History and Physical Examination Essay Example for Free

History and Physical Examination Essay Admitting Diagnosis: Stomatitis possibly methotrexate related. Chief Complaint: Swelling of lips causing difficulty swallowing. HISTORY OF PRESENT ILLNESS: This patient is a 57-year-old Cuban woman with a long history of rheumatoid arthritis. She has received methotrexate on a weekly basis as an outpatient for many years. Approximately two weeks ago she developed a respiratory infection for which she received antibiotics and completed that course of antibiotics. She developed some ulcerations of her mouth and was instructed to discontinue the methotrexate approximately 10 days ago. She showed some initial improvement but over the last 3 to 5 days has had malaise, a low grade fever and severe oral ulcerations with difficulty in swallowing. Although she can drink liquids with less difficulty. Patient denies any other problems at this point except for a flare of arthritis since discontinuing the methotrexate. She has rather diffuse pain involving both small and large joints. This has caused her some anxiety. MEDICATIONS: 1. Prednisone 7.5 mg p.o. daily. 2. Estradiol 0.5 mg p.o. q.a.m. 3. Mobic 7.5 mg p.o. daily, recently discontinued because of questionable allergic reaction. 4. HCTZ 35 mg p.o. every other day and oral calcium supplements. 5. In the past she has been on penicillamine, azathioprine, and hydroxychloroquine but she has not had Azulfidine, cyclophosphamide or chlorambucil. ALLERGIES: None by history. FAMILY/SOCIAL HISTORY: None contributory. PHYSICAL EXAMINATION: This is a chronically ill appearing female alert oriented and cooperative. She moved with great difficulty because of fatigue and malaise. VITAL SIGNS: Blood pressure 107/80. Heart rate 100 and regular. Respirations 22. HEENT: Normocephalic, no scalp lesions, dry eyes with conjunctival injection, mild exophthalmos, dry nasal mucosa, marked  cracking and bleeding of her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palate. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. SKIN: She has some mild ecchymosis on her skin and some erythema. She has patches but no obvious skin breakdown. She has some fissuring in thebuttocks crease. PULMONARY: Clear to percussion and auscultation bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMIN: Soft, non-tender, protuberant, no organomegaly and positive bowel sounds. NEUROLOGIC: Cranial nerves 2 through 12 are grossly intact. Diffuse hyporeflexia. MUSCULOSKELETAL: Corrosive destructive changes in the elbows, wrists and hands consistent with rheumatoid arthritis. Has bilateral total knee replacements with stove pipe legs and perimalleolar pitting edema 1+. I feel no pulses distally in either leg. PHYCIATRIC: Patient is a little anxious about these new symptoms and theyre significance. We discussed her situation and I offered her psychological services. She refused for now. PROBLEMS: 1. Swelling of lips and dysphasia with questionable early Stevens-Johnson syndrome. 2. Rheumatoid arthritis class 3, stage 4. 3. Flare of arthritis after discontinuing methotrexate. 4. Osteoporosis with compression fracture. 5. Mild dehydration. 6. Nephrolithiasis 7. Anxiety PLAN: 1. Admit patient for IV hydration and treatment of oral ulcerations. 2. Obtain a dermatology consult.  3. IV leucovorin will be started and the patient will be put on high dose corticosteroids. 4. Considering patients anxiety perhaps obtain services of Stella Rose Dickinson PHD phycology at a later date.

World Cuisines In Kerala Cultural Studies Essay

World Cuisines In Kerala Cultural Studies Essay Kerala was and is known all over the world for its rich spices. Hence from ancient times many people from the West and East came to Kerala in search of the rich and rare spices. This impact with the rest of the world had its effects on the culture, food and religion of the people of Kerala. Gradually the pure vegetarians became non-vegetarians. But they adopted their cooking of meat and fish to suit their convenience, palate and the availability of the ingredients around them. Thus they slowly evolved an indigenous cooking of their own which is a combination of distinctive cuisines and a harmonious fusion of many cultures and religions (Mathew, 2008). Owing to many reasons, much has changed in the culinary scenario of Kerala in the past four decades. The research looks to understand these changes and to obtain a clear picture of the dining trends and various aspects of the foods prepared in the households of Kerala today. 1.2 Aim of the Research The aim of the research is to analyse the changes in Kerala in the past four decades from a culinary perspective in terms of food, food preparation, eating and dining preferences of the natives. Change is inevitable and has many causes and effects. Over the last forty years, the economy of India has boomed. This is very evident in the state of Kerala. The migration of the natives to other states of India and other countries in search of better jobs and incomes has reflected upon the growth in the economy of the state as well. This led to major changes in lifestyle and also saw significant improvements in the items and provisions available on the market. All this has left the people of Kerala with better living conditions and a greater disposable income. This has also resulted in social exposure and cultural exchange to a great extent. Both partners in a married family doing jobs to support the family members is now common across the world, and it is no different in Kerala. This means that the availability of time to prepare meals at home is lesser. As a result of this people tend to use packaged ingredients to prepare food. Some even buy readymade dishes to have at home and many prefer to dine out since they cannot find enough time at home to cook meals. The research will examine all such changes in Kerala. 1.3 Motivation of the Research Gastronomy has become a major field of interest and study in the world today. People across the world are not only interested in their own cuisine and culture, but also that of other regions across the world. Being a student of Gastronomy, the researcher is keen to study the major changes in Kerala regarding the kind of food prepared in households and the changes in dining trends. The researcher would like to understand the religious and cultural taboos present in Kerala with regards to the type of food consumed and find out whether such ideologies are still being followed. 1.4 Objectives The researcher will be concentrating on understanding certain changes that took place in Kerala pertaining to the culinary world. To begin with, the researcher would examine the changes that have taken place in the way foods are prepared in households, i.e. how the preparation of ingredients have changed, how the utensils used to prepare food have changed and whether the dishes prepared in households are similar to what they were before. The researcher will also study the change in the dining trends in Kerala with a focus on the current dining trends in the major cities of Kerala including Thiruvananthapuram, Ernakulam and Kozhikode. 