Should USA got in war with Iraq Research Paper Example | Topics and Well Written Essays - 1750 words

Should USA got in war with Iraq - Research Paper Example The war is undeniably illegal as defined by the United Nations (UN) and International Court of Justice (ICJ), the two most paramount legal bodies in the world. Iraq had no link to terrorism, no weapons of mass destruction (WMD), and no legal rationale to attack. Despite this, Bush decided to invade the Republic of Iraq for causes deemed objectionable to the majority of other countries so he frequently relied on and utilized false information to rationalize it. He lied. This discussion will examine how the truth was a casualty early and often during the lead up to the war and outlines some of the consequences brought about by these far-reaching and deadly deceptions. Bush voiced his disagreement to the concept of ‘nation building’ during the 2000 presidential election debates but as president waged an undeclared war against a sovereign country that had neither attacked first nor threatened to. Immediately following and as a reactionary reply to the terrorist attacks on Se ptember 11, 2001, Bush stated the county’s intention to begin a ‘War on Terrorism’ which he portrayed as a protracted battle against those that would use terrorist actions in addition to the countries that enabled them. The eventual culmination of the selective legal reasoning and rhetoric concerning the ‘War on Terror’ was Bush’s order of the military to invade both Afghanistan and Iraq, an illegal action on many fronts. Bush had constantly claimed that these actions were legal. First, he argued, due to language existing within the UN Security Council Resolution 1441 regarding Iraq and secondly, the invasions were an act of self-defense which is permitted by international law. Conversely, according to Richard Perle, advisor to U.S. Defense Secretary Donald Rumsfeld and official of the U.S. Defense Policy Board, â€Å"international law ... would have required us to leave Saddam Hussein alone.† (Burkeman & Borger, 2003). However, this op tion would have been â€Å"morally unacceptable† according to the Bush administration. Bush chose to solicit then followed the advice of biased, self serving legal opinion from a low-level Justice Dept. employee despite strong disagreement by higher level personnel within the Dept. in addition to and the U.S. State Department which cautioned against ignoring international law and U.N. laws in addition to covenants of the Geneva Convention. The Bush administration was determined in its careless use of military force and disregard for laws established to by the world’s community of nations. The initial foreign incursion of the U.S. military along with the ‘coalition of the willing’ in its ‘War on Terror’ was Afghanistan, more specifically the Taliban terrorist faction based in that country. The U.S. claimed to possess ‘clear and compelling evidence,’ that the State of Afghanistan was giving refuge to terrorists, as did Iraq. However , if this assertion were true, why then didn’t the Bush administration divulge this information to the UN Security Council so as to obtain legal grounds to invade? The United Nations Charter, Article 51, Chapter Seven stipulates â€Å"nothing shall impair the inherent right of individual or collective self defense if an armed attack occurs against a member of the United Nations†

Minnisota V Riff Case Study Example | Topics and Well Written Essays - 500 words

Minnisota V Riff - Case Study Example The defendant then left the store at about 12.20 a.m. He discarded the hammer in the side alley between Marquette's Market and Art Own's Hardware. There are witnesses to prove that he ran home and also when he discarded the money bag and dropped $2 of the money. He used the money to purchase a guitar. There was a Canadian $5 bill purported to have been stolen from Marquette's Market. The defendant was arrested the day after by Officer Schield at 3.30 p.m. on the ground that he broken into, entered, and burglarized Marquette's Market. The Defense's case is that the defendant, Ronald Riff, won over $900.00 in a poker game between 8.30 p.m. and 12.00 a.m. of the night of the alleged burglary. There are witnesses to prove that Riff won a great deal of money, including the Canadian five dollar bill found in Riff's person. Riff borrowed a tan cloth money bag from Red's Pleasure Palace to put his winnings into. He took the hammer from Rusty Fender's to protect himself and his money. He never stopped by Marquette's Market, but he did toss away the hammer at the point as he ran home. Riff had no motive to steal from Marquette's Market as he had won enough to pay off his debts to Vibes and buy a new guitar. The prosecution has proved that the defendant, Ronald Riff, is guilty of stealing $910 from Marquette's Market after breaking into the store. There is no doubt about Riff's involvement in the crime.

