The True Dangers of the H5N1 Virus :: Bird Flu Avian Influenza Pandemic

The True Dangers of the Feared Pandemic Conceptual The H5N1 strain of the avian influenza is an infection. It can possibly be perilous particularly through its methods of transmission. The measurements of the present passings and potential passings additionally show the conceivable pandemic emerging soon. Be that as it may, this subject must be placed into point of view and the basic conviction that it will destroy our reality is somewhat misrepresented. There is really a higher possibility that the avian influenza won't become a dangerous executioner. In any case, there are numerous prospects and nobody can be totally certain about the result. The H5N1 Virus Avian influenza is likely one of the most dreaded potential episodes. The H5N1 strain is the specific strain being referred to. On the off chance that this strain transforms, taking into account simple human to human transmission, there is a huge possibility for an overall pandemic. This pandemic could leave the Earth desolate with the conceivable destruction of people except if there is a quality that permits a little percent of people to be safe (Siegel 33). The H5N1 infection has been the most dreaded infection in light of its probability to transform. The structure of the H5N1 infection is the primary explanation of its conceivable transformation. The envelope of the H5N1 infection is included three proteins. Two of them are the hemagglutinin (H) and the neuraminidase (N). The hemagglutinin is the layer used to enter the host cell. It has receptors that dilemma to cells, permitting it to open and penetrate the host cells. The receptors are unmistakable to the receptors on the cells to which it ties. This is the explanation that infections with H5N1 Dangers 2 the H5 subtype have not had the option to transmit from human to human without any problem. Fowls have been its primary objective and as yet, have been influenced to most. The neuraminidase fills in as a component used to cut the infection liberated from the bodily fluid and other repressing elements of the safe framework, permitting the infection to move about uninhibitedly in the body (Tambyah, Leung 16). Since this infection infrequently contaminates people, the obstruction it will look in the human insusceptible framework is anticipated to be insignificant. The harmfulness of H5N1 in its capacity to increase quickly, making it almost certain for the infection to transform by some coincidence. The biggest dread is that the infection will change such that licenses it to increase airborne transmission, permitting it to spread quickly from human to human.

John Brown: Past and Present :: essays research papers

John Brown: Past and Present Host: â€Å"Looking into the precious stone ball, I wonder who our visitor will be. As the mist lifts from the sphere, an image of a man that has enormously affected our socially acknowledged perspectives starts to show up. Who is this man? All things considered, he is known as both a saint and a psychopathic executioner. He has been known as a glaring liar just as a man of solid feelings, all simultaneously. In any case, his most eminent commitment to our nation is without a doubt his inclusion in the abolitionist development. The man I am alluding to is John Brown. While we talk with him today, we will contrast the outcomes of past activities and the results of today’s activities. Along these lines, let’s give a warm round of commendation as we invite John Brown to a tough situation. In any case, why don’t you give the crowd a tad of back ground about yourself. Disclose to us where you were conceived and something about your childhood.† John Brown: â€Å"I was conceived on May ninth in the time of our Lord 1800. To comprehend my story, I should initially educate you concerning my dad, Owen. As a kid during the Revolution, his dad, John Brown, was away battling in the Revolution and Owen ended up taking care of a great deal of the obligations around the home. During the day he worked in the fields close by a slave, from Guinea, named Sam. Sam used to convey my dad on his back and my dad developed to cherish him. At the point when Sam kicked the bucket, it was to be the primary burial service my father had ever joined in. Since Owen’s father was gone during the Revolution and Sam remained in as a mindful dad figure, Sam wound up being the seed of my father’s sees about subjection. My father considered Sam to be a guide and not as a slave or a man of shading. After Sam’s demise, my dad went to religion for comfort. This was during a similar time as the Great Awakening and my dad began going to the restorations. During one such recovery, my dad heard a lesson by the late Reverend Jonathan Edwards where he expressed that subjection was a cardinal sin against God. Subsequent to hearing this message, his mentality towards servitude was solidified. The last occurrence that made my dad become dynamic in the abolitionist development at that point happened. An evangelist by the name of Mr. John Brown: Past and Present :: expositions investigate papers John Brown: Past and Present Host: â€Å"Looking into the precious stone ball, I wonder who our visitor will be. As the haze lifts from the circle, an image of a man that has enormously affected our socially acknowledged perspectives starts to show up. Who is this man? All things considered, he is known as both a saint and a psychopathic executioner. He has been known as an explicit liar just as a man of solid feelings, all at the same moment. In any case, his most remarkable commitment to our nation is without a doubt his inclusion in the abolitionist development. The man I am alluding to is John Brown. While we talk with him today, we will contrast the outcomes of past activities and the results of today’s activities. Along these lines, let’s give a warm round of commendation as we invite John Brown to a tough situation. In any case, why don’t you give the crowd a tad of back ground about yourself. Reveal to us where you were conceived and something about your childhood.† John Brown: â€Å"I was conceived on May ninth in the time of our Lord 1800. To comprehend my story, I should initially educate you regarding my dad, Owen. As a kid during the Revolution, his dad, John Brown, was away battling in the Revolution and Owen wound up dealing with a great deal of the duties around the home. During the day he worked in the fields close by a slave, from Guinea, named Sam. Sam used to convey my dad on his back and my dad developed to cherish him. At the point when Sam kicked the bucket, it was to be the principal memorial service my father had ever joined in. Since Owen’s father was gone during the Revolution and Sam remained in as a mindful dad figure, Sam wound up being the seed of my father’s sees about subjugation. My father considered Sam to be a coach and not as a slave or a man of shading. After Sam’s passing, my dad went to religion for comfort. This was during a similar time as the Great Awakening and my dad began going to the r ecoveries. During one such recovery, my dad heard a lesson by the late Reverend Jonathan Edwards where he expressed that subjugation was a cardinal sin against God. In the wake of hearing this lesson, his disposition towards servitude was solidified. The last occurrence that made my dad become dynamic in the abolitionist development at that point happened. An evangelist by the name of Mr.

That Lovely Pre-Finals Period

That Lovely Pre-Finals Period I just presented some intercultural communication challenges in the IBM/Lenovo merger for class. It was a team project on mergers as a whole, with each of us choosing a merger case and exploring its respective aspects of communication. The final report, some 33+ pages worth, is due Friday by 11:59:59 PM. I love assignments due by email. :-) I still need to finish a few pages for Friday, along with studying a bit for my (last!) French exam, but that doesnt mean I need to wake up any earlier than 11 all week. Theres a lot of buzz on campus right now about some proposed changes to the GIRs (General Institute Requirements). These are the sorts of changes that affect future classes (maybe you), so naturally there are opinions of all kinds about tradition and change. Todays MIT home page spotlight is the Task Force on the Undergraduate Educational Commons, so apparently other people think its worth a look as well! I personally think that the current structure of required/core classes leaves much to be desired, but it can be quite helpful for freshmen to take a variety of subjects when they arent sure what they want to study as upperclassmen. And while this isnt the approach most advertised to incoming freshmen, even if you do know what you want to study, you dont *need* to take all of the GIRs your first year. If it suits you, its certainly beneficial to mix things up a bit with more than one elective course in the spring term, or even one or two in the fall. I guess it depends on the four-year class plan of the department in which you plan to major. Im being encouraged to post more often by various folks around here, so I think one way to accelerate this strategy is for me to carry my camera around far more often. Im going to take pictures of random things during the day and see what happens. To the newly un-waitlisted folks, congratulations! On a more organized note, what are you guys doing this summer? Ill be at MIT, staying in East Campus, but probably working full-time on a fairly interesting train schedule project. (Yes, I think train schedules are fascinating. I have boxes upon boxes of them!)

