AUDITOR INDEPENDENCE AND AUDITOR SCEPTICISM Essay

AUDITOR INDEPENDENCE AND AUDITOR SCEPTICISM - Essay Example To justify these responsibilities an auditor must possess certain personal qualities such as honesty and ethicality. To be precise, the auditor whether internal or external, has his responsibilities towards the governance of an organisation and its quality (The Institute of Internal Auditors, 2005). However, in the realistic phenomenon auditors have been constantly judged on their personal qualities, which directly indicate to the appropriateness of the concept of auditor independence and scepticism. The concept of auditor independence and scepticism were both raised with the focus on the nature of responsibilities which a professional needs to abide while ensuring the quality of the financial statements of a company (Kleinman & Et. Al., 2001). Nature of Auditor Independence and Auditor Scepticism The Nature of the Auditor Independence To define the term ‘Auditor Independence’, authors have referred it as the foundation of auditing in a realistic behaviour. Relying on th e nature of auditing, auditors need to identify, control and eradicate the inefficiency of the financial statements produced by the accountants of a firm in order to ensure the accurate status of the financial health of the organisation. Auditor independence, in this scenario assists the auditor to render value-added services to the client and the community at large. Auditor independence is strongly influenced by the audit process. The process instigates from the selection procedure and ends by reporting the findings and opinion of the auditor. Therefore, the concept of audit independence emerges to be crucial with due consideration to its importance and nature. It is in this context, that audit independence is implemented based on three basic principles, i.e. the auditors must belong to the external environment of the organisation and therefore are prohibited to be a part of the client organisation, the auditors are also proscribed to audit their own workings and cannot play any ad vocacy role to support the organisation if found guilty (Rezaee, 2007). Nature of Auditor Scepticism Auditor Scepticism is another concept introduced in the auditing practices, which refers to the personal skill of the auditors to challenge the management’s statements in order to critically evaluate the accuracy of the financial statements of an organisation. However, scepticism needs to be controlled due to the fact that challenging almost any and every assertion of a well established company will in turn affect the willingness to publish the financial statements (Peursem, 1989). The factors which play a crucial role in determining the appropriateness of scepticism are the regulations prescribed in relation to auditing and the financial practise of the company and the nature of the corporate. To be precise, the nature of auditor scepticism indicates to be an attitude of questioning the management and identifying and eliminating the probable chances of producing misstatements related to error or deception. It is of vital importance due to the fact that it not only ensures the auditing to be confirmed with extra professional efficacy but also proves supportive in performing the task rigorously. However, the level of

Developing an Integrated Marketing Communications Strategy Essay

Developing an Integrated Marketing Communications Strategy - Essay Example This paper will focus on developing an integrated marketing communication strategy for Selfridges, a departmental store located in London, United Kingdom. The objectives of the marketing strategy will include: increasing awareness of the products and brand visibility, increasing company sales, and customer base, enlarging the marketing channels and integrating the marketing content to convey a similar message that focuses on product quality and excellent customer shopping experience ad service. These objectives will be achieved by launching a comprehensive marketing campaign that will focus on several marketing channels. These channels include offline, online, mobile and social media marketing strategies. The department store is also called Selfridge & Co. It is a chain of high-end departmental stores that was founded by Gordon Harry Selfridge. The basis of the store's success is the innovative marketing strategies that have been used over time. For example, at the initial stages, Go rdon used creativity to making shopping adventurous by putting merchandise on display so that customers would be attracted to the departmental stores. He put highly profitable items at the front end so that customers could easily see them. He made policies that made it easy and safe for customers to shop. These techniques have been developed by other departmental stores worldwide. The stores have a slogan that says that the customer is always right. The company has successfully launched profitable advertising campaigns based on this slogan. Following their good customer focus and creative marketing strategy, the stores are very popular and register high profits year after year.