Cross Cultural Transitions Research Paper Example | Topics and Well Written Essays - 3750 words

Cross Cultural Transitions - Research Paper Example Le Ly Hayslip then made up her mind to divert all her energy towards her career, to establish a restaurant and to supervise all the rental properties in her possession. After she had accumulated her assets, she made up her mind to support her own native land using the wealth she had acquired. She managed to set up medical clinics after establishing a foundation that was known as the east meets the west. In addition, Hayslip was determined to end the existing hatred and to heal wounds that had resulted from the war. The earlier war completely separated Hayslip whole family. One of her brothers lost touch with the family for 20 years after fleeing to Hanoi. Another brother lost his life in a landmine. Her father, on the other hand, received great pressure from the Viet Cong. They wanted him to take the initiative to persuade her daughter Hayslip to become a saboteur.In trying to understand, the real meaning of culture shock our reference mainly is the life and experiences of Le Ly Hays lip during her childhood and the early adulthood stages. She was forced by the then existing hostility and insecurity in her own homeland, Vietnam to seek for safety in different countries. In trying to link up the transition experienced by Le Ly Hayslip, culture shock meaning has to be well understood. Culture shock is the difficulty experienced by individuals when they are forced by certain circumstances to adjust to another culture that varies from that in their native land.... Out this marriage, Le Ly Hayslip bore a second son. Her main objective was to get an opportunity to move to America and she did a few years later. Her husband died after they had relocated to America and she remarried Dennis Hayslip in spite him being an alcoholic and abusive. Their marriage took place after Dennis Hayslip had assisted Le Ly’s sister to flee from Vietnam. However, after formalizing their union, their differences escalated and Hayslip filed for a divorce. Their marriage ended after the death of Dennis through carbon monoxide poisoning. Le Ly Hayslip then made up her mind to divert all her energy towards her career, to establish a restaurant and to supervise all the rental properties in her possession. After she had accumulated her assets, she made up her mind to support her own native land using the wealth she had acquired. She managed to set up medical clinics after establishing a foundation that was known as the east meets the west. In addition, Hayslip was d etermined to end the existing hatred and to heal wounds that had resulted from the war. The earlier war completely separated Hayslip whole family. One of her brothers lost touch with the family for 20 years after fleeing to Hanoi. Another brother lost his life in a land mine. Her father on the other hand, received great pressure from the Viet Cong. They wanted him to take the initiative to persuade her daughter Hayslip to become a saboteur. Hayslip father however, opted to commit suicide instead of yielding into the pressure. In trying to understand, the real meaning of culture shock our reference mainly is the life and experiences of Le Ly Hayslip during her childhood and the early adulthood stages. She was forced by the then existing hostility and

Take home assignment Example | Topics and Well Written Essays - 1250 words

Take home - Assignment Example The population of both plants and animals evolved in accordance to the doctrines and dictations of natural selection. The first account on natural selection was steered by Charles Darwin, where he proposed that the continuation of a species is based on its flexibility in responding to the changes in stimuli. The crop plant has undergone this form of selection, since the crops selected for cultivation have been identified in accordance to the necessities of the human cultivators. Response to Question 2 Crop Top producer country (2010) Total worldwide production (2010) Wheat Russia 651 million tones Rice China 821 million tones Soyabeans Thailand 635 million tones Peanuts China 624million tones Corn USA 718 million tones Respond to Question 4 The disease burdens of humans after the Neolithic Revolution (the origins of agriculture) are considered by Spencer Wells to be trans-generational effects. The trans-generational effects including disease burdens he considered and discuss how thes e various burdens have changed over time since agriculture began. Response to Question 5 Human culture is centered on the possible models of sustenance that a population adopts to meet their daily survival. These models are frequently affected by the changes in the climate. Various adjustments are deployed upon the occurrence of adjustments in the climatic patterns reflect similar adjustment in the adopted models of sustenance. This eventuates in an adjustment in the cultural practices attributed to a given community. Response to Question 6 Spencer Wells identifies speech coherence as a chief contributory factor in the success of the Homo sapiens, as compared to the Neanderthals. His argument is based on the activities of the two stages of human development. The Neanderthals are described to have engaged on sustenance models that did not involve communal efforts. Hunting and gathering was among the central models identified. On the other hand, Response to 8 Plato’s Glaucon id entified morality as the compromise between the desire to commit injustice and the knowledge that one might be the recipient of such injustice. How well does Wells’ proposal for achieving consilience concerning the origins of agriculture, greed, materialism, the rise of family values and fundamentalism identify with hunting and gathering people’s mythos? Response to Question 8 1. Researchers have identified a compound in cilantro, a key component of Mexican and other dishes that kills harmful Salmonella bacteria. It shows promise as a safe, natural additive that could help prevent foodborne illnessA foodborne illness (also foodborne disease) is any illness resulting from the consumption of food. Although foodborne illness is commonly called food poisoning, this is often a misnomer. .....Click the link for more information.. Although previous studies by scientists showed that salsa has antibacterial antibacterial  /an ·ti ·bac ·te ·ri ·al/ (-bak-ter?e-al) de stroying or suppressing growth or reproduction of bacteria; also, an agent that does this. an ·ti ·bac ·te ·ri ·al adj.activity, this is the first time that the researchers isolated any of the antibacterial compounds from it. The compound--dodecenal--was isolated from the fresh leaves of cilantro, or coriandercoriander  (kor'ean`d?r), strong-smelling Old World annual herb (Coriandrum sativum) of the family Umbelliferae (parsley family), cultivated for its fruits. .....Click the l

The Future of Hybrid Electric Vehicles Essay Example for Free

