What is a Double-Blind Study

What is a Double-Blind Study At some point or another in our lives, everyone has needed for a certain medicine. Is it a headache? Here, pop an Aspirin! Do you have bad digestion?An antacid! An antibiotic for your infection, and so on.Hopefully, fewer people had more severe medical issues that required more aggressive treatment immunosuppressants, cancer drugs, chemotherapy, and so many others.But when you just take the medicine that the doctor prescribed, has it ever crossed your mind to wonder how did a pharmaceutical company came to a conclusion that that specific medicine works for that specific ailment?Another thing that comes to mind is: why do doctors say that you should not use medicine X anymore, but that you should start to use medicine Y because it is better i.e. it has fewer side effects, it works quicker, it works better.How do they know?Well, it is obvious that they did not just randomly decide that.Recommendations of the kind are a product of a carefully conducted process that starts with the cre ation of the new medicine that may include biotechnology, testing it in a lab and later on animals, after that comes the time for human testing, and finally, putting it out to be purchased off the counter or prescribed by a doctor.In this text, we will focus on the third part of drug testing and that is human testing.We will answer questions on how the studies/trials are conducted, what the types of studies are, are they ethical and so on.WHAT IS A CLINICAL TRIAL?A clinical trial is conducted when there is a potentially better, new drug or treatment for a specific ailment or disease.It is usually the case with rare or difficult diseases or diseases that still do not have a treatment that works e.g. Alzheimers.The trials also happen for cancer treatments, or any other condition people might develop to be it physical or psychological.Clinical trials may observe the effects of the drug, the side effects, and behavioral changes. They are conducted with the advancement of medicine, and p eoples overall wellbeing in mind.For a clinical trial to be conducted in a way that gives significant and valid results, participants have to be chosen according to particular criteria that relate to the object of the clinical trial.For example, if a new Alzheimers drug is being tested- a participant firstly has to have the disease, then they have to be at a preferred stage of the disease (e.g. starting to show symptoms, but the disease is not too far gone).To determine whether a patient qualifies for the trial there is the participant screening process that is used as the baseline for potential improvement and data collection.The participants, if they qualify, are then informed about the possible benefits, risks, outcomes and so on, and are required to sign an informed consent stating that they have understood all that will be happening during the trial.If a person participating in a study is not able to make their own decisions, their medical proxy signs the informed consent.If yo u have or know somebody who has a condition that might be improved by participating in a clinical trial, you should know that participants are randomly chosen, although the participation has to be voluntary.The doctor may mention that a study is available, and you can choose to participate.Patients choose to participate because they want to potentially be one of the first people to ever receive treatment for a condition.In such a way they are actively contributing to the development of medicine, and without volunteers who are open to such participation, medical advancement would be thwarted.TYPES OF CLINICAL TRIALSThere are various ways in which a clinical trial may be conducted and they are called study designs. In this text, we will focus on randomized trials and their subtypes. Source: anzmtg.org The way in which you can conduct a randomized study is the blind studies.In blind studies either the participants or the medical team along with the participants are not aware of the fact whether they have received the treatment which is being tested or not.i. Single-Blind StudyIn a single-blind study, the medical team knows which group has gotten medication that is being tested, but the participants do not know that.It is used in treatments where patients bias can affect the results of the trials.The issue with a single-blind study is that, since they have all the information, the medical teams bias can harm the research.They can subconsciously pay more attention to the subjects receiving the treatments as opposed to those who are not. This is avoided with a double-blind study.ii. Double-Blind StudyIn a double-blind study, neither the medical team nor the participants are aware of the treatment distribution.It is considered a go-to study design for many reasons th at are mainly ethical and psychological, and it ensures the most valid results at the end of the research because both participants and teams bias is eliminated.A double-blind study is also used in many other types of scientific research besides medical research, such as psychological, behavioral, market research and so on. HOW DOES A DOUBLE-BLIND STUDY WORK?First of all, there has to be a sufficient number of study participants.The double blind study happens in the second and third phase of a clinical trial. In the second phase the required number of participants is from 20 to 80.The participants are usually healthy individuals. The data collected in this stage of the trial are usually related to the side effects that the drug may cause i.e. worsening in the subjects; condition.The third stage of the trial is a second double blind study. The number of participants in this stage is usually at least 100, however more preferable one ranges from 100 to 300 participants. The participant s are then randomly divided into 2 groups:The ones who receive the active treatment, new drug, supplement or anything else that could be tested in a trialThe ones who get a placebo or an already standardized medication depending on the type of study Source: prehospitalresearch.euOptionally, there is the third group of participants a.k.a. the control groups whose members do not get any treatment whatsoever but are just used as a baseline.For example, people with depression will naturally show improvement after some time that cannot be contributed to the effects of the medicine given in a trial which tests the new antidepressant.Let us say here how important it is to understand depression, and to seek help where needed.The difference between the improvements between groups with treatment (both actual medicine and placebo) is compared to the improvements of the control group and they show the actual effects of the new antidepressant.In many cases, the placebo group can be considered the control group.For example, if a new cancer drug is being tested, the control group will get standard treatment, and the other