Biochemical and Hormonal Changes in Childhood Obesity

Biochemical and Hormonal Changes in Childhood Obesity The prevalence of chronic or non communicable disease is escalating much more rapidly in developing countries than in industrialized countries. According to World Health Organization (WHO) estimates, by the 2020, non communicable diseases will account for approximately three quarter of all deaths in the developing countries (WHO. Global Strategy for non communicable disease prevention, 1997). In this regard, a potential emerging public health issue for the developing countries may be increasing incidence of childhood obesity with associated complications, which in turn is likely to create public health burden for poorer nations in the near future (Freedman et al, 2001). Lower to middle income nations face the double burden of having both malnourished and over nourished population, with most overweight and obese children being concentrated in urban areas. Rapid urbanization is associated with unhealthy lifestyle or New World Syndrome. In addition, in such communities, childhood obesit y is still considered a sign of healthiness and high social class. There is no universal consensus on a cut off points for defining overweight and obesity in children and adolescents, usually, for clinical practice and epidemiological studies, child overweight and obesity are assessed by means of indicators based on weight and height measurements, such as weight for height measures or body mass index (weight (kg)/height (m2))(WHO. Report series no.847, 1995).The US Centers for Disease Control and Prevention (CDC) defines obese as being at or above 95th percentile of body mass index for age (Kuczmarsk RJ et al, 2000). History of obesity is both interesting and gives details of its progression. Obesity is an age-old health condition. Through out the history of obesity, its reputation varies from appreciation and opposite among cultures and in time. Ancient Egyptians are said to consider obesity as disease. Perhaps the most famous and earliest evidence of obesity is the Venus figurines, Statuettes of an obese female torso that probably had a major role in rituals. Ancient China has also been aware of obesity and dangers that come with it. They always were a believer of prevention as a key to longevity. The Aztecs believed that obesity was supernatural, an affliction of the gods. Hippocrates, the father of medicines was aware of sudden deaths being more common among obese men than lean ones as stated in his writings. In certain cultures and areas where food is scarce and poverty is prevalent, is viewed as symbol of wealth and social status. To date, an African tribe purposely plumps up a bride to pre pare her for child bearing. Before a wedding can be set, a slim bride is pampered to gain weight until she reaches the suitable weight. Through out the history of obesity, the publics view and status of obesity changed considerably in the 1900s. It was regarded as unfashionable by the French designer, Paul Poi ret who designed skin-revealing clothes for women. About the same time, the incidence of obesity began to increase and become wide spread. Later in 1940s, Metropolitan life insurance published a chart of ideal weight for various heights. They also advocated that weight gain parallel to age is unhealthy. The government and medical society become more hands-on with obesity by imitating campaign against it. This was preceded by a study of risk factors for cardiovascular disease revealing obesity in the high ranks. Since then various diets and exercise programs have emerged. In 1996, the Body Mass Index (BMI) was published. This statistical calculation and index determined that a person is obese or not. At this time ,obesity incidence have soared, led by children and adolescent obesity, tripling in just a few short years, greater than any number in the history of obesity. This increase in the incidence of childhood obesity with associated cardiovascular risks, type 2 diabetes mellitus and stroke is supported by a considerable body of evidence. The prevalence of overweight and obesity in childhood and adolescents has been increasing throughout much of the developed and developing world for the past few decades. It has become increasingly clear that excess adiposity in childhood predisposes individual not only to increased risk of adiposity and its sequaele as adults (Freedman et al, 2001), but also to increased risk of multiple chronic diseases in childhood and adolescence (Rosen bloom et al, 1999). Though mechanism not clearly delineated, excess body weight and adiposity is associated with type 2 diabetes mellitus and its complications, cardiovascular disease risk factors, non alcoholic fatty liver disease and asthma in youth. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity and Economic Growth 1930-1983 Childhood obesity was related to the economic growth during the 50 years of economic growth in the industrialized world especially in Denmark. Annual measurements of height and weight were available for all children born between 1930 and 1983 attending primary schools in Copenhagen Municipality. 165,389 boys and 163,609 girls from the age of 7 through 13 years were included in this study. After computerization SBMI (kg/m2) were calculated and the prevalence of overweight and obesity according to international age and gender–specific criteria. Economics growth was indicated by the Gross National Product and the overall consumption per capita, adjusted for inflation. Prevalence of overweight and obesity among Danish children rose in phases, which were not paralleled by trends in economic growth. The microeconomics growth indicators seem inappropriate as proxies for the environmental exposures that have elicited the obesity epidemic. Childhood obesity and television viewing Children spend a substantial portion of their lives watching television (TV). Investigators have hypothesized that TV viewing causes obesity by one or more than three mechanisms: Displacement of physical activity. Increased calorie consumption while watching or caused by the effects of advertising. Reduced resting metabolism. The relationship between TV viewing and obesity has been examined in a relatively large number of cross sectional epidemiological but few longitudinal studies. Many of them have found relatively weak, positive association or mixed results. Many experimental studies have found that reducing TV viewing may help to reduce the risk of obesity. One school based experimental study was designed specifically to test directly the casual relationship between TV viewing behaviors and body fatness. The results of this randomized controlled trial provide evidence that TV viewing is a cause of increased body fatness and that reducing the TV viewing is a promising strategy for preventing childhood obesity (Robinson; 2001). The objective of another study (Utter J et al, 2006), was to explore how time spent watching television (TV) is associated with the dietary behavior of New Zealand children and young adolescents. Total number of participants was 3275 children aged 5-17 years. The findings suggest that longer duration of TV watching (thus more frequent exposure to advertising) influences the frequency of consumption of soft drinks, some sweets and snacks and some fast foods among children and young adolescents. Efforts to control the time spent watching TV may result in better dietary habits and weight control for children and adolescents. Childhood Obesity US- A decade of progress, 1990-1999 Current data suggest that 20% of US children are overweight .An analysis of the secular trends suggest that 20% of US children are overweight, and a clear up ward trend in body weight in children of 0.2 Kg between 1973 and 1994. In addition, childhood obesity is more prevalent among minority sub groups such as African Americans. Obesity that begins early in life persists into adulthood and increases the risk of obesity related conditions later in life. There has been tremendous increase in the number of studies examining the etiology and health effects of obesity in children (Goran MI, 1990-1999).1980 (boys 0.2% girls 0.5%) and 1997 (boys 1.2%, girls 2.0%). Ten years trends of childhood obesity in Israel 1990-2000 Cross sectional data was collected from 13284 second and fifth class school; children between 1990-2000. Prevalence of obesity was determined using Israeli and US reference values. BMI values at 95th percentile increased overtime in all ages and sex categories. Between 1990 and 2000, 95th centile values were increased by 12.7%and 11.8% among second grade boys and girls respectively. Among fifth graders in 2000, 10.7% of boys and 11.1% of girls exceeded the 1990 BMI reference values. The proportion of obese children increased over time using both Israeli and US reference values (Huerta Michael et al, 2008). Netherlands. Overweight, Obesity in 2003: V.1980-97. Data on 90,071 children, aged 4-16 years were routinely collected by 11 Community Heath Services during 2002-2004. International cut -off points for BMI to determine overweight and obesity. On average, 14.5% of boys and 17.5% of the girls were overweight (including obesity), which is a substantial increase since 1980 (boys 3.9% and girls 6.9%) and 1997 (boys 9.7% and girls 13%). Similarly 2.6% of the boys and 3.3% 0f the girls aged 4-16 years were obese, which is much higher than in 1980 (boys 0.2% and girls 0.5%) and 1997 (boys 1.2% and girls 2.0%), (KatjaVan Den Husk, 2007). Obesity trends in US. 2003-2006 Height and weight measurements were obtained from 8164 children and adolescents as apart of the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey (NHANES). Because no statistically significant differences in the prevalence of high BMI for age were found between the estimates for 2003-2004 and 2005-2006, data for four years were combined to provide more stable estimates for the most recent time period. Over all, in 2003-2006, 11.3% of children and adolescents aged 2 through years were at or above 97th percentile of the 2000 BMI- for- age growth charts, 16.3% were at or above 95th percentile. Prevalence estimates vary by age and by racial/ethnic group. Analysis of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999-2000, 2001-2002, 2003-2004, and 2005-2006) for either boys or girls (Cynthia l.Ogden et al, 2008). 11-March 2005. Public Release Date: Consensus on Childhood Obesity, Recommends classification as disease A common statement on childhood obesity was published to day in the journal of Chemical Endocrinology and Metabolism (one of the journals of Endocrine Society). The consensus statement reflects the conclusions from an international summit held in Israel last year (2004) and includes a controversial recommendation to classify obesity as a disease. This decision was based upon the available research on the diagnosis, prevalence, causes (including endocrine disorders), risks, prevention and treatment of childhood obesity. Pediatric obesity is now recognized as a major health problem all over the world. Researcher have found that children who are obese have a higher risks adult obesity, which is strongly associated with many serious medical complications that impair quality of life and lead to additional increased risks. The statement also noted the prevalence of overweight/obesity among children 6-11 years (in the US) doubled between the years 1980-2000. By classifying obesity as legiti mate disease, public funding and in user sreimbursement for obesity treatment becomes legalized (consensus on childhood obesity, 2005). Serious health risks will likely to begin to appear in obese children and adolescents as they grow older. These may include diabetes mellitus, metabolic syndrome, hyperandrogenism, heart disease, hypertension, respiratory factors, and sleep disorders. Obese children are also at greater risk of anxiety and depression. It also recommended a number of measures that can be implemented by parents; schools, health providers and government and regulatory agencies to help to prevent the onset of childhood obesity Endocrine Regulation of Energy Metabolism Adipocytokines and Obesity The mechanism underlying obesity was further explained by the discovery of adipocytokines, the role of peripheral thyroid hormones (T4, T3), thyroid stimulating hormone and insulin the regulation of energy metabolism. The levels of some of the adipocytokines were shown to be related to visceral obesity, type 2 diabetes mellitus and coronary artery disease. Plasma levels of all the adipocytokines increase with the obesity except adiponectin (Yuji Matsuzawa et al, 2003). Recent studies point out to the adipose tissue as a highly active organ secreting a range of hormones, Leptin, Adiponectin, and Resistin. They are considered to take part in the regulation of energy metabolism. Leptin, Adiponectin and Resistin are produced by the adipose tissue. Leptin and Adiponectin are insulin sensitizing while Resistin increase the insulin resistance. Leptin The notion that genetic abnormalities contribute to obesity gained important support with the identification of the Ob gene and its protein product in 1994 (Zhangy et al, 1996). The Ob gene termed Leptin from the Greek Leptos, meaning thin, is produced in adipose tissue and is thought to act as an afferent satiety signal in a feed back loop that affects the appetite and satiety centre in the hypothalamus of brain. The ultimate effect of this loop is to regulate body-fat mass. In human, as noted by Considine et al, 1996; caloric restriction reduces leptin concentrations and Ob mRNA levels in adipose tissue, and refeeding increases these levels. One fundamental mechanism of obesity is insensitivity to the action of Leptin, presumably in the hypothalamus. The Leptins primary physiological function is to provide a signal to suppress body fat by decreasing food intake or increasing energy expenditure. Serum leptin concentrations change more during weight loss than during weight gain (Rose nbaum M et al, 1997). Adiponectin Adiponectin or Adipo Q, an adipocyte specific secreted protein with roles in glucose and lipid homeostasis (Insulin stimulates the secretion of adiponectin). Circulating adiponectin concentrations are high 500-30,000 Â µg/l (5-30mg/ml) accounting for 0.01% of total plasma proteins (Berget et al, 2002). Adiponectin was discovered in the mid 1990s by four different groups of researchers (Hu E et al, 1996). Adiponectin has various biological functions including insulin sensitizing (Hotta K et al, 2000), antiatherogenic (Yamauchi T et al, 2003), anti-inflammatory (Ouchi N et al, 2003), antiangiogenic and anti tumor functions (Brakenhielm E et al, 2004). Adiponectin acts through Adiponectin receptors, Adipo R1 and Adipo R2. Adipo