The Future of Hybrid Electric Vehicles Essay Honda is a well-known and reputable car manufacturer in North America. It is now 2002, and Honda is planning on launching its second Hybrid Electric Vehicle (HEV) to the market a hybrid version of Hondas top selling vehicle, the Civic. The companys first HEV, the two-seater Honda Insight coupe, was introduced to the U. S. in 1999. It experienced modest sales of 3,788 units in 2000 and 5,000 units in 2001 and retailed at a base price of approximately $19,100. However, demand outstripped supply and consumers were forced to wait between one to two months for their vehicles. Honda anticipates that sales of the hybrid Civic model will be much stronger than previous HEV models, since the Civic already possesses a longstanding, strong brand name. Right now, Honda must decide if they are willing to launch the hybrid Civic and make it a part of its production line-up, despite the uncertain reception of the vehicle in the market and the risk of a potential loss in profits. Problem Statement The problem that Honda faces right now, which could hurt the company’s overall profits, is that consumers are not well educated and informed about the benefits that this hybrid technology can offer. In other words, the positive features of a HEV have not been marketed well enough to change buyers’ outlook on transportation options and train them to look beyond the price premium (of up to $5,000) and buy a hybrid car. According to a large-sample survey of recent car buyers, the top three factors that were identified as being most important when purchasing a car were â€Å"reliability†, â€Å"value for the money† and â€Å"well-made vehicle†. Similarly, auto dealers stated that buyers routinely ranked â€Å"functionality†, â€Å"safety† and â€Å"price† as important factors when shopping for a car. Factors, such as â€Å"gas mileage†, â€Å"technical innovation† and â€Å"environmentally friendly† were also listed, but were all ranked well below the top five. Therefore, Honda is faced with the obstacle of teaching buyers to consider other aspects when purchasing its new Civic hybrid model. Situation Analysis The automobile industry is a very mature and is based almost entirely on gas engines. It is a highly competitive and consolidated industry, however, Honda differentiates itself with a value strategy. Internal Analysis Strengths. Honda Motor Company has a very strong reputation around the world for building quality, reliable and performance-oriented automobiles, motorcycles and power equipment. Honda has traditionally focused heavily on RD capabilities and thus it tends to be on the cutting edge of automotive technology. Weaknesses Adding high tech and performance-oriented features to their cars has meant that Honda has occasionally had to recall their products, leading to a weaker brand image. In addition, the spending on RD has led to declining operating margins while the market share is threatened by huge lineups from Toyota and Nissan. Opportunities There is an upsurge of interest in environmentally friendly vehicles, and Honda’s RD focus means that it is well poised to capitalize on its expertise in this industry. In addition, Honda is a major player in the emerging markets (BRIC countries). Threats Rising oil and raw material prices in the world market can lead to decreased demand for automotive vehicles. In addition, increased costs have led to decreased consumer spending and the competitive rivalry is very high in this industry. External Analysis. Political There is increased pressure on governments from lobby groups to provide tax incentives and subsidies to encourage consumers to purchase more environmentally sensitive products. In addition, the Kyoto Accord has led to a renewed focus on reducing pollutants. Economic Rising gas prices and increased costs of cleaning pollutants have started hurting the consumer’s pocketbooks. Social Consumers have a higher awareness of the hidden costs of pollutants, and are also more sensitive to prices. Therefore, there is a large number of consumers who are willing to pay for technology and products that will help the environment. Technology Recent RD investment into hybrid technology has led to significant gains in efficiency and reductions in cost of the technology. Network Model User Network – The identified user network for hybrid cars would be the consumers who see a benefit to paying a premium for these cars in the hope that the expected benefit to the environment will be enough to justify the extra cost. Complement Network – The complement network includes the dealers, gas stations and service facilities that facilitate the ownership, operation and maintenance of any automobile. Producer Network – The producer network includes Honda Motor car, it’s automotive parts suppliers and all other stakeholders associated with the production of the automobile Now using the Identify - Differentiate - Interact - Customize model we have to progress down a path of methodically segmenting our current target market into smaller segments that we can target individually. At the customize stage, Honda should be flexible enough to be able to offer the customers who require higher value the products that they need, while focus on driving down their cost-to-serve for the lower margin consumers. Resource Identification. Having completed our SWOT analysis and our network model breakdown, we can come to some key identifications of success factors in a product that the industry requires to be successful. In addition, we can then compare these factors to the core competencies of the Honda hybrid initiative. We can see that car buyers value three factors above any other: â€Å"reliability†, â€Å"value for the money† and â€Å"well-made vehicle†. Honda can provide all of these but there is uncertainty in the first. Because the hybrid engines have not been around a long time, car buyers are uncertain of the long term maintenance costs of such vehicles. In addition, they are also not sure about the resale value of these cars, something which ties in to our next point. Although hybrid cars have traditionally not been able to makeup their premium strictly via gasoline cost savings, Honda has strived to only price the hybrid Civic about $1000 $2000 above the normal Civic. This minimzes the non-tangible benefit that Honda needs to prove to consumers to persuade them to buy the car. In addition, hybrids cost about $4 to $5 thousand more to produce than regular vehicles. Honda is subsidizing a large portion of this cost to make the vehicle more affordable to the consumers. In terms of reliability, Honda has a global reputation as a maker of quality automobiles. Alternatives and Evaluation After analyzing this case, it is apparent that Honda must choose one of two paths. Namely, launch the Civic hybrid or not launch. However, if Honda decides to launch, it can either manufacture a full hybrid or mild hybrid version. Therefore, Honda is essentially faced with three alternatives: (1) launch a full hybrid model, (2) launch a mild hybrid model or (3) decide not to launch a hybrid in the North American market at all. Before we can elaborate on the pros and cons and evaluate each alternative, we must consider some very relevant underlying issues that exist in the case. Specifically, there are some key questions that must be addressed when assessing both Alternative One and Alternative Two. For example, should Honda lobby for government subsidies and/or tax credits in order to mitigate its exposure to potential profit losses or should it fully expose itself to this risk? How many vehicles should Honda manufacture (since price decreases with economies of scale)? And how much money should Honda invest in marketing to educate consumers and promote the product? The suggested answers to these questions will be given in the Recommendation. Alternative One: Launch a Full Hybrid Version of the Civic One of the obvious pros to launching the full hybrid Civic would be that Honda would become a market leader with respect to alternative-fuel vehicles. Specifically, Honda could gain a competitive advantage over its competitors by leveraging its knowledge and expertise gained early on during the introduction of the Honda Insight. In addition, Honda could also earn the reputation of being environmentally friendly and at the cutting edge of automotive technology. For instance, the full hybrid can improve gas mileage by as much as 100% over a comparable gasoline-only vehicle, which would decrease the amount of emissions produced. Creating this image could be very beneficial for Honda; especially in a society whose emphasis and attention on sustainable development and the environment will only continue to escalate. There are also some potentially negative implications to launching the full hybrid Civic. First and foremost, there is the potential that margins generated from the new model will be lower than expected. The cost of producing a full hybrid vehicle is substantially higher than the costs involved in manufacturing a comparable gasoline-only car. In fact, some industry experts estimate that this value is somewhere in the range of $4,000 to $5,000. In addition, the current demand for hybrids is not strong enough to engender economies of scale (which would lower the retail price). Also, adverse studies show that