1.5 The Reach and Inadequacy of the Research This research in many of its aspects tends to obtain only a generalised view of the current culinary scenario of the state of Kerala. The study of the current dining trends is restricted to three major cities of Kerala. The research does not cover the cuisines of the minor communities present in the state. The time given for primary research is inadequate as there are many attributes to be covered in this study. The resources available for secondary research on this topic are few. 1.6 Research Structure The study has been divided into four chapters to provide a systematic representation of the research. The first chapter covers the aim and objectives of the research apart from an outline of the various cuisines of Kerala, festive foods and the major utensils used to prepare food in household kitchens across Kerala. Chapter two examines the research methodology where the qualitative method of research is a collection of data which is generated in verbal form. Observational surveys, depth interviews, open ended questionnaires, expert discourses and discussions are studied. The design of the research and methods of data collection and data analysis are discussed. In chapter three, the data obtained from primary research are analysed and interpreted to better understand the outcomes of the research. Chapter four summarises the findings, details the thoughts and opinions of the researcher and determines the scope for future research. At the end of the research, the researcher provides a bibliographical collage of notable works cited and referred to in the process of carrying out this study. 1.7 Kerala A Melting Pot of Cuisines Kerala cuisine as experienced today is an amalgamation of three different traditions Muslim, Christian and Hindu. Though all of them are made up of sub-denominational and regional practices and tastes, the Hindu tradition also has caste differentiations and overtones. 1.7.1 Moplah Cuisine The Malabar region of northern Kerala is the birthplace of the distinctive cuisine of the Moplahs, the Muslims of Kerala. The term Moplah derives itself from Mapillai, which means bridegroom or from Mahapillai which means a person held in high esteem. These Muslims are descendants of Arab traders who married local Kerala women, later expanding their ranks by conversion (Achaya, 2007). Majority of the Moplah population are settled in the northern districts of Kerala including Malapuram, Kozhikode, Wayanad, Kannur and Kasargod. The Moplah cuisine is noted for its liberal use of a wide variety of spices. 1.7.1.1 Dietary Laws Meats eaten by the Muslims are halal. They also abstain from consuming pork and alcohol as they are forbidden in Islam. 1.7.1.2 Specialities of the Cuisine This cuisine includes many kinds of biryanis and pilafs, not simply combining rice with meat and chicken, but also with many kinds of fish a natural development of a coastal state. Instead of using the long grained basmati that is the standard for biryanis and pilafs in northern India, Moplahs use kaima rice, a local short-grained variety. The Moplah biryani is made by cooking the rice, and meat or fish separately, arranging them in alternating layers, and baking with live coals from above and below. The mutton is cooked tender, and the rice is flaky. It is skilfully spiced with the right proportions of condiments. One difference between the Moplahs and the other Muslims of India is that the Moplahs do not make kebabs. Instead they have meats in a dry form or in rich gravies. Among their specialities is roast chicken made on the stovetop, instead of in a conventional oven. The chicken is stuffed with spices and a hard-boiled egg and slowly fried over a very low heat in a deep pot. Also, wheat and meat are combined in various ways. Wheat is coarsely ground for a porridge called aleesa, or it is left whole and combined with minced meat, for a dish called kiskiya. There are some exquisite dishes that are solely the product of Moplah imagination. One of the best known and most delicious dishes among the Moplahs is neichoru, which is rice fried in ghee with onions, cloves, cinnamon and cardamom. During the fasting month of Ramadan, the evenings dinner often consists of pathiri, and meat and chicken dishes. Pathiri is a bread made from rice flour. Some are thin like a chapati, some thick, and some are deep fried. After preparation it is sometimes soaked in coconut milk to keep it soft and to improve the flavour. The word pathiri comes from the Arabic word fateerah, which means pastry. Variants of pathiri include neypathiri which is prepared with ghee, poricha pathiri which is fried, irachi pathiri which is stuffed with meat and meen pathiri which is stuffed with fish. One of the most famous Moplah dishes is a dessert called mutta-maala, the literal meaning of which is A garland of eggs. Egg yolks are cooked in syrup until they form long strands. They are then removed from the syrup and spread out on a plate. An accompanying dessert, a snow-like pudding called Pinnanthappam, is then made by beating the egg whites until fluffy, blending them with the leftover syrup, and then cooking the mixture in a steamer. The soft, white confection is cut into diamonds and served with the yellow egg strands. The Kozhikode halwa is another famous dessert of the Moplahs. The Malabar Muslims have a distinguished culinary culture that flaunts tastes and flavours bearing strong influences of Arab, Mughal and local Kerala cuisine. 1.7.2 Syrian Christian Cuisine Christianity is believed to have reached Kerala in 52 A.D., much before it reached many European countries. Syrian Arab Christians fleeing persecution at the hands of the Muslims took refuge under the king of Kerala. They left a heavy influence on the cuisine of Kerala, which might explain why Keralian food is so different from its neighbouring Tamilian cuisine. It also explains the prevalence of non-vegetarian food in Keralian dishes. Kerala Syrian Christian Cuisine is basically the name given to the unique culinary style of the Syrian Christians, who live mainly in areas like Kottayam and Pala in Kerala. 1.7.2.1 Dietary Laws The most interesting feature of the Christian eating style is that the Christians do not have any dietary restrictions. All kinds of meats and alcohol can be consumed by them. All other non-Christian communities in India have certain restrictions on what they can eat or drink. 1.7.2.2 Specialities of the Cuisine The Syrian Christians have created a whole slew of recipes for meat including beef, pork, duck and chicken. Their best known dish is a Stew which combines pieces of meat with potatoes and a few other vegetables like carrots, beans and green peas in a lightly seasoned broth containing coconut milk. The stew is usually served with Appams, which are rice flour pancakes with white and thick but spongy centres, and golden, thin and crisp lacy edges. It can be a starter at an elaborate formal meal, or it can even be eaten at breakfast. According to late Ms. Thangam Philip, the Appam is a variation of the Dutch pancake with coconut milk, while Acchappam is a derivation of Dutch cookies (Kannampilly, 2003). Idiappam is another breakfast dish of cooked rice noodles, eaten with sweetened coconut milk or a meat or chicken curry. There are many types of Appams in Kerala. While the basic ingredient for any Appam is rice flour, the other ingredients, size and shapes vary. Among other Syrian Christian dishes there are several mouth-watering preparations. Chicken is cooked either in a spicy sauce made with both red and green chillies, star anise, and crushed cashew, or with grated and fried coconut. Duck is gently simmered with coconut milk. Beef Ularthiyathu has chunks of beef which are combined with large pieces of coconut and fried together with spices. This served with Kerala Parotta is also one of the most common meals at any thattukada. Thattukadas are the Kerala version of fast food joints. Other well known preparations include beef cutlets with Sallas (a salad made of sliced onions, green chillies and vinegar), Meen Peera a dry dish of fish with grated coconut, Meen Mulakittathu a fish preparation cooked in spicy red chilly gravy, and duck roast. Kappa Vevichathu is a mashed tapioca dish made by boiling pieces of tapioca combined with ground coconut and a variety of spices. It is tempered with mustard, curry leaves, brown onions and red chilli es. It is accompanied by Meen Mulakittathu. Other popular fish preparations include Meen Moilee and Meen Mappas, both of which are cooked in coconut milk. The Syrian Christians also brought with them their love for wild game including duck, and rabbit. The incorporation of these meats with the spices and cooking techniques that existed in India already created some very masterful dishes, including the stuffed, roasted duck that is eaten as part of a traditional Christmas feast. These people have made Kerala as well known for its variety of meat dishes as for its seafood dishes. 