R1 is mostly expressed in skeletal muscles and Adipo R2 is abundant in liver. These receptors are also expressed by the pancreatic ß cells (Kharroubi et al, 2003), macrophages and atherosclerotic lesions (Chinetti et al, 2004) as well as in brain (Yamauchi et al, 2003). Circulating Adiponectin levels display diurnal variation with a nocturnal decline and maximum levels in the late morning (Gavrila et al, 2003). Adiponectin is also found in breast milk, which in turn is implicated in childhood obesity prevention (Savino et al, 2008). Among the various adipocytokines, adiponectin, which is an abundant circulating protein (247 amino acids) synthesized purely in adipose tissue, appears to play a very important role in carbohydrates, lipid metabolism and vascular biology. Adiponectin appears to be a major modulator of insulin action and its levels are reduced in type 2 diabetes mellitus, which could contribute to peripheral insulin resistance in this condition. It has significant insulin sensitizing as well as anti inflammatory properties that include suppression of macrophage phagocytosis and TNF-a secretion and blockage of monocytes adhesion to endothelial cells in vitro. Although further investigations are required, Adiponectin administration, as well as regulation of the pathway controlling its production, represents a promising target for managing obesity, hyperlipidemia, insulin resistance, type 2 diabetes mellitus, and vascular inflammation (Manju Chandran et al, 2003). Resistin Human resistin is 108 amino acids prepeptide and is cleaved before its secretion from the Adipose tissue. Resistin circulates in the blood as dimeric protein consisting of 92 amino acids polypeptides that are linked by a disulfide bridge. Holcomb et al, 2000 first described the gene family and its tissue specific distribution. Originally described as lung specific, is also produced by the adipose tissue and peripheral blood monocytes. It is also present in dividing epithelia of the intestine. Resistin increase blood glucose and insulin concentration in the mice and impairs hypoglycemic response to insulin infusion. In addition, anti resistin antibodies decrease blood glucose and insulin sensitivity in obese mice (Ukkalo O, 2002). The physiological role of resistin in human remains controversial. There more resistin protein in obese than lean individuals, with a significant positive correlation between resistin and BMI. BMI is a significant predictor of insulin resistance, but resisti n adjusted for BMI is not. These data demonstrate that resistin protein is present in human adipose tissue and blood and that there is significantly more resistin in serum of obese individuals. Serum resistin is not a significant predictor of insulin resistance in human (Youn et al, 2003, Rear R and Donnelly R, 2004). Tumor Necrosis Factor-a It will be unreasonable not to mention the Tumor Necrosis Factor a and its role in vascular inflammation related to atherosclerosis especially in obesity. It is a cytokine involved in systemic inflammation and is a member of a group of cytokines that stimulate the acute phase reaction. The primary role of TNF is in the regulation of immune cells. TNF is able to induce apoptotic cell death, to induce inflammation and to inhibit tumourgenesis and viral replication. Dysregulation and, in particular, over production of TNF have been implicated in a variety of human diseases, as well as cancer (Locksley et al, 2001). The theory of antitumoural response of the immune system in vivo was recognized by the physician William B in 1968. Dr A Granger reported a cytotoxic factor produced by lymphocytes and named it Lymphotoxin (Kalli WB and Granger GA, 1968). Dr L Loyal old, in 1975 reported another cytotoxic factor produced by macrophages and named it Tumor Necrosis Factor (TNF) (Cars well et al, 1975). Interleukin – 6 (IL-6) Chronic inflammation is linked to endothelial dysfunction, atherosclerosis, and insulin resistance (Fernandez-Real JM and Ricart W, 2003 and Fernandez-Real JM, Ricart W, 2005). Plasma concentrations of proinflammatory cytokines, such as interleukin (IL) 18, IL-6, and tumor necrosis factor (TNF)-a, and of several other inflammatory markers are increased in patients with ischemic heart disease (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2002, Engstrom G et al, 2004, Ridker PM et al, 1997, Pradham AD et al, 2002). Circulating cytokines also are elevated in type 2 diabetes, obesity, and insulin resistance syndrome and play a central role in the pathogenesis of these disorders (Fernandez-Real JM and Ricart W, 2003). IL-6 is a mediator of the inflammatory response, and it is linked to dyslipidemia, type 2 diabetes, and risk of myocardial infarction (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2000, Esteve E et al, 2005, Yudkin JS et al, 2000). IL-6 is secreted by a variety of different cell types, including lymphoid and endothelial cells, fibroblasts, skeletal muscle, and adipose tissue. Circulating IL-6 levels correlate with obesity and insulin resistance and may predict the development of type 2 diabetes mellitus (Yudkin JS et al, 2000, Pradhan AD et al, 2001, Akira S et al, 1993, Mohamed-Ali V et al, 1997). Endothelial dysfunction is regarded as a causal factor in the development of atherosclerosis (Hansson GK, 2005). It is one of the earliest abnormalities that can be detected in people at risk for cardiovascular events, and it is linked to insulin resistance and type 2 diabetes (Steinberg HO and Baron AD, 2002, Natali A et al, 2006). Cytokines have an important role in the endothelial injury induced by inflammation. The vascular endothelium is involved in the inflammatory response to atherosclerosis (Hansson GK, 2005, Steinberg HO and Baron AD, 2002, Natali A et al, 2006, Widlansky ME et al, 2003), and changes in endothelium function could underlie the association between cardiovascular disease and inflammation. Obesity Related Insulin Resistance: Definition and Pathogenesis Insulin resistance is a state in which a given amount of insulin produces a subnormal biological response (Kahn CR, 1978). In particular, it is characterized by a decrease in the ability of insulin to stimulate the use of glucose by muscles and adipose tissue and to suppress hepatic glucose production and output (Matthaei et al, 2000). Furthermore, it accounts a resistance to insulin action on protein and lipid metabolism and on vascular endothelial function and genes expression (Bajaj M and Defronzo RA, 2003). Several defects in the insulin signaling cascade have been implicated in the pathogenesis of insulin resistance, Insulin resistance is believed to have both genetic and environmental factors implicated in its etiology (Matthaei et al, 2000 and Liu et al, 2004). The genetic component seems to be polygenic in nature, and several genes have been suggested as potential candidates (Matthaei et al, 2000). However, several other factors can influence insulin sensitivity, such as obesity, ethnicity, gender, perinatal factors, puberty, sedentary lifestyle and diet (Liu et al, 2004). The Role of Fatty Acids and Adipocytokines Obesity represents the major risk factor for the development of insulin resistance in children and adolescents (Caprio S, 2002), and insulin resistance/hyperinsulinemia is believed to be an important link between obesity and the associated metabolic abnormalities and cardiovascular risk (Weiss R and Kaufman FR, 2008). Approximately, 55% of the variance in insulin sensitivity in children can be explained by total adiposity, after adjusting for other confounders, such as age, gender, ethnicity and pubertal stage (Caprio S, 2002). Obese children have hyperinsulinemia and peripheral insulin resistance with an ~40% lower insulin-stimulated glucose metabolism than non-obese children (Caprio S et al, 19996). Adipose tissue seems to play a key role in the pathogenesis of insulin resistance through several released metabolites, hormones and adipocytokines that can affect different steps in insulin action (Matsuzawa Y, 2005) (Fig. 1). Adipocytes produce non-esterified fatty acids, which inhibit carbohydrate metabolism via substrate competition and impaired intracellular insulin signaling (Matsuzawa Y, 2005, Griffin ME et al 1999 and Randle PJ, 1998). In children, as in adults, several adipocytokines have been related to adiposity indexes as well as to insulin resistance. Adiponectin is one of the most common cytokines produced by adipose tissue, with an important insulin sensitizing effect associated with anti-atherogenetic properties (Despres JP, 2006 and Gil-Campos M et al, 2004). Whereas obesity is generally associated with an increased release of metabolites by adipose tissue, levels of Adiponectin are inversely related to adiposity (Matsuzawa Y, 2005). Therefore, reduced levels of this adipocytokine have been implicated in the pathogenesis of insulin resistance and metabolic syndrome (Matsuzawa Y, 2005). Decreased levels of Adiponectin have been detected across tertiles of insulin resistance in children and adolescents (Weiss R et al, 2004), where it is a good predictor of insulin sensitivity, independently of adiposity (Lee S et al, 2006). Adipose tissue also produces tumour necrosis factor-a, an inflammatory factor, which can alter insulin action at different levels in the intracellular pathway (Matsuzawa Y, 2005). Interleukin-6 (IL-6) is ano ther inflammatory cytokine released by adipose tissue and its levels are increased in obesity (Matsuzawa Y, 2005). IL-6 stimulates the hepatic production of C-reactive protein and this can explain the state of inflammation associated with obesity, and could mediate, at least partially, obesity-related insulin resistance (Matsuzawa Y, 2005). Data based mainly on animal studies also suggest that increased levels of resistin, another molecule produced by adipose tissue, could impair insulin sensitivity (Matsuzawa Y, 2005). The close relationship between Leptin levels and insulin resistance in children has also been suggested by the data (Chu NF et al, 2000). Serum levels of retinol-binding protein 4 (RBP4) correlate with insulin resistance in subjects with obesity as well as in those with impaired glucose tolerance (IGT) or type 2 diabetes mellitus, therefore suggesting that it could be useful in assessing insulin resistance and the associated risk for complications (Graham TE et al, 2006). Serum RBP4 is independently related to obesity as well as to components of the metabolic syndrome in normal weight and overweight children (Aeberli I et al, 2007). Diet composition in obese children might be an additional factor promoting and/or worsening insulin resistance. Animal and human studies suggest that a high energy intake as well as a diet rich in fat and carbohydrates and low in fiber could increase the risk of developing insulin resistance (Canete R et al, 2007). The Role of Fat Distribution An altered partitioning of fat between subcutaneous and visceral or ectopic sites has been associated with insulin resistance (Weiss R and Kaufman FR, 2008). Visceral fat has a better correlation with insulin sensitivity than subcutaneous or total body fat (Caprio S et al, 1995), in both obese adults and children. Visceral fat has higher lipolytic activity compared with subcutaneous fat, therefore a greater amount of free fatty acids and glycerol gain entry or carried out to the liver (Matthaei et al, 2000). Visceral fat in girls is directly correlated to the glucose-stimulated insulin levels and inversely correlated with insulin sensitivity and the rate of glucose uptake. No correlation was found between abdominal subcutaneous fat (Caprio S et al, 1995). Ectopic deposition of fat in the liver or muscle can also be responsible for insulin resistance in obese subjects, as the accumulation of fat in these sites impairs insulin signaling, with a reduced glucose uptake in the muscle and a decreased insulin-mediated suppression of hepatic glucose production (Weiss R and Kaufman FR, 2008). Intramyocellular lipid (IMCL) accumulation has been shown as a factor related to decreased insulin sensitivity (Jacob S et al, 1999 and Thamer C et al, 2003). Obese insulin sensitive children and adolescents present lower levels of visceral fat and IMCL when compared with obese insulin resistant children (Weiss R et al, 2005). Accumulation of fat in the liver has also been associated with insulin resistance, independently of adiposity (Kelley DE et al, 2003). It has also been suggested that deposits of fat around blood vessels can produce several cytokines and therefore contribute to the development of insulin resistance, through a so-called vasocrine effect (Yudkin JS et al, 2005). Insulin Resistance and Associated Complications Insulin resistance in obesity is strictly related to the development of hypertension (Marcovecchio ML et al, 2006 and Cruz ML et al, 2002), dyslipidemia (Howard BV and Howard WJ, 1994), impaired glucose tolerance (IGT) (Sinha R et al, 2002), hepatic steatosis (DAdamo E et al, 2008), as well as to the combination of these factors, also known as metabolic syndrome (Eckel RH et al, 2005). Furthermore, insulin resistance is associated with systemic inflammation, endothelial dysfunction, early atherosclerosis and disordered fibrinolysis (Dan Dona P et al, 2002). It is alarming that these metabolic and cardiovascular complications are already found in obese children and adolescents (Dietz WH, 2004). The presence of these alterations in prepubertal children is then particularly worrying, as insulin resistance and related complications might be further exacerbated by the influence of puberty, due to the physiological decrease in insulin sensitivity associated with normal pubertal development (Caprio S et al, 1989). Insulin resistance in childhood can track in adult life (Sinaiko AR et al, 2006). Insulin resistance at the age of 13 years predicts insulin resistance at age 19 years, independently of BMI, and is also associated with cardiovascular risk in adulthood (Sinaiko AR et al, 2006). The fundamental role of insulin resistance in human disease was already recognized in 1988 by Reaven (Reaven GM, 1988) who emphasized its role in the development of a grouping of metabolic abnormalities, which he defined as syndrome X. Later studies strengthened the concept of insulin resistance as a key component of the metabolic syndrome, a cluster of impaired glucose tolerance (IGT), dyslipidemia, hypertension, hyperinsulinemia, associated with an increased risk of type 2 diabetes mellitus and cardiovascular disease (Eckel RH et al, 2005). Insulin resistance represents a serious and common complication of obesity during childhood and adolescence. A timely diagnosis and an appropriated prevention and treatment of obesity and insulin resistance are required in order to reduce the