Liberty Shoes Franchise Cost Essay Example

Liberty Shoes Franchise Cost Essay This report discusses the detail of 1) Bata’s main line of business. 2) Its main competitors and their value chain comparison. 3) Strategy the company is following. 4) Current Costing System of the company. 5) Decision making on the basis of cost and information. 6) Decisions are being taken using management accounting information. To summarise the above points we know that Bata is the fastest growing footwear brand in the country with a presence across 400 cities.The brand offers a wide range of comfortable, stylish and trendy footwear at affordable prices, ensuring there is something in the collection for everyone. The USP of the brand lies in the fact that they have successfully made fashion and durability so affordable and accessible to all. This explains why Bata India sells over 45 million pairs of footwear every year and serves over 120,000 customers every day. Today, Bata India is the largest retailer and leading manufacturer of footwear in India.Bata’s main com petitors are Mirza Intl, Liberty Shoes, Crew B. O. S; Bhartiya Inter. In this report we have compared the Value chains of Bata India Ltd and liberty Shoes Ltd which says that Bata has a competitive advantage over Liberty shoes. Bata follows backward integration and are not dependent on some third party for procurement of raw materials which makes it cost effective. Apart from this Bata has a huge competitive advantage over Liberty in the area of sales and distribution channel. Bata follows Cost leadership strategy.The company enjoys the highest market share in India and this is evident from the fact that the total retail presence of the company currently is more than thrice that of its closest competitor (Liberty: 381 stores). Bata has over 15% market share in Organized Retail market and around 6. 5% share in unorganized retail. Bata is produces its own raw material to improve its profitability. Bata reduces its cost by demand based production, setting up manufacturing base in tax-f ree locations, using different mix for footwear production with cheaper raw material.Also, they started cutting some cost through sales and distribution network, which is really huge distribution network. Bata earlier concentrated only on manufacturing footwear and selling them anyhow but in recent times it has changed its image of the production oriented company to affordable, market driven, fashion conscious, lifestyle brand and hence the decision to reposition. The Company has been focusing on consumers and market demand which will reduce inventories and improve sales-to-stock turnover. Bata has also adopted cost cutting strategies without any compromise on style, quality and design.Management Accounting Project: Company selected – Bata India Ltd. a. What is the company’s main line of business and which sector? Bata India is the largest retailer and leading manufacturer of footwear in India and is a part of the Bata Shoe Organization. b. Who are the main competitors ? Bata India’s main competitors are Mirza Intl, Liberty Shoes, Crew B. O. S; Bhartiya Inter. Bata has the highest market share compared to all its competitors. c. Try to compare and contrast the value chains of the two companies.Value Chain Analysis describes the activities that take place in a business and relates them to an analysis of the competitive strength of the business. The activities of a business could be grouped under two headings: (1) Primary Activities those that are directly concerned with creating and delivering a product (e. g. component assembly) (2) Support Activities not directly involved in production, may increase effectiveness or efficiency. The following come under support activities: Procurement Technology Development Human Resource management Firm infrastructureIt is rare for a business to undertake all primary and support activities. BATA INDIA LTD. : Operations (Backward integration)- Company’s own tanneries located in Batanagar and Mokame hghat insures uninterrupted supply of raw material. Now they are not dependant on some third party for procurement of raw material. Sales and distribution- Bata operated through exclusive chain of executive own and franchise stores located in prime location country wide. Bata owns network of 300 exclusive wholesalers who serviced 30,000 retail outlets throughout country.Overall it has over 1,600 showrooms, 27 wholesale depots and 8 distribution centers across the country. Technological resources- In 2004, Bata installed point of sale management information system (POS), for providing sales and inventory information across the company’s stores. This provides company to plan production and optimize inventory level. LIBERTY SHOES LTD. : Technology – It has introduced a new material called TPU (Thermo Plastic Urethane), for high quality footwear, into the country. This material has better properties than PVC or TPR (conventional materials used for footwear).Liberty has als o been instrumental in introducing EVA (Ethyl Vinyl Acetate), which is a direct injection moulding used for making sole for the first time in Asia. This technology uses very light material amp; the footwear is made with the direct injection system. Liberty also pioneered the PU (Poly Urethane) Technology in India for the footwear industry. Besides these Thermo Plastic Elastomer has been developed for the first time in India at Liberty. A CAD/CAM design centre is in place at Liberty. The Sympatex waterproof technology in footwear was pioneered by also Liberty.Liberty is also the first company to market PPE products for safety purpose. Operations- Gharaunda is the first plant of its kind in this part of Asia that is equipped with Desma machines for PU Direct Injection Moulding. Using PUF technology and Computer Aided Systems this vertically integrated plant produces Industrial Safety Shoes that are made to European standards. Sympatex TEX booties as well as ordinary booties are also m ade here. Beside these Gharaunda has a design centre where an ambitious team of young designers working in tandem with experienced technologists. . Which strategy do the companies follow? Cost Leadership, Differentiation or Focus? Bata India Ltd. follows Cost Leadership strategy. Cost optimization and margin improvement: The Company is focusing on margin improvement and cost effectiveness programs which have started yielding results. The Company has initiated strict control on costs in purchases and outsourcing and is looking at global sourcing for raw materials to improve the net realization. The Company has also been clearing old merchandize through discount sales, write offs, etc. hich will enable it to focus on improving sales. e. The reflections about the current costing systems of the company? Currently the company is mainly focusing mainly on cost reducing strategies which are as follows: 1. Cost optimization: Strict control on costs in purchases and outsourcing. It is produ cing its own raw materials to improve its profitability. 2. Demand based production: The Company is focusing on consumers and market demand which will reduce inventories and improve sales-to-stock turnover. 3.Tax-free zone manufacturing base: After Himachal Pradesh and Uttaranchal the company is looking at and negotiating with the third party manufacturing facilities in two other tax-free states of Assam and Jammu and Kashmir. 4. Cost-cutting: Raw material used for used for 33% of total cost. Now Bata identified this problem and started using different mix for footwear production with cheaper raw material. Also, they started cutting some cost through sales and distribution network, which is really huge distribution network. f. How do the companies manage cost and use the information for decision making and control?Cost management in BATA : 1. BATA tried to reduce the costs of raw material. For this it tries to use different mix for footwear production with cheaper raw material. 