group of participants will get the new drug.This type of a blind-study is called comparative blind study (as opposed to pla cebo-controlled study) as the premise is that you compare the effects and side effects of an old drug that is already in use to the (side) effects of a new one.Having a third group of cancer patients as a control group here would be extremely unethical as they would be deprived of a medicine.On the other hand, if, for example, you are testing a new supplement that is supposed to, say, improve athletic performance, then it will be completely okay to use three groups of participants and observe the effects of both the supplement and the placebo.For the study to be correct, all three groups would have to be on the same workout regime, sleep management, and diet. So the study would look like this:Group one: training + supplementGroup two: training + placeboGroup three: trainingAfter the two blind studies, if the effects of the substance are proven beneficial, the FDA approves its use and allows it to be used.The effects and side effects are still followed, although in a non-controlled e nvironment, on a larger number of people (3000+) and over a longer period of time.EXPERIMENT EFFECTFor any type of blind study to give valid results, participants have to be unaware of whether they have received a placebo or an active substance that is being tested.In a double-blind study the team, as was already mentioned, is also unaware of this.This is important as people are highly susceptible to biases which can affect both the patient and the medical staff.It is long known that a patients psychological state and motivation can highly influence the outcome of treatments or interventions the ones with the will to fight the illness have a better success rate than those who lost their hope and have already given up regardless of the fact that they have received the exact same treatment for the exact same (level of) disease.Keeping the participants blind to the information what they have received eliminates both good and bad effects of motivation, and provides the conditions for o bjective results regarding the effects of the substance on trial.On the other hand, there is something called the experimenter effect, the observer-expectancy effect or the Clever Hans effect.The experimenter effect is characterized by the staff working on the trial subconsciously affecting the study rendering it invalid.People are emotional beings so, if included in a trial as a part of the research team, you want the research to succeed either for the pure altruism- you wish to help people, or just because you want to be connected to a medical breakthrough and have a successful career.If a doctor knows which patient got a placebo and which one got an active agent, they might subconsciously ask questions in a manner that will give out that information to the patient, who, again subconsciously picks up the cues that the doctor emits.This psychological effect has been shown on a number of occasions, and it is very interesting to note that even animals can pick up such cues, so why no t people?A doctor may also tend to pay closer attention to the patients on the drug rather than those on placebo.The people involved in collecting and comparing data might, under such biases, overlook the lack of valid data or the negative data, and read into the preferable data too much.In any case, the results of the study are not valid enough to continue with the research knowing that there are real scientific benefits of the medicine.PlaceboThe definition of the placebo is a pharmacologically inert preparation prescribed for the mental relief of the patient, or used especially in controlled experiments testing the efficacy of another substance .   The origin of the word is Latin for I shall please.The placebo can be a sugar pill of the same shape, taste, and size as the actual pill, a saline solution for intravenous infusions such as chemotherapy, or any other form which corresponds to the active substance.The reason behind it is that a patient should not be able to deduce that they may get a placebo instead of the active medication.In clinical studies, as well as in life in general, a placebo can have really powerful effects on the human psyche and it is called the placebo effect.The placebo effect is based on the premise that the human brain is capable of convincing the body to heal itself (or harm itself as we will see later in the text).It is about getting real results with fake input. It is already well known that this happens but it is still not understood how this happens.Placebos have been proved to alleviate depression, anxiety, pain, insomnia, improve your mood and sharpen thinking. It is based on the belief that you are taking an actual medication.Here is an example of a placebo in a less serious and formal environment. Namely, in the tv series The Big Bang Theory a character named Raj has a disorder that manifests as his inability to speak to women unless he has had some alcohol.In this scene, he drinks a beer and manages to have a conversation with a girl on the train, only to stop when it is pointed out to him that the beer was a non-alcoholic beer (start at 2:20). However, it is more than just positive thinking and auto-suggestion that make you feel better.There have been studies that show that people still show signs of improvement after they have been informed that what they got was, in fact, a placebo.This improvement is said to come as a consequence of the ritualistic behavior of visiting a doctor and the trust we put in them. It has to do with the expectations we expect to feel better after we consult with a doctor.It is pretty much the same thing as when a mother kisses a childs knee after he has fallen and injured himself.The kiss does not really heal the hurt knee, but the very action and attention that the child receives help him feel better.Even adults sometimes use this as a very open placebo. Remember the origin of the word? I shall please.And even this is not all. It is not only our mental perception but also our physiological reaction to that anticipation, which actually activates immune responses that limit the secretion of damaging stress hormones.Studies have linked the placebo effect with the bodys natural production of pain-relieving endorphins.So the expectation of feeling better, in reality, causes the brain to secrete endorphins that naturally make you feel better.NoceboThe power of thought, however, can work against you, too.The nocebo effect is completely the opposite of the placebo effect, and it is characterized by human brain creating negative effects on the body and the psyche.For example, when you are in a fun park and want to go in a haunted house, your belief that something scary awaits is what actually makes you scared, even though there are just dolls, spider webs and surprises inside. Your body expects something negative and reacts