Biochemical and Hormonal Changes in Childhood Obesity Biochemical and Hormonal Changes in Childhood Obesity The prevalence of chronic or non communicable disease is escalating much more rapidly in developing countries than in industrialized countries. According to World Health Organization (WHO) estimates, by the 2020, non communicable diseases will account for approximately three quarter of all deaths in the developing countries (WHO. Global Strategy for non communicable disease prevention, 1997). In this regard, a potential emerging public health issue for the developing countries may be increasing incidence of childhood obesity with associated complications, which in turn is likely to create public health burden for poorer nations in the near future (Freedman et al, 2001). Lower to middle income nations face the double burden of having both malnourished and over nourished population, with most overweight and obese children being concentrated in urban areas. Rapid urbanization is associated with unhealthy lifestyle or New World Syndrome. In addition, in such communities, childhood obesit y is still considered a sign of healthiness and high social class. There is no universal consensus on a cut off points for defining overweight and obesity in children and adolescents, usually, for clinical practice and epidemiological studies, child overweight and obesity are assessed by means of indicators based on weight and height measurements, such as weight for height measures or body mass index (weight (kg)/height (m2))(WHO. Report series no.847, 1995).The US Centers for Disease Control and Prevention (CDC) defines obese as being at or above 95th percentile of body mass index for age (Kuczmarsk RJ et al, 2000). History of obesity is both interesting and gives details of its progression. Obesity is an age-old health condition. Through out the history of obesity, its reputation varies from appreciation and opposite among cultures and in time. Ancient Egyptians are said to consider obesity as disease. Perhaps the most famous and earliest evidence of obesity is the Venus figurines, Statuettes of an obese female torso that probably had a major role in rituals. Ancient China has also been aware of obesity and dangers that come with it. They always were a believer of prevention as a key to longevity. The Aztecs believed that obesity was supernatural, an affliction of the gods. Hippocrates, the father of medicines was aware of sudden deaths being more common among obese men than lean ones as stated in his writings. In certain cultures and areas where food is scarce and poverty is prevalent, is viewed as symbol of wealth and social status. To date, an African tribe purposely plumps up a bride to pre pare her for child bearing. Before a wedding can be set, a slim bride is pampered to gain weight until she reaches the suitable weight. Through out the history of obesity, the publics view and status of obesity changed considerably in the 1900s. It was regarded as unfashionable by the French designer, Paul Poi ret who designed skin-revealing clothes for women. About the same time, the incidence of obesity began to increase and become wide spread. Later in 1940s, Metropolitan life insurance published a chart of ideal weight for various heights. They also advocated that weight gain parallel to age is unhealthy. The government and medical society become more hands-on with obesity by imitating campaign against it. This was preceded by a study of risk factors for cardiovascular disease revealing obesity in the high ranks. Since then various diets and exercise programs have emerged. In 1996, the Body Mass Index (BMI) was published. This statistical calculation and index determined that a person is obese or not. At this time ,obesity incidence have soared, led by children and adolescent obesity, tripling in just a few short years, greater than any number in the history of obesity. This increase in the incidence of childhood obesity with associated cardiovascular risks, type 2 diabetes mellitus and stroke is supported by a considerable body of evidence. The prevalence of overweight and obesity in childhood and adolescents has been increasing throughout much of the developed and developing world for the past few decades. It has become increasingly clear that excess adiposity in childhood predisposes individual not only to increased risk of adiposity and its sequaele as adults (Freedman et al, 2001), but also to increased risk of multiple chronic diseases in childhood and adolescence (Rosen bloom et al, 1999). Though mechanism not clearly delineated, excess body weight and adiposity is associated with type 2 diabetes mellitus and its complications, cardiovascular disease risk factors, non alcoholic fatty liver disease and asthma in youth. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity and Economic Growth 1930-1983 Childhood obesity was related to the economic growth during the 50 years of economic growth in the industrialized world especially in Denmark. Annual measurements of height and weight were available for all children born between 1930 and 1983 attending primary schools in Copenhagen Municipality. 165,389 boys and 163,609 girls from the age of 7 through 13 years were included in this study. After computerization SBMI (kg/m2) were calculated and the prevalence of overweight and obesity according to international age and gender–specific criteria. Economics growth was indicated by the Gross National Product and the overall consumption per capita, adjusted for inflation. Prevalence of overweight and obesity among Danish children rose in phases, which were not paralleled by trends in economic growth. The microeconomics growth indicators seem inappropriate as proxies for the environmental exposures that have elicited the obesity epidemic. Childhood obesity and television viewing Children spend a substantial portion of their lives watching television (TV). Investigators have hypothesized that TV viewing causes obesity by one or more than three mechanisms: Displacement of physical activity. Increased calorie consumption while watching or caused by the effects of advertising. Reduced resting metabolism. The relationship between TV viewing and obesity has been examined in a relatively large number of cross sectional epidemiological but few longitudinal studies. Many of them have found relatively weak, positive association or mixed results. Many experimental studies have found that reducing TV viewing may help to reduce the risk of obesity. One school based experimental study was designed specifically to test directly the casual relationship between TV viewing behaviors and body fatness. The results of this randomized controlled trial provide evidence that TV viewing is a cause of increased body fatness and that reducing the TV viewing is a promising strategy for preventing childhood obesity (Robinson; 2001). The objective of another study (Utter J et al, 2006), was to explore how time spent watching television (TV) is associated with the dietary behavior of New Zealand children and young adolescents. Total number of participants was 3275 children aged 5-17 years. The findings suggest that longer duration of TV watching (thus more frequent exposure to advertising) influences the frequency of consumption of soft drinks, some sweets and snacks and some fast foods among children and young adolescents. Efforts to control the time spent watching TV may result in better dietary habits and weight control for children and adolescents. Childhood Obesity US- A decade of progress, 1990-1999 Current data suggest that 20% of US children are overweight .An analysis of the secular trends suggest that 20% of US children are overweight, and a clear up ward trend in body weight in children of 0.2 Kg between 1973 and 1994. In addition, childhood obesity is more prevalent among minority sub groups such as African Americans. Obesity that begins early in life persists into adulthood and increases the risk of obesity related conditions later in life. There has been tremendous increase in the number of studies examining the etiology and health effects of obesity in children (Goran MI, 1990-1999).1980 (boys 0.2% girls 0.5%) and 1997 (boys 1.2%, girls 2.0%). Ten years trends of childhood obesity in Israel 1990-2000 Cross sectional data was collected from 13284 second and fifth class school; children between 1990-2000. Prevalence of obesity was determined using Israeli and US reference values. BMI values at 95th percentile increased overtime in all ages and sex categories. Between 1990 and 2000, 95th centile values were increased by 12.7%and 11.8% among second grade boys and girls respectively. Among fifth graders in 2000, 10.7% of boys and 11.1% of girls exceeded the 1990 BMI reference values. The proportion of obese children increased over time using both Israeli and US reference values (Huerta Michael et al, 2008). Netherlands. Overweight, Obesity in 2003: V.1980-97. Data on 90,071 children, aged 4-16 years were routinely collected by 11 Community Heath Services during 2002-2004. International cut -off points for BMI to determine overweight and obesity. On average, 14.5% of boys and 17.5% of the girls were overweight (including obesity), which is a substantial increase since 1980 (boys 3.9% and girls 6.9%) and 1997 (boys 9.7% and girls 13%). Similarly 2.6% of the boys and 3.3% 0f the girls aged 4-16 years were obese, which is much higher than in 1980 (boys 0.2% and girls 0.5%) and 1997 (boys 1.2% and girls 2.0%), (KatjaVan Den Husk, 2007). Obesity trends in US. 2003-2006 Height and weight measurements were obtained from 8164 children and adolescents as apart of the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey (NHANES). Because no statistically significant differences in the prevalence of high BMI for age were found between the estimates for 2003-2004 and 2005-2006, data for four years were combined to provide more stable estimates for the most recent time period. Over all, in 2003-2006, 11.3% of children and adolescents aged 2 through years were at or above 97th percentile of the 2000 BMI- for- age growth charts, 16.3% were at or above 95th percentile. Prevalence estimates vary by age and by racial/ethnic group. Analysis of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999-2000, 2001-2002, 2003-2004, and 2005-2006) for either boys or girls (Cynthia l.Ogden et al, 2008). 11-March 2005. Public Release Date: Consensus on Childhood Obesity, Recommends classification as disease A common statement on childhood obesity was published to day in the journal of Chemical Endocrinology and Metabolism (one of the journals of Endocrine Society). The consensus statement reflects the conclusions from an international summit held in Israel last year (2004) and includes a controversial recommendation to classify obesity as a disease. This decision was based upon the available research on the diagnosis, prevalence, causes (including endocrine disorders), risks, prevention and treatment of childhood obesity. Pediatric obesity is now recognized as a major health problem all over the world. Researcher have found that children who are obese have a higher risks adult obesity, which is strongly associated with many serious medical complications that impair quality of life and lead to additional increased risks. The statement also noted the prevalence of overweight/obesity among children 6-11 years (in the US) doubled between the years 1980-2000. By classifying obesity as legiti mate disease, public funding and in user sreimbursement for obesity treatment becomes legalized (consensus on childhood obesity, 2005). Serious health risks will likely to begin to appear in obese children and adolescents as they grow older. These may include diabetes mellitus, metabolic syndrome, hyperandrogenism, heart disease, hypertension, respiratory factors, and sleep disorders. Obese children are also at greater risk of anxiety and depression. It also recommended a number of measures that can be implemented by parents; schools, health providers and government and regulatory agencies to help to prevent the onset of childhood obesity Endocrine Regulation of Energy Metabolism Adipocytokines and Obesity The mechanism underlying obesity was further explained by the discovery of adipocytokines, the role of peripheral thyroid hormones (T4, T3), thyroid stimulating hormone and insulin the regulation of energy metabolism. The levels of some of the adipocytokines were shown to be related to visceral obesity, type 2 diabetes mellitus and coronary artery disease. Plasma levels of all the adipocytokines increase with the obesity except adiponectin (Yuji Matsuzawa et al, 2003). Recent studies point out to the adipose tissue as a highly active organ secreting a range of hormones, Leptin, Adiponectin, and Resistin. They are considered to take part in the regulation of energy metabolism. Leptin, Adiponectin and Resistin are produced by the adipose tissue. Leptin and Adiponectin are insulin sensitizing while Resistin increase the insulin resistance. Leptin The notion that genetic abnormalities contribute to obesity gained important support with the identification of the Ob gene and its protein product in 1994 (Zhangy et al, 1996). The Ob gene termed Leptin from the Greek Leptos, meaning thin, is produced in adipose tissue and is thought to act as an afferent satiety signal in a feed back loop that affects the appetite and satiety centre in the hypothalamus of brain. The ultimate effect of this loop is to regulate body-fat mass. In human, as noted by Considine et al, 1996; caloric restriction reduces leptin concentrations and Ob mRNA levels in adipose tissue, and refeeding increases these levels. One fundamental mechanism of obesity is insensitivity to the action of Leptin, presumably in the hypothalamus. The Leptins primary physiological function is to provide a signal to suppress body fat by decreasing food intake or increasing energy expenditure. Serum leptin concentrations change more during weight loss than during weight gain (Rose nbaum M et al, 1997). Adiponectin Adiponectin or Adipo Q, an adipocyte specific secreted protein with roles in glucose and lipid homeostasis (Insulin stimulates the secretion of adiponectin). Circulating adiponectin concentrations are high 500-30,000 Â µg/l (5-30mg/ml) accounting for 0.01% of total plasma proteins (Berget et al, 2002). Adiponectin was discovered in the mid 1990s by four different groups of researchers (Hu E et al, 1996). Adiponectin has various biological functions including insulin sensitizing (Hotta K et al, 2000), antiatherogenic (Yamauchi T et al, 2003), anti-inflammatory (Ouchi N et al, 2003), antiangiogenic and anti tumor functions (Brakenhielm E et al, 2004). Adiponectin acts through Adiponectin receptors, Adipo R1 and Adipo R2. Adipo