Leadership Profile, Jane Goodall - 4664 Words

Personal Leadership Profile Abstract The following report is a reflective a case study of Jane Goodall, the influential leader who I admire. I have analyze the various dimensions of the Jane Goodall’s strengths and limitations through data collections from reputable sources, evaluating her personal traits, behavioral styles, situational responsiveness, communication skills ,and other dimensions of leadership. I have also evaluated my own strengths and limitations of these same dimensions, compiling a personal leadership profile that summarizes what I admired about Jane Goodall and how I compare my own leadership strengths and limitations to hers. Introduction I will be analyzing the leader I admire and inspire to be like, Jane†¦show more content†¦The Five Factor model uses the following traits: neuroticism, extraversion, and agreeableness, openness and conscientiousness to rate someone’s traits on a scale of effectiveness as a leader. Each trait is explained below: The tendency to be emotionally reactive, anxious, susceptible to stress, hostile, and insecure would describe the traits of a person with neuroticism or neurotic tendencies, neuroticism is rated low on effectiveness according to the Factor Five Model. Goodall’s attempts to gain access to chimpanzee’s habit required hours of quiet reflection and meditation, she sat for weeks before the first chimp approached her. This kind of diligence and perseverance is not expected from a person with neurotic tendency. Nor do I see neurotic qualities in myself. Extraversion, or the tendency to be energetic, assertive, and sociable is rated as a highly effective trait for leaders within the Factor Five model. Goodall has demonstrated both introverted and extraverted traits during her life’s works, her year of study in Africa with the chimps required methodical thinking and a great deal of solitude behaviors often exhibited in introverted approaches, however her years following the two decades in Africa, where spent educating and motivating people, requiring more extraverted tendencies. I feel Goodall possesses both qualities of introverts and extroverts. I have always been a more extraverted person with highShow MoreRelatedSAT Top 30 Essay Evidence18536 Words   |  75 Pages................................................................................. 55 Scientists and Mathematicians: Charles Darwin (and his revolutionary Theory of Natural Selection) ...................................................... 57 Jane Goodall (She lived with wild chimpanzees!) .................................................................................... 59 Marie Curie (Famous female scientist) .................................................................................

Sex Education Is An Important Class Modern Day Society

Sex education is an important class in modern day society. Many adolescents today are surrendering their virginity at very young ages. Therefore, teens need to be informed about all the risks that may accompany participation in sexual intercourse. These classes can help decrease the number of STD cases and teen pregnancies each year as well as encourage teens to have â€Å"safe sex† if they choose to engage in it at all.* Sex education classes are valuable because they help teens realize the devastating risk of diseases that can be a consequence of sex, advise students to have safe sex if they are going to partake in it, and warns them of the risky probability of the female becoming pregnant as a result. Partaking in sexual intercourse puts that person at risk for multiple STD’s depending on the sexual history of both partners. Diseases of this variety, like any other, often are accompanied by horrible life-long repercussions. â€Å"An STD is any disease that is spread primarily by sexual contact,† says About Health. There are a variety of known STD’s, but some of the more common ones are: Chlamydia, HIV/AIDS, and Herpes/HSV. â€Å"Chlamydia is the most common curable STD,† says About Health. This painful disease concerns the female’s cervix and male’s penile urethra. This STD is incredibly common because some people don’t display any symptoms for, sometimes, very long periods of time. Some profound symptoms that one may experience are: pain during intercourse and discharge from theShow MoreRelatedSexual Education in Public Schools760 Words   |  3 PagesSexual education has long been a topic of debate among many different in our American society.  The public schools system offers sexual education or sex ed to all students, and offer parents the option to exclude their children from these class rooms.  Discussions to making these classes mandatory has drawn some positive supports and negative support s in the forum disputes of sex education topic.  Due to the high number of teen pregnancies (As of 2012, the teen birth rate was 29 births per 1,000 teenRead MoreGender Roles Of The United States1195 Words   |  5 PagesGender roles refer to the set of social and behavioral norms that are socially appropriate for individuals of a specific sex. Gender roles are never comprehensive, even within a single country, and they are always historically and culturally unpredictable. Gender roles in the United States for one cultural group likely is not true for another cultural group. Similarly, gender roles in the United States have changed drastically over the time period. Gender roles has been the historical evolution fromRead MoreHow Slavery Has Changed Today s Modern Society1324 Words   |  6 PagesHow do you define slavery in today’s modern society? The word slavery sparks up heated conversations. The idea that all humans were born with their own rights, no matter what rac e or class they were in, was not prevalent during the early developmental stages of America. There has always been slaves throughout the history of man, dating all the way back to the 1600’s until today’s day in age when it is no longer legal but still seems to prevail. There are still cases in which slavery still existRead MoreTechnology, Social Media, And Education890 Words   |  4 PagesThe three most significant new developments in society during my lifetime thus far would be: technology, social media, and education. For my father, the three most significant new developments in society throughout his lifetime would be the Soviet/Afghan War, migration, and technology. In the past decade, technology has revolutionized the way humans in society today think, speak, work and communicate. With the rapid progression of technology, the world has become a smaller place; keeping in touchRead MoreSocietal Norms And Practices Surrounding Gender Essay1550 Words   |  7 PagesThe schooling system is a dominant institution in society that acts as a significant agent in the reproduction of culture. In this essay I will be discussing the ways in which societal norms and practices surrounding gender are reflected in the schooling system and are consequently reproduced into the next generation. I will explore how gender is a social construct, changing across time and culture, and performed by individuals. I will analyse how through my socialisation at school, I have learnedRead MoreWho Are Philosophers And Writers Of Great Ingenuity?1545 Words   |  7 Pagescontinues to have a proportionate amount of significance to contemporary society, as it did about 166 yea rs ago. It certainly takes high levels of understanding to put down into direct words such global concepts, as are portrayed by the works of Karl Marx and Friedrich Engel, both of whom are philosophers and writers of great ingenuity. With the main aspects continuing to serve as important criticisms of modern day society, reflecting back upon the ideologies brought forth by two of the most influentialRead MoreSingle-Sex Education and Co-ed Education Essay1059 Words   |  5 PagesSingle-Sex Education and Coed Education. The single-sex format creates opportunities that do not exist in the coed classroom. (Edison 1) Researchers are unaware that both genders brains function differently. This lack of knowledge may be why the real truth about single-sex education being more efficient than co-ed education has not been discovered. Some say single-sex education may be the key for a brighter generation. It shows to improve test score dramatically. The number of public schools experimentingRead MoreDifferences Between Gender And Social Division Essay1575 Words   |  7 Pages Any society displays a certain degree of inequality. Researches, studies or media analysis in various fields such as history, sociology, philosophy or anthropology highlight the existence of at least one social division at any given time in the history of mankind. The issue raised and analysis below is â€Å"to what extend is social division in Aoteroa New Zealand organised around gender relations†. Gender relation refers to differences that appear in all aspects of men and women lives and how theseRead MoreAssessment of the Usefulness of Functionalism in Understanding the Family1223 Words   |  5 PagesAssessment of the Usefulness of Functionalism in Understanding the Family Functionalism is a structuralist theory. This means it sees the individual as less important as the social structure of society. It is a ‘top down’ theory. The family can be defined as an intimate domestic group composed of people related to each other by blood, sexual relations and legal ties. When assessing how useful functionalism is when looking at the family, other views/perspectives Read Morehe Impact of Heteronormativity on the Transgender Community In society, children are taught1200 Words   |  5 Pagesof Heteronormativity on the Transgender Community In society, children are taught expectations as to what is sociably acceptable: who to like, what to wear, and where to live, based on of the environment they grew up in. As children grow up, and go on through life, they then begin to impose these expectations onto the people around them. More often than not these societal expectations conform with that of a heteronormative mindset1. In a modern western context, heteronormativity is the notion that