1.7.2.3 Savoury Dishes The main snack items include Acchappam, Neiappam, Unniyappam, Vattayappam and Avalose. Acchappam is a deep-fried rose-cookie made of rice, the name coming from the frame required to make it. It is a common snack item. Neiappam is a deep-fried, chewy dark doughnut made from toddy-fermented rice and jaggery. Unniyappam is made using rice flour, bananas, and jaggery in a special type of vessel called unniappa chatty. Its shape is somewhere between a small ball and a muffin. Vattayappam is a sweet, thick pancake made with rice flour, coconut milk, semolina and sugar. Resins and cashew nuts are also added for flavour. Avalose is a dish that uses a rice-coconut combination. The rice is fried in this. It can be eaten with jaggery, coconut and bananas. It can also be mixed with jaggery syrup and rolled into a ball, the size of a lemon, and is called Avalose unda. Wine is an important part of Kerala Syrian Christian cuisine. Another attractive trait of this cuisine is the liberal use of coconut oil, coconut milk, curry leaves and mustard seeds. 1.7.3 Hindu Cuisine The Hindus were the original natives of Kerala. Their cuisine primarily consisted of vegetarian dishes earlier, although some castes included certain non-vegetarian items in their cuisine. Majority of the Hindu population are settled in the southern and central districts of Kerala including Thiruvananthapuram, Kollam, Pathanamthitta, Alappuzha, Kottayam, Idukki, Ernakulam, Thrissur and Palakad. The Hindus of Kerala constitute primarily of three castes, including Ezhavas, Nairs and Nampoothiris. 1.7.3.1 Dietary Laws Consumption of beef and alcohol is strictly prohibited among all Hindus of Kerala and doing so often resulted in violence or excommunication during the pre-independence era. The Nampoothiris are strict vegetarians and avoid the use of garlic and onion. 1.7.3.2 Specialities of the Cuisine The Ezhavas form the largest Hindu community in Kerala. Appam and stew are the common breakfast items. The stew varies from fish in coconut milk with bits of mango, mutton in coconut milk, or merely sweetened coconut milk. A bread speciality is nai-patthal, in the shape of a starfish. Pachadi, a curd based dish made of finely chopped and boiled vegetables with coconut, green or red chillies and tempered in oil with mustard seeds, ginger and curry leaves is a famous dish of the Ezhavas. Desserts include various types of Pradhaman, which is prepared by boiling a certain main ingredient like green gram, banana, jackfruit or cooked rice flakes in coconut milk and flavouring with palm jaggery, cardamom and ginger powder and tempering with fried cashew nuts, raisins and coconut chips. The Nairs form the second largest Hindu community in Kerala. Traditionally, majority of Nairs were non-vegetarians as consumption of fish was permitted, while some sub-castes were strict vegetarians. Chicken and mutton dishes are also prepared in many Nair homes nowadays, but they were prohibited earlier. Breakfast items include Puttu, which is a steamed rice cake. Rice powder is moistened and layered with fresh shredded coconut and steamed in a special utensil called a puttu kutti. It is accompanied by either kadala (chickpea) curry, bananas, sugar, papadam, egg curry or boiled green lentils. Certain vegetable varieties though eaten by all Keralites, have special Nair associations. Popular dishes include Sambhar, Aviyal, Kaalan and Olan. Aviyal is a mix of a variety of vegetables including beans, carrot, yam, drumstick, etc. which are cooked with curd, ground coconut, shallots and turmeric powder and seasoned with coconut oil. Kaalan is prepared using plantain, curd and coconut. Olan is a dish of white pumpkin and dried beans cooked in coconut milk and coconut oil. Ada Prathaman and Paal-Payasam are common dessert items. The domestic cooking of meat and chicken by the Nairs is spiced and uses a great deal of coconut and coconut milk which tempers the dish to mildness. The Nampoothiris are Brahmins. Thoran is a chief dish of Nampoothiris. It is a dry dish made by stir frying vegetables with coconut and some spices. There are a variety of thorans, including cabbage thoran, carrot and beans thoran, ivy gourd thoran, etc. Thorans can be made with almost every vegetable. 1.8 Onam Sadya Onam is the most important festival of Kerala and is celebrated by all Keralites. It occurs during Chigam, the first month of the Malayalam calendar, which is between August and September. It marks the homecoming of the legendary King Mahabali. At the core of the festival is the Onam Sadya or Onasadya, a feast of almost 13 to 15 dishes. This can go up to 30 dishes at sadyas served in hotels and temples. Some of the main dishes include Sambar, Erisseri, Parippu, Thoran, Olan, Kaalan, Pachadi, Injipulli, Aviyal, Plantain Chips, Sharkara Varatti, pickle and Pappadam. Desserts include Paalada Pradhaman and Parippu Pradhaman. The sadya is always served on a banana leaf and is a completely vegetarian meal. 1.9 Earth, Stone and Metal The Cooking Utensils of Kerala The best known Malayali cooking utensil is the uruli made of bell metal. It is circular, squat and wide-mouthed and comes in many sizes. The other metallic utensils are the charakku, a large round cauldron with handles on either side of the rim, and the vaarpu, a large pan made of bronze. All these utensils are used to make payasam, sambar and curries, except kalan, pachadi, chutneys and pickles as they are sour. These dishes are made in a kalchatti, a utensil carved out of soft stone, with a mouth wider than its base. Generally a kalchatti is tall with the height being more than the circumference. The uruli, charakku and kalchatti get hot gradually and retain heat for some time, hence they are used for cooking everything except rice. The cooking of rice is done in a chembu, a low, wide-mouthed utensil made of copper a metal that heats quickly. Various long-handled metal spatulas of different types are used for stirring payasam and different types of gravy items. Generally wooden ladles are used for the vegetables so as not to bruise them and to transfer rice from the chembu into the serving baskets. Fish is cooked in a flat-bottomed, open-mouthed terracotta vessel called the meenchatti (meaning cooking utensil for fish). The Kerala style of preparing fish generally calls for slow cooking. This leads to two problems. The curry could easily brown and stick to the base of the vessel and stirring it could lead to the disintegration of the fish. Holding the rim of the vessel with both hands and swirling the curry around prevents these mishaps. The structure and design of the meenchatti allows for all these. It retains heat inside for a long time, thus aiding in slow cooking, and remains just warm enough on the outside, to permit the gentle swirling. The kadhai is used for all stir-fried dishes and for deep frying. In Malayalam, the kadhai is called cheenachatti. The appachatti is used for making Appam, the sevanazhi or idiappam press for Idiappam, and the puttukutti for puttu.