accordingly.Another drastic example is of a butcher who accidentally locked himself in a cold room.He started to panic and caused hi mself to freeze although the cold room was out of order at the time, and the temperature inside was as in any other room in the shop.The nocebo effect in the clinical trials is seen in the manifestation of the drugs side effects. Namely, participants who are given the active agent may feel some side effects, although they are more likely to experience them if they were previously informed about what they may be.If the side effects are not communicated to the participants they are less likely to experience them.Proof of this lays in the fact that a certain percentage of participants on placebo experience the same side effects like the ones on the active agent, even though there is absolutely no physical or physiological reason for the side effects to appear.This could be avoided by keeping the side effects from the participants but that action would not be in ethical or legal accordance with the informed consent. The other issue with the nocebo or the lack of placebo is directly rela ted to how the patients are given the medicine in a double-blind study.The doctor essentially says you may be given a real medicine or you may be given a placebo. You dont know, and I dont know.This action may create doubt and thus, the nocebo effect, not just about the side effects of the medicine but its general effectiveness.BALANCED PLACEBO DESIGNA possible solution for the issues that arise in the double-blind study regarding the placebo and nocebo effects can be solved by implementing the balanced placebo design.This design would consist of four groups of participants two placebo groups and two active agent groups.The effects of the medicine, as well as expectancy, would be more realistically measured because, in this design, the groups are differently informed about what has been given to them. For example placebo:Group 1 is given a placebo and is informed that what they have received is placeboGroup 2 is given placebo and is informed but they have received the active agen tGroup 3 is given the active agent but is informed that they have received placeboGroup 4- is given the active agent and is informed that they have received the active agentSo this is a trial that simultaneously tracks the efficacy of the substance, and the psychological effects of the placebo.Although balanced placebo design provides the solution for the statistical issues that arise and the psychological effects on the drugs success, it is arguable how ethical it is to deliberately misinform the participants on what they are actually getting from the trial.FINAL WORDWith the constant advancement of medicine and the appearance of new drugs for diseases and illnesses that have been a serious problem for many people all over the world, the need for double-blinded studies is ever-present.Thanks to them, and their volunteer participants medical breakthroughs are happening more often in this day in age than ever before.Yes, the risks are great, as great as the benefits, but without tho se risks medical and pharmaceutical progress would be stunted, leaving many people without hope of a cure.Considering ethical, legal and medicinal aspects of a double-blind study, we can say that, although not perfect, it is still the best choice for such a type of research.Well, at least until the technology comes up with ways to test new substances without experimenting on animals and people.

Overview of the Second Opium War

In the mid-1850s, the European powers and the United States sought to renegotiate their commercial treaties with China. This effort was led by the British who sought the opening of all of China to their merchants, an ambassador in Beijing, legalization of the opium trade, and the exemption of imports from tariffs. Unwilling to make further concessions to the West, the Qing government of Emperor Xianfeng refused these requests. Tensions were further heightened on October 8, 1856, when Chinese officials boarded the Hong Kong (then British) registered ship Arrow and removed 12 Chinese crewmen. In response to the Arrow Incident, British diplomats in Canton demanded the release of the prisoners and sought redress. The Chinese refused, stating that Arrow was involved in smuggling and piracy. To aid in dealing with the Chinese, the British contacted France, Russia, and the United States about forming an alliance. The French, angered by the recent execution of missionary August Chapdelaine by the Chinese, joined while the Americans and Russians sent envoys. In Hong Kong, the situation worsened following a failed attempt by the citys Chinese bakers to poison the citys European population. Early Actions In 1857, after dealing with the Indian Mutiny, British forces arrived at Hong Kong. Led by Admiral Sir Michael Seymour and Lord Elgin, they joined with the French under Marshall Gros and then attacked the forts on the Pearl River south of Canton. The governor of Guangdong and Guangxi provinces, Ye Mingchen, ordered his soldiers not to resist and the British easily took control of the forts. Pressing north, the British and French seized Canton after a brief fight and captured Ye Mingchen. Leaving an occupying force at Canton, they sailed north and took the Taku Forts outside Tianjin in May 1858. Treaty of Tianjin With his military already dealing with the Taiping Rebellion, Xianfeng was unable to resist the advancing British and French. Seeking peace, the Chinese negotiated the Treaties of Tianjin. As part of the treaties, the British, French, Americans, and Russians were permitted to install legations in Beijing, ten additional ports would be opened to foreign trade, foreigners would be permitted to travel through the interior, and reparations would be paid to Britain and France. In addition, the Russians signed the separate Treaty of Aigun which gave them coastal land in northern China. Fighting Resumes While the treaties ended the fighting, they were immensely unpopular within Xianfengs government. Shortly after agreeing to the terms, he was persuaded to renege and dispatched Mongolian General Sengge Rinchen to defend the newly returned Taku Forts. The following June hostilities recommenced following Rinchens refusal to allow Admiral Sir James Hope to land troops to escort the new ambassadors to Beijing. While Richen was willing to allow the ambassadors to land elsewhere, he prohibited armed troops to accompany them. On the night of June 24, 1859, British forces cleared the Baihe River of obstacles and the next day Hopes squadron sailed in to bombard the Taku Forts. Meeting heavy resistance from the forts batteries, Hope was ultimately forced to withdrawal with the aid of Commodore Josiah Tattnall, whose ships violated US neutrality to assist the British. When asked why he intervened, Tattnall replied that blood is thicker than water. Stunned by this