Cory Monteith Dies at 31 Free Essays

I was never a Glee fan but for a short period, ummmm say 1 season, I actually enjoyed it because of Noah! Of course, I never did discount the talent of Rachel and Finn. Cory Monteith’s life was cut tragically short on Saturday, July 13. The Glee star, who celebrated his 31st birthday on May 11, was found dead in a hotel room at the Fairmont Pacific Rim Hotel in Vancouver, Canada, police announced in a press conference. We will write a custom essay sample on Cory Monteith Dies at 31 or any similar topic only for you Order Now According to Vancouver PD, emergency personnel arrived at the hotel shortly after noon, at which point Monteith was pronounced dead on the scene by paramedics. The coroner is investigating cause of death. Foul play is not suspected. â€Å"We are so saddened to confirm that the reports on the death of Cory Monteith are accurate,† the actor’s rep said in a statement to Us Weekly shortly after news broke of the tragedy. † We are in shock and mourning this tragic loss. † PHOTOS: Stars gone too soon Monteith had recently completed treatment for substance addiction. On March 31 of this year, he announced via his rep that he had voluntarily checked himself into rehab, buoyed by the support of his girlfriend, Lea Michele, and others. â€Å"Cory is a beloved member of the Glee family, and we fully support his decision to seek treatment,† 20th Century Fox TV said in a statement at the time. â€Å"Everyone at the show wishes him well and looks forward to his return. † In recent weeks, the actor had seemed happier and healthier. After leaving rehab on Apr. 26, he tweeted his appreciation to fans. Sending out big love to everyone,† he wrote. â€Å"Thank you for the continued support! It means the world to me! † The actor had previously opened up about his struggles with drugs and alcohol, telling Parade in 2011 that he did â€Å"anything and everything, as much as possible,† after he dropped out of high school at age 16. â€Å"I had a serious problem,† he admitted. Afraid he â€Å"could die,† the British Columbian star’s family and friends staged an intervention when he was 19. â€Å"That’s when I first when to rehab,† he told Parade. I did the stint but then went back to doing exactly what I left off doing. † He finally realized he needed to turn his life around when he was caught stealing â€Å"a significant amount of money from a family member,† he said. â€Å"I was so desperate I didn’t care. It was a cry for help. † Monteith was best known for playing Finn Hudson on Glee, but he also had roles in Final Destination 3 and Monte Carlo. He and Michele, 26, had been dating for more than a year. This article in quote originally appeared on Usmagazine. om: Cory Monteith Dead: Glee Star Dies at 31 Don’t you feel sad when someone your age dies? I do. I feel like the mortality rate becomes high within our age bracket. Gone are the days that people die due to old age. I feel like people are just wasting their chances of living life the way we’re supposed to live it! I don’t want to sound preachy but I hope people realize that we are all created for one purpose and that it to glorify God. Life is indeed too short for nonsense. I feel sad that Cory Monteith died but life goes on†¦ e must all just figure out a better way of coping and for the youngsters of today to avoid such circumstance†¦ I hate losing people like Heath, Brad Renfro, among others†¦ substance abuse must be condemned†¦ we’ve lost too many people out of it†¦ Yes, this death is for yet another Cory (Haim) and he somehow resembles Heath Ledger who was dating Michelle Williams, odd that Cory’s dating Lea Michele†¦ I know these are all coincidental and do not make sense, it’s just worth writing so not to forget about it†¦ How to cite Cory Monteith Dies at 31, Papers

Symbolism in A Streetcar Named Desire Blanches Essay Example For Students

Symbolism in A Streetcar Named Desire Blanches Essay Dubois mysterious lifeIn Tennessee Williams play, A Streetcar Named Desire, the character of Blanche Dubois is a vivid example of the use of symbolism throughout the play. Blanche wants to view things in an unrealistic way. I dont want realism. I want magicI try to give that to people. I misrepresent things to them. I dont tell truth, I tell what ought to be truth (Blanche p.117). She doesnt want reality; instead she wishes to view a rose-colored version of life that goes along with her old-fashioned southern belle personality. Blanche doesnt want to face the reality of her problems. She wants everything to be softened and dimmed for her, just as the light is softened and dimmed by the shade. Light often symbolizes truth, which is why she doesnt like to stand in an illuminated room. She hides from reality and lives in a world of her own creation. I cant stand a naked bulb, any more than I can a rude remark or a vulgar action (Blanche p.55 scene 3). She had bought a little colored paper lantern to put it over the light bulb, so the room could get that mysterious touch that she wanted. Soft people have got to shimmer and glow- theyve got to put on soft colors, the colors of butterfly wings, and put a paper lantern over the light It isnt enough to be soft. Youve got to be soft and attractive. And I-Im fading now! I dont know how much longer I can turn the trick (Blanche p. 79 scene 5). Blanche can also now look at herself in the more favorable dimmed light, where the passage of time isnt quite as visible. Unde r this precept, she doesnt have to accept her fading beauty. We will write a custom essay on Symbolism in A Streetcar Named Desire Blanches specifically for you for only $16.38 $13.9/page Order now In the play she is constantly taking luxurious baths, which reflect her necessity to cleanse herself of her awful dealings, to rid her body of the grit of everyday life and the harsh, unforgiving world that surrounds her, all freshly bathed and scented, and feeling like a brand new human being! (Blanche p.37 scene 2). She feels dirty and wants to release all her sins, taking long baths until her skin crumbled. It is her way of liberating all those problems that made her wish to start her life over, leaving her past life at Belle Rve. Arriving at Elysian Fields is the best thing that happens to Blanche, because nobody knows her and she believes she can start a new life again with no regrets, in her own way.Blanche also mentions the meaning of her name. Its ironic because it means white, which stands for purity, and because of her promiscuity and past actions, it doesnt apply to her. .. Its a French name. It means woods and Blanche means white, so the two together mean white woods (Bla nche, p.55 scene 3). ..My birthdays next month, the fifteenth of September; thats under Virgo.. Virgo is the Virgin (Blanche p.77 scene 5) Besides the so-called purity her name implies, Blanche also brings to attention her astrological sign. Supposedly, Virgo implies, and stands for, virginity. Blanche certainly isnt pure anymore, due to all the actions that she has committed, including losing her job as a teacher as a direct consequence of having an affair with a seventeen year old. Although the author doesnt state the reasons for the affair, it can be implied that it was a desperate attempt from Blanche to retain her quickly fading youth. Throughout the play the Williams shows how Blanche turns promiscuous, and why her astrological sign certainly doesnt match with her personality. Due to her relations with other men, the author makes it clear that virgin isnt a good way to describe Blanche. As stated, society is composed of people with a lot of different thoughts and styles, yet a s time passes, things change and views and ideals arent the same. Blanche Dubois isnt the classical heroine usually portrayed, but she expresses and shows how some people hide their true nature or believe that there is some type of protocol for living life. Blanche represents a deep-seated attachment to the past. Her life is a lesson in how a single tragic event can ruin the future; her refusal to come out of the time warp and cope with the real world, makes her unrealistic and flighty. She convinces herself that she has remained pure because inside, I never lied. She knows that her soul, or inner self, remained uninvolved in her physical encounters. Blanche is a truly tragic heroine. She was, indeed, capable of supreme sacrifice and that is one of the main reasons in why Williams wants to show and express her character through the heavy usage of symbolism.