Affirmative Action :: essays research papers

Affirmative Action   Ã‚  Ã‚  Ã‚  Ã‚  In the Human Rights Act, Chapter 214 of the revised statutes, 1989, it states that â€Å"in recognition that human rights must be protected by the rule of law, this Legislature affirms the principal that every person is free and equal in dignity and rights without regard to race, religion, religious creed, colour, sex, physical or mental disability or ethnic or national origin.† Unfortunately though, sometimes this law is not always abided by. Women, aboriginal people who are physically or mentally challenged, and visible minorities have often been denied employment equity, or equal employment opportunities due to discriminatory practices. These groups should enjoy equal representative share of employment opportunities in all occupations and at all levels.   Ã‚  Ã‚  Ã‚  Ã‚  An example of discrimination that denies equal opportunity is the practice of allowing members of these four groups to advance within a company only to a certain level. The company may appear to be equitable by including members of these groups in management positions. However, the top executive positions are still out of reach for members of these groups not because these people are not qualified for the jobs, but because they are discriminated against. Legislation, including the federal Employment Equity Act, exists to ensure employment equity. Such legislation requires employers to report what proportion of their employees belong to these four groups. Employers must then prove that all groups are equally represented at all levels within their organizations.   Ã‚  Ã‚  Ã‚  Ã‚  Affirmative action promotes equality in the workplace in such areas as hiring, training-apprenticeships, promotion, compensation, transfer, layoff, termination and goals. It also promotes equal employment opportunities for those groups or individuals who are disadvantaged due to race, religion, creed, colour, disability, national or ethnic origin, sex, age or marital status. Affirmative action programs are designed to improve the lot of people who have suffered as a result of past discrimination.   Ã‚  Ã‚  Ã‚  Ã‚  By the year 2000, white males will likely account for only 15% of new workers - 85% of new workers will consist of women, aboriginal people, physically or mentally challenged people, and members of visible minorities. The number of women and minorities has increased in many occupations because of affirmative action programs. Some companies actually make a point of advertising that they are Equal Opportunity Employers.   Ã‚  Ã‚  Ã‚  Ã‚  Application forms and advertisements for employment should not make any inquiry that directly or indirectly expresses or invites any limitation, specification, preference or information as to age, race, colour, religion, creed, sex, sexual orientation, physical or mental disability, ethnic, national

Waterloo :: essays research papers

BATTLE OF WATERLOO   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  The Battle of Waterloo was the final and decisive action of the Napoleonic Wars, the wars that effectively ended French domination of the European continent and brought about drastic changes in the political boundaries and the power balance of Europe. Fought on June 18, 1815, near Waterloo, in modern Belgium, the battle ranks as a great turning point in European history.   Ã‚  Ã‚  Ã‚  Ã‚  After raising France to a position of preeminence in Europe , Napoleon met defeat in 1814 by a coalition of major powers, notably Prussia, Russia, Britain, and Austria. Napoleon was then deposed and exiled to the island of Elba1, and Louis XVIII was made ruler of France. In September 1814, the Congress of Vienna convened to discuss problems arising from the defeat of France. On February 26, 1815 while the congress was in session, Napoleon escaped from Elba and returned to France. Many veterans of his former campaigns flocked to his side, and on March 20, 1815, he again took the throne. The Congress of Vienna, alarmed by Napoleon's return to power, had reacted quickly to the crisis. On March 17 Austria, Great Britain, Prussia, and Russia each agreed to contribute 150,000 troops to an invasion force to be assembled in Belgium near the French border.2 A majority of other nations present at the congress also pledged troops for the invasion of France, which was to be launched on July 1, 1815.   Ã‚  Ã‚  Ã‚  Ã‚  Napoleon, learning of the invasion plan, was determined to attack the allies on their own ground before their army could form. He mobilized an army of 360,000 trained soldiers within two months. He deployed half of these troops within France as a security force and sent the remainder into attack units. On June 14, 1815, Napoleon, moving with speed and secrecy, reached the Franco-Belgian border with 124,000 of his troops. Another 56,000 men were left behind in supporting positions.   Ã‚  Ã‚  Ã‚  Ã‚  On June 15, 1815, Napoleon moved across the border of Belgium, and his sudden arrival caught the allied command unprepared. Napoleon ordered his left wing, under Marshal Michel Ney, to attack a brigade of Wellington's cavalry at Quatre-Bras, north of Charleroi. He next ordered the right wing, to move eastward against a Prussian brigade stationed in the town of Gilly. By nightfall on that first day of fighting, Napoleon's armies held the strategic advantage. The emperor had succeeded in placing his army between the advance elements of the armies of both Wellington and Blà ¼cher, and his main force was in a position to swing either left against the Anglo-Dutch army or right to fight the Prussian

Educating On Obesity And Exercise Health And Social Care Essay

There are two types of metabolic reactions, catabolic and anabolic which fundamentally mean to interrupt down and construct up. This is of import when looking at exercising and the construct of firing fat and edifice of musculus. During exercising energy is released when big molecules are broken down into smaller 1s. This is called the katabolic reaction. The energy is so used during the anabolic reaction to construct up complex molecules needed by the organic structure to keep life and develop new tissue. A individual ‘s metamorphosis establishes the rate at which the organic structure burns Calories and how rapidly weight is gained or lost. The higher a individual ‘s metamorphosis is, the quicker they will lose weight. Using the construct of anabolic and katabolic reactions, the short term weight loss is best achieved by aerophilic exercising to interrupt down molecules into energy that the organic structure can utilize to construct musculus. Muscle burns more Calories than fat, so the edifice of musculus will hike a individual ‘s metamorphosis in the long term and increase the sum of Calories burned. A After any type of surgery, the organic structure is susceptible to infection. Clostridium perfringens infections have a high mortality rate. This being multiplies in the myometrium and can distribute to the womb and circulatory system to go a systemic infection if non treated rapidly. It can do serious jobs such as myometriosis which may take to sterility. Surgical intercession such as a hysterectomy may be performed early nevertheless, for a patient that is merely 33 old ages old this may be lay waste toing. 