reversal, the British and French began assembling a large force at Hong Kong. By the summer of 1860, the army numbered 17,700 men (11,000 British, 6,700 French). Sailing with 173 ships, Lord Elgin and General Charles Cousin-Montauban returned to the Tianjin and landed on August 3 near Bei Tang, two miles from the Taku Forts. The forts fell on August 21. Having occupied Tianjin, the Anglo-French army began moving inland towards Beijing. As the enemy host approached, Xianfeng called for peace talks. These stalled following the arrest and torture of British envoy Harry Parkes and his party. On September 18, Rinchen attacked the invaders near Zhangjiawan but was repelled. As the British and French entered the Beijing suburbs, Rinchen made his final stand at Baliqiao. Mustering over 30,000 men, Rinchen launched several frontal assaults on the Anglo-French positions and was repulsed, destroying his army in the process. The way now open, Lord Elgin and Cousin-Montauban entered Beijing on October 6. With the army gone, Xianfeng fled the capital, leaving Prince Gong to negotiate peace. While in the city, British and French troops looted the Old Summer Palace and freed Western prisoners. Lord Elgin considered burning the Forbidden City as punishment for Chinese use of kidnapping and torture, but was talked into burning the Old Summer Palace instead by other diplomats. Aftermath In the following days, Prince Gong met with the Western diplomats and accepted the Convention of Peking. By the terms of the convention, the Chinese were forced to accept the validity of the Treaties of Tianjin, cede part of Kowloon to Britain, open Tianjin as a trade port, allow religious freedom, legalize the opium trade, and pay reparations to Britain and France. Though not a belligerent, Russia took advantage of Chinas weakness and concluded the Supplementary Treaty of Peking which ceded approximately 400,000 square miles of territory to St. Petersburg. The defeat of its military by a much smaller Western army showed the weakness of the Qing Dynasty and began a new age of imperialism in China. Domestically, this, coupled with the flight of the emperor and the burning of the Old Summer Palace, greatly damaged the Qings prestige leading many within China to begin questioning the governments effectiveness. Sources http://www.victorianweb.org/history/empire/opiumwars/opiumwars1.html http://www.state.gov/r/pa/ho/time/dwe/82012.htm

Formal Speech Formal Meeting - 1491 Words

FORMAL MEETING GUIDE U.S. 11648 Submitted By MAYANK TIMBADIYA BL5-14074758B Submitted to ANIKA VATS Vats.anika30@gmail.com CONTENTS INTRODUCTION 1 THE MARAE 1 MEETING IN MAORI –MAORI HUI 1 1. A TYPICAL AGENDA 1 2. THE PROCESS AND ANY REGULATIONS TO BE FOLLOWED AT A HUI 2 3. RECORDS REQUIREMENT OF HUI MEETING 2 COMPANY SHAREHOLDER MEETING- NEW ZEALAND CULTURE 3 1. RULES AND REGULATIONS OF MEETING 3 2. AGENDA 4 3. MEETING PROCESS 4 4. RECORD OF MEETING 4 GLOSSARY 5 BIBLIOGRAPHY 6 Introduction The Marae is the place where Maori people can gather to discuss and debate, to celebrate, meetings or functions. This document tells us about meeting. In this document, I mention two different types of meetings organized by different cultures such as Maori culture and New Zealand culture. Before starting to read this document, it becomes very important to know about meeting. Meeting: A meeting is a gathering of persons convened to transact business, discussion matters of note or act in a matter of common interest. Meeting is an assembly of people for a particular purpose, especially for formal discussion. The Marae Hui Maori is another instance of a meeting. Meeting of Maori culture is known as â€Å"The Marae†. The Marae is totally central to the Maori approach of life; it is a concentration for teams WHO share kinship, whanau, hapu, iwi. Here they meet discussion and debate, to celebrate, to welcome the living and bid farewell to those who have passed on.The Marae, holy openShow MoreRelatedCommunication in Health and Social Care1156 Words   |  5 Pagesexpression between two or more people. It includes individuals conversing with each other, be it direct conversation or telephonic conversation. Speeches, presentations, discussions are all forms of verbal communication. 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Could be formal, informal - one-to-one, group of people. could be verbal or non-verbal. 1. one-to-one 2. group of communication 3 formal communication 4. posture 5. eye contact. 2A.P1 Communication is a process of sending and receiving message between two or more people in order to achieve a desired action or effect. communicationRead MoreFormal and Informal Meetings, An Outline Essay1075 Words   |  5 Pages1. Formal meetings: Meetings can be formal or informal. Formal meetings are pre-planned which required two or more people who have assembled for the purpose of achieving a common goal through verbal interaction. 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Your goal as a speaker should be not to intimidateRead MoreCulture And Values Of New Zealand Essay1548 Words   |  7 PagesFORMAL MEETING GUIDE TWO CULTURES This Report is about the multi culture of New Zealand SAHIL KUMAR 14075027b Submitted to ANIKA VATS Assignment no: 11647 â€Æ' Contents INTRODUCTION 3 MAORI CULTURE 3 OTHER CULTURE 3 ABOUT HUI 3 PROCESS OF MEETING 4 AGENDA 4 DATE AND TIME 4 BEHAVIOUR AND FORMAL 4 ROLES 4 PREPARE IN ADVANCE 5 COMMUNICATION SKILL 5 NOTICE OF MEETING 5 REGULATION OF MEETING 5 RECORD OF THE MEETING 5 COUNTDOWN 5 AGENDA 6 PLANNING AND PROCEDURESRead MoreCypop 23632 Words   |  3 Pages1. UNDERSTAND THE SPEECH, LANGUAGE AND COMMUNICATION ASSESSMENT PROCESS FOR CHILDREN AND YOUNG PEOPLE WHO ARE LEARNING MORE THAN ONE LANGUAGE. 1.1 Explain how to identify which languages are used by children and young people in the work setting. 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Fish Essay Free Essays

Below is a free essay on â€Å"Fish Market† from Anti Essays, your source for free research papers, essays, and term paper examples. Be there, play,make their day and choose your attitude. Those are the four simple steps that the Pike Place Fish Market in Seattle, Washington uses to provide exceptional customer service. We will write a custom essay sample on Fish Essay or any similar topic only for you Order Now After seeing the Fish video, I think that every business should do business the way that Pike Place does. What does it mean to really be there for your customers? The way Pike Place Fish Market sees it, you should be one on one with your customer. When you are helping someone, you should focus on what they need and make them feel like more than just a customer. The second step to exceptional customer service is play. Whether it’s throwing fish or making jokes, the employees at the Pike Place Fish Market know how to keep the job fun. In the Fish video, I watched the employees having fun by repeating what eachother says. The third step is make their day. As a crowd of 100+ people gather around the fish market to watch the employees having a great time, they get to become part of that. In the video, one of the men said that sometimes they get people walking by that are having a bad day and they are just in a really bad mood and after talking to the employees, they walk away with a smile on their face. They event let onlookers join in on throwing and catching the fish. The employees will even tell people in the crowd how beautiful they are just to make their day. The last of the four simple steps is choose your attitude. It’s hard to have fun at work if you are in a bad mood. When working at a place like Pike Place, it should be easy tobe in good spirits at work because they make it fun. But in order to make it fun they have to show up in a good mood. The employees have to choose their attitude. If one person is upset it could make the whole staff have a bad day. How to cite Fish Essay, Essay examples

