation, skeletal muscle relaxation and control of seizures. Benzodiazepines are commonly used, even without knowing completely the potential adverse effects they could have.







Kenner, C., & Lott, J. W. (2007). Comprehensive neonatal nursing: An interdisciplinary approach. St. Louis, MO: Saunders Elsevier.

Aronson, J. K. (2012). Side Effects of Drugs Annual: A Worldwide Yearly Survey of New Data in Adverse Drug Reactions. Oxford: Elsevier Science.

Hey, E. (2011). Neonatal Formulary: Drug Use in Pregnancy and the First Year of Life. Chichester: John Wiley & Sons.

Borgelt, L. M., & American Society of Health-System Pharmacists. (2010). Women’s health across the lifespan: A pharmacotherapeutic approach. Bethesda, Md: American Society of Health-System Pharmacists.

Riordan, J., & Wambach, K. (2010). Breastfeeding and human lactation. Sudbury, Mass: Jones and Bartlett Publishers.

LAWRENCE, R. A. (2010). Breastfeeding: a guide for the medical professional. Philadelphia, Pa, Saunders.

Zaoutis, L. B. (2007). Comprehensive pediatric hospital medicine. Philadelphia: Mosby/Elsevier.

Ruiz, P., Strain, E. C., & Lowinson, J. H. (2011). Lowinson and Ruiz’s substance abuse: A comprehensive textbook. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Blackburn, S. T. (2013). Maternal, fetal, & neonatal physiology: A clinical perspective. Maryland Heights, MO: Elsevier Saunders.

Polin, R. A., Fox, W. W., & Abman, S. H. (2011). Fetal and neonatal physiology: Volume 2. Philadelphia: Elsevier Saunders.

Aronson, J. K. (2010). Meyler’s side effects of analgesics and anti-inflammatory drugs. Amsterdam: Elsevier Science.

Walker, M. (2011). Breastfeeding management for the clinician: Using the evidence. Sudbury, Mass: Jones and Bartlett Publishers.

Sachdeva, A., & Dutta, A. K. (2012). Advances in Pediatrics. New Delhi: Jaypee Brothers Medical Publishers.

Hey, E. (2007). Neonatal formulary 5: Drug use in pregnancy and the first year of life. Malden, Mass: Blackwell Pub.

In Zibadi, S., In Watson, R. R., & In Preedy, V. R. (2013). Handbook of dietary and nutritional aspects of human breast milk.




Cryptocurrency: A Digital Alternative to Traditional Money


            With the mention of cryptocurrency, something that readily comes to mind is the bitcoin currency. Bitcoin is one among the numerous digital currencies that have proliferated in the market of cryptocurrency. Perhaps it would greatly be pragmatic to define what cryptocurrecny is before delving into its potential significances to conventional monetary systems that have been used for many centuries across the world’s different economies. It should be pragmatic to note that the idea of digital currency was first conceptualized back in 2008 when financial turmoil was rocking the world. Sotoshi Nokomoto, actually a pseudonym of a cryptocurrency developer, was among the pioneer researchers who have been working around turning into a reality, the concept of digital money (Mu, 2014). The obscurity of the capitalistic system in the modern world has been blamed on the concentration of risks that subject traditional currencies to risks of slumping. One of the driving impetuses toward the creation of virtual currency was to solve the risks of modern capitalism that subjected the world and economies to credit crunch as witnessed back in 2008. In 2009, the first cryptocurrency was launched, the bitcoin. The overarching opinion back than was that the arrival of the bitcoin was going to create more secure trading environment where there would be no issues of financial insecurities that arise from the conventional government controlled legal tenders. The bitcoin was envisioned to provide a low cost business environment and high security. Bitcoin was to operate in an environment where payment was peer to peer bases system. Cryptocurrency is a new phenomenon that is beyond control of governments and central banks, as a consequence, it is plausible to argue that many people would remain skeptical of the digital currency mining process, sustainability and ethics surrounding their usage.

Evolution of Money from the Age of Barter Trade into the 21st Century

            The era of increased digitization has heralded the dawn of digital currencies that people can use as medium of exchange or even store value in the cyberspace. As at present, there are several digital currencies that have been released into the markets through a process called mining. It is undeniably a cheaper means of making purchases online especially from stores that accept digital currencies. However, there are great social, economic, and ethical issues that are likely to emerge if many people from around the world would embrace the use of digital currencies. There are also two major categories of digital currencies, including platform based digital coins like those that are released by the Amazon and Facebook. On the other digital coins like the bitcoins are not attached to a specific issuer but are mined by a community of miners that are using specific mining programs (Fung & Halaburda, 2014). The platform on which a specific digital currency is used determines other factors about digital currencies that include how users obtain and use the digital coins. Specific platform based digital coins determine the limitations and possibilities that people can attain while using the digital coins as a medium of exchange (Fung & Halaburda, 2014). Bitcoin is a decentralized cryptocurrency with no single platform where it used, but it can be used to make purchases of virtual and real products across many platforms online that accept them as a means of payment. On the other hand, digital units of payments, irrespective of whether they are centralized or decentralized could be used cannot be used as units of claiming the value of assets as at now.

            Additionally, some of the early adopters of the cryptocurrency in exchange of goods online include video gaming corporations, social networking, and some app developers for computing gadgets like tablets. There are quite a number of salient issues that relate to the use of virtual currencies in exchanging goods and services. First, due to the fact that virtual money has assumed a parallel path of operation to traditional money, it is largely plausible to understand what traditional currency is and how it operates. According to European Central Bank (2014), anthropological evidence bears scanty information on the period when human societies began using physical form of money as a medium of exchange. However, historically, human societies are believed to have begun using some form of money as a medium of exchange from around 2200 BC. Then, money was just some form of a physical item with an intrinsic monetary value attached to them. Some of the earliest items that were used by traditional societies to conduct exchanges of commodities include cattle, mineral based items like gold, silver, and copper (European Central Bank, 2013). Modern economies rely on the use of fiat money that represents value of items based on the units that are released by central authorities in different countries (European Central Bank, 2013). One the most obvious reasons why people accept fiat money is because there is a control authority that has been given autonomy by the government to control issuance of money into the economy.

There three major purposes that traditional money serve in economies. First, money is used as a medium of exchange, which simply means that money is an invaluable intermediary in exchange of goods and services. Secondly, money is used unit of accounting for the numerical value of assets, and lastly, money is used in storing value. One can have his money saved and later retrieved for use. This short historical account of money means that money serves a great social function in human societies. From the ages of barter trade systems and fiat currencies, money has shown a great stride in evolution with age. The current human race toward establishing modern monetary systems in the virtual world is the flexible nature of money to adapt to times and need of human race at different stages of their evolution (European Central Bank, 2013).

Ethics and Sustainability of Cryptocurrency























Mu, E. (2014). The bitcoin derivative boom can be a mark of the cryptocurrency’s coming of age. Forbes. Retrieved from

Fung, B., & Halaburda, H. (2014). Understanding platform-based digital currencies. Bank of Canada Review. Retrieved from