Ethan Frome - Rushing into Marriage; the Wrong Decision essays

Ethan Frome - Rushing into Marriage; the Wrong Decision essays Marrying is a very delicate decision which affects a persons life forever; therefore, choosing a life-long mate should be a decision taken after pondering thoroughly. In the book Ethan Frome, the author, Edith Wharton describes very well how the main character ruins his life because he contemplated, and not other pressures and opinions like what family or society might think. In the novel, Ethan did not ponder enough and ended married to the wrong woman. The decision of whom to marry should be made personally without any pressures from anybody else; not from your parents, not from loneliness, and not even if the partner wants to. It is an issue that concerns a persons happiness forever and it should not be rushed into. In some cultures parents are the ones who choose their childrens mate. They search for an individual that comes from a good family. He must be able to support a family economically, and he must look appropriate to be a good husband or wife. These are not necessarily the qualities needed when a person is to spend his whole life with somebody. Sometimes individuals marry the wrong person only to please their familys expectations. Marriages can also be rushed in through other internal pressures. For example, in Edith Whartons Ethan Frome, the main character gets married to Zeena because he does not want to be alone anymore. He does not love her; he does not even like her very much. External conditions like the need of a woman in the house, and internal feelings such as loneliness are the ones that drive Ethan into getting married. This loneliness is expressed in this quote: After his mothers funeral, when he saw her preparing to go away, he was seized with an unreasoning dread of being left alone; and before he know what de was doing he asked her to stay here with him (Wharton 52). This mistake drives him to unhappiness in his life. Later, when he meets the wo...