Fish Essay Free Essays

Below is a free essay on â€Å"Fish Market† from Anti Essays, your source for free research papers, essays, and term paper examples. Be there, play,make their day and choose your attitude. Those are the four simple steps that the Pike Place Fish Market in Seattle, Washington uses to provide exceptional customer service. We will write a custom essay sample on Fish Essay or any similar topic only for you Order Now After seeing the Fish video, I think that every business should do business the way that Pike Place does. What does it mean to really be there for your customers? The way Pike Place Fish Market sees it, you should be one on one with your customer. When you are helping someone, you should focus on what they need and make them feel like more than just a customer. The second step to exceptional customer service is play. Whether it’s throwing fish or making jokes, the employees at the Pike Place Fish Market know how to keep the job fun. In the Fish video, I watched the employees having fun by repeating what eachother says. The third step is make their day. As a crowd of 100+ people gather around the fish market to watch the employees having a great time, they get to become part of that. In the video, one of the men said that sometimes they get people walking by that are having a bad day and they are just in a really bad mood and after talking to the employees, they walk away with a smile on their face. They event let onlookers join in on throwing and catching the fish. The employees will even tell people in the crowd how beautiful they are just to make their day. The last of the four simple steps is choose your attitude. It’s hard to have fun at work if you are in a bad mood. When working at a place like Pike Place, it should be easy tobe in good spirits at work because they make it fun. But in order to make it fun they have to show up in a good mood. The employees have to choose their attitude. If one person is upset it could make the whole staff have a bad day. How to cite Fish Essay, Essay examples

Maf free essay sample

First, customer profitability analysis assigns the costs to individual customers rather than products, services or departments. It allows management to determine which of the customer is profitable or if the company should charge a higher price. Second, customer profitability analysis can be used at aggregate level or disaggregated level. It allows the management to analyze a particular customer or a large group of customer at one time. Third, customer profitability analysis change from product focus to a customer focus which focus on multiple products sold to a single customer rather than a single product sold to many customers. It will allow management to identify the downstream costs of the customer and thus make a strategic decision on which customer that company want to target. DIFFERENCES OF CUSTOMERS. All the customers are different and this can be due to differences in revenue charged to the customers and the differences in costs used to service the customers. We will write a custom essay sample on Maf or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Differences in revenue can be arise because customers are charged different prices when the company operates in the different markets, customers are given different discounts, sales volume are different or different products purchased by the customers. Differences in customer costs arise from the way customers use company’s resources by using the downstream activities which can be divided into four customer groups. First, the customers are different because of customization of products. Some customers may require additional features to be added to the products. For example, some customers at Pizza Hut might request additional item to be added into their pizza such as adding more cheese or extra sauce. Second, marketing and selling activities. Some customer may prefer to purchase products through online and some of them may prefer to purchase from sales gent through direct calls. Customer who makes frequent order will use more resources than those who make infrequent order. Third, products can be offered through many distribution channels. Some customer may purchase products directly from the company, some of them may purchase from warehouse, agents or internet. For example, in Malaysia there are a lot of company that provide courier services such as Pos Malaysia to deliver the products to customers. Lastly, there are differences in customer support activities that are offered to the customers such as technical support, training, on-site visits and help lines. It is not depend on the products sold but it depends on particular customers. For example, if there is a problem incurred on the product, the company will send their staff to provide with repairing and maintenance services. CUSTOMER DRIVEN ACTIVITIES Before management can calculate the customer cost, management need to recognize first the hierarchy of customer driven activities so that it can help management assign the cost to each of the customer group more accurately. Customer activities are the activities that facilitate the customer from taking customer order until delivered the product to the customer. There are three levels of customer driven activities i. e. order level activities, customer level activities and market level activities. The first level is order level activities, it is triggered each time an order placed by the customer. These activities are driven directly by selling and delivered the product to the customer. It means that this activities starts from when company taking the order from the customer, selling process until deliver the product to the customer. For example, taking an order from the customer, processing an invoice, packaging the product and lastly deliver the product to the customer. For the second level is customer level activity. It relates on how company