R1 is mostly expressed in skeletal muscles and Adipo R2 is abundant in liver. These receptors are also expressed by the pancreatic ß cells (Kharroubi et al, 2003), macrophages and atherosclerotic lesions (Chinetti et al, 2004) as well as in brain (Yamauchi et al, 2003). Circulating Adiponectin levels display diurnal variation with a nocturnal decline and maximum levels in the late morning (Gavrila et al, 2003). Adiponectin is also found in breast milk, which in turn is implicated in childhood obesity prevention (Savino et al, 2008). Among the various adipocytokines, adiponectin, which is an abundant circulating protein (247 amino acids) synthesized purely in adipose tissue, appears to play a very important role in carbohydrates, lipid metabolism and vascular biology. Adiponectin appears to be a major modulator of insulin action and its levels are reduced in type 2 diabetes mellitus, which could contribute to peripheral insulin resistance in this condition. It has significant insulin sensitizing as well as anti inflammatory properties that include suppression of macrophage phagocytosis and TNF-a secretion and blockage of monocytes adhesion to endothelial cells in vitro. Although further investigations are required, Adiponectin administration, as well as regulation of the pathway controlling its production, represents a promising target for managing obesity, hyperlipidemia, insulin resistance, type 2 diabetes mellitus, and vascular inflammation (Manju Chandran et al, 2003). Resistin Human resistin is 108 amino acids prepeptide and is cleaved before its secretion from the Adipose tissue. Resistin circulates in the blood as dimeric protein consisting of 92 amino acids polypeptides that are linked by a disulfide bridge. Holcomb et al, 2000 first described the gene family and its tissue specific distribution. Originally described as lung specific, is also produced by the adipose tissue and peripheral blood monocytes. It is also present in dividing epithelia of the intestine. Resistin increase blood glucose and insulin concentration in the mice and impairs hypoglycemic response to insulin infusion. In addition, anti resistin antibodies decrease blood glucose and insulin sensitivity in obese mice (Ukkalo O, 2002). The physiological role of resistin in human remains controversial. There more resistin protein in obese than lean individuals, with a significant positive correlation between resistin and BMI. BMI is a significant predictor of insulin resistance, but resisti n adjusted for BMI is not. These data demonstrate that resistin protein is present in human adipose tissue and blood and that there is significantly more resistin in serum of obese individuals. Serum resistin is not a significant predictor of insulin resistance in human (Youn et al, 2003, Rear R and Donnelly R, 2004). Tumor Necrosis Factor-a It will be unreasonable not to mention the Tumor Necrosis Factor a and its role in vascular inflammation related to atherosclerosis especially in obesity. It is a cytokine involved in systemic inflammation and is a member of a group of cytokines that stimulate the acute phase reaction. The primary role of TNF is in the regulation of immune cells. TNF is able to induce apoptotic cell death, to induce inflammation and to inhibit tumourgenesis and viral replication. Dysregulation and, in particular, over production of TNF have been implicated in a variety of human diseases, as well as cancer (Locksley et al, 2001). The theory of antitumoural response of the immune system in vivo was recognized by the physician William B in 1968. Dr A Granger reported a cytotoxic factor produced by lymphocytes and named it Lymphotoxin (Kalli WB and Granger GA, 1968). Dr L Loyal old, in 1975 reported another cytotoxic factor produced by macrophages and named it Tumor Necrosis Factor (TNF) (Cars well et al, 1975). Interleukin – 6 (IL-6) Chronic inflammation is linked to endothelial dysfunction, atherosclerosis, and insulin resistance (Fernandez-Real JM and Ricart W, 2003 and Fernandez-Real JM, Ricart W, 2005). Plasma concentrations of proinflammatory cytokines, such as interleukin (IL) 18, IL-6, and tumor necrosis factor (TNF)-a, and of several other inflammatory markers are increased in patients with ischemic heart disease (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2002, Engstrom G et al, 2004, Ridker PM et al, 1997, Pradham AD et al, 2002). Circulating cytokines also are elevated in type 2 diabetes, obesity, and insulin resistance syndrome and play a central role in the pathogenesis of these disorders (Fernandez-Real JM and Ricart W, 2003). IL-6 is a mediator of the inflammatory response, and it is linked to dyslipidemia, type 2 diabetes, and risk of myocardial infarction (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2000, Esteve E et al, 2005, Yudkin JS et al, 2000). IL-6 is secreted by a variety of different cell types, including lymphoid and endothelial cells, fibroblasts, skeletal muscle, and adipose tissue. Circulating IL-6 levels correlate with obesity and insulin resistance and may predict the development of type 2 diabetes mellitus (Yudkin JS et al, 2000, Pradhan AD et al, 2001, Akira S et al, 1993, Mohamed-Ali V et al, 1997). Endothelial dysfunction is regarded as a causal factor in the development of atherosclerosis (Hansson GK, 2005). It is one of the earliest abnormalities that can be detected in people at risk for cardiovascular events, and it is linked to insulin resistance and type 2 diabetes (Steinberg HO and Baron AD, 2002, Natali A et al, 2006). Cytokines have an important role in the endothelial injury induced by inflammation. The vascular endothelium is involved in the inflammatory response to atherosclerosis (Hansson GK, 2005, Steinberg HO and Baron AD, 2002, Natali A et al, 2006, Widlansky ME et al, 2003), and changes in endothelium function could underlie the association between cardiovascular disease and inflammation. Obesity Related Insulin Resistance: Definition and Pathogenesis Insulin resistance is a state in which a given amount of insulin produces a subnormal biological response (Kahn CR, 1978). In particular, it is characterized by a decrease in the ability of insulin to stimulate the use of glucose by muscles and adipose tissue and to suppress hepatic glucose production and output (Matthaei et al, 2000). Furthermore, it accounts a resistance to insulin action on protein and lipid metabolism and on vascular endothelial function and genes expression (Bajaj M and Defronzo RA, 2003). Several defects in the insulin signaling cascade have been implicated in the pathogenesis of insulin resistance, Insulin resistance is believed to have both genetic and environmental factors implicated in its etiology (Matthaei et al, 2000 and Liu et al, 2004). The genetic component seems to be polygenic in nature, and several genes have been suggested as potential candidates (Matthaei et al, 2000). However, several other factors can influence insulin sensitivity, such as obesity, ethnicity, gender, perinatal factors, puberty, sedentary lifestyle and diet (Liu et al, 2004). The Role of Fatty Acids and Adipocytokines Obesity represents the major risk factor for the development of insulin resistance in children and adolescents (Caprio S, 2002), and insulin resistance/hyperinsulinemia is believed to be an important link between obesity and the associated metabolic abnormalities and cardiovascular risk (Weiss R and Kaufman FR, 2008). Approximately, 55% of the variance in insulin sensitivity in children can be explained by total adiposity, after adjusting for other confounders, such as age, gender, ethnicity and pubertal stage (Caprio S, 2002). Obese children have hyperinsulinemia and peripheral insulin resistance with an ~40% lower insulin-stimulated glucose metabolism than non-obese children (Caprio S et al, 19996). Adipose tissue seems to play a key role in the pathogenesis of insulin resistance through several released metabolites, hormones and adipocytokines that can affect different steps in insulin action (Matsuzawa Y, 2005) (Fig. 1). Adipocytes produce non-esterified fatty acids, which inhibit carbohydrate metabolism via substrate competition and impaired intracellular insulin signaling (Matsuzawa Y, 2005, Griffin ME et al 1999 and Randle PJ, 1998). In children, as in adults, several adipocytokines have been related to adiposity indexes as well as to insulin resistance. Adiponectin is one of the most common cytokines produced by adipose tissue, with an important insulin sensitizing effect associated with anti-atherogenetic properties (Despres JP, 2006 and Gil-Campos M et al, 2004). Whereas obesity is generally associated with an increased release of metabolites by adipose tissue, levels of Adiponectin are inversely related to adiposity (Matsuzawa Y, 2005). Therefore, reduced levels of this adipocytokine have been implicated in the pathogenesis of insulin resistance and metabolic syndrome (Matsuzawa Y, 2005). Decreased levels of Adiponectin have been detected across tertiles of insulin resistance in children and adolescents (Weiss R et al, 2004), where it is a good predictor of insulin sensitivity, independently of adiposity (Lee S et al, 2006). Adipose tissue also produces tumour necrosis factor-a, an inflammatory factor, which can alter insulin action at different levels in the intracellular pathway (Matsuzawa Y, 2005). Interleukin-6 (IL-6) is ano ther inflammatory cytokine released by adipose tissue and its levels are increased in obesity (Matsuzawa Y, 2005). IL-6 stimulates the hepatic production of C-reactive protein and this can explain the state of inflammation associated with obesity, and could mediate, at least partially, obesity-related insulin resistance (Matsuzawa Y, 2005). Data based mainly on animal studies also suggest that increased levels of resistin, another molecule produced by adipose tissue, could impair insulin sensitivity (Matsuzawa Y, 2005). The close relationship between Leptin levels and insulin resistance in children has also been suggested by the data (Chu NF et al, 2000). Serum levels of retinol-binding protein 4 (RBP4) correlate with insulin resistance in subjects with obesity as well as in those with impaired glucose tolerance (IGT) or type 2 diabetes mellitus, therefore suggesting that it could be useful in assessing insulin resistance and the associated risk for complications (Graham TE et al, 2006). Serum RBP4 is independently related to obesity as well as to components of the metabolic syndrome in normal weight and overweight children (Aeberli I et al, 2007). Diet composition in obese children might be an additional factor promoting and/or worsening insulin resistance. Animal and human studies suggest that a high energy intake as well as a diet rich in fat and carbohydrates and low in fiber could increase the risk of developing insulin resistance (Canete R et al, 2007). The Role of Fat Distribution An altered partitioning of fat between subcutaneous and visceral or ectopic sites has been associated with insulin resistance (Weiss R and Kaufman FR, 2008). Visceral fat has a better correlation with insulin sensitivity than subcutaneous or total body fat (Caprio S et al, 1995), in both obese adults and children. Visceral fat has higher lipolytic activity compared with subcutaneous fat, therefore a greater amount of free fatty acids and glycerol gain entry or carried out to the liver (Matthaei et al, 2000). Visceral fat in girls is directly correlated to the glucose-stimulated insulin levels and inversely correlated with insulin sensitivity and the rate of glucose uptake. No correlation was found between abdominal subcutaneous fat (Caprio S et al, 1995). Ectopic deposition of fat in the liver or muscle can also be responsible for insulin resistance in obese subjects, as the accumulation of fat in these sites impairs insulin signaling, with a reduced glucose uptake in the muscle and a decreased insulin-mediated suppression of hepatic glucose production (Weiss R and Kaufman FR, 2008). Intramyocellular lipid (IMCL) accumulation has been shown as a factor related to decreased insulin sensitivity (Jacob S et al, 1999 and Thamer C et al, 2003). Obese insulin sensitive children and adolescents present lower levels of visceral fat and IMCL when compared with obese insulin resistant children (Weiss R et al, 2005). Accumulation of fat in the liver has also been associated with insulin resistance, independently of adiposity (Kelley DE et al, 2003). It has also been suggested that deposits of fat around blood vessels can produce several cytokines and therefore contribute to the development of insulin resistance, through a so-called vasocrine effect (Yudkin JS et al, 2005). Insulin Resistance and Associated Complications Insulin resistance in obesity is strictly related to the development of hypertension (Marcovecchio ML et al, 2006 and Cruz ML et al, 2002), dyslipidemia (Howard BV and Howard WJ, 1994), impaired glucose tolerance (IGT) (Sinha R et al, 2002), hepatic steatosis (DAdamo E et al, 2008), as well as to the combination of these factors, also known as metabolic syndrome (Eckel RH et al, 2005). Furthermore, insulin resistance is associated with systemic inflammation, endothelial dysfunction, early atherosclerosis and disordered fibrinolysis (Dan Dona P et al, 2002). It is alarming that these metabolic and cardiovascular complications are already found in obese children and adolescents (Dietz WH, 2004). The presence of these alterations in prepubertal children is then particularly worrying, as insulin resistance and related complications might be further exacerbated by the influence of puberty, due to the physiological decrease in insulin sensitivity associated with normal pubertal development (Caprio S et al, 1989). Insulin resistance in childhood can track in adult life (Sinaiko AR et al, 2006). Insulin resistance at the age of 13 years predicts insulin resistance at age 19 years, independently of BMI, and is also associated with cardiovascular risk in adulthood (Sinaiko AR et al, 2006). The fundamental role of insulin resistance in human disease was already recognized in 1988 by Reaven (Reaven GM, 1988) who emphasized its role in the development of a grouping of metabolic abnormalities, which he defined as syndrome X. Later studies strengthened the concept of insulin resistance as a key component of the metabolic syndrome, a cluster of impaired glucose tolerance (IGT), dyslipidemia, hypertension, hyperinsulinemia, associated with an increased risk of type 2 diabetes mellitus and cardiovascular disease (Eckel RH et al, 2005). Insulin resistance represents a serious and common complication of obesity during childhood and adolescence. A timely diagnosis and an appropriated prevention and treatment of obesity and insulin resistance are required in order to reduce the