History of the Inca Empire

History of the Inca Empire The Inca Empire was the largest prehispanic society of South America when it was discovered by the Spanish conquistadors led by Francisco Pizarro in the 16th century AD. At its height, the Inca empire controlled all of the western part of the South American continent between Ecuador and Chile. The Inca capital was at Cusco, Peru, and the Inca legends claimed they were descended from the great Tiwanaku civilization at Lake Titicaca. Origins Archaeologist Gordon McEwan has built an extensive study of archaeological, ethnographic, and historical sources of information on the Inca origins. Based on that, he believes that the Inca arose from the remnants of the Wari Empire based at the site of Chokepukio, a regional center built about AD 1000. An influx of refugees from Tiwanaku arrived there from the Lake Titicaca region about AD 1100. McEwan argues that Chokepukio may be the town of Tambo Tocco, reported in Inca legends as the originating town of the Inca and that Cusco was founded from that city. See his 2006 book, The Incas: New Perspectives for more detail on this interesting study. In a 2008 article, Alan Covey argued that although the Inca arose from the Wari and Tiwanaku state roots, they succeeded as an empire- compared to the contemporary Chimà º State,  because the Inca adapted to regional environments and with local ideologies. The Inca began their expansion from Cusco about 1250 AD or so, and before the conquest in 1532 they controlled a linear stretch of some 4,000 kilometers, including nearly one million square kilometers in area and over 100 different societies in coastal regions, pampas, mountains, and forests. Estimates for the total population under Incan control range between six and nine million persons. Their empire included land in what are the modern countries of Colombia, Ecuador, Peru, Bolivia, Chile, and Argentina. Architecture and Economics To control such a huge area, the Incas built roads, including both mountainous and coastal routes. One existing fragment of the road between Cusco and the palace of Machu Picchu is called the Inca Trail. The amount of control exercised by Cusco over the rest of the empire varied from place to place, as might be expected for such a huge empire. Tribute paid to the Inca rulers came from farmers of cotton, potatoes, and maize, herders of alpacas and llamas, and craft specialists who made polychrome pottery, brewed beer from maize (called chicha), wove fine wool tapestries  and made wooden, stone, and gold, silver and copper objects. The Inca were organized along a complex hierarchical and hereditary lineage system called the ayllu system. Ayllus ranged in size from a few hundred to tens of thousands of people, and they governed access to such things as land, political roles, marriage, and ritual ceremonies. Among other important duties, ayllus took maintenance and ceremonial roles involving the preservation and care of honored mummies of the ancestors of their communities. The only written records about the Inca that we can read today are documents from the Spanish conquistadors of Francisco Pizarro. Records were kept by the Inca in the form of knotted strings called quipu (also spelled khipu or quipo). The Spanish reported that historical records- particularly the deeds of the rulers- were sung, chanted, and painted on wooden tablets as well. Timeline and Kinglist The Inca word for ruler was capac, or capa, and the next ruler was chosen both by heredity and by marriage lines. All of the capacs were said to be descended from the legendary Ayar siblings (four boys and four girls) who emerged from the cave of Pacaritambo. The first Inca capac,  the Ayar sibling Manco Capac, married one of his sisters and founded  Cusco. The ruler at the height of the empire was Inca Yupanqui, who renamed himself Pachacuti (Cataclysm) and ruled between AD 1438-1471. Most scholarly reports list the date of the Inca empire as beginning with Pachacutis rule. High-status women were called coya and how well you could succeed in life depended to a degree on the genealogical claims of both your mother and father. In some cases, this led to sibling marriage, because the strongest connection you could have would be if you were the child of two descendants of Manco Capac. The dynastic king list which follows was reported by the Spanish chroniclers such as  Bernabà © Cobo  from oral history reports and, to a degree, it is somewhat under debate. Some scholars believe that there was actually a dual kingship, each king ruling half of Cusco; this is a minority viewpoint. Calendrical dates for the reigns of the various kings were established by Spanish chroniclers based on oral histories, but they are clearly miscalculated and so are not included here (some reigns supposedly lasted over 100 years). Dates included below are those for  capacs  that were personally remembered by the Inca informants to the Spanish. Kings Manco Capac (principal wife his sister Mama Occlo) ca. AD 1200 (founded  Cusco)Sinchà ­ Roca (principal wife Manco Sapaca)Lloque Ypanqui (p.w. Mama Cora)Mayta Capac (p.w. Mama Tacucaray)Capac YupanquiInca RocaYahuar HuacacViracocha Inca (p.w. Mama Rondocaya)Pachacuti Inca Yupanqui (p.w. Mama Anahuarqui, built the  Coricancha  and  Machu Picchu, reformed Inca society) [ruled AD 1438-1471], royal estates at Pisac,  Ollantaytambo  and Machu PicchuTopa Inca (or Tupac Inca or Topa Inca Yupanqui) (principal wife his sister Mama Occlo, first capac considered supernatural in his lifetime) [AD 1471-1493], royal estates at Chinchero and  ChoquequiraoHuayna Capac [AD 1493-1527], royal estates at Quespiwanka and Tombebamba[civil war between Huascar and Atahuallpa 1527]Huascar [AD 1527-1532]Atahuallpa [AD 1532](Inca conquered by Pizarro in 1532)Manco Inca [AD 1533]Paullu Inca Classes of Incan Society The kings of the Inca society were called  capac. Capacs could have multiple wives, and often did. Inca nobility (called  Inka) were mostly hereditary positions, although special persons could be assigned this designation.  Curacas  were administrative functionaries and bureaucrats. Caciques  were agricultural community leaders, responsible for maintenance of agricultural fields and tribute payment. Most of the society was organized into  ayllus, who were taxed and received domestic goods according to the size of their groups. Chasqui  were message runners who were essential to the Inca system of government. Chasqui traveled along the  Inca road system  stopping at outposts or  tambos  and  were said to be able to send a message 250 kilometers in one day  and to make the distance from Cusco to Quito (1500 km) within one week. After death, the  capac,  and his wives (and many of the highest officials) were mummified and kept by his descendants. Important Facts Alternate names:  Inca, Inka, Tahuantinsuyu or Tawantinsuyu (the four parts together in Quechua)Population:  Estimates widely accepted by Inca scholars range between six and 14 million within an area extending from Colombia to Chile, in 1532 when the Spanish arrived.State language:  Inca rulers adopted a form of Quechua for their administrative language  and doing so spread it into outlying areas of their empire, but the Inca incorporated many different cultures and their languages. The Inca called their form of Quechua runasimi or mans speech.Writing system:  The Inca apparently kept accounts and perhaps historical information using a  quipu, a system of knotted and dyed string; according to the Spanish, the Inca also chanted and sang historical legends and painted wooden tablets.Ethnographic sources:  Lots of ethnographic sources are available about the Inca, primarily Spanish military leaders and priests who were interested in conquering the Inca. These texts are var iously useful and often quite biased. Some few examples include  Bernabà © Cobo, Historia del Nuevo Mundo 1653, and Relacion de las huacas, among many other reports;  Garcilaso de la Vega, 1609; Diez Gonzalez Holguin, 1608; anonymous Arte y vocabulario en la lengua general del Peru, 1586; Santo Tomas, 1560; Juan Perez Bocanegra, 1631; Pablo Joseph de Arriaga, 1621; Cristobal de Albornoz, 1582 Economics Intoxicants:  Coca, chicha (maize  beer)Markets:  A widespread trade network facilitated by open marketsCultivated crops:  Cotton, potatoes,  maize, quinoaDomesticated animals:  Alpaca,  llama,  guinea pigTribute  was paid to Cusco in goods and services; tribute tallies were kept on quipu and an annual census was kept including the number of deaths and birthsLapidary arts:  ShellMetallurgy:  Silver, copper, tin and to a lesser extent gold were cold-hammered, forged, and air-annealedTextiles:  Wool (alpaca and  llama) and cottonAgriculture:  When necessary in the steep Andean terrain, the Inca built terraces with a gravel base and stepped retaining walls, to drain excess water and allow water flow from the terrace tread to the next terrace downslope. Architecture Construction techniques used by the Inca included fired adobe mud bricks, roughly shaped stones interspersed with mud mortar, and large, finely shaped stones coated with mud and clay finishing. The shaped stone architecture (sometimes called pillow-faced) is among the finest in the world, with large stones sanded into tight jigsaw like patterns. The pillow-faced architecture was reserved for temples, administrative structures and royal residences like Machu Picchu.Many Inca military installations and other public architecture were constructed throughout the empire, at sites such as Farfn (Peru), Qara Qara and Yampara (Bolivia), and Catarpe and Turi (Chile).The Inca Road  (Capaq Ñan or Gran Ruta Inca) was built connecting the empire  and included some 8500 kilometers of major thoroughfare crossing fifteen distinct ecosystems. 30,000 kilometers of subsidiary trails branch off the main road, including the Inca Trail, which is the part that leads from Cusco to Machu Picchu. Religion Ceque system: a system of shrines and ritual pathways radiating out from the capital city of Cusco. Emphasis on ancestor worship and fictive kinship structures (ayllus).Capacocha ceremony: a state event that involved the sacrifice of objects, animals and sometimes children.Burials:  The Inca dead were mummified and placed in open sepulchers so that they could be disinterred for important annual ceremonies and other rituals.Temples/shrines  known as huacas included both built and natural structures Sources: Adelaar, W. F. H.2006  Quechua. In  Encyclopedia of Language Linguistics. Pp. 314-315. London: Elsevier Press.Covey, R. A. 2008  Multiregional Perspectives on the Archaeology of the Andes During the Late Intermediate Period (c. A.D. 1000–1400).  Journal of Archaeological Research  16:287–338.Kuznar, Lawrence A. 1999 The Inca Empire: Detailing the complexities of core/periphery interactions. Pp. 224-240 in  World-Systems Theory in Practice: Leadership, production, and exchange, edited by P. Nick Kardulias. Rowan and Littlefield: Landham.McEwan, Gordon. 2006  The Incas: New Perspectives.  Santa Barbara, CA: ABC-CLIO. Online book. Accessed May 3, 2008.