3. Stephanie and Daryl Donnelly are both 31 old ages old and would wish to get down a household. Stephanie has a household history of Duchenne muscular dystrophy and admirations what the impact will be in footings of her ain kids holding the disease. The twosome has come to the clinic to discourse their options. I would explicate to the twosome that although Stephanie does non hold symptoms of the disease, she may be a bearer. Duchenne muscular dystrophy is an familial disease where males are more likely to develop symptoms than are adult females. The boies of females who are bearers of the disease each have a 50 % opportunity of holding the disease. The girls each have a 50 % opportunity of being bearers. If the account of the disease was indicated, I would discourse the class of the disease, clinical manifestations, life anticipation and the effects on the kid and health professionals. I would rede familial guidance since Stephanie has a household history of the upset. A Although there is no remedy for this disease, the familial mutant has been identified. This can let for a more informed determination as to whether the twosome wants to travel frontward with get downing a household. Stephanie can undergo DNA analysis of blood samples to set up bearer position of the mutant. Besides, antenatal diagnosing is possible as early as12 hebdomads by trying chorionic villi. If the sample was positive for the cistron mutant, the household would hold adequate clip to fix for the kid or the option to end the gestation. This would be a hard determination either manner, but with current research at the least the household would cognize prior to the birth of the kid. If a kid is born affected by the disease, ongoing research is being conducted to diminish the badness of the symptoms. These include root cell replacing therapy, exon-skipping, linear up-regulation and cistron replacing, every bit good as drug therapy to decelerate disease patterned advance. 4. The households of two kids are concerned about the integrating of their kids into the local junior high school. Melissa, age 13, has Turner syndrome, and Timothy, age 14, has Klinefelter syndrome. The households are non related. They approach the community wellness nurse for counsel. Adolescence and the demand to â€Å" suit in † create fright and anxiousness in most adolescents. The organic structure is traveling through emotional, physical, and hormonal alterations. Adolescents are concerned about their outward appearance.A Some of the most of import elements to discourse with the household about Turner syndrome are the physical alterations that develop in females. Females with this status be given to be shorter than mean misss of the same age. They besides may hold excess tegument on the cervix dropsical custodies and pess and skeletal abnormalcies. Other medical jobs that may originate from Turner syndrome may include bosom mutters, high blood force per unit area and kidney jobs. About 10 per centum of misss develop scoliosis or an under-active thyroid. The ovaries of females with Turner syndrome do non bring forth estrogen and Lipo-Lutin. Tiffany will non develop chests or get down her period unless she is treated with endocrine therapy. Although sterility may non be an issue during adolescence, this should be addressed as Tiffany ages as the ovaries are non-functional due to the disease. Although non all males with Klinefelter syndrome have the same symptoms, I would turn to the physical, linguistic communication and societal facets of the status. As Timothy is considered pubescent adolescent, he will non do as much testosterone as other male childs. This may ensue in less musculus mass and less facial and organic structure hair than other boys his age. He may besides hold wider hips, larger chests and lower energy degrees. A big per centum of males have some kind of linguistic communication jobs, such as reading, treating spoken linguistic communication and showing ideas and demands efficaciously. From a societal point of view these male childs tend to be quiet and diffident. They may fight in school and athleticss, which may ensue in trouble adjustment in with their equals. 5. Margaret, age 3, has merely taken a bath. She wants to demo her ma a new fast one that she ‘s learned and bends rearward. As Margaret extends rearward, her female parent notices a big, stick outing mass from her venters. Her female parent instantly takes Margaret to the local clinic for farther appraisal. A I would discourse the most common tumours found in kids, and other possible causes of the mass such as hernia, ascites. The possibility of a hernia may bring forth no symptoms but have the hazard of going an exigency state of affairs if it becomes strangulated. Besides, I would discourse scrutinies, diagnostic proving such as CT scans, lab draws, and echography. If indicated more testing of blood, bone marrow may be done if malignance is suspected. 6. Mary, 82 old ages old, lives in a residential senior attention place. Her household has noticed the following bit by bit happening over the past hebdomad: agitation, crossness, and confusion ; musculus vellication of appendages ; and ailments of being thirsty all the clip, even after imbibing. They have noticed that her urinary catheter bag does n't hold every bit much fluid in it, and she looks flushed at times. Mary has had frequent episodes of diarrhoea. The nursing staff drew blood for complete blood count ( CBC ) , serum osmolarity, and electrolytes and has been supervising her BP and bosom rate every 4 hour. Her BP has ranged from 86/60 to 88/66, and her pulse scope is 105 to 118 and regular. The staff besides reviewed her medicine profile and discovered that Mary received two excess doses of lactulose that were non ordered. 7. Vanessa, age 33 old ages, is a individual female parent of two adolescent misss and works as a director full clip with a fiscal investing house. She has merely enrolled in an MBA plan part-time. She comes to the exigency section today because her â€Å" bosom has been rushing for about 30 proceedingss. † She was at place working on her first assignment and making house work in between. Her girls were inquiring for money to purchase some new school apparels when she says she merely â€Å" lost it † and get downing shouting at them. The nurse placed her on the bosom proctor, and Vanessa ‘s beat showed sinus tachycardia at a rate of 142/min. Vanessa has no other symptoms. A Stress is about impossible to extinguish, but with good techniques it can be successfully managed. I would discourse with Vanessa some ways to director her emphasis such as inquiring her kids to assist with family jobs, and perchance acquiring occupations. This would assist the misss with money to purchase their ain school apparels and give Vanessa some quiet clip to analyze. Meditation, deep external respiration and yoga may assist Vanessa loosen up when holding nerve-racking minutes. She may besides seek a warm bath, loosen uping music or taking a walk outside. Although she is busy with kids, work and school, everyone needs clip to loosen up. Just a five minute interruption may be all person needs when they feel a nerve-racking minute coming.