managing the customer in terms of acquiring the new customer and maintaining the existing customer or customer group. In this stage, company should know are the element that emphasize by the customer. Customer usually wants higher quality of product at a lower price. Then, they also demand a good service from the company not only during buying the product, but also after sales. To attract the new customer, company can attract by making an initial call nd advertise about the new products and what is the special feature. Furthermore, company can make certain promotion to attract the new customer because majority of the customer love to buy the product at lower price. To maintain the customer, company can give samples to the customer so that they can update themselves with the new product. By giving technical support to the product that have been bought by the customer as well as handling the complaint also can r etain the customer from moving to the competitors or switching to the other products. For the third level is market level activities, it relates with the particular markets or class of the customers. This stage is very important as company need to know what their customer wants the most so that they can satisfy their needs. However, before company can know about it, company need to analyse them and making some observation through research or questionnaire. Company also can satisfy their need by developing the new technology after they know the customer needs. Thus, it can maintain the presence of the company in the particular market attract more new customer. CALCULATING CUSTOMER PROFITABILITY ANALYSIS After company knows about these levels of activities, company can apply the Activity Based Management Costing (ABC) system method in customer profitability analysis. This is because, the techniques are just the same except that customer profitability analysis is emphasize more on customer cost whereas ABC system emphasize on the overhead cost. For customer profitability analysis, the cost that incurred to facilitate the customer will be spread over each of the customer group. However, for ABC system the overhead cost that incurred to manufacture the product will be spread over the products. There are five (5) steps that should be taken by management to carry out customer profitability analysis. First step is company need to identify customer driven activities which are the order level activities, customer level activities and market level activities. After that, management need determine the total cost of these activities. Next, company needs to identify the activity driver. It is very important to identify the activity driver because it helps the company to assign the cost more accurately as we know what the activities that drive the costs are. After company knows the total cost, the cost need to be allocate according to each of the customer group so that company can determine the profitability of each customer group. The aim of company carry out the customer profitability analysis is to determine the profits that have been brought by each of company customer group i. e. direct customers, large retailers and small retailers. If one of the customer group contribute to negative percentage, company need to analyse and respond the reason behind it. After knows the reason, company may influence their buying behaviour or preference so that the cost that incurred by that customer group can be reduce (positive contribution) and lastly increase the profit of the company. CUSTOMER PREFERANCE MEASURES For company, customer is very important because it can increase the profitability of the company. Thus, company need to satisfy the customer and maintain their relationship so that they can bring last longer profit to the company. In order to know whether customer is satisfied or not, company need to have customer performance measurements to define and measure the customer performance. There are five (5) cores of customer measures that apply to all forms of organization i. e. customer satisfaction, customer acquisition, customer retention, customer profitability and market share. For customer satisfaction, company can measure in terms of specific aspect of value such as quality of product or services. This can be achieve by making a survey through mails, telephone and ask the degree of their satisfaction in terms of product, service or quality. By measuring the customer acquisition, company can know the rate of organization in terms of attracting and win the new customers. This can be measured by calculating the number of new customers and what are the total sales that have been contributed by them. After we attract the new customer, of course the company wants to retain the customer loyalty towards the organization itself (customer retention). At this level company needs to maintain ongoing relationship with the customers so that customer will not switching to the other products or moving to the competitors. This can be measure through the percentage of business growth that has been contributed by the exiting customers. By measuring the customer profitability, company can know the net profit attributable to a customer or customer group. This can be measured through change in customer profitability per quarter or proportion of loss customers compared to the profitable customers. In simple way, company can apply customer profitability analysis in this level. Lastly is market share which customer wants to measure the proportion of sales in the given market. This can be measure through the proportion of the customers’ revenue or sales volume based on proportion of the market size. In conclusion, satisfaction contributes to the acquisition of the customer and it makes the customer to retain their loyalty to the products. Thus, it contributes to the customer profitability which lastly increases the market share of company. ADVANTAGES AND DISADVANTAGES OF CUSTOMER PROFITABILITY ANALYSIS Information on the customer profitability can be used in the strategic decision of the management. From the customer profitability analysis, management can identify which of the customers generate the highest profit and how can the company do to retain those customers, which of the customers generate lowest profit and what can the company to make those customers profitable and what types of customers should the company focus on to maximize profitability. These will help the management to make strategic decisions on which customers or distribution channels that need to be focus on and help to identify the areas for cost control and cost reduction. In addition to that, the company can protect their existing highly profitable customers. It means that, from the analysis, the management can identify which of their customers are profitable and which are not profitable to the company. They will focus more on the highly profitable customers and thus secure these customers