Linear Model and Nonlinear Model Essay Example | Topics and Well Written Essays - 2000 words

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Analysing a Company: DHL

Analysing a Company: DHL   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  The aim of this strategic planning document is to thoroughly analyze a company and based on the analysis find the right strategy that fits the companys business purpose and mission. The right strategy, depending at what is directed, should help the company strengthen its position on the market; increase profits; help with further development. If a company implements a wrong strategy, it can cause bad damage or it can have huge financial impact on the company which could even end up in bankruptcy, which wipes the company off the market. The company chosen for this paper is DHL Express with focus on European region. DHL is part of the Deutsche Post DHL (further DP DHL) brand/group. The reason why I have chosen DHL for the Strategic Planning Document is that I have been working for DP DHL group for four years. I work specifically for IT Services which is the service line that internally supports the whole IT technology of the whole DP DHL group. ABOUT THE COMPANY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  DHL was founded in San Francisco exactly 40 years ago by 3 budding entrepreneurs Adrian Dalsey, Larry Hillblom and Robert Lynn. It went from small company shipping papers by airplane from San Francisco to Honolulu1 to global company shipping EVERYTHING around the world. DHL delivers time-critical shipments as well as goods and merchandise by road, rail, air or sea. DHL transports courier and express shipments via one of the worlds most extensive networks to over 220 countries and territories. The company employs more than 300,000 employees all around the world.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  DHL Express provides wide range of easily accessible services and solutions for their customers; from transport of letters, information to transport of parcels and goods. It operates in more than 220 countries around the world and employs more than 100,000 employees. DHL Express is number one in Europe with 25% of market share. Brief history 2 1969 DHL founded by Adrian Dalsey, Larry Hillblom and Robert Lynn in San Francisco; 1974 The first UK office opened in London. Globally, DHL had more than 3,000 customers; 1979 DHL extends its services to delivering packages. Only document services had been available until now. 1983 DHL is the first air express forwarder to serve Eastern European countries. An international distribution centre was opened in Cincinnati, USA; 1985 A state of the art hub was opened in Brussels. More than 165,000 shipments are handled per night 1998 Deutsche Post became a shareholder in DHL; 2002 Deutsche Post World Net became the major shareholder in DHL and 100% shareholding was completed by the end of the year. DHL: Our Company Portrait [online]. Available at www: DHL: Steps to success [online]. Available at www: 2005 DP DHL acquires Exel, the British logistics corporation. Exel primarily offers transport and logistics solutions for key customers; 2008 DHL opens new state of art European air hub at Leipzig/Halle Airport in Germany. DHL legally operates under Groups title defined as Deutsche Post AG and uses its brand name DHL. As previously mentioned DHL is part of DP DHL group and is formed by 3 divisions: Express, Global Forwarding, Freight and Supply Chain supported by internal services Global Business Services. Mail is a standalone division that is part of Deutsche Post brand. All four divisions together create Deutsche Post DHL as the picture below describes. DP DHL: Corporate Presentation, October 2009, p. 3 [online] Available at www. DHL has a divisional form of structure. The DP DHL group is organized into four operating divisions, each of which operates under the control of its own divisional headquarters. The Group management functions are performed by the Corporate Center. Management responsibilities are structured in accordance with decision-making, responsibility and reporting lines: Board departments Corporate departments Business departments Service departments Regions Departments DHL Express provides standardized products and services courier, express and parcel (CEP) both locally and globally depending on the country. Whether it is document or parcel, road or air, DHL Express provides several different types of services that are divided to four basic groups: 1. Same Day An immediate pick-up of a shipment by a dedicated courier, with an emergency delivery within the same day via a dedicated network. 2. Time Definite Express door-to-door delivery by a certain time on an overnight or next possible business day basis. 3. Day Definite Reliable door-to-door delivery within a certain number of days 4. Optional Services Shipping convenience with a range of optional services to support your express transportation DP DHL: Annual Report 2008, p. 22 [online] Available at www. DHL: Express Services Good afternoon [online]. Available at www: External Analysis Courier Express and Parcel (CEP) services exist in every single country around the world. It is neither country specific nor region specific industry. There are thousands of logistics companies operating locally or internationally around the world and Europe is not an exception. PESTLE PESTLE analysis is a view on external environment companies operates in. There are five external factors that influence life of organizations: Political environment, Economical environment, Socio-cultural environment, Legal environment and Environmental factor. The below PESTLE analysis focuses on CEP companies in European market. Political Environment   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  European region is stable environment that is not affected by any significant political crisis in countries and no major changes in political structure are expected in near future. More than half of European states are integrated into European community, European Union and create one of the biggest single markets for trade and investment in the world. EU enlargement has removed border lines and has made trade and business more accessible for its members. It has brought greater opportunities for businesses, wider range of companies and benefits for their customers.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  EU has created closer links with immediate neighbors and enables bigger exports, free movement of services, payments and capital for trade and investment. Prior liberalization in 90s there were many national postal operators acting as monopolies. EU decided to start postal reform that firstly completely liberalized CEP market. Liberalization has enabled both national postal operators (Post Offices) and private postal companies to enlarge their business portfolio into parcel and express market. This happens through acquisitions of well-established companies and smaller national companies. Exactly, as it happened to DHL through acquisition by Deutsche Post in 2002. Full liberalization in Europe will be completed by 2012 which gives current companies time to strengthen their positions, build new networks and gain wider portfolio of customers. EU has also built up confidence in European political and economical future of each member which enables companies to make longer term decisions, strategies and investment plans. Currently the CEP market is highly competitive and companies have to have capital to establish strong and powerful position in such an environment and have to have built up networks supported by the modernist technologies. Summary: Europe is stable environment where no major political changes are expected. Full liberalization of European postal market that will be finished by 2012 will bring more competition especially on domestic level. However, there is a potential to merge or acquire those companies operating in the local markets and increase market share. Big companies operating on international level have an advantage of built global networks and modern technology behind them. Economical Environment CEP is highly potential market and its growth is directly related to the level of GDP. Global trade is on the rising level and together with industrialization has made CEP services more important for majority of industries. Additionally, product life cycles have been reduced, quality awareness among customer is growing and in order to succeed companies are forced to maintain high quality standards. The global economic crises caused decline in economy and it has affected the entire logistics sector. Volume of shipments decreased and the recession slowed down the whole market. Even the big corporations have to fight with decreased revenues and change their investment plans and business strategies. Governments around Europe support investment plans by structural reforms and programs that encourage investors to invest. During the big economic crisis in 30s this did not happen and governments tended to act individually without multinational or even global cooperation. Todays economies learnt from those mistakes which help to lower the implications, increase customer demand and support start of growth. Due to the crisis companies changed their investment plans but did not stop them. Merges with smaller companies, agreements and strategic acquisitions represent one way of increasing the competitive advantage. Emerging markets represent big opportunity in long-term perspective. There is potential for investment and development in emerging markets and it is expected that industrialization will bring opportunities, the economy will growth and market for services will accelerate. The crisis negatively affects profits of every company on one hand but on the other hand big corporations with strong brand and position in the market have to exploit this opportunity. Smaller companies do not have potential to expand because they are in bigger risk of losing money or even bankruptcy if they fail. Big corporations are able to absorb that risk much easier. Companies have started to reduce cost and people have started losing their jobs. Restructuring of company structure is one of the way how to move forward. IT is core element of every company that operates in logistics industry. Companies have to invest huge amount of money to development and maintenance of their IT infrastructure. Recent trend leaves development in Europe and transfers hosting and maintenance of the infrastructure to Asia. Summary: Conclusion from the Economical environment analysis is that companies should not stop their investment plans because of economic crisis. It is important in current situation to strengthen position in the market and expand if possible. Emerging markets represent a potential of rapid economy growth. The risk of loss is the same for all companies but for big corporations is more acceptable. Reduction of cost is evitable for every company and restructuring or outsourcing are the ways of dealing with it. Socio-Cultural Environment The third aspect of PESTLE analysis focuses on forces within society. Social and cultural forces affect customers attitudes, interests and opinions. Companies must be able to offer products and services that aim to complement and benefit customers needs and wants. If they do not quickly respond to changes in society they will lose market share and demand for their product or service will decrease. Removing of border lines makes trade and business in Europe more accessible. Emerging markets are place that is constantly developing and rapidly growing. Although the infrastructure is not as developed as in Western countries, there will be improvement with economic growth. It is important for the company to establish its brand and achieve good and reliable image and service quality among its customers. The portfolio of services that is offered in developing countries is not usually complete and focuses on the biggest needs and wants of the business. Companies do not have the only affect and responsibility to their customers. There are different parts of society they are in contact with. There are needs of employees, investors and the society as a whole. Research Development department play an important role in this area. Customer satisfaction surveys, employee satisfaction surveys, market surveys help the company to build its brand and image, increase employees commitment and shape public awareness. CEP market and logistics industry play one of the key roles in the economic growth globally not only within European market. Increases in volumes of goods transport has lead to higher CO2 emissions which according to climate scientists have direct affect on global warming. It is social cost for the society and governments discourage those social costs with fines, taxes and legislation. Companies responsibility is to decrease these cost and work with more efficient and environmentally friendly means of transport. Social cost have negative affect on customers spending but could be balanced by larger offer of environmental friendly oriented products. Summary: Social forces affect customers needs and wants and it is important for the company to know it and benefit from it. Therefore the role of Research Development is very important. Company has to respond to changes in society quickly not to loose market share and demand for services. Customer satisfaction surveys, market surveys, employee surveys play important role in building companys brand and image in the market. Border lines have been removed within EU and services are more accessible in the whole Europe. Emerging markets represent an opportunity for companies to enter and establish their brand and image. Additionally, there are also social costs for the society that companies have responsibility for. The affect on environment is significant and companies role is to decrease those costs by working with more efficient and environmentally friendly technology which is then balanced by larger portfolio of environmental friendly oriented customers. Technological Environment   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Technology environment is vital part of every business that rapidly moves it forward. Technological innovations have changed the world and manner in which every business operates. Technology has created society expecting immediate results. Information exchange between customers, companies, people or any stakeholders is faster. That gives benefit to businesses as they can react quickly to any changes in the operating environment. However, the ability to quickly react also brings extra pressure on companies because they are expected to deliver on time and without any delays. Customers in service industry have to continuously face new challenges in planning, managing and monitoring their business processes. Companies in CEP market (and not only there) started offering customized logistics solutions to meet challenges: for example safety transport of sensitive products such as pharmaceuticals and vaccines to the healthcare industry done within a temperature-controlled environment. Operations in logistics industry is not only about cars, vans and aircraft there are other parts of infrastructure that needs technological development and improvement: posting, collection, sorting, transport, warehousing, delivery and last but not least Information Technologies. IT is core. Speed and reliability are key success factors to be able to meet standards and quality and gain advantage among competition.