it takes several years before the gas savings from hybrids offset the price premium. For many buyers, the intrinsic environmental benefits of buying a hybrid are not enough on their own to justify paying a higher price. Therefore, Honda could lose money by launching the full-hybrid Civic. Another potential con is that Honda’s competitors can reap the benefits of being a follower. They can avoid the evident risks of introducing a hybrid now, and learn from Honda’s mistakes. Afterwards, these competitors can use what they have learned and produce a superior product that would directly compete with Honda’s vehicles. Alternative Two: Launch a Mild Hybrid Version of the Civic. One of the pros of manufacturing a mild hybrid version is that the mild hybrid technology can be more easily incorporated into current vehicle models than the full hybrid technology. As a result, the premium incorporated in the price of a mild hybrid is lower than in that of a full hybrid. For example, the price premium associated with a full hybrid is approximately $5,000, relative to the $2,000 to $3,000 price premium associated with a mild hybrid version. This lower premium may increase consumer demand for hybrid vehicles and allow Honda to manufacture on a larger scale. Also, launching a mild hybrid would allow Honda to offer comparable prices to other hybrid models produced by other vehicle manufacturers. Most other American manufacturers interested in offering hybrid vehicles have chosen to employ the mild hybrid technology for the reasons mentioned above. If Honda decides to manufacture a full hybrid, its prices may too high and buyers interested in purchasing a hybrid may be attracted to the lower prices offered by Honda’s competitors. One of the cons of manufacturing a mild hybrid vehicle is that this option seems to be a step backwards in terms of technological progress. Honda spent significant time and money toward developing its full hybrid Insight model and to employ the less-advanced mild hybrid technology would almost be counterintuitive. Moreover, by launching a mild hybrid, Honda would lose its opportunity to distinguish its product from those of its competitors and perhaps relinquish a temporary competitive advantage. Another con would be that Honda might damage its image of being a company concerned about the preservation of the environment. Although mild hybrid technology offers superior gas mileage compared to a traditional gasoline-only vehicle, it can only improve it by 10% to 20%. This is almost insignificant and seems to make the entire process pointless. Alternative Three: Do Not Launch the Civic Hybrid If Honda does not launch the Civic hybrid model, it avoids any of the risks associated with its manufacture. However, Honda is currently a market leader in the hybrid car segment and has already invested a lot of money into research and development. A decision to withdraw from the launch of the Civic hybrid would appear to go against the organizational strategy witnessed to date and may forgo an opportunity to achieve a competitive advantage in this cutthroat industry. Recommendation After weighing the pros and cons of each alternative, we have come to the conclusion that Alternative One is the most attractive option for Honda. Full hybrid technology is not being implemented in the vehicles of most of Honda’s competition. Therefore, by utilizing the technology it already has, Honda currently has the opportunity to distinguish its product from those of its rivals and achieve a competitive advantage in the industry. There are some risks related to launching the full hybrid Civic but these risks can be mitigated with proper marketing campaigns and education initiatives. Firstly, Honda should lobby the government for subsidies and/or tax credits in order to offset the price premium of the vehicle. This will both encourage consumers to buy a hybrid and to minimize Honda’s risk of losing money. There have already been discussions about increasing tax credits to $3,000 per vehicle. Therefore, Honda should try and confirm this increase before launching the new model. This tax incentive would surely make the marketing of the product easier. Also, any subsidy program the government could offer would likely eliminate any hesitations Honda might have in moving forward. In terms of marketing, Honda should consider investing a considerable amount of money toward educating the public about benefits of a full hybrid Civic via a large-scale marketing campaign. Luckily, Honda already has an established brand name, but it now must focus on teaching consumers both the financial and social rewards of buying a hybrid. For example, not only do hybrids have superior gas mileage (dollar savings), but also reduce the amount of emissions released into the air. Studies have shown that visits to dealerships, consumer guides and word of mouth are the three most useful sources of information for potential buyers. Therefore, Honda should ensure that its dealership sales team is prepared to handle inquiries about the product and be able to convincingly sell the attractive features of the vehicle. Moreover, Honda should create a lot of excitement and propaganda (especially during the year before and of the launch) about the new product, with special focus on public relations. In addition to these tactics, Honda can improve its chances of making this venture profitable by establishing strong producer and complements networks. For example, Honda could sell their hybrid technology to other car manufacturers and generate revenue by creating a special maintenance service for hybrid cars (if they are perceived as experts in the field). In conclusion, the Honda Civic has a strong brand as a fuel efficient, easily maintainable car. Creating a hybrid version of this model follows along with their existing strategy, thereby strengthening their brand. Implementation Honda already has plans to offer the hybrid Civic in 2002, effectively for its 2003 model year. Our focus is on marketing this model, rather than manufacturing it, as Honda already has the manufacturing plan well underway. At a high level, our implementation plan includes: †¢Lobby the government for subsidies and/or tax credits starting immediately. †¢In the summer of 2002, hold training seminars for all Honda Dealers, to ensure they are up to speed on the hybrid as well as its benefits. †¢Create promotional packages for each dealership to bring an awareness of the hybrid to those who are shopping for new cars. These should be in place at the dealerships before the new model year cars are available, essentially in August 2002 at the latest. †¢Utilize car shows as soon as possible to incorporate as much of a â€Å"wow† factor as can be gleaned due to the high technology nature of the hybrid engine in an every day automobile. †¢Place promotional material in consumer guides beginning in September 2002, for a 6-month period. Revisit this item at the end of term to see if it is effective. †¢We anticipate Honda allocating approximately 5% of their marketing budget to the hybrid Civic, keeping in mind that all Brand advertising for the Civic will also include the hybrid model. Appendices Appendix 1: SWOT Analysis Marketing MixStrengthsWeaknesses ProductStrong Brand Reputation RD-Cannibalization of existing market -Recalls Price -Hybrid costs more to build so a premium on price; few sold so few economies of scale -Declining operating margin PromotionCan capitalize on the existing Brand Place- Growing market (more interest in environment) Well placed in emerging marketsStill just a small niche market. AreaOpportunitiesThreats Social Hybrid reputation – stop gap measure, poor acceleration, not as much power Technological- Get into the market early expertise in hybrids improved hybrid performance- Mild hybrids, fuel cell cars, alternative fuels Highly competitive market EconomicEnvironmentally friendly –reduces emissions- Globalization and Consolidation Price of Gas Rising cost of cleaning pollutants decreased consumer spending Political- In line with government requirements to reduce emissions reduces reliance on foreign fuel Kyoto Accord.