2. I t also tried to reduce costs through sales and distribution network which is a very huge distribution network. So they continued to invest in expanding retail business. 3. They also tried to generate skilled manpower and cut costs through manpower reduction. 4. They reduced the inventory costs by clearing the existing merchandize by offering discounts. g. What decisions are being taken using management accounting information? 1. Decision to reposition:Bata earlier concentrated only on manufacturing footwear and selling them anyhow but in recent times it has changed its image of the production oriented company to affordable, market driven, fashion conscious, lifestyle brand and hence the decision to reposition. 2. Decision to produce based on logistics and demand: To optimise the utilisation of production facilities the logistics team focuses on obtaining orders from the market for the best selling designs and sizes and ensures that all raw materials are available in the factories we ll in time so that the Company can produce and place in shops the products that consumers want.Thus the Company has been focusing on consumers and market demand which will reduce inventories and improve sales-to-stock turnover. 3. Training and restructuring the frontline sales force: The Company has reorganized its front line sales force. It has undertaken an intensive training programme for its shop assistants and managers to ensure excellence in service to customers. It has also undertaken a rural marketing thrust wherein its reach is rapidly growing. It is recruiting managers with fresh ideas to inspire and empower the workforce with the requisite skills. . Bata uses technology like installation of point of sale management information system to keep an update about the inventory level, sale figure etc. 5. Bata also adopted the cost cutting strategy through use of different mix of raw materials for footwear production and also through sales and distribution but without any comprom ise on the style, quality and design of the product as it endeavours to break the myth of price factor by producing economy range of good quality and stylish products.RECOMMENDATIONS: ) The main recommendation we can give Bata is to repositioning itself. In India we still believe that Bata is just a company which produces footwear for school goers, office goers and regular use footwear like slippers and snickers. Bata is still trying to change its image of production oriented company to affordable, market driven, fashion conscious, lifestyle brand. Today they have a huge shoe line with a huge range of new designs on offer. To name a few they are Marie Claire, Weinbrenner, North Star, Power, Hush Puppies, Dr.Scholls, Ambassador, Bubblegummer etc but only a few segment of people know about this. So Bata must back their campaign through TVC’s, print media and word of mouth. 2) According to the survey conducted by Bata in African continent it was observed that people were not wea ring shoes at all. This means that there is a high scope of marketing shoes in African continent as no one has shoes. References: www. bata. in www. wikinvest. com www. moneycontrol. com www. inrnews. com www. scribd. com Liberty Shoes Franchise Cost Essay Example Liberty Shoes Franchise Cost Essay This report discusses the detail of 1) Bata’s main line of business. 2) Its main competitors and their value chain comparison. 3) Strategy the company is following. 4) Current Costing System of the company. 5) Decision making on the basis of cost and information. 6) Decisions are being taken using management accounting information. To summarise the above points we know that Bata is the fastest growing footwear brand in the country with a presence across 400 cities.The brand offers a wide range of comfortable, stylish and trendy footwear at affordable prices, ensuring there is something in the collection for everyone. The USP of the brand lies in the fact that they have successfully made fashion and durability so affordable and accessible to all. This explains why Bata India sells over 45 million pairs of footwear every year and serves over 120,000 customers every day. Today, Bata India is the largest retailer and leading manufacturer of footwear in India.Bata’s main com petitors are Mirza Intl, Liberty Shoes, Crew B. O. S; Bhartiya Inter. In this report we have compared the Value chains of Bata India Ltd and liberty Shoes Ltd which says that Bata has a competitive advantage over Liberty shoes. Bata follows backward integration and are not dependent on some third party for procurement of raw materials which makes it cost effective. Apart from this Bata has a huge competitive advantage over Liberty in the area of sales and distribution channel. Bata follows Cost leadership strategy.The company enjoys the highest market share in India and this is evident from the fact that the total retail presence of the company currently is more than thrice that of its closest competitor (Liberty: 381 stores). Bata has over 15% market share in Organized Retail market and around 6. 5% share in unorganized retail. Bata is produces its own raw material to improve its profitability. Bata reduces its cost by demand based production, setting up manufacturing base in tax-f ree locations, using different mix for footwear production with cheaper raw material.Also, they started cutting some cost through sales and distribution network, which is really huge distribution network. Bata earlier concentrated only on manufacturing footwear and selling them anyhow but in recent times it has changed its image of the production oriented company to affordable, market driven, fashion conscious, lifestyle brand and hence the decision to reposition. The Company has been focusing on consumers and market demand which will reduce inventories and improve sales-to-stock turnover. Bata has also adopted cost cutting strategies without any compromise on style, quality and design.Management Accounting Project: Company selected – Bata India Ltd. a. What is the company’s main line of business and which sector? Bata India is the largest retailer and leading manufacturer of footwear in India and is a part of the Bata Shoe Organization. b. Who are the main competitors ? Bata India’s main competitors are Mirza Intl, Liberty Shoes, Crew B. O. S; Bhartiya Inter. Bata has the highest market share compared to all its competitors. c. Try to compare and contrast the value chains of the two companies.Value Chain Analysis describes the activities that take place in a business and relates them to an analysis of the competitive strength of the business. The activities of a business could be grouped under two headings: (1) Primary Activities those that are directly concerned with creating and delivering a product (e. g. component assembly) (2) Support Activities not directly involved in production, may increase effectiveness or efficiency. The following come under support activities: Procurement Technology Development Human Resource management Firm infrastructureIt is rare for a business to undertake all primary and support activities. BATA INDIA LTD. : Operations (Backward integration)- Company’s own tanneries located in Batanagar and Mokame hghat insures uninterrupted supply of raw material. Now they are not dependant on some third party for procurement of raw material. Sales and distribution- Bata operated through exclusive chain of executive own and franchise stores located in prime location country wide. Bata owns network of 300 exclusive wholesalers who