Comparing the Tragedies of Hamlet, Oedipus the King, and Death of a Sal

Comparing the Tragedies of Hamlet, Oedipus the King, and Death of a Salesman The tragedies Hamlet, Oedipus the King, and Death of a Salesman have strikingly different plots and characters; however, each play shares common elements in its resolution. The events in the plays’ closings derive from a tragic flaw possessed by the protagonist in each play. The downfall of each protagonist is caused by his inability to effectively cope with his tragic flaw. The various similarities in the closing of each play include elements of the plot, the reflection of other characters on the misfortune of the tragic hero, and expression of important themes through the dialogue of the characters. The protagonists of Hamlet, Oedipus the King, and Death of a Salesman each possess a tragic flaw that ultimately induces their demise. Hamlet is characterized as a hesitant hero. He thoroughly contemplates his options instead of taking action; however, when he does not have the time to consider his alternatives, he acts rashly and impulsively. For example, he did not kill Claudius when he was presented with the opportunity in Act III scene iii. Oedipus’ tragic flaw was his excessive pride, or hubris. He believed that he was flawless and thus maintained the false notion that he was also infallible. Willy Loman was plagued by his enchantment with the ephemeral promises of the American Dream. There are various similarities and differences among the events that occur in the resolutions of the three tragedies, including physical destruction of the protagonist, assumption of the protagonist’s former position by a rival, and suffering caused by disillusionment. The three tragic heroes Hamlet, Oedipus, and Willy Loman are subjected to various forms of physical destruction. Hamlet is slain in a fencing match by a poisoned foil, Oedipus mutilates himself and is exiled from Thebes, and Willy Loman commits suicide by intentionally crashing his car. Another common thread in the resolutions of all three tragedies is that a rival of the tragic hero assumes the responsibilities of the protagonist following his demise. Creon – the man secretly covetous of royal power – becomes the leader of Thebes after Oedipus falls from his position of authority. Fortinbras assumes a position of leadership in Denmark after the death of Claudius and his successors. In Death of a Salesman... ...ine. And when they start not smiling back – that’s an earthquake. And then you get yourself a couple of spots on your hat and you’re finished† (138). With these words, Charley attributes Willy’s despair to the hardships of his profession. Biff’s comment that his father â€Å"never knew who he was† (138) insinuates that people should strive to discover their true place in life. Willy’s dissatisfaction with his life was a result of his vain attempt to be someone that he was not. The three tragedies Hamlet, Oedipus the King, and Death of a Salesman have similar resolutions despite their diverse storylines. In each play, the tragic hero suffers from great misfortune that ultimately leads to his downfall. Various plot elements in the closing related to the destruction of the protagonist are shared among the three tragedies. The closing of each play reveals thoughts and feelings of characters regarding the demise of the tragic hero. Also, major themes are expressed through the discussion and action of the characters. Most importantly, the conclusion of each tragedy not only evokes feelings of sympathy but also teaches the audience an important lesson about the human condition.

Modified Food Essay

The fact of the matter remains, there is potential for an amazing breakthrough in modifying the genetic components of our foods. If such a breakthrough were to come about, it could lead to a promising future of provisions for people who may not currently receive the benefits of a direct agricultural provider. There are current efforts to achieve insect, herbicide, and disease resistant crops of which could grow faster and in less fertile regions. In addition, these crop varieties could also pack in extra nutrients, take longer to ripen (extending their shelf life), and even contain essential vaccines for specific regions of the Earth. These predicted ‘super-crops’ could potentially put a large dent in the world issues of starvation, malnutrition, and disease. Obviously the future prospects of genetically modified foods are very exciting, and should continue to be explored. In my opinion, the money spent now researching and applying genetic theory could bring these possibilities to fruition and ultimately make a much larger impact then would allocating that money elsewhere. All things considered, there will always be the unknown and uncertain; in this case that remains the extension of genetically modified food use over time. Lab rat testing has warranted varying results of cancer and sickness on a minuscule level. Looking at this, we can surmise that the possibility of repercussions stemming from a continual and consistent diet of food that has been genetically tinkered with remains small. With this in mind, I would venture to guess that if we continued with the current implementation of genetically modified food into society, as well as the continual research into their future possibilities, it will end up benefiting us far beyond the influence of these negative implications. I agree that GE foods are not a direct solution to world hunger, malnutrition, and starvation; and I agree that alternative solutions should continue to be explored. Therefore, I entirely support the further investigation of genetically modified foods with the hope that it will not only lighten these societal burdens but potentially put a large dent in them. Anything will help at this point, considering how well the current system of resource distribution is working. All in all, with the prospects of what could be a fruitful future coming from genetically engineering and modifying our food, I’m all for it. BMJ 1999;318:581-584 ( 27 February ), Clinical review, Science, medicine, and the future, Genetically modified foods, Editorial by Dixon: (http://www. bmj. com/cgi/content/full/318/7183/581). Wikipedia! (of course†¦): (http://en. wikipedia. org/wiki/Genetically_modified_food) GM Food, Controversies Surrounding the Risks and Benefits of Genetically Modified Food: (http://scope. educ. washington. edu/gmfood/).