Attitude Legislation And Litigation Education Essay

Provision of instruction in the current universe has been faced with many challenges particularly sing the equality issues in the society. This paper addresses the societal deductions of attitude, statute law and judicial proceeding on the lives of pupils with disablements. Introduction Over the old ages, handicapped people in the society have been forced to populate with many challenges sing their handicapped position. Disabled people have several jobs in footings of motion, instruction and many other societal activities as they are non able to take part and be able to be involved in these activities. The instruction sector has non been left out as the handicapped pupils are faced with many challenges in larning compared to their fellow pupils who are non disabled. The society has been forced to come up with ways in which the handicappeds can be given discriminatory intervention and services compared to the other members of the society through debut of statute law and extenuations to regulate the instruction of the handicapped. For the past old ages, the services given to people with disablement particularly in the instruction sector have been uneffective as a consequence of several grounds that cause hapless service bringing to the disabled in the particular instruction sector. Fiscal issue has been a major hinderance in proviso of services in the particular instruction sector as there have been issues of fewer financess allocated to this sector. There is besides a job sing logistics as the aid and services offered by several bureaus require a batch of attempt for them to move and give the necessary aid needed ( Gordon, 2004 p.72-89 ) . The attitude of people towards people with disablements has several impacts on the lives of the people populating with disablements. The handicapped have been forced to populate with the impacts of negative societal attitude towards them and a farther societal stigma apart from the larger job they are confronting sing their mental or physical hindrances as a consequence of their disablement. The negative attitude towards people with disablements can be seen through societal rejection of handicapped people by the society members a frailty that is present across several civilizations. Peoples with disablements have several more demands than that of a normal individual and therefore there is development of a impression in the society that people with disablements are a load to the society. This factor helps nature the negative attitude towards people with disablements in the society. This negative attitude impacts negatively on the lives of pupils with disablements as it makes them see themselves as a load to the society from their many demands and furthers the societal stigma these pupils are faced with a factor that impacts negatively on their instruction. Attitude towards people with disablement has been negatively displayed through several civilizations that see mental deceleration as psyches that are possessed by evil liquors or punished by God and therefore require spiritual intercessions or dispossession. Such attitudes vested in the heads of people impacts negatively on their attitude towards the disabled as they are forced to see the handicapped as less human existences and farther the societal stigma faced by people with disablement ( Gordon, 2004 p.72-89 ) Students without disablement have negative societal response to other pupils with disablements particularly the mentally retarded as a consequence O f their negative attitude towards them despite the several steps that have been developed to change this that include legislative support, improved attention and the improved and sophisticated ways to give a medical history of the beginning of different disablements. The fact that disabled pupils were treated otherwise from the other pupils by debut of particular instruction that was chiefly provided in particular schoolrooms or even particular schools a fact that furthered the stigma among the handicapped pupils as these meant they were non equal to their opposite numbers who are non disabled ( Ramirez ) . Provision of instruction to the handicapped pupils has become a major challenge to different authoritiess and provinces. Educators have been faced with challenges of how best they can supply instruction to the handicapped and has seen the debut of particular instruction that meant that handicapped pupils were non included in schoolrooms with other able pupils and meant arrangement in separate schoolrooms or schools. The societal attitude that the handicapped pupils should be treated individually as a consequence of their disablement is wholly incorrect and it discouraged the formation of Torahs that would regulate the general instruction of exceeding pupils or handicapped pupils on the footing that dividing the pupils with disablements from those who are non disabled is far from doing them equal and that all the pupils had equal protection from the jurisprudence. The thought that the handicapped pupils should be separated from their fellow pupils has greatly changed as a consequence inequality that consequences from this action and hence there was demand to develop the statute laws and judicial proceedings that govern the instruction of pupils with disablements ( Ramirez, 2003 p. 12 ) . Several opinions against segregation by the United States Supreme Court set the gait in the hunt for equality in the instruction sector that included people with disablement. The celebrated Fourteen Amendment provides the right to equal instruction for any member of the province and no province may deny equal right to education to any individual within its legal power. Students with disablements have a right to equal instruction like their nondisabled opposite numbers as provided by the jurisprudence. The proviso of particular instruction that was ab initio provided outside the regular schoolroom is now provided in the regular schoolroom and there is no separation of the handicapped pupils from the schoolroom hence they learn together a system referred to as inclusion ( Ramirez, 2003 p. 13 ) . Legislations and judicial proceedings have been passed to regulate the instruction of the handicapped pupils. The construct of particular instruction by the Congress as it passed an act that instruction would be provided for all the disabled kids and guaranteed the proviso of public instruction to all pupils irrespective of their ability which provided the footing for inclusive acquisition. It provided that every pupil was eligible to have appropriate public instruction and have the chance to larn in a no limitation environment. In inclusive acquisition, general instruction provided to pupils plants in cooperation with particular instruction with the chief purpose of proviso of quality instruction plans to the pupils irrespective of their disablement. Such statute laws provided that pupils with disablements both in public and private establishments would have instruction with the nondisabled pupils, there should be no particular categories, separate schooling and that no pupil should be removed in their categories unless the badness of the disablement hinders the proviso of instruction to that pupil wholly ( Ramirez, 2003 p. 12 ) . The inclusion of the handicapped pupils into mainstream categories with other chap nondisabled pupils has some positive and negative impacts to the pupils with disablement. Though we may state that the handicapped pupils benefit in this environment through societal and academic interaction with the other pupils, it is difficult to disregard the fact that they are forced to meet rough academic competition from their chap nondisabled pupils. The inclusion of the handicapped pupils in the same categories as the nondisabled pupils increases the force per unit area on both the instructor and the handicapped pupils to be at par with their chap nondisabled pupils and failure to make so may increase the stigma in the pupil. The current instruction clime may non prefer much the instruction and public presentation of certain disablement instances like the mentally retarded hence particular instruction will better flatly in the hereafter. Decision Students with disablement are faced with many challenges in life as a consequence of their disable position. Introduction of statute laws and judicial proceeding to regulate their instruction is a first positive measure in guaranting they benefit from instruction provided in establishments. Social forums and public instruction should besides be encouraged so as to assist alter the attitude of the society towards people with disablement hence bettering their lives.