serviced 30,000 retail outlets throughout country.Overall it has over 1,600 showrooms, 27 wholesale depots and 8 distribution centers across the country. Technological resources- In 2004, Bata installed point of sale management information system (POS), for providing sales and inventory information across the company’s stores. This provides company to plan production and optimize inventory level. LIBERTY SHOES LTD. : Technology – It has introduced a new material called TPU (Thermo Plastic Urethane), for high quality footwear, into the country. This material has better properties than PVC or TPR (conventional materials used for footwear).Liberty has als o been instrumental in introducing EVA (Ethyl Vinyl Acetate), which is a direct injection moulding used for making sole for the first time in Asia. This technology uses very light material amp; the footwear is made with the direct injection system. Liberty also pioneered the PU (Poly Urethane) Technology in India for the footwear industry. Besides these Thermo Plastic Elastomer has been developed for the first time in India at Liberty. A CAD/CAM design centre is in place at Liberty. The Sympatex waterproof technology in footwear was pioneered by also Liberty.Liberty is also the first company to market PPE products for safety purpose. Operations- Gharaunda is the first plant of its kind in this part of Asia that is equipped with Desma machines for PU Direct Injection Moulding. Using PUF technology and Computer Aided Systems this vertically integrated plant produces Industrial Safety Shoes that are made to European standards. Sympatex TEX booties as well as ordinary booties are also m ade here. Beside these Gharaunda has a design centre where an ambitious team of young designers working in tandem with experienced technologists. . Which strategy do the companies follow? Cost Leadership, Differentiation or Focus? Bata India Ltd. follows Cost Leadership strategy. Cost optimization and margin improvement: The Company is focusing on margin improvement and cost effectiveness programs which have started yielding results. The Company has initiated strict control on costs in purchases and outsourcing and is looking at global sourcing for raw materials to improve the net realization. The Company has also been clearing old merchandize through discount sales, write offs, etc. hich will enable it to focus on improving sales. e. The reflections about the current costing systems of the company? Currently the company is mainly focusing mainly on cost reducing strategies which are as follows: 1. Cost optimization: Strict control on costs in purchases and outsourcing. It is produ cing its own raw materials to improve its profitability. 2. Demand based production: The Company is focusing on consumers and market demand which will reduce inventories and improve sales-to-stock turnover. 3.Tax-free zone manufacturing base: After Himachal Pradesh and Uttaranchal the company is looking at and negotiating with the third party manufacturing facilities in two other tax-free states of Assam and Jammu and Kashmir. 4. Cost-cutting: Raw material used for used for 33% of total cost. Now Bata identified this problem and started using different mix for footwear production with cheaper raw material. Also, they started cutting some cost through sales and distribution network, which is really huge distribution network. f. How do the companies manage cost and use the information for decision making and control?Cost management in BATA : 1. BATA tried to reduce the costs of raw material. For this it tries to use different mix for footwear production with cheaper raw material. 2. I t also tried to reduce costs through sales and distribution network which is a very huge distribution network. So they continued to invest in expanding retail business. 3. They also tried to generate skilled manpower and cut costs through manpower reduction. 4. They reduced the inventory costs by clearing the existing merchandize by offering discounts. g. What decisions are being taken using management accounting information? 1. Decision to reposition:Bata earlier concentrated only on manufacturing footwear and selling them anyhow but in recent times it has changed its image of the production oriented company to affordable, market driven, fashion conscious, lifestyle brand and hence the decision to reposition. 2. Decision to produce based on logistics and demand: To optimise the utilisation of production facilities the logistics team focuses on obtaining orders from the market for the best selling designs and sizes and ensures that all raw materials are available in the factories we ll in time so that the Company can produce and place in shops the products that consumers want.Thus the Company has been focusing on consumers and market demand which will reduce inventories and improve sales-to-stock turnover. 3. Training and restructuring the frontline sales force: The Company has reorganized its front line sales force. It has undertaken an intensive training programme for its shop assistants and managers to ensure excellence in service to customers. It has also undertaken a rural marketing thrust wherein its reach is rapidly growing. It is recruiting managers with fresh ideas to inspire and empower the workforce with the requisite skills. . Bata uses technology like installation of point of sale management information system to keep an update about the inventory level, sale figure etc. 5. Bata also adopted the cost cutting strategy through use of different mix of raw materials for footwear production and also through sales and distribution but without any comprom ise on the style, quality and design of the product as it endeavours to break the myth of price factor by producing economy range of good quality and stylish products.RECOMMENDATIONS: ) The main recommendation we can give Bata is to repositioning itself. In India we still believe that Bata is just a company which produces footwear for school goers, office goers and regular use footwear like slippers and snickers. Bata is still trying to change its image of production oriented company to affordable, market driven, fashion conscious, lifestyle brand. Today they have a huge shoe line with a huge range of new designs on offer. To name a few they are Marie Claire, Weinbrenner, North Star, Power, Hush Puppies, Dr.Scholls, Ambassador, Bubblegummer etc but only a few segment of people know about this. So Bata must back their campaign through TVC’s, print media and word of mouth. 2) According to the survey conducted by Bata in African continent it was observed that people were not wea ring shoes at all. This means that there is a high scope of marketing shoes in African continent as no one has shoes. References: www. bata. in www. wikinvest. com www. moneycontrol. com www. inrnews. com www. scribd. com

Databases Essays - Database Management Systems, Data Management