Spectrum of Benign Breast Disease and Its Management

Spectrum of Benign Breast Disease and Its Management AUTHORS: Dr.( Mrs) Archana shukla (Assistant Professor )dept of surgery Gandhi medical college, Bhopal M.P. Dr. S. S. Pal (Associated professor) dept of surgery Gandhi medical college Bhopal M.P. ABSRACT: Breast disease in females causes great deal of anxiety and fear of carcinoma and thus losing it. Not all breast diseases and lumps are carcinoma. To study this enigma of females, patients with breast symptoms were studied for 12 months of time Jan 2013 to Dec 2013 in unit iii, dept of surgery, Hamidia hospital, Gandhi medical college Bhopal. Study was conducted to determine the incidence, role of histopathology and imaging in diagnosis and management. The disease is complex group of symptoms and sign such as lump, mastalgia, nipple discharge and combination of these. This was done so as to differentiate and identify the benign group which was much larger in number. They require more counseling, assurance and education regarding benign nature and it being a developmental disorder. Such disorders if untreated may convert into disease which is more persistent. The mean age was 32 as the youngest was age of 14 yrs and the oldest was of 50 yrs of age. The commonest diagnosis was fibroadenoma followed by fibroadenosis . Tuberculosis was the most concerning disease we came across. KEYWORDS: Benign Breast Diseases, young female, fibroadenoma. INTRODUCTION: Majority of patients having sign and symptoms of breast disease fall under benign group rather than carcinoma yet carcinoma takes the precedence over it due to its fearsome nature.1,2,3,4 The benign breast disease group patients have variable symptoms including lump, lump with pain, nodularity, nipple discharge due to relative heterogeneous underlying pathology.5Breast development is governed by growth hormone and cortisol. Breast function is governed by oestrogen progesterone prolactine and oxytocin. Breast undergoes dynamic cyclic changes governed by these hormones and growth factors. 15 These hormones have profound trophic effect. These changes are seen in epithelium and stroma from onset of puberty to menopause. Estrogen have effect on ducts where as progesterone have effect on epithelium. With the onset of puberty there is decrease in sensitivity of the hypothalamus and pituitary axis to negative feedback and increased sensitivity to positive feedback of estrogens. This initiates GnRH, FSH, LH causing increase in estrogens and progesterone which is the cause for menstrual cycle. This increase is responsible for proliferation of epithelium, duct and stroma. These changes may lead to Aberration in normal development of breast and involution of breast, causing majority of benign breast disorder. These disorders may convert into disease if untreated. Exaggerated response to hormones oestrogen causes development of single or multiple proliferatory breast diseases such as fibroadnenoma which is benign solid mobile mass which has both fibrous and glandular part.11 Fibroadenoma of more than 10 cm are termed as phylloids tumor owing to shape it attains due to large size. Sometimes the changes have proliferation of ducts, lobules, interlobular and inter lobular stroma leading to fibrous changes with cystic changes commonly termed fibrocystic disease. 13 Such proliferation may have atypical hyperplasia including ductal and lobular hyperplasia, which has increased risk for development of carcinoma in future. Apart from this, multifocal lesions with calcification increase many fold risk.6,7.8 Then there are symptoms of nipple. As a developmental defect there may be nipple inversion which may present as subareolar abscess in later age. During involution phase there is ductal involution causing ductal ectasia if not treated can lead to periductal mastitis or may sometimes have atypical hyperplasia.6 During lactation the breast undergoes many dynamic changes and if there is problem in expression of milk there may be occurrence of breast abscess. If not treated adequately may lead to chronic breast abscess, antibioma and milk sinus. To certain the diagnosis of usually neglected and underestimated disease there is a huge role of histopathology and imaging technologies. With the help of histopathology proliferatory , non proliferatory disorders and diseases, breast cyst and other pathologies such as tuberculosis and lipoma can be detected. 20 There is a role of microbial culture in diagnosis of infectious disease. Similarly ultrasonography is helpful in diagnosis and in management also.13,22 Triple assessment test, which include clinical examination imaging and histopathology examination is the gold standard approach to the diagnosis though elderly females may require mammography.20,21,22 We have conducted study to determine the frequency of the disease, to analyze the role of triple assessment and to know implication in management. 13,15 16 METHOD Our study was conducted for one year in Jan 2013 to Dec 2013, under unit 3 Dept. of Surgery, Hamidia Hospital, Gandhi Medical College. We included all the patients coming to surgery OPD with breast complaints.14 Informed consent was obtained from all the patients. Patients were recorded under following points: History, Clinical examination FNAC of all palpable lumps, nodularities was done. In patients where there was dilemma trucut biopsy was done. Microbial examination and abscess wall biopsy was done in all case of breast abscess and antibiomas. USG, mammography Imaging was done. In our setup, USG was the most accessible radiographic investigation available. All the patients were subjected to USG to locate and know the lesion but in doubtful cases mammosonography was done. Age varied from 12-50 years hence 4 groups were made: 12-20 years 20-30 years 30 -40 years 40 and above RESULT: In first age group the most common complaint was lump in one of the breast or both. Most of these patients did not have complaints of pain. It was followed by lump with pain. We did not have any patients with complaint of nipple discharge in this group.15,16,17 In second group most common complaint was lump in breast with pain and bilateral generalized breast pain without lump and nodularity which were grouped under mastalgia. The third group was lesser in number. They were mainly having complaints of lump, fever and pain. There were very few patients in fourth group and complaints were that of pain and nipple discharge. In total there were 148 patients with lump and out of which 62 were that of fibroadenoma, 4 patients of fibroadenoma were of size more than 10 cm hence labelled as phylloid. Most of the fibroadenoma were unilateral and only 7 patients had bilateral adenomas. 