Tabula Rasa

Tabula Rasa or blank slate was a theory that became popular because of John Locke (HelpingPsychology). The Blank Slate theory is a theory that says everyone is born with a blank mind. There are no ideas or thoughts. Everything must be must learned and interrupted from the world around. This debate has been going on for a decades. Whether the mind is born blank or that there are ideas and thoughts when we are born. In the article The Blank Slate by Steven Pinker he speaks about the Blank Slate theory. He speaks about the debate and different views.Pinker uses John B. Watson and B. F. Skinner as examples for the debate. Watson believed that the when a child is born with nothing and has to gain the knowledge through experience. Watson’s most famous boost about this subject â€Å"Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in, and I’ll guarantee to take any one at random and train him to become any type of specialist I might se lect-doctor, lawyer, artists merchants-chief, and yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. (Watson, 21)† The debate about Blank Slate theory has been discussed but it has also caused problems.The Blank Slate theory in society has given way to cause problems between parent and child. It has also led to social problems. â€Å"And the conviction that humanity could be reshaped by massive social engineering projects has led to some of the greatest atrocities in history. (Watson, 21)† When the ignorance of a subject clouds the eyes of people it becomes easy to see where the distortion of truth is. When the people believe that they are able to shape their children exactly to how they want them they create the perfect situation to become disappointed. Not necessarily in the child but that they did not turn out as hoped or planned.Before reading this article and further reading I believed that humans were born with blank slates. I believed this because as we mature we need to be  taught how to do this like walk and talk. The older we get the more we learn and develop because of our environment. After reading the article, further reading, and more thinking I came to the conclusion that it is not purely one or the other.It like the Nature Nurture debate play off each other. I believe that we as humans are born with certain things in our minds but they are not strong thoughts or ideas. This thoughts and ideas are shadows or microscopic beings that in different environments will grow into something. Whether that something is positive or not depends again on the environment.The Blank Slate theory is something that has been discussed for decades. It has caused social distress. My views on it have been changed after reading more about it. Whether we are born or not with thoughts or ideas this is something that fascinates people, everyone from psychologists to anthropologi sts.

Consideration for Ethics and Diversity Proposal

Consideration for Ethics and Diversity Proposal Ethics in organizations is an important ingredient of organizational success. Both the employers and employees ought to act ethically to ensure that the goals and objectives of the organization are achieved (Mello, 2006). However, given the different personalities and thinking of human beings, ethical problems in organizations are inevitable.Advertising We will write a custom essay sample on Consideration for Ethics and Diversity Proposal specifically for you for only $16.05 $11/page Learn More As such, it is important that the human resource department of each organization puts in place appropriate measures to deal with ethical problems facing them. It is because of this that most organizations have in place a â€Å"code of ethics† that shows the expectations of the employer with regard to ethics. The main ethical consideration affecting my division is the high rate of absenteeism by most of the workers. Upon careful review of the workers’ mas ter roll books and clocking schedule, I have noted with a lot of concern that most of the workers fail to report to work during some days of the week. This is a weighty issue because the production rate in my division has in turn significantly gone down. Upon further calculation of the hours lost by the absent employees, the Account department has noted a decline in company’s profits in the last quarter of the financial year. This prompted my department to find out the reasons behind the high rate of absenteeism. It has come to my attention that the workers are complaining of long working hours with few breaks which makes the workers very fatigued and opting to allocate themselves off-days by being absent from work. It is my humble request that a re-schedule is made on the duty rooster of the workers to incorporate more breaks during working hours as well as rotational off-days for the workers. I also request the incorporation of three shifts in my division instead of the cur rent two in order to have workers work for shorter hours. This will not only reduce the rate of absenteeism but it will boost the morale of the workers thus increasing productivity hence higher organizational profits. In addition, it will also improve the reputation of the company on the basis of corporate social responsibility. Diversity is yet another significant issue of concern in organizations. It is brought about by the differences in the culture, race, social class, age and gender of different people (Bohlander Snell, 2007). Given the increase in rate of globalisation where companies are operating in the international market, the issue of diversity is inevitable.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Miscommunication is one of the diversity considerations that are prevalent in my division. Given the fact that the division currently holds people from different cul tural backgrounds who speak different languages, the workplace has in the recent past become hostile. This has significantly affected productivity since most of the time is either spent in arguments or resolving disputes instead of doing constructive work as expected. It is therefore my appeal to the Human Resource Director that proper sensitization and education is done to all the workers in order to make them accustom to different cultures and backgrounds. This will help promote an open and clear atmosphere in the workplace where each individual feels safe and comfortable. This will in turn increase productivity of the workers hence profits. In addition, the human resource department could make formal communication to all the workers regarding the common language to be used in the company in order to avoid cases of miscommunication. Reference List Bohlander, G., Snell, S. (2007). Managing human resources (14th ed.). Mason, OH:  Thomson Higher Education. Mello, J. (2006). Strate gic Human Resource Management. Westford: South-Western  Cengage Learning.

Free Essays on The Painted Door

The Painted Door Of the many different mood disorders, depression is the most common, and one of the most misunderstood. While modern research indicated that brain chemical imbalances cause the condition, many people still believe that chronic depression indicates a weak personality or character flaw. This makes seeking help difficult as people hesitate before admitting this weakness, however healing only starts with learning to recognize the symptoms. â€Å"The Painted Door’s,† Ann, demonstrates many qualities that lead the reader to believe such disorder is present. Ann is so unhappy due to her dissatisfaction with her lifestyle, her frustration with her husband, and the inner conflict she experiences. In the first instance, it’s quite clear that Ann is not satisfied with her lifestyle. When John first decides to go visit his father, Ann is quick to explain how lonely she gets while alone in the house. Even though staying home alone is a regular occurrence for her, it’s not something she’s necessarily gotten used to. Ann tries to explain this to John but he doesn’t understand, so she finally gives up; â€Å"Pay no attention to me. Seven years a farmer’s wife– it’s time I was used to staying home alone† Also, Ann comes to the realization that they are on a path of never ending routine. Each day consists of labour, day in, day out, with nothing to look forward to. Unfortunately, this isn’t good enough for Ann; â€Å"She was young still, eager for excitement and distractions† Regrettably, these desires of hers are not ones easily fulfilled as a farmer’s wife. Ann is a sociable person but doesn’t get out as much as she’d like. The labour involved in such a lifestyle is constant without much change. All of these norms of being a farmer’s wife are still estranged to Ann, and she doesn’t seem willing to settle for it anymore. The dissatisfaction she holds towards her lifestyle contributes to her unhappine... Free Essays on The Painted Door Free Essays on The Painted Door The Painted Door Of the many different mood disorders, depression is the most common, and one of the most misunderstood. While modern research indicated that brain chemical imbalances cause the condition, many people still believe that chronic depression indicates a weak personality or character flaw. This makes seeking help difficult as people hesitate before admitting this weakness, however healing only starts with learning to recognize the symptoms. â€Å"The Painted Door’s,† Ann, demonstrates many qualities that lead the reader to believe such disorder is present. Ann is so unhappy due to her dissatisfaction with her lifestyle, her frustration with her husband, and the inner conflict she experiences. In the first instance, it’s quite clear that Ann is not satisfied with her lifestyle. When John first decides to go visit his father, Ann is quick to explain how lonely she gets while alone in the house. Even though staying home alone is a regular occurrence for her, it’s not something she’s necessarily gotten used to. Ann tries to explain this to John but he doesn’t understand, so she finally gives up; â€Å"Pay no attention to me. Seven years a farmer’s wife– it’s time I was used to staying home alone† Also, Ann comes to the realization that they are on a path of never ending routine. Each day consists of labour, day in, day out, with nothing to look forward to. Unfortunately, this isn’t good enough for Ann; â€Å"She was young still, eager for excitement and distractions† Regrettably, these desires of hers are not ones easily fulfilled as a farmer’s wife. Ann is a sociable person but doesn’t get out as much as she’d like. The labour involved in such a lifestyle is constant without much change. All of these norms of being a farmer’s wife are still estranged to Ann, and she doesn’t seem willing to settle for it anymore. The dissatisfaction she holds towards her lifestyle contributes to her unhappine...