from buying the products from the competitors by maximizing the sales or services to profitable customers. Besides that, the analysis will improved the strategic decisions of the management by providing useful information for customer related decisions including pricing, discounting and marketing decisions to increase the profit. The disadvantages of customer profitability analysis are the management may not have the required resources and data capture systems including the information technology, equipment and staff for the analysis and preparation of the customer profitability to produce accurate estimation of customer segmental revenues and costs. Besides that, as the customer profitability analysis depends on the mix of products or services that the customers bought however, the analysis might be used on specific underperforming products or services and will overlook the impact of sales of other products to the customers. TRADITIONAL VERSUS CUSTOMER PROFITABILITY ANALYSIS APPROACH Before customer profitability analysis develops, all customers are treated equally regardless of their contribution. But since the customer profitability analysis develop, the service is driven by customer contribution to maximized value and ensure the customer relationship is profitable. It means that company will maintains the relationship with the customers that bring profit only and they will give good services to them because they contribute high profit to the company. In traditional, company has minimum understanding on how to increase the customer profitability. However, in customer profitability analysis, company has deeper understanding of customer profitability and knows how it can benefit the company. If one of the customer groups always brought negative contribution, company who has deeper understanding will make an analysis and respond to it by influence their buying behavior of preference so that the profitability of that customer group can be increase and thus increase the company profit. Lastly, in traditional approach, company has little or no awareness on how individual customer affects the profit. However, in customer profitability analysis, company has designed clear action for each of the customer. For example, company will only targeting high performing customer and mediate the unprofitable customer. ACTIVITY BASED MANAGEMENT ANALYSIS Activity based management (ABM) is a method used in order to seek out areas in company, where company losing money, so they can eliminate those activity or improve it in order to increase company profit. ABM analyse cost of employees, equipment, facilities, distribution and overhead cost. The result of ABM enables company to produce more accurate budget and financial forecasts. Activity based management can be applied to government agencies, manufacturers, service providers, schools and non-profit organization. The objective of ABM is to improve the effectiveness and efficiencies of organization in securing its markets. When management want to perform activity based management analysis, they must first obtain information from activity based costing system (ABC). After that, management will do analysis on activities involved in production process, cost driven and its performance. However, simple activity analysis in is not very useful when it comes to cost management, thus ABM analysis need more comprehensive analysis that cover matters in details. ABM analysis should cover all activities that incurred at greater level of detail which will reflect individual tasks or step in a process. It also should include the total cost of these activities, for example direct labour cost and manufacturing overhead cost. The analysis also need to include all cost of non-manufacturing activities, as ABM assume the process to produce a product always extend to non-manufacturing areas. PROCESS TO REDUCE COST ON ABM Basically in order to achieve purposes of ABM which are to create customers value and to increase profitability of the company, manager of the company firstly need to reduce the cost of production. So from that, company will produce products that have high quality then it will indirectly increase profit of the company. There are four steps to reduce the cost of company. The first step is identify major opportunities, follow by determine the real root cause, develop a new program and introduce and monitor the performance of the program. The first step is identifying the major opportunities for cost reduction. At this stage, company must identify each activity and its cost incurred in organization. After that, they may perform value analysis, where this analysis can be used to classified activities into two categories, either value added activities or non-value added activities. Value added activities is the activities that provided essential value to the customers or to functioning of businesses while non-value added activities is the product that did not add value of products from customer’s or business’s perspective. Therefore, non-value added activities can be eliminated by the company. Second step is determining the real root cause. At this stage, company focus more on eliminating non-value added activities, so from there they need to find the real root cause of non-value added cost. There are two ways that occurred in order to eliminated non-value added cost, first by transform activities into process and second by performing cost drivers analysis. By transforming activities into process, company can get better understanding on all process of production involved, start from input into output. After that, they can start to identify the root cause cost drivers of major non value added activities using cost driver analysis, a method that identifies root cause cost drivers of activities. For example, if in the production have four processes of non-value added activities. First, company need to identify which one out of four processes of non-value added activities incur more cost. Let see, if process number one incurred more cost, thus company need to focus more on that process in order to eliminate the cost. After main root of the cause was found in the previous step, then company need to develop new program that can overcome the root cause. Developing new program is a complex task as there is a need on the involvement of all managers across organization, its may tackling individual activities or requires fundamental restructure of production process. For example, based on previous situation, after the company knew that process number one incurred more non-value added cost, so in order to eliminate this cost, company need to restructure back its production process, where in the new production process, there is no non-value added activity incurred. The last step is to measure company performance. After completing the implementation of new program in company, they need to measure their performances by using activity