5,12 There were 40 patients who were diagnosed as fibroadenosis. All patients underwent FNAC one patient showed atypical hyperplasia. 6,7,8 After this, the next common diagnosis was that of breast abscess which was common in lactating females. The diagnosis which worried us the most was that of tuberculosis of breast. We found 10 cases of this disease presenting as chronic and recurrent breast abscess, showed mycobacterium tuberculi in culture.1 8 We also found 6 patients of antibioma and 2 patients of galactocoele. There were patients of ductal ectasia and one patient of lipoma and one of breast cyst. Patients having significant symptoms of pain but not found with any lesion on radiographic investigation were labeled as mastalgia. Out of 7 only 3 were cyclical and rest were not related to cycle. 15,16,17 MANAGEMENT- Out of 62 patients of fibroadenoma, there were 18 patients with lesion less than 2 cm as detected clinically and confirmed by ultrasonography .these patients were treated conservatively.22 Surgery was proposed to all other 44 patients 40 patients consented for surgery and were operated, in all these excision was done under anesthesia.12 We registered 40 patients of fibroadenosis, in 6 patients excision of the most painful and noduler area was done rest of the patients were treated conservatively by oral medication of evening prime rose oil and vitamin E. In patients not getting relieved by above, Danazol which is an anti gonadotrophin was found useful. As it is having androgenic effects non compliance was observed in most of the patients. In one patient with FNAC showing atypical hyperplasia excision of affect quadrant with subsequent follow-up was done by series of mammography. As patient with atypical hyperplasia, multi focal lesion with calcifications have many fold increased risk for developing carcinoma 6,7,8 Patient was subjected risk reduction strategies like yearly mammography, stopping oral contraceptive pills and hormone replacement therapy if any.6,7 In patients with mastalgia cyclic or non cyclic patients are treated with conservative manner by life style modification, eating low fat diet and avoiding caffeine. After ruling out infection pt responds well to NSAID and Danazol. Simple breast cyst was treated with aspiration.22 All 12 the patients of breast abscess were treated by surgical ID. microbial examinations were done all the cases.21,23 10 patients came history of presence of lump and pain and low grade fever and malaise, on ultrasonography showed hypo echoic lesion suggestive of abscess showed presence of mycobacterium tuberculi in abscess wall biopsy and were treated by anti tubercular treatment.18 Patient with antibioma were treated in conservative manner in lactating women where as in non lactating open drainage and curettage was done. There were two patients of galactocoele and one of breast cyst in which aspiration was done. One patient of breast lump after excision biopsy was diagnosed as lipoma. All the patients with complaints of nipple discharge underwent cytological examination of discharged fluid. There was one patient of ductal ectasia which on ultra sonogrphy showed ductal pappiloma for which microdochectomy was done. Patients with bilateral breast pain with cyclic nodularity were diagnosed as mastalgia. These patients underwent series of ultrasonography but no focal lesion was found. In patients with mastalgia cyclic or non cyclic patients are treated with conservative manner by life style modification, eating low fat diet and avoiding caffeine. Patient responds well to NSAID and Danazol. DISCUSSION: When a female notices breast lesion she undergoes great degree of anxiety due to apprehension of gruesome carcinoma which causes breast lose and most fearful disfigurement.1.3.4 Benign breast diseases are much more common than malignant lesions but the aggressive nature of carcinoma takes the precedence of the worry.9 Thus it the most important priority of surgeon to reach up to a definite diagnosis and once the carcinoma is excluded the patient should be reassured and educated for further follow up.10,23 It is also there for prolonged period of time and requires counseling and reassurance apart from definitive treatment. Triple assessment test is essential for the patients with complaints of breast diseases.19 Any clinical or suspicious lesion requires pathological diagnosis. Patients with proliferatory disease without atypia have very little risk of breast cancer but patients with atypia have substantial great risk of breast cancer.6 The common age group for BBD is younger age group, who have less say in the family. The symptoms are considered trivial and discomfort converts in pain. FNAC had high predictive value. In our study there was high sensitivity to fibroadenoma. 12,19The poor sensitivity to fibroadenosis is due to poor cellular aspirate. Frequent FNAC were required some times as the disadvantage of scaring of excision biopsy and damage to ductal system architecture was not acceptable.21,22,23 In studies done by Abhijit M. G. in rural area of karnatak, India in year 2009- 2011 there is high incidence of fibroadenoma, total pt were 110, 68 underwent exicision( 61.8%)of which 60 (88.2%) were fibroadenoma. In Pakistan study done by Batool et al at Lahore, out of 63 patients of BBD there were 38 patients of fibroadenoma. In our study there were 41.9% of fibroadenoma out of that 29.03 % of cases were less than 2 cm and were treated conservatively were as in 70.9 % of cases were proposed surgery but only 64.6 % of patient got operated. There were 25.9% cases of fibroadenosis. In above studies there less incidence of tuberculosis which is 6.2% in our study. This the matter of concern and required more follow ups. In developing country especially in rural area the treatment of breast disease poses lots of problem care system due to social stigma, illiteracy poverty and lack of availability of authentic health care system. CONCLUSION The disease of breast which is concluded to be benign may be trivial for family members but it imposes substantial anxiety and affected day to day life of sufferers.9,23 The mean age affected was 32. The common benign breast disorder which we came across is fibroadenoma which is more common in young age.12,19,23 They are best treated surgically though small sized can be managed conservatively with good follow up. The disease variant of this disorder phylloids tumor needs more diagnostic confirmations to rule out malignancy, excision and follow-ups. Fibroadenosis and mastalgia patients suffer more as there is no surgical cure and the conservative management is not very affective. Anti gonadotrophins due to androgenic side effects are not tolerated well. Anti oestrogen drugs also do not have good compliance due to systemic side effects like flushing and nausea and vomiting as they are to be consumed for prolonged period of time. Periodic NSAID and lifestyle management was more accepted. Infectious disease were found commonly in lactating females Main concern were patients of tuberculosis which are 6.28 % of all patients and much higher in no. than other studies we came across. 