Databases Essays - Database Management Systems, Data Management Databases The Many Faces of Databases Large databases can contain hundreds of interrelated files. Fortunately a database management system can shield users from the complex inner workings of the system, providing them with only the information and commands they need to get their jobs done. In fact, a well-designed database puts on different faces for different classes of users. Downsizing and Decentralizing The earliest file management programs could only do batch processing, which required users to accumulate transactions and feed them into computers in large batches. These batch systems weren't able to provide the kind of immediate feedback we expect today. Today disk drives, inexpensive memory, and sophisticated software have allowed interactive processing to replace batch processing for most applications. Users can now interact with data through terminals, viewing and changing values in real time. Batch processing is still used for printing periodic bills, invoices, and reports and for making backup copies of data files. But for applications that demand immediacy, such as airline reservations, banking transactions, and the like, interactive, multiuser database systems have taken over. Until recently most databases were housed in mainframe computers. But for a growing number of organizations, the traditional centralized database on a mainframe system is no longer the norm. Some companies use a client/server approach: Database software in client desktop computers works with files stored in central server databases on mainframes, minicomputers, or desktop computers. Other companies use distributed databases that use data strewn out across networks on several different computers. From the user's point of view, the differences between these approaches may not be apparent. Tomorrow's Databases? Many computer scientists believe that the relational data model may be supplanted in the next decade by an object-oriented data model, and that most future databases will be object-oriented databases rather than relational databases. Instead of storing records in tables and hierarchies, object-oriented databases store software objects that contain procedures (or instructions) along with data. Object-oriented databases often are used in conjunction with object-oriented programming languages. Tomorrow's databases will be able to respond intelligently to commands and queries issued in natural human language. Rules of Thumb: Dealing with Databases A few common-sense rules when working with file managers or relational database management systems are: o Choose the right tool for the job. o Think about how you'll get the information out before you put it in. o Start with a plan, and be prepared to change it. o Make your data consistent. o Databases are only as good as their data. o Query with care. o If at first you don't succeed, try another approach. NO SECRETS: COMPUTERS AND PRIVACY The Privacy Problem Businesses and government agencies spend billions of dollars every year to collect and exchange information about you and me. For most of us this data is out of sight and out of mind. But every day lives are changed because of these databases. Big Brother and Big Business With modern networked computers it's easy to compile profiles by combining information from different database files. When files share a unique field, record matching is trivial and quick. Sometimes the results are clearly beneficial. But these benefits come with at least three problems: o Data errors are common. o Data can become nearly immortal. o Data isn't secure. Protection against invasion of privacy is not explicitly guaranteed by the U.S. Constitution. Legal scholars agree that the right to privacy-freedom from interference into the private sphere of a person's affairs-is implied by other constitutional guarantees, although debates rage about exactly what this means. Federal and state laws provide various forms of privacy protection, but most of those laws were written years ago. When it comes to privacy violation, technology is far ahead of the law. Rules of Thumb: Your Private Rights Here are a few tips for protecting your right to privacy: o Your Social Security number is yours; don't give it away. o Don't give away information about yourself. o Say no to direct mail and phone solicitations. o To maximize your privacy, minimize your profile. o If you think there's incorrect or damaging information about you in a file, find out. o Support organizations that fight for privacy rights.

Poetry Explication Essay Example | Topics and Well Written Essays - 750 words

Poetry Explication - Essay Example This means that the other half was inside the water. In the human world, the fish is an alien organism, while in the water, the fish is at home. To the fisherwoman, the fish is unpleasant organism, and it is weak (Bishop, 1983). It is therefore a victim of humanity, and it is vulnerable to the whims of the mankind. This paper analyzes the use of symbolism in the poem. This is because the entire poem is full of symbolism, which is used to explain the relationship that exists between man and the aquatic world. The poem by Elizabeth Bishop is not organized into stanza, but it is written in a prose form. It is kind of a narration that a fisherwoman gives on her experiences when she was out fishing. This poem is not rhythmic in nature, and the words used are easy to understand. This is even though there is a lot of symbolism and stylistic devices in it (Bishop, 1983). Furthermore, the poem is very descriptive in nature. The narrator of the poem manages to describe how the fish looked like, and the emotions that she felt towards the fish. She felt pity, and this is because the â€Å"Fish† was weak and vulnerable to human activities. There are numerous stylistic devices used in this poetry, and an important one is symbolism. The description that the speaker describes the â€Å"Fish† resembles as if it is dead, rather than alive (Bishop, 1983). Furthermore, the fact that the aquatic animal is caught means that death is imminent. For instance, the narrator denotes that the stripes of the Fish brown skin looked like an ancient wall paper, and the patterns of these wall papers were lost through the ages (Bishop, 1983). Furthermore, the narrator denotes that the Fish is bespeckled, and it is covered with white sea lice. This is a symbol of death. In symbolizing death, the narrator further denotes that the Fish is covered in rags of green weed. The narrator was

Staffing Handbook Case Study Example | Topics and Well Written Essays - 2500 words

Staffing Handbook - Case Study Example R&W Barbers Human Resource Department regularly reviews job titles and job descriptions for the positions we have available. This gives a more accurate account of the expectations we have for our associates. Position Duties: Duties include but are not limited to, giving up to date haircuts, classic razor shaves, scheduling appointments, making business contacts, and other added duties required to maintain a proper work environment. When we can, R&W strives to hire from within. When hiring in house, people have prior knowledge of the expectations of the company and what our standards are. It also promotes a culture of team work and loyalty. Standard barber/hair stylist position open. Must perform haircuts and shaves, make appointments, and other duties needed to perform tasks. Must have required qualifications in cosmetology and one year prior experience. If the position is not filled within a sufficient amount of time, up to 7 days or no more than 14, the job will be posted on our website for the public to view. The public post is similar to the internal post. The exception would be education, training, and experience requirements will be specified in detail. Any and all applications will be posted for managers to review, through the company intranet. All applications have a disclaimer stating that the information provided is truthful. It also contains a signature and date line. While the applications are online, they will be printed and signed at the time of hire. Applications are a type of legal form, treat them as such. R&W Barbers utilizes our website to collect and store applications. Applications, through this online process, automatically verify that the forms are complete. Completed applications are then open for managers to review. Applications will be printed and signed when an applicant is hired. This form is to be stored in the employee’s file. Again, an application is a legal form.