Marketing plan Essay

This Report presents the strategic Market entry plan of Victoria Secret in Singapore. Victoria Secret is an American brand owned by Limited Brands Company with retail of Lingerie, Women’s Wear and beauty products with annual revenue of USD 8. 7 billion and market share of over 50 percent in North America. It was launched in 1970 by Roy Raymond who started this chain when he had nightmare experience while showing Lingerie for his Wife. He believed that â€Å"Underwear† is not just an Innerwear but can be converted into a Fashion product by tuning in proper colours, styles and patterns and make a product a sex symbol. As it caters to large market in its home country it has been strongly based but now for better growth and more returns Victoria secret has started International expansion. It is one of the fastest growing Lingerie products under Limited Brands Company Umbrella and contributing more than 40% of profits. 1000 number of Stores give strong presence to Victoria Secret and Online shopping ads to the charm. Victoria Secret invests heavily on Advertising with USD 65 Million average for year. The brand symbolizes romance, class, love, desire and romantic moments. They marketed these products by show casing their products with angel looking models breaking ice of set standards of modelling. It is one of the most watched and appreciated Fashion Shows of the world and features world’s best Supermodel as there showstopper creating a feel of sensation in female gender. The brand also took lines from Dove Advertisements by redefining beauty and showing the product users with boosted confidence and sexier looks. The company has done horizontal integration by expanding product range from Lingerie products only to cosmetics, women wear and cosmetics. The appealing brand image gave quick returns on the new product range and helping Victoria Secret in capturing new markets at higher pace. Also what is helping Victoria Secret is its excellent supply chain and IT collaboration which have helped in cutting down overheads. As companies are looking for growth and stability the expansion into Asian market is unavoidable so is for Victoria secret. Singapore being expanding and booming economy can be next destination for Victoria Secret. Singapore also has high fashion conscious population with high income. Singapore being financial hub and supply chain hub is residence for people who have highest per capita expenditure on luxury brands in all segments. In Asia, Singapore boosts for being top market for growing luxury brands. Country also boosts strong tourism and having largest malls in South east Asia helps cater to being selected as best destination in Asia for expansion. Being business friendly government adds to positive of Singapore. Business environment Factors Demography Population rose 2. 5% in 2012. Total population was 5. 4 Million. The Demography of Singapore consists of mix of Chinese, Indians and Malays which account for 74 %, 9 %, and 13% respectively with maximum population between 20-64. Singapore also is world tourist attractor and counts for approx 12 million tourists a year. Total female population is approx 50% and this results in large market size. Female also play dominant role in the society as they also earn. This results in freedom of females and opportunity for them to satisfy their needs. Political Stability Singapore the synonym for freedom to do business was ranked in top 10 best countries to start business. It takes 3 Days on average to start business in Singapore and this is result of stable political System in the country. It has been ranked among top countries for business environment for consecutive 14 years setting benchmark. Singapore is worlds one of the least corrupt country in the world. It ranks 1’st in corruptions perception Index, 2013. The political Stability in the country has provided the most stable economy in South East Asia. Economy The Economy of Singapore is strong with 5. 1% in 3’rd of 2013. The Gross Domestic Product (GDP) in Singapore was worth 274. 70 billion US dollars in 2012. The Expected Net GDP for Singapore is expected to beat market trends and grow more positively in 4’th quarter. The Economy is supported by FDI, skilled labour and fully planned and excellent Infrastructure. The Rising economy has lead to rising per capita income. With the current economic scenario Singapore will attract more youth and global players which will bring more fashion conscious society which will indeed help growth of luxury segment. Industry With rising brand conscious population and trending international brands today brand is equally important for innerwear as is for outer wear. This was proved by growth of this segment industry even during depression of 2008. The rising economies of scale and large production numbers has led to reduced price of product which has increased demand and purchasing capacity. The following factors have contributed largely for growth of this industry: 1) E-Commerce: With rising e-commerce trend and more sophisticated players coming in picture the market has been taken by storm by these players. The customers have not fallen but E-commerce has attracted more customers because of easy access and getting products sitting home. Singapore boosts well E-commerce network with many local players in market along with international Players. The E-commerce has led to fall in prices of product as it involves lesser overhead costs. Association with global E-Commerce players has helped Victoria Secrets attain marvel in other countries and can do the same in Singapore also. 2) Sophisticated Supply chain: With rising use of Sophisticated IT tools for inventory planning, forecasting, Designing and scheduling has helped to reduce costs and development of industry in total. Many Global Brands with innovation in Supply chain have set example for the world. Singapore boosts excellent supply chain network and being Supply chain Hub is excellent destination. Market Analysis Singapore Market size Increase in Per capita income has led to entry to Luxury and premium brands coming in Singapore. The Size of market is expanding and will have higher success rate in coming years. The Table Below shows the growth of Women’s Inner-ware in Singapore. Source: Euro monitor International from trade associations, trade press, company research, trade interviews, trade sources a) Target Females in Age group of 18-50 which means 200,000 females. Middle and Upper Class Tourists Young and Brand Conscious Generation. Competition Triumph , Aerie , Calvin Kline , Armani , Sorella , Etam , La Perla Adore-Me offers direct-to-consumer lingerie at about half of Victoria’s Secret prices Intimint asks customers to take a quiz and sends them new lingerie selections every month, based on their preferences True ; Co. sends women five bras a month, giving them the option of keeping what they like and sending back what they don’t. Low Price and high variety local Players who have well established network in Singapore c) Porters 5 Forces 1) Supplier Power: LOW, As Victoria Secret has Production facilities in Thailand and India the supplier Power is very low. Buyer Power: HIGH, As Singapore already has high end Lingerie brands in its vicinity the Customers have wider options and can shift their preferences. The market has both lower prices segment and more premium segment. 3) Competitive Rivalry: HIGH, As Singapore already houses Premium Luxury lingerie brands who have worldwide recognition, Victoria Secret has high competition. 4) Threat of substitution: HIGH, The price range plays critical role as Victoria Secret has Competition with lower, same and high price range Products. 5) Threat of New Entry: LOW, Being well established worldwide name has its own fan following which attracts masses. New entries will take time to create impact and in that mean Time Victoria secret can come up with Contingency plan. Landscape a) Independent Women: Singapore being modern and economically sound has Independent women who earn well and spend well. This has led to brand conscious population b) Internet Penetration and Media sensitivity: Singaporeans are always connected to Internet. This has led to Strong E-commerce market here. The Media plays important role as Singaporeans try new western brands more frequently and invest heavily in it if the like the brand . Population Mix: Being strong economy Singapore has attracted  nationalities from various countries which have brought in sense of fashion, demand for authentic classy items. This Demand is of high end products. d) Location: With production plants in nearby countries such as Thailand and India and Strong Supply chain hubs the Location is also ideal. Singapore being small can’t accommodate Production facility so being centre for supply chain helps. ENTRY IN SINGAPORE: MARKET FEASIBILITY STUDY Design Victoria Secret is renowned for its strong designing team which comprise mixture of people around the world to understand each geographic trend. Once they understand the trends they create new trends in the market. It defines Sexiness as youthful, mature, energetic, adorable and intimate. The competitors have targeted another value like Triumph emphasises on Simplicity. Victoria Secret will benefit from point that Singapore is mix of many. The Design Teams have large market size which they can target with larger variety. Bold and Loud Brand Promotion This brand brings sense of comfort and pride among women. This is reflected in there promotion activities. The brand highlights the beauty of every individual and helps concealing imperfections with its unique designs. It is most bought product by models. Their Catalogues feature world’s hottest and sexist women in the world. Singaporeans are vivid about Fashion and Luxury products. With Rising Per capita income and proper promotion by hiring trending models of Singapore Victoria Secret can target masses. The Footfall in malls is one of the highest in Asia which can contribute to high sales if located at proper places. Rapid Growth of High-end Female Market Women are booming rapidly in Singapore who are either in White collar jobs, Leaders, Elites, working in Multinationals, entrepreneurs etc. These women have decent jobs, High disposable income and strong purchasing power. Maximum percentage of Women are highly educated. They are open and eager to accept and use trendy and fashionable Products with good quality. They Care about their Lifestyles, Health and bodies. This is supported by fact that Singapore has low obesity Rate of 7. 