18This was more common in age group of 20-30 yrs. Though all mentioned patient were treated completely to our satisfaction. With senescence, there was complaint of nipple discharge in elderly patients due to ductal ectasia and periductal mastits. It required more detailed and dedicated approach so as to rule out the carcinoma which is higher in this age group. Thus benign breast disease has good prognosis but requires thorough investigations and management for desired results.9 References 18 Mehta G, Mittal A, Verma S. Breast Tuberculosis Clinical Spectrum and Management. Indian J Surg 2010;72:433- 19 Lopez-Ferrer P, Jimenez-Heffernan JA, Vicandi B, Ortega L, Viguer JM. Fine needle aspiration cytology of breast fibroadenoma: a cytohistologic correlation study of 405 cases. Acta Cytologica 1999;43:579- 20 . Park IA, Ham EK. Fine needle aspiration cytology of palpable breast lesions. Acta Cytologica 1997;41:1131- 21. Iglehart JK, Smith BL. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 18th ed. India: Elsevier; 2008:858-61. 22 Thomas JM, Fitzharris BM, Redding WH, Williams JE, Trott PA, Powles TJ, et al. Clinical examination, xeromammography, and fine-needle aspiration cytology in diagnosis of breast tumours. Br Med J 1978;21:1139-412 23 Srivatsava A, Dhar A. Benign Breast Disease: A neglected entity. Recent Advances in Surgery 2006;10:175-2011. TABLE NO 1 ETIOLOGICAL DISTRIBUTIONS CHART 1 OPERATIVE AND CONSERVATIVE TABLE NO 2 AGE DISTRIBUTION CHART 2 SPECTRUM OF DISEASE

The Competitive Position Of A Company

The Competitive Position Of A Company This statement (in the coming referred to as The Statement) holds two different perspectives on the strategy thinking one based on competitive positioning and the other one based on industry structure and The Statement could to all appearances come from Porter. In Porters world it is the industry in which a company operates that is the foundation for the strategic analysis (reference). This is where the rules for competition are being made something that is well documented in Porters earlier work (see box Black box reference). In his later work (efter 1980 reference) Porter is more concerned about the resource needed to create a favorable competitive position within the industry. According to Porter every strategic formulation therefore needs to contain the two elements industry analysis and competitive positioning analyses (reference). My argument in this paper is that the two approaches cannot stand alone and that they are the two sides of the same coin. Taken the word limitations of this assignment into consideration, this is a short version of a huge area of strategic thinking, literature and ideas. How and why the stages of the evaluation has been undertaken I will be evaluating The Statements through two different theoretical approaches to strategy. The industry analyses (outside-in) versus the resource based view (inside-out). I will be working with the two approaches as two opposite poles in strategy thinking. In the industry analyses part I will be focusing on Porters early work (and the positioning school in the coming referred to as P-School) and their approach to strategy thinking. On the other side I will be focusing on the resource based view (in the coming referred to as RVB). This will be done through 2 different aspects A) The two approaches fundamental hypothesis and B) The two approaches key points of criticism. Finally I will compare the two rirections and make the following conclusion/thesis: The main statement of the assignment is too simplistic. In my view its a combination of internal and external factors that determines the competitive position of a company. The inside-out and the outside-in approaches have much in co mmon and for strategy development both approaches are relevant. A theoretical approach to evaluation of the statement There have been several attempts in literature to categorize strategy perspectives or schools of thought (e.g. Mintzberg 1990 and Whittington 2001). The two schools I will be looking at here P-school and RVB school each describing one part of a the SWOT framework (Barney 1991). RVB describes the strengths and weaknesses of a company, and the industry analyses are accountable for opportunities and threats as described in Barneys view on strategic framework. In the following I will try to make the correlation between two key views which both are occupied with the concept of competitive advantage through two components (Verdin Williamson, 1994); external sources and internal sources. Focus on the internal sources Resource based view (Inside out) The resources based view underlines the internal capabilities of the organisation in achieving sustainable competitive advantages in the market. Studies show that there are differences in companies returns within specific industries (Werner Field Montgomery, 1988). These differences are interpreted as caused by the existence of company specific differences in resources and skills. So it can be argued that it is the companies portfolio of resources and skills and the effective use of them, which determines a sustainable competitive advantage. Jay Barney is often mentioned as the author of the RVB approach (reference), but also significant contributions have been made by authors like Wernerfelt (1984) and Gary Hamel/ C. K. Prahalad (1990). With the publication of the book: The Theory of the Growth of the Firm (Penrose 1959) Edith Penrose advocates the view that the limitation of a companys growth opportunities are primarily related to its internal resources and capabilities. Grant, an other noble contributor to the RBV, puts the theses internal resources into three groups: tangible, intangible and human (reference). They all have similar but still slightly different understandings of RBV, but fundamentally they argument for an inside-out view, where the competitive advantage derives from a companys resources. Studies show that there are differences in companies returns within specific industries (Werner Field Montgomery, 1988). These differences are interpreted as caused by the existence of company specific differences in resources and skills. So the main hypothesis of the RBV writers is