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  It is important to pay special attention to IT area because service industry is fully dependent on it. Companies invest huge amount of money to development and maintenance of their IT infrastructure. As mentioned above IT is one of the key elements for logistics and operations processes. Systems must be accessible and available at all times; security is evitable unauthorized access to data and data manipulation must be prevented, to ensure that software is not delivered with defects or too late. Companies have to fight with decreased revenue and reduce their cost in times of economic crisis but importance of IT technology is so significant that they cannot stop investing in it. Otherwise there is a threat that they will fall behind and loose their market share.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Outsourcing or in other words subcontracting is a way of reducing cost in IT area. Development of new technologies, software or applications goes to another organization. Usually, the company is specialized in software development. Or hosting and maintenance of applications or services are transferred to another company. The decision whether to do in-house or outsource is often based on achieving lower production cost and usage of available resources in better way and focus energy on the core competencies of the business. Summary: Modern technology and environment is key to success of the company that helps to maintain or gain competitive advantage. IT is the most important technology factor for logistics business because speed and reliability are equal to success. However, there is an indisputable constant threat of falling behind.Investments to the modernist technologies are evitable and in times of economic crisis are much more important then anytime before. Company has to decide if it runs internal IT organization or if it outsources most of the services and reduce cost. Legal Environment Legal rules play a role in nearly every aspect of companys operation from state regulations through contracts to treatment of employees. Legal factor is very important because companies work within legislative framework where legislation can either place numerous obligations or can create market conditions beneficial for business. CEP market is regulated by Postal directive applicable in all EU states. Full liberalization process will be completed by 2012 which gives current companies time to strengthen their position, build new networks and get more customers before new competition arrive. CEP market was fully liberalized during 90s and no special license or authorization is required in most of the EU countries. Ten states of EU require companies to receive explicit decision of National regulatory authority that is called general authorization that enables them to start operating in those countries but it does not represent a barrier. General authorization document contains several conditions that are related to e.g. confidentiality of correspondence, restrictions on transport of dangerous goods, data protection standards, etc. As I said previously there are social cost for the society that must be balanced by companies obligations in terms of fines, taxes and additional legislations related to regulation of aircraft noise, regulations concerning emission standards, obligations to reduce greenhouse gas that forces companies to invest into more environmentally friendly means of transport. Summary: Legal factor is important for operations of every company. Companies have obligations like directives, taxes and rules that they must be aligned with to be able to operate in the market. Legal factor can either place numerous obligations on the company or can create market conditions beneficial for business. Liberalization is an example of the benefit. Removal of border lines together with liberalization enabled building and strengthening of positions in the logistics market. There are no special and expensive authorizations necessary in CEP industry which is another benefit for companies. On the other hand there are obligations that balance the above benefits in terms of fines, taxes and directives that are mainly related to environment. Companies are forced to invest into environmentally friendly operations. Environmental Analysis Transportation industry causes major impact on the green house gases in the atmosphere. Mobility has increased and brought many indisputable advantages that must be weighed against the social, economic and environment costs it causes. Countries issue legislation that forces companies to reduce emissions. Companies have started implementing projects that help them to find out ways how to reduce pollutions and to be compliant with issued legislation. Transportation companies are dependent on fossil fuels and to reduce their dependency they have to look for commercial vehicles and aircraft powered differently or non-conventionally. Change of vehicle is not the only option that would reduce air pollution there are other ways that companies could take: to make their business more efficient and effective, to reduce shipping time, to take uniform approach, to offer climate-neutral products or train employees. Research Development department plays important role in those projects because it helps to come up with new ideas, technologies, procedures and processes. Summary: Transportation industry has great effect on air pollution globally. It is undisputable fact and companies are forced to fulfill the requirements of governments to reduce their contribution on pollution of the global environment. Companies have started implementing projects that help them fulfill those requirements. Research Development department is key to the success of it. PESTLE Summary Based on the PESTLE analysis I have identified opportunities and threats that will be taken into account during the SWOT analysis. Opportunity: Full liberalization of European postal market that will be finished by 2012 brings new opportunities to increase market share by acquisitions or merges with other logistics companies or newly liberalized companies. Established companies wit big market share, global network and technology have competitive advantage. Opportunity: Border lines have been removed within EU and services are more accessible in the whole Europe. Emerging markets represent a potential of rapid economy growth therefore it is an opportunity for companies to enter and establish their brand and image and gain bigger market share. Threat: Role of Research Development department in the company is very important. Company has to respond to changes in society quickly not to loose market share and demand for services. Customer satisfaction surveys, market surveys, employee surveys play important role in building companys brand and image in the market. Threat: In times of economic crisis economy slowed down and revenue decreased. Reduction of cost is evitable for every company and restructuring or outsourcing are the ways of dealing with it. Threat: Social costs represent a responsibility of companies towards society. The affect of transportation and logistics companies on environment is significant and companies role is to decrease those costs by working with more efficient and environmentally friendly technology which is then balanced by larger portfolio of environmental friendly oriented customers. Companies are forced to invest into environmentally friendly operations by fines, taxes and directives placed by governments. Therefore, companies have started implementing projects that help them fulfill those requirements. Threat: Modern technology and environment is key to success of the company that helps to maintain or gain competitive advantage. IT is the most important technology factor for logistics business because speed and reliability are equal to success. However, there is an indisputable constant threat of falling behind. Investments to the modernist technologies are evitable and in times of economic crisis are much more important then anytime before. The role of Research Development is evitable here. Porters Five Forces   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Courier Express Market is highly competitive market and its growth is directly related to growth of GDP. Customers of logistics companies are demanding. Technology improvements reduce product life cycles, quality awareness among customer is growing and in order to succeed companies are forced to maintain high quality standards. DHL Express has three biggest competitors in CEP market. They are UPS, TNT and FedEx. As you can see in the Picture 2 below DHL Express has the highest market share of 25% as a single company in Europe. All four major competitors operate internationally and have global network with good and modern technology behind them. The picture below also shows us that third of the European market is dismantled among small and medium sized companies that operates independently. European market portrait Customers of logistics companies vary from individuals to big industrial or manufacturing companies. All of them expect that the delivery service will be simple and convenient and that the delivery will be on time without any delay and in a good quality. Customers are more and more demanding because range of suppliers is broadening and they are looking for customized and innovative solutions for delivery of their goods. DP DHL: Annual Report 2008, p. 58 [online] Available at www. The range of offered products is wide but could be introduced in three basic categories: Courier services are fast, door-to-door pick up and delivery services of high-value goods or urgently required documents. Express services are time-sensitive, usually guaranteed services and have delivery time a specific day (in general the next day) and/or specific time. Parcel services are the transport of largely standardized packages with usually non-guaranteed delivery time of 2-3 days (Time-definite and Day-definite) Porters Five Forces mode will help me to analyze five forces that influence the logistics industry and better understand the environment in which DHL Express operates in and competitive advantage the company has or could gain. Threat of New Entrants HIGH   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  CEP market is large and very attractive to business. Everyone needs to deliver package or parcel. Everyone needs to use courier. Logistics industry is important and dominates to the service sector. It is very easy to entry. There are no special legal barriers, patents or licenses necessary to run the business. There are exceptions as described in PESTLE analysis but those exceptions do not represent impossible to achieve requirements. The market is still growing and there is an assumption that will grow further.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  There are no border lines among members of EU which would threaten new companies to enter the CEP market. Company that wants to succeed in such a competitive environment has to have a good network that enables it to operate on local and international level. Good network requires time and financial investment. High technology standard is must. Companies have to protect themselves from the threats of new entrants therefore it is important for them to find ways to turn disadvantages in their favor. They have to capitalize from their historical experience and try to find better ways to provide their service. Current big players in CEP market are well established leaders that have significant cost advantage that is unavailable for the new entrants. Large companies have buying power that allows them to offer discounts to their customers. Simply, bigger the business is lower average unit cost they are able to produce. Customers loyalty is another important factor that increases barriers to entry for other competitors. Loyal and satisfied customer will be unlikely tempted to go to competitors or new entrants. Established companies usually do business set on long-term partnerships and contracts. The basic rule says that customers get everything they need or want.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  There are many advantages that economies of scale gives to big corporations but there are also limitations that must be taken into account. Those limitations give competitive advantage to smaller and medium sized companies. Large companies are very complex and with higher complexity the product range is widening. This makes it difficult to succeed and be the best. Specialization and innovative ideas are crucial. Large companies are also known for their high level of bureaucracy which gives smaller companies big advantage because they can satisfy customer faster and it is what matters in logistics industry. Also large companies have thousands of employees with different labor relations in every country which causes additional legal cost. In case of powerful workers union it can decrease power of the company and make their operation more difficult especially in time of restructuring.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  As I have mentioned modern technology is an important factor that significantly helps to increase market share and creates more barriers for new entrants. Outsourcing or off shoring are possibilities for companies to take advantage of other economies of scale and use their buying power and specialization in favor of further development. Summary:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  In summary, logistics market is large and is attractive to business because when GDP grows the demand for services grows. There is no special barrier to entry. In fact, it is very easy to entry. The market is still growing and there is an assumption that will grow further. Successful companies have built networks that enable them to operate on local and international level. Good network requires time and financial investment. High technology standard is must. Historical experience and appearance in the market is an advantage for companies like DHL. Big companies and corporations use economies of scale in their favor. Bigger company can provide higher discount and has lower profit. Customers loyalty is another important factor that increases barriers to entry for other competitors because of long-term partnerships and contracts.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  On the other hand there are also disadvantages for big companies that must be taken into