3 % in females and ranks much below America where obesity is 35. 5% in females. As women consider themselves independent and delicate it is highly possible for them to spend a remarkable amount of income on underwear and branded lingerie for self rewards. This will help Victoria Secret to enter the market easily and reap Benefits of growing and educated economy. Price Barriers and Distribution Channels Normal bra Ranges from 40-80 USD in US which reduces to almost half during sales. Singapore can also cater to demand with same or lesser Price as there are production facilities in India and Thailand. This will help in taming local players who play games of lower prices. Price would not be a Barrier for Victoria Secret to enter into Singapore. Having strong supply chain network with both these countries and being placed near the demand can be met. The Retail Distribution channels are strong and can be built easily in Singapore owing to small country size and Strong local infrastructure. Being Business friendly environment will help Victoria Secret to Establish Strong Distribution channels in Shorter Periods. Overview Retail market in Singapore is up by 3. 3% in August 2013 is back on track after falling slightly. Total number of Retailers in Singapore is more than 30000 with less than 1% for Lingerie Products. The Scope of market is high. Singapore is heavily sustained on Imports from US, Malaysia, Thailand and Australia. Market Challenges and Opportunities Singapore has tightened foreign nationals working in labour market and this has led to increase in labour markets. The Rentals have gone for toss and are very high. The overheads cost the most for setting up business in Singapore. Being business friendly country the market attracts large number of players who provide cheap products, copied items from various world renowned brands. With challenges are opportunities also, being supply chain hub the country can act as stepping stone to enter bigger markets like of china. The Strong judiciary System and quick decision making helps to curb challenges faced such as intellectual copyrights and those related to design copying. SETTING UP RETAIL OUTLET IN SINGAPORE 1) Documents Required for Registration The following documents/information is required for registering a Singapore branch office: a) A certified copy of the Certificate of Incorporation of the foreign company. b) A certified copy of Memorandum and Articles (MAA) of the foreign company. c) Particulars of the directors of the foreign company. A memorandum of appointment and details of at least two persons resident in Singapore who will act as the agents for the Singapore branch office. e) A memorandum executed by or on behalf of the foreign company stating the powers of the local agents. f) Details of the registered office address in Singapore 2) Registration Procedure and Timeline The professional firm hired to handle the branch office registration will take care of all the necessary registration formalities. No physical visit of company executives is required from headquarters. The registration process consists of two basic steps: 1) Name approval 2) Entity registration. The name for the Singapore branch must be the same as that of the parent company. It will generally be approved unless it is identical to any existing company name or is vulgar in nature. Assuming necessary document are ready and there are no delays in the name approval process, registration of a Singapore branch can be completed in 1-2 days. The company registrar will send an email notification confirming the registration of the Singapore branch 3) Retail Outlets – Key Facts and Requirements a) Business Incorporation: Before one can begin operations, retail outlet must first be registered with the Singapore Companies Registrar, ACRA. This involves just two procedures that can be completed online within 24 hours. It is best if retail outlet offers unique products and services that are not currently available in Singapore’s colourful retail market. b) Approval for Premises: One must ensure that intended business premise is an approved location for retail business. To have retail outlet in a conservation building or private property, approval from the Urban Redevelopment Authority of Singapore (URA) is required for making additions or alterations to the premises. A Fire Safety Certificate from the Singapore Civil Defence Force (SCDF) must be obtained to verify that retail outlet meets all fire safety requirements. If outlet is located in a shopping mall, the landlord may expedite the necessary approvals for you. 4) Licenses for Setting Up a Retail Outlet in Singapore Depending on the nature of the merchandise or products offered by retail outlet, apply for the relevant licenses. If outlet offers products which can affect human health and safety, relevant licenses may be required. To Import and sell cosmetics products domestically, notify the Health Sciences Authority (HSA) before placing the product in the market via the HSA’s PRISM site. The fee for the notification of cosmetic products is pegged to each product’s risks and variation (colour etc). 5) Hiring Staff Starting a retail outlet or franchise means that one may need to bring on board employees from home country to oversee operations. If one intends to employ or transfer employees from home country, apply for the relevant Singapore employment pass on their behalf. The Singapore employment pass is however subject to approval by the manpower authority and must meet Singapore’s new productivity vision. 6) Taxation of Singapore Branch A Singapore branch is generally considered a non-resident company for tax purposes. Non-resident companies are not eligible for tax benefits resulting from available tax incentives and tax treaties meant for resident companies.   Annual Filing Requirements Section 373 of the Companies Act requires a foreign company to file its Annual Report and the audited accounts of its Singaporean branch office within two months of its Annual General Meeting, or within 7 months from the  end of its financial year whichever is earlier. Also, each Singapore branch is required to file a Tax Return on an annual basis. MARKET ENTRY STRATEGY Victoria secret can enter Singapore Market in following ways: American exporters use agents or distributors to serve the Singapore market and other markets in Southeast Asia. Singapore firms are aggressive when it comes to representing new products and usually respond enthusiastically to new opportunities. Singaporean companies are open to joint venture proposals. Price, quality and service are the main selling factors in Singapore. Prospective exporters to Singapore should be aware that competition is strong and that buyers expect good after-sales service. Selling techniques vary according to the industry and product, but are comparable to the techniques used in any other sophisticated market. It is also important for U. S. firms to visit their representatives and maintain a good relationship with them. Victoria Secret has expanded in Maximum countries with 100% ownership strategy expect countries where it is difficult or impossible. As Singapore is business friendly and Provides Option for 100% investment Victoria Secret should come as 100% subsidiary. RECOMMENDATIONS 1) Enter the Singapore with 100 % subsidiary 2) Launch all product range in one go from Innerwear, shoes, cosmetics and clothes. 3) Target Shopping Centres for their retail operations for better Visibility 4) Promotion using both international and domestic models for better appeal 5) Enter with 2-3 Stores in Initial Phase for better understanding and Expand Further after setting customer base 6) Join hands with E-Commerce industry both domestic and International to promote brand 7) Target not only Young but also Middle age and Old age 8) High Variety and Utmost quality to remain Core of Business in Singapore also 9) Customized Marketing using social media and Electronic Platform 10) Customized Designs for Singapore Customers as per their taste and like 11) Customer Engagement using print media 12) Virtual Trial Rooms and trained Women staff for guidance on shape and size