that is its portfolio of resources and skills and the effective use of them, which is the prerequisite for achieving sustained competitive advantage (reference). Fahy, Smithee (1999) cites Hooley, Moller and Broderick (1998) for criticising the resource-based view for its inward focus which risks ignoring the nature of market demand. Also Priem Butler (2001) made several points of critic by arguing that the role of product markets is underdeveloped in the argument, and that different resource configurations can generate the same value for firms and thus would not be competitive advantage. Priem and Butler further argue that the RBV is lacking detail and therefore being difficult to implement. The most outspoken criticism of the schools theory and method is directed against the schools one-sided emphasis on the companys resource at the expense of the market. It can be argued that this theory is too one track minded on enterprise resource being the only factor in building competitive advantages. The resource-based only relates inward inside out, so it does not create an immediate understanding of its environment, or the fact that a company must act in the environment in order to be competitive. Focus on the external sources Industry Perspective Porter is a prominent scientist in relations to the outside-in view at least his work before 1980 (reference) (which is what I will comment here). Porter and the P-School, tries explaining why some companies are more successful than other companies when they apparently are subject to the same business conditions (reference). In addition, the school has focused on answering the question What forces drive competition in an industry? (reference). In relation to The Statement Porter believes that for the individual company, the industry structure is essential for the companys strategic development and competitive position (reference). Porter identifies 5 different basic forces which determine a companys competitive position in the market a model of industry attractiveness Porters 5 Forces. The five forces is an out-side strategy tool which is used to illuminate the main competition issues in a market and measure how strong and important each one of them is. A critic of Porter and the P-school is linked to the fact that the choice of strategy is largely based on analytical desk work, without prior knowledge of real market conditions. Mintzberg writes in his book The rise and fall of Strategic Planning: The whole positioning school of which Porter is the leading spokesman depends to such an extent on strategic analyses, that it virtually replaces overall planning as the main activity (Mintzberg 1994:273). Porters Five Forces Model has some limitations with the market and business environment we have today. One of the criticisms is that the model assumes a relatively static market structure ((Prahalad and Gary, 1990) that can only create a snapshot picture of the market situation. Porters model is based primarily on the economic situation in the 80s were characterized by strong competition and a stable market structures. Todays market is dynamic, hectic and constantly changing (Prahalad and Gary, 1990), which also affects the firms acting in these markets. Another recent critique is made by Larry Downes (2001) who comments on Porters theory not being as important as they used to be, as new economic laws, conditions and markets have raised ( globalisation, digitalisation and deregulation). Still they are valid to some extent, as long as they are used with the knowledge that they have limitations within them. Hill and Jones (1995) make further criticisms of Porters 5 forces by stating that a companys success is not certain to be successful just because it operates in an attractive industry. The positioning school are solely focused on the market conditions and their crucial role in the competitive position of a company (reference). They do not involve the internal environment in determining/improving the competitive position of a company. This is a very limited view, which is the same critique as I put on the RBV its too one-sided. Alternative nonfinancial perspective to Inside-Out and Outside-in approach An alternative theoretical approach to Inside-Out and Outside-in in a nonfinancial measure could be done by looking at the contingency approach to management and strategy development. Fiedlers contingency model has the basic assumption that there is no best way of organizing or leading (Fiedler, 1964). Charles W. Hofer (1975) discusses the concept in terms of business strategy development. The contingency approach to strategy thinking underlines the importance of developing a best fit between structure, strategy and environment (là ¦rebogen side 69). Summery Not either or, but complementary I have now looked at our statement through two perspectives to strategy thinking. In my opinion, there is no one best way. Its about finding the perfect fit between inside out and outside in focus. The industry perspective and RBV perspective in strategic analysis are two parts of the same whole. E.g. in analyzing the industry perspective, it is possible to identify elements, which lies outside the area of RBV and vice versa. To be able to navigate successfully and be successful in todays dynamic markets you have to adapt to the external environments as well as the internal resources and ideally create the perfect fit between them. So its not neither or, but a complementary of both approaches, which is also the direction Porter is giving in his later work from 1985 (Murray, A. I.:390). Conclusion Strategic analysis has two dominant approaches or better referred to as fractions or perspectives. Outside In which is based on Porter and the positioning schools and the inside out concept which is often referred to as RBV Barney being the central author. This papers main point is that none of them can do without the other. The fundamental difference is that inside-out looks at the strategic analysis and a company competitive ability as being based on the internal resources and capabilities of which the company has at its disposal. On the other hand, outside in works from the starting point that it is the structure of a given industry which determines the companies competitive ability. An industry analyses requires both internal and external analyses to be successful. The Statement The competitive position of a company is determined by the industry structure in which it competes. should be rephrased to The competitive position of a company is determined by the internal resources available to the company and by the industry structure in which it competes. if the statement should be fully correct.