An experiential Assignment Example | Topics and Well Written Essays - 250 words

An experiential - Assignment Example Apparently, I perceive my community as an important ‘sum’ to look at or respond to and in return, it also collects to itself from our individual ideas that share similar attributes and become responsible for the identity of our common sphere and necessary law which everyone is drawn to follow in the course of nature despite diversity in lifestyles we possess. In this regard, I can thus envision a future role in contributing to enhance the aspect of communication for the community in order that one’s insights and feelings are conveyed properly in the light of truth from which to recognize the real value of a member according to stable measures. For me, communication is amply indispensable that it makes me consider being designated in a teaching profession whereby I attain to the capacity of educating the youth with knowledge that is not only rich in colorful literature and good vocabulary, but even with values and application of the literary lessons yielded in the process to create inspiration for the rest of humanity to act righteously and joyfully at the same time. I believe that, in this manner, every motivation and learning spread via effective communication of wisdom taught would, with much certainty, improve the status of our community in the hope of advancing to a higher level of economic and social

Haemolytic Disease of the Fetus and Newborn (HDFN)

Haemolytic Disease of the Fetus and Newborn (HDFN) List and briefly describe three clinical signs for Haemolytic Disease of the Fetus and Newborn (HDFN) Haemolytic disease of the fetus and newborn (HDFN) is a rare disease that occurs when maternal alloantibodies cross the placenta during pregnancy and cause the destruction of fetal red blood cells (RBCs) (Delaney and Matthews, 2015; Haas et al., 2015). HDFN can result in fetal anaemia with progression to severe morbidities, such as ascites, hydrops fetalis, heart failure, kernicterus, and death (Delaney and Matthews, 2015). The clinical presentation of HDFN is variable, in which there are several manifestations that may occur (Murray and Roberts, 2007). Three of the most prevalent clinical signs that allows for neonatal paediatricians to suspect HDFN includes splenomegaly, oedema, and jaundice. HDFN is characterised by the accelerated destruction of RBCs, which results in differing rates of haemolysis and fetal anaemia (Urbaniak and Greiss, 2000). The continuous and rapid process of haemolysis causes extramedullary haematopoiesis, a result of erythropoiesis failing in the bone marrow, in the fetal liver and spleen (Dean, 2005). Organs, such as the liver and spleen, that are involved in the synthesis of RBCs increase the production to combat the rate of destruction and counteract the overall loss (Dean, 2005). The increased workload of the spleen results in its enlargement, termed splenomegaly (Bowman, 1997; Dunn, 1963).          Oedema is an important clinical sign of HDFN that is also associated with the degree of haemolysis and anaemia (Delaney and Matthews, 2015). Oedema can occur due to low levels of serum albumin through a decrease in osmotic pressure (Dean, 2005). Moreover, as the body compensates for fetal anaemia, the fetus can develop a hyperdynamic circulation (Haas et al., 2015). This can result in hydrops fetalis, a severe and life-threatening condition in which there is widespread oedema in the fetal and skin and serous cavities (Haas et al., 2015). A further clinical sign of HDFN is jaundice. Jaunice may occur as a result of haemolysis, in which there is an increase in the level of bilirubin within the body (Urbaniak and Greiss, 2000). Throughout pregnancy, bilirubin is removed via the maternal circulation by the placenta (Dean, 2005). Therefore, a high level of haemolysis may be present with a low level of bilirubin (Murray and Roberts, 2007). However, after birth the haemolytic process continues. At this stage of development, the liver of the neonate is immature and unable to conjugate the excess bilirubin (Urbaniak and Greiss, 2000). The unconjugated bilirubin begins to build and accumulate in the blood of the neonate, causing the skin and whites of the eyes to turn yellow (Dean, 2005). Within 24 to 48 hours after delivery, the level of bilirubin may increase substantially (Urbaniak and Greiss, 2000). Left untreated, this can lead to the development of kernicterus, a condition in which bilirubin deposits form in the basal ga nglia and brain stem nuclei (Haas et al., 2015). Describe the progression of HDFN, from sensitisation to fetal red cell destruction, in a D negative mother carrying a D positive fetus that has not received RhIg. Throughout pregnancy, antibodies from the maternal circulation play a vital role in providing protection for neonates; crossing the placenta from the maternal to the fetal circulation (Dean, 2005). This is essential for the fetus, as by delivery newborns have a relatively immature immune system (Murray and Roberts, 2007). Although the presence of maternal antibodies provides protection, the active transporting of antibodies across the placenta can result in HDFN (Dean, 2005). HDFN is triggered by a sensitisation event. This most often occurs during the first pregnancy; however, it can also arise from a blood transfusion or organ transplant (Delaney and Matthews, 2015). During the course of pregnancy, the maternal and fetal circulations gradually mix with each trimester (Delaney and Matthews, 2015). This results in maternal alloimmunisation, as the maternal circulation has been exposed to foreign RBCs (Haas et al., 2015). Despite the relatively small amount of fetal blood that passes into the maternal circulation, only a small amount is needed for sensitisation to occur (Dean, 