based performance measures. This method is used to monitor the effectiveness of cost reduction effort and customer value. In order to measure company performances, management need to identify major or important aspect of performance that they believe critical in achieving strategy objective. By continuously monitoring company performance, managers could obtain feedback on their performance, set target that they want to achieve in future and take corrective actions when required. IMPACT OF ACTIVITY BASED MANAGEMENT. According using ABM application, it will have some impact that incurred. Impacts of using ABM are real cost had been identified, cost saving can be achieved, improved profitability and also increase customers’ satisfaction. Based on real cost drivers had been identified, it will refer on the step to reduce cost which is on step two, determined the real cause. Through this step, manager of the company will eliminated the non-value added activities so in order to eliminate the company will find the real root cause of non-value added activities. So those through using ABM it involve process to identify real cost drivers when making cost reduction. After know what type of non-value added cost was incurred, the company will minimize as well the cost that only incurred value added and few cost of non-value added so that cost saving of the company can be achieved since the production does not incurred with non-value added cost. Next impact is improving profitability of the company. Since the purpose of using ABM is to reduce cost and improve profitability, company will take action in the production, in order to minimize the costs and improve the high quality of the product. ABM provide reliable basis for strategic decision making so that the company know more accurate about the product cost. Moreover, part of the improvement was due to increase customer satisfaction. In addition to tracking cost drivers, activity-based performances enable the company to monitor and improve quality and delivery. Due to the high quality of product, it indirectly will improve customers satisfaction because of the product was fulfilled their need. MANAGING SPARE CAPACITY TO ACHIEVE COST REDUCTION. The outcome of undertaking ABM, result in creation of spare capacity. Management cannot reduce their cost if the spare capacity is not reduced. Spare capacity that is created through reduction in root cause cost drivers need to eliminate or used for other value added activities. For example, when company eliminate non added activity like move material, they need to reorganize the position of machinery in company’s factory to shorten the time taken by employees to move material from one machine to another machine. Thus, it will lead to creation of spare capacity in terms of idle time for employees to move materials and free space on factory floor. Those spare capacities must be eliminated or used for other value added activities in order for company to achieve their objective. For employees involved in moving material activity, they are paid wages by company so in order to reduce the cost, company can terminate some of the employees or transfer them to other value added activities. For free space on factory floor, since company cannot eliminate these free space as they still need incurred cost on that particular area such as factory lease, factory insurance and maintenance cost of factory, company can used it for other profitable activities that will help company to improve their performance and thus increase company profit.

3 Disagreements About How to Use Either and Neither

3 Disagreements About How to Use Either and Neither 3 Disagreements About How to Use â€Å"Either† and â€Å"Neither† 3 Disagreements About How to Use â€Å"Either† and â€Å"Neither† By Mark Nichol Use of either and neither, and their associated words or and nor, is complicated by disagreements about proper usage. Here’s a discussion of the words and the opinions about their appropriate use. An â€Å"either . . . or† or â€Å"neither . . . nor† construction can include more than two elements, but some grammar guides advise writers to restrict the usage to reference to two choices: â€Å"I’m going to wear either blue or green† but not â€Å"I’m going to wear either blue, green, or red.† If you agree with that restriction (I don’t), delete either from the latter sentence and it’s optional in the first one, for that matter. Omitting neither is not an option in the sentence â€Å"I’m going to wear neither blue nor green,† but the idea can also be rendered â€Å"I’m not going to wear blue or green.† The proscription against using or, rather than nor, with neither (â€Å"I was neither here or there† instead of â€Å"I was neither here nor there†) is likewise not absolute, but nor is most common, and in this case I support the restriction. The third divergence is about agreement with a verb. The more restrictive rule is that when either or neither is the subject, or part of the subject, of a sentence or a clause, it should be accompanied by a singular verb: â€Å"I don’t think either of the candidates is qualified.† When two nouns or pronouns are framed by either and or, use a singular verb if the noun or pronoun closest to the verb is singular (â€Å"Either the boys or the girl is responsible†) and a plural verb if the closest noun or pronoun is plural (â€Å"Either the girl or the boys are responsible†) or both nouns or pronouns are plural (â€Å"Either the girls or the boys are responsible†). However, it is common to see a plural verb with either or neither in reference to a sole plural noun or pronoun, as in â€Å"Neither of the parties are willing to compromise.† The more conservative choice is to write â€Å"Neither of the parties is willing to compromise,† and I adhere to that option. Here are several other considerations: When constructing an â€Å"either . . . or† or a â€Å"neither . . . nor† statement, take care to place verbs appropriately. If one verb applies to both choices, place it before the â€Å"either . . . or† phrase: â€Å"She was going to leave either tomorrow or Saturday.† If a separate verb applies to each choice, either should precede the first verb, and or should come before the second one: â€Å"She was going to either leave tomorrow or wait until Saturday.† Also, avoid using a â€Å"not . . . either† phrase, as in â€Å"They will not vote on either the amended proposal or the original one†; revise to a â€Å"neither . . . nor† construction: â€Å"They will vote on neither the amended proposal nor the original one.† Finally, a statement that two things are not true can also be rendered with a â€Å"never . . . nor† construction: â€Å"Their facility had never completed an evaluation nor ever met anyone representing the contracting agency.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Style category, check our popular posts, or choose a related post below:Direct and Indirect Objects26 Feel-Good WordsSentence Adverbs