Causes and Effects of the English Language Essay Example for Free

Causes and Effects of the English Language Essay Creative writing (164) , English language (137) company About StudyMoose Contact Careers Help Center Donate a Paper Legal Terms & Conditions Privacy Policy Complaints In America, English is the national language. However, with many different cultures and ways of life, everyone doesn’t speak the same English. In the north, people tend to speak clearly and to some this is correct. In the south, people tend to tie their words together and to some this is incorrect. Ultimately, the question is, is what is good language what is bad and what causes the two. In Orewell’s piece, he criticizes the English language starting from the teachers who teach us on to the authors who entertain us. He emphasizes how bad language begins with those to people and their bad habits. He also stresses that if we â€Å"remain strong in this fight against bad English† then we will soon overcome the bad habits and whatnot. Orewell talks about dying metaphors and usage of words that aren’t in layman term. He suggests that when authors use common metaphors and uncommon scientific words, they are writing incorrectly. Consequently, readers and other writers are reading, writing, and learning incorrectly. In my opinion, Orewell’s essay was not efficient in any way. He was nothing short of a hypocrite doing what they do best. He speaks of creative writing and original methapors, but he uses neither. He speaks of using cumbersome words that nobody relates to, yet the majority of his essay was written as if he spoke old English. He doesn’t follow any of the rules that he strongly suggests will bring us out of this fight of bad English. He’s setting no example for the so-called unrightfully successful authors and novice writers. The English language has many different meanings, expressions, causes and effects. So many, that there can no be one specific person determining which are the most perfect. As stated before different regions of the U.S. determine how those people talk, so unconsciously people read and write the way they speak. Many authors use metaphors to allow the audience to better relate to the message their relaying. Many authors use scientific and uncommon words to help broaden their readers vocabulary and to expose them to more than they knew before reading their piece. These critical readers  pick up dictionaries and thesauruses and begin to further explore the language they’re so familiar with. Orewell is neither the most qualified nor perfect person to suggest how authors should write. After all, no on is criticizing his piece and how it negatively drew the audience in. If he is criticizing the way English is taught then he’s ultimately criticizing the way people interpret. Many people are doing just fine without Orewell’s negative views of the English language. Causes and Effects of the English Language. (2016, Jun 06). We have essays on the following topics that may be of interest to you

Constructing Pro-Forma Statements (Heartland Express) Term Paper

Constructing Pro-Forma Statements (Heartland Express) - Term Paper Example e income taxes 53,264 26,833 13,617 26,833 Federal and state income taxes 9,350 9,350 9,350 9,350 Net income 43,914 17,483 4,267 17,483 FINANCIAL STATEMENT ANALYSIS THROUGH RATIO ANALYSIS A method widely used by the investors and analyst in order to evaluate and analyze the financial history of the company is the ‘Ratio Analysis’. Ratio analysis is a very accurate and reliable tool when it comes to analyzing the financial outlook of an entity. The primary reason to conduct a ratio analysis is to quantify the results of the operations of a company and compare them with that of the prior year(s) in order to assess different aspects of the financial feasibility. The ratios can be divided into various categories such as profitability, gearing and liquidity, each focusing on a different area of the financial outlook of the organization and highlighting the company’s performance. The financial analysis of Heartland Express is divided into three main categorize namely Pr ofitability, Liquidity and Gearing. Profitability Ratios    2011 2010 2009 2008 2007 2006    Profitability Ratios Gross profit margin 20.16% 18.31% 17.18% 15.66% 18.66% 21.58% Net profit margin 20.30% 18.59% 17.69% 17.12% 20.40% 23.63% ROCE 31.50% 27.79% 22.11% 29.74% 35.22% 27.30% EPS 0.78 0.69% 0.62 0.73 0.78 0.89 Gross profit margin is an analyzing tool which assists in identifying how effectively and efficiently the company is utilizing its raw materials [1], variable cost related to labor and fixed costs such as rent and depreciation of property plant and equipment. The gross profit margin analysis of the last five years shows that subsequent to the financial year 2006, the gross profit margin declines. Though the sales of the company kept on increasing subsequent to the financial year 2006, but the... The liquidity ratio measures the company’s ability to pay its short-term liabilities. The ratio illustrates that how quickly a company can convert its assets into cash and cash equivalent in order to pay off its short-term liabilities. The most commonly used liquidity ratio, the current ratio, which is calculated by comparing the current assets and current liabilities. The strengthened the current ratio the more ability the company has to pay its debts and short-term obligations over the next 12 months. An overall analysis of the ratio would portray that in all the years the company had enough assets to pay off its obligations and debts. In the financial year 2007, the current ratio decreases from 3.35 to 2.91 due to the decrease in the current assets of the company by a staggering 32% which majorly pertains to the decrease in the short term investment from 322 million to 186 million. The cause of the decrease in the current ratio for the financial year 2008 also pertains to t he massive decrease in the short term investment. The reason for this decline is during that particular period, the equity shares market was going through its worst time. The companies rather than recording losses on market to market of these securities started selling these securities in the stock market. The acid test, which is also regarded as the quick ratio, is calculated by subtracting the inventory balance from the total current assert balance. Out of the current assets mentioned, inventories are regarded as the one which takes comparatively more time to be converted into cash or cash equivalent. The acid test ratio has followed the same trend as the current ratio.

Research methods Essay Example | Topics and Well Written Essays - 3000 words

Research methods - Essay Example The paper is divided into four main sections. First is an examination of the reason why racism existed in Britain and for how long has it existed. It is proposed in this paper that racism has affected and gave valuable impacts to the present British laws, either through as a reaction of the legislation to the rising concerns depicting racism within the country or to a larger scale, the global commotions in different parts of world depicting racial discrimination. A thorough discussion of these laws is imperative followed by detailed examples of how and up to what level has it affected policy making in the country. It is hypothesized, that the issues of racism has particularly impact policies on global relations, and even to laws pertaining to basic human rights and civil lerties such as rules on criminal procedure, due process, and sanctions for criminal acts. 1. LITERATURE SEARCH (500 WORDS) Racism is belief that a certain group of people is more superior to another. This theory oft entimes results into hostile conduct, unwarranted assaults, and violence towards the race labeled as inferior. Subtly, this belief sparked the constant practice of discrimination, oppression, and most often than not, history is the witness that the pursuit of the superior race to the opposite is often concluded in genocide. At a backdrop, racism is the assertion that the human race is divided into hierarchies, into partitions and these levels are distinguished from each other through superficial standards such as color and more profoundly by cultural behaviour; however, standards of racism vary from culture to culture at different parts of the world and this difference prompted various racism theories and hypotheses of its origins (Dijk). Power play is also an imperative factor when studying racism, the way power acts as an external influence it alters racism over time makes it a compelling factor. Most of the time, racism is more than just a showcase of disparity or a struggle betw een the inferior and the superior race or as an anti-social reflection, rather, racism in the modern society is a struggle between society and the State (Kundnani, 2001). However, racism is not confined and limited to a simple power struggle and stratification, since in fact, power is a product of and molded by racism itself (Modood, 2005). Creating a link between past and present laws is significant in considering the evolution of racism laws as developed in the United Kingdom. It is often acclaimed that UK has some of the most extensive and comprehensive laws and policies when it comes to race legislations (Modood, 2005). One of the earliest British laws on racism was the 1976 Race Relations Act that sanctions discrimination on the bases of colour, nationality and ethnical background among others. The 1976 Act was strengthened by the 2000 Race Relations Act. The Act aims to furnish wider safeguard against discrimination done by public authorities while placing positively enforceab le duties to these authorities. These changes are clear response to the compelling need of the contemporary times. The 1976 Act gave more attention to clearly negative and almost retaliatory measures towards the ethnic and cultural minorities in the UK (Kundnani, 2007).

Week 8 Discussion Board Assignment Example | Topics and Well Written Essays - 250 words

Week 8 Discussion Board - Assignment Example Today, in the US, many non-natives still live in the congested apartment projects while the wealthy, both native and non- natives, live in villas, mansions and terraced houses. This is similar to the Victorian suburb where the wealthy natives lived together in huge mansions, although racism was worse in the past. Both today and in the Victorian suburb, people from higher social class have better houses from those from low social class. People, who live in the suburbs, both current and in the historically, are wealthy and powerful. Historically, one had to be introduced by people you know in the suburbs to the society otherwise you were not welcomed. They did not allow average people to their society not unless one belonged to the same social class. Most people who lived in the suburbs were old money. Historically, living in the suburbs meant one had to keep up with the rest of the suburbia residents. You had to dress in a certain way, belong to specific membership clubs and attend specific social gatherings. If one did not do the things that came with the social status, you did not â€Å"belong† and people said that you were not â€Å"living†. One had to have a lot of money to cater for all the social activities that came with the status (Cutting, 1907). Currently, anyone who can afford to buy a house in the suburbs is free to do so. People live their lives without being concerned with the way their neighbors live. Neighbors might even be strangers and they keep different

UK LAND LAW (question is in the instructions box) Essay

UK LAND LAW (question is in the instructions box) - Essay Example on relates to whether the lease transferred by Troy to Ai-Ai was in conformity or in breach of Lakshmis covenants in the initial lease agreement or not. The second issue relates to Troys position in the contract after the property is transferred to Ai-Ai. Is Troy bounded by his guarantee to check performances of new assignees or not. What is the position of the guarantee in relation to Lakshmi and can be held responsible for the actions of Ai-Ai and Boo? The third issue relates to the possibility of Ai-Ais transfer of the property to Boo. Is the extended holiday in Thailand tantamount to abandonment and is Boos usage of the property tantamount to an assignment? This is an issue because Ai-Ai does not have the right to assign the property without Lakshmis consent. Hence, there is a clear breach. But what are the legal implications? Can Lakshmi sue for forfeiture? The final pointer that will be examined is the legal position of Boos breaking down of the wall in the property to allow in more air. Alterations on the property is a covenant in the lease. Does Lakshmi have the right of forefeiture? And a possible request for damages? A leasehold covenant is a clause in a lease specifying specific obligations on the part of either party2. This include express terms about how things will occur and how the lease is to be regulated. An assignment occurs when a tenant transfers whole or part of his remaining interest in the property to someone else who is an assignee. An assignment is somewhat like a three tier arrangement between a landlord who hands over to the tenant who also hands over to an assignee. In some cases, leases forbid assignments because landlords do not want their property to be transferred to assignees they do not know3. However, in a case where the lease agreement forbids tenants from assignments, a tenant can transfer interest in the lease to another person with the consent of the landlord and this transferee becomes a sub-tenant4. When a tenant