2005). This is typical for an RhD negative mother carrying an RhD positive fetus. Sensitisation frequently transpires during the birth of the firstborn RhD positive child, where fetal maternal haemorrhage (FMH) is common (Delaney and Matthews, 2015). However, the risk of sensitisation increases in complicated and extensive labours (Dean, 2005). Sensitisation can also occur through earlier  events in pregnancy, such as a prenatal bleed, trauma, termination of pregnancy, chronic villus sampling, and miscarriage (Sebring and Polesky, 1990). The greatest risk of developing FMH is during the process of labour (Murray and Roberts, 2007). Subsequently, alloantibodies are most likely to form after delivery (Delaney and Matthews, 2015). After sensitisation of an RhD negative mother carrying an RhD positive fetus, the mothers serum will contain anti-D (Dean, 2005). Importantly, the maternal anti-D that is formed is of the IgM class and unable to effectively cross the placenta (Delaney and Matthews, 2015). As a result, HDFN is rare in first-born children and unlikely to have any clinical consequence or significance (Dean, 2005). However, once the maternal circulation has been exposed to the fetal circulation the maternal immune system has the potential to respond to foreign red cell antigens (Delaney and Matthews, 2015). Through extensive research and cohort studies, it has been established that HDFN is most likely to effect subsequent pregnancies (Dean, 2005). Maternal alloantibodies of the IgG1 and IgG class cause significant haemolysis, thus the most clinically significant forms of HDFN (Roberts, 2008). In the event that an RhD negative mother becomes pregnant for a second time, interaction with the RhD antigen stimulates the production of IgG type anti-D, which can be transported across the placenta into the fetal circulation (Delaney and Matthews, 2015). Once anti-D has entered the fetal circulation, it binds to the RhD antigens found on fetal RBCs and labels them to be destroyed (Delaney and Matthews, 2015). From here, the pathophysiology of the disease ensues, as illustrated in figure 4. Explain the action of RhIg in a D negative mother that has a D positive fetal bleed. Rh immunoglobulin (RhIg) is routinely used in clinical practice to prevent HDFN. RhIg is prepared from human plasma that has been immunised to the D antigen and functions by targeting RBCs that are positive for the D antigen (Brinc and Lazarus, 2009). The use of prophylactic anti-D remains the gold standard approach of antibody-mediated immunosuppression, having been used for several decades (Giancarlo et al., 2010). However, the mechanism of action of RhIg is not fully understood and there are three key hypotheses that have been proposed to explain its method of action. Antigen Clearance Hypothesis The first hypothesis is the antigen clearance hypothesis and is considered the main mechanism of action. Here, IgG is understood to prevent an antibody response by increasing the rate of phagocytosis and the removal of RBCs from circulation via the mononuclear phagocytic system, prior to recognition by the immune system (Brinc and Lazarus, 2009). IgG opsonised RBCs are believed to engage in the activation of IgG receptors (FcÃŽÂ ³Rs) on effector cells, stimulating phagocytosis. IgG is also suspected to increase the clearance of RBCs through the stimulation of complement activation on the RBC surface. Anti-D does not activate complement and therefore it is believed that FcÃŽÂ ³R-mediated phagocytosis is the mechanism by which anti-D is cleared (Brinc and Lazarus, 2009). FcÃŽÂ ³RIIB mediated B-cell inhibition hypothesis This mechanism is the most recently proposed and came about through the discovery of increased levels of transforming growth factor-ÃŽÂ ² and prostaglandin E2 in a number of pregnant women who were given RhIG. This mechanism proposes that RBCs and IgG form a complex in which a negative signal is delivered to inactivate antigen-specific B cells. However, mice models deficient in FcÃŽÂ ³RIIBhave shown that the involvement of FcÃŽÂ ³RIIB is not needed to induce antibody-mediated immune suppression. Furthermore, FcR-like molecules have been discovered in both mice and humans. It is believed that the FCRLs mediate the B-cell inhibition, however, this has yet to be demonstrated (Brinc and Lazarus, 2009). Steric Hindrance Hypothesis The Steric hindrance hypothesis proposes IgG binds the antigen, preventing the B-cell receptor from recognising the corresponding epitopes. Most anti-D epitopes are not blocked by RhIg. This allows free D epitopes to be detected after administration of RhIg. Monoclonal anti-D has been shown to prevent antibody responses by binding 10-15% of epitopes. This pathway has not been studied in detail and therefore knowledge of the immunobiology is limited. However, it is believed that IgG binding of D epitopes allows a formation between RBCs and B cells, in which this prevents B-cell activation (Brinc and Lazarus, 2009). The established methodology in the UK for the Quantification of a D positive fetal bleed is via flow cytometry with FITC-anti-D (FITC-BRAD3). Name and describe 3 alternative methods used worldwide to detect fetal bleeds In addition to the use of flow cytometry, several alternative screening methods are available to determine and quantify FMH (Kim and Makar, 2011). Three screening methods that are used worldwide include the rosette screen, Kleihauer-Betke acid elution test, and flow cytometry using anti-fetal haemoglobin antibodies. The rosette test is a screening method that is used to qualitatively detect fetal bleeds equal to or greater than 10 mL and 0.2% of fetal cells present in the maternal circulation (Kim and Makar, 2011). The rosette test works by indirectly identifying the presence of D positive fetal RBCs in D negative mothers (Solomonia et al., 2012). To perform this test, a maternal blood sample is collected, incubated with exogenous anti-D, and washed. D positive RBCs are added and are key as they act as an indicator. The sample is examined using a light microscope. In the presence of fetal D positive cells, the indicator RBCs form aggregates or rosettes around the coated fetal RBCs (Solomonia et al., 2012). A positive result is indicative of an FMH greater than 10 mL and requires quantification by Kleihauer-Betke acid elution test or flow cytometry to determine the dose of RhIg to administer (Kim and Makar, 2011). This test can encounter and produce false-positive results. This largely occurs if the mother of fetus is weak D. Furthermore, in the presence of a direct antiglobulin test (DAT), the rosette test may produce a false-negative result. This can be attributed to crosslinking and agglutination of the mothers antibody coated cells (Kim and Makar, 2011). The Kleihauer-Betke acid elution test is a screening method that differentiates between fetal haemoglobin (HbF) RBCs and adult Hb (Bromilow and Duguid, 1997). The underlying notion of this test is fetal RBCs largely contain HbF and are resistant to acid elution, whereas in contrast, adult Hb is acid-sensitive (Kim and Makar, 2011). To perform this test, a maternal blood sample is taken to prepare a thin peripheral smear. The peripheral smear is dried, immersed in fixative, exposed to and incubated with an acid buffer, and stained with eosin. Under a microscope, the test reveals fetal cells to be stained a dark pink-red colour, whilst adult red cells appear pale or as uncoloured ghost outlines (Kim and Makar, 2011). Under a microscope, the fetal cells are counted and reported as a percentage of adult cells (Kim and Makar, 2011). Flow cytometry using anti-fetal haemoglobin antibodies is a variant of flow cytometry that detects RhD positive fetal cells (Kim and Makar, 2011). In this method, monoclonal antibodies are directed against HbF (Davis, 2007). A maternal blood sample is collected and an RBC count is performed (Davis, 2007). Cells are then fixed and permeabilised with detergent to enable antibodies to enter the cellular membrane and bind HbF (Davis, 2007). A flow cytometer is used to analysed the antibody stained cells (Davis, 2007). This method uses positive and negative controls simultaneously to differentiation between fluorescence from fetal RBCs and non-specific background staining (Kim and Makar, 2011). The positive control is also highly important in setting out the parameters for gating a sample (Kim and Makar, 2011). Rosette test Kleihauer-Betke acid elution test Flow cytometry using anti-fetal haemoglobin antibodies Advantages: Commercial kits Widley available Simple to use Fast Inexpensive Advantages: Not dependent on presence of RhD antigen Requires only basic laboratory equipment Inexpensive Can be used to assess fetal welfare in RhD positive patients Advantages: Quantitative Automated good precisions, sensitivity, accuracy, and reproducibility Cost-effective Less labour intense Disadvantages: Only applicable to RhD negative mothers carrying RhD positive fetus Qualitative only not quantitative Disadvantages: Laborious to perform Accuracy and precision limited due to variation in test characteristics Poor reproducibility Subjective Disadvantages: If mother and fetus have the same RhD type or mother is RhD positive cannot be used to determine FMH False positives due to hereditary persistence of fetal Hb, increased levels of Hb in pregnancy and certain disease states a) A >2mL bleed is detected via acid elution test in a sample taken from a D negative mother. Quantification via anti-D flow cytometry results in a zero bleed. Explain two possible reasons for the opposing results. The differing results of the acid elution test and anti-D flow cytometry may be explained by the RhD status of the mother and fetus. If the mother is not RhD negative and is carrying an RhD positive fetus, this test would not reproduce the results of the acid elution test. Additionally, if the fetus has an RhD negative status, this would also cause the test to fail and detect a zero bleed. Furthermore, flow cytometry cannot accurately detect weak and partial D variants, resulting in a false negative result. Therefore, if the mother or fetus has either of these D variants, FMH would not be detected via flow cytometry. An alternative reason for the differing results between the two tests could be attributed to haemoglobinopathies, in which the flow cytometer detects HbF. Lastly, there could be a mistake in the tube, such that the antibody was not detected, causing an incorrect result. b) Suggest a suitable test alternative to those already conducted to investigate the sample further and explain your reasoning for the alternative test. The use of flow cytometry using anti-fetal haemoglobin antibodies would be a beneficial test to implement in order to clarify the results and detect if a bleed is present. This is important to ensure the appropriate and correct dose of RhIg is administered. Testing the sample using HbF flow cytometry would be useful as flow cytometry using anti-D failed to reproduce the results of the acid elution test. There is a possibility that the acid-elution test produced a false positive result. The acid-elution test is limited in that is has poor accuracy and is prone to variations. The false positive may arise as a result of adult hereditary persistence of HbF, which is known in 1 to 2% of the population. Furthermore, during pregnancy the level of HbF rises by 25%. Therefore, the use of HbF flow cytometry would be able to detect if this is what caused the result. The following bleeds were detected via anti-D flow cytometry in a D negative woman. Using the Mollison calculation work out: The bleed volume in mL The total RhIg dose in each case to the nearest 500 IU The top up RhIg dose required in each case to the nearest 500 IU The Mollison calculation is used to calculate the volume of bleed. To do this, the background of the isotope matched control is subtracted from the number of events obtained in the D positive region, as recommended in the BCSH guidelines. The Mollison equation is as follows: D (+) events D (-) events1800FMH = X -ml X 1.22 Total number of events 1 The equation can be simplified to the following: FMH = % of D positive events x 18 x 1.22 0.81% x 18 x 1.22 = 17.79 mL 18 ml bleed* = 18 x 125 = 2250 IU Rounded to nearest 500 = 2500 IU 2500 IU 500 IU = 2000 IU 0.45 x 18 x 1.22 = 9.88 mL 10 mL bleed = 10 x 125 = 1250 IU Rounded to nearest 500 = 1500 IU 1500 IU 500 IU = 1000 IU 0.091 x 18 x 1.22 = 1.99 mL 2 mL bleed = 2 x 125 = 250 IU Rounded to nearest 500 = 500 IU 500 IU 500 IU = 0 IU This bleed is under 4 mL and therefore no top up is required as 500 IU is routinely administered for a bleed of up to 4 mL. 1.09 x 18 x 1.22 = 23.94 mL 24 mL bleed = 24 x 125 = 3000 IU Rounded to nearest 500 = 3500 IU 3500 IU 500 IU = 3000 IU 0.02 x 18 x 1.2 = 0.43 1 mL bleed = 1 x 125 = 125 IU Rounded to nearest 500 = 500 IU 500 IU 500 IU = 0 IU This bleed is under 4 mL and therefore no top up is required as 500 IU is routinely administered for a bleed of up to 4 mL. References Brinc, D. and Lazarus, A. (2009). Mechanisms of anti-D action in the prevention of hemolytic disease of the fetus and newborn. Hematology, [online] 2009(1), pp.185-191. Available at: http://asheducationbook.hematologylibrary.org/content/2009/1/185.long [Accessed 6 Mar. 2017]. de Haas, M., Thurik, F., Koelewijn, J. and van der Schoot, C. (2015). Haemolytic disease of the fetus and newborn. Vox Sanguinis, [online] 109(2), pp.99-113. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25899660 [Accessed 6 Mar. 2017]. Dean, L. (2005). Blood groups and red cell antigens. 1st ed. [Bethesda, Md.]: NCBI. Delaney, M. and Matthews, D. (2015). Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn. Hematology, [online] 2015(1), pp.146-151. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26637714 [Accessed 6 Mar. 2017]. Giancarlo Maria Liumbruno, Angelo DAlessandro, Federica Rea, Vanessa Piccinini, Liviana Catalano, Gabriele Calizzani, Simonetta Pupella, Giuliano Grazzini (2010). Blood Transfus. 2010 Jan; 8(1): 8-16. doi: 10.2450/2009.0108-09 Kim, Y. and Makar, R. (2012). Detection of fetomaternal hemorrhage. American Journal of Hematology, [online] 87(4), pp.417-423. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22231030 [Accessed 6 Mar. 2017]. Murray, N. and Roberts, I. (2007). Haemolytic disease of the newborn. Archives of Disease in Childhood Fetal and Neonatal Edition, [online] 92(2), pp.F83-F88. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2675453/ [Accessed 6 Mar. 2017]. Roberts, I. (2008). The changing face of haemolytic disease of the newborn. Early Human Development, [online] 84(8), pp.515-523. Available at: https://www.ncbi.nlm.nih.gov/pubmed/18621490 [Accessed 6 Mar. 2017]. Urbaniak, S. and Greiss, M. (2000). RhD haemolytic disease of the fetus and the newborn. Blood Reviews, [online] 14(1), pp.44-61. Available at: https://www.ncbi.nlm.nih.gov/pubmed/10805260 [Accessed 6 Mar. 2017].      Ã‚  

Playing the Character John from Blue Remembered Hills :: Blue Hills Remembered Danile Potter Plays Essays

Playing the Character John from Blue Remembered Hills The group, consisting of John, Audrey, Angela, Willie and Raymond; have heard a bomb siren going off from the nearby prison camp. They know that this means danger and as they are in the woods, they cant go anywhere for cover and start to worry about one of the prisoners, or â€Å"Ities† and â€Å"Wops† as they call them, having escaped. They decide to keep an eye out for any dangers but all the talk of these â€Å"Ities† had got them just frightening each other even more. Raymond hears a sudden noise and the threat sends them running for cover in the long grass, huddling together as a group. After a while, they find out that the disturbing noise was in fact their friend, Peter, running through the woods towards them because of the sirens. Having left Angela’s pram behind, John and Peter decide to go looking for it; and this is where the scene ends. When we first see the group in this scene, they are all huddled together in the cover of the long grass. John reassures the rest of the group that this is a safe place to hide. (unsure) â€Å"Him wont find us down here† â€Å"This is nice and safe. Ennit?† John is slightly unsure of just how safe they are and in both quotes he is not only reassuring the group but also himself. I would say the first quote with confidence and while looking through the grass. The second line would be said in a lower pitch of voice as he is not as confident and say â€Å"Ennit?† as in an agreeable way and not in an asking way; even though John is adding this as if asking for support. â€Å"Did – did you see him?† I would say the first â€Å"did† in a nervous way but then adjust my voice to sound more confident in the rest of the sentence emphasizing the â€Å"see† as it is in italics. I think the reason the writer did this was because John wants to seem braver than he really is, but when he asks this question, he wants to know if there actually is a threat before he appears too nervous. â€Å"They’ll have the guards out after him. They’ll soon catch him.† Again, here John is reassuring himself by reassuring the group. When Audrey states, that shooting the escapee is a â€Å"Good job†, she shows just how confident she is and how little fear she has compared to the rest of the group. Angela soon starts to worry about the pram, which is obviously precious to her; John states that it will be fine where it is.