Disadvantages of Large Population of a Country in Relation to Development Essay

â€Å"Overpopulation is a curse to the society’s overall growth. Several countries facing this problem are trying to control their population growth. India, for example, has been introducing family planning programs to curtail the growth of its population.† Population growth in a country using a capitalist economic system means more demand for products and therefore economic growth. For a country with a low population and a lot of land, it can be an advantage especially if the distribution of wealth remains close to level so everybody can prosper. That’s not a long term solution for the planet however. The disadvantage is that population growth puts tremendous pressure on economic and ecological resources. In the long term, the world will have to come to terms with the fact that we are consuming at a faster rate than nature is able to produce right now. The consequences of not making an adjustment in an orderly manner will not be a pretty sight. Some of the underdeveloped and developing countries face the problem of over population. Too many mouths to feed and fewer natural resources on hand can have a devastating effect on the economy. Countries like India and China have large population. In India, population growth has been on a higher scale than what the country’s economy can handle. The prosperity of a nation depends upon the standard of living of its people. Developed countries, such as the US with less population provide a better standard of living for their people. The Americans have good food to eat, enjoy a luxurious living as compared to the people belonging to Sou th-East Asia. What are the disadvantages of overpopulation one may ask? Depletion of Natural Resources: The effects of overpopulation are quite severe. The first of these is the depletion of resources. The Earth can only produce a limited amount of water and food, which is falling short of the current needs. Most of the environmental damage being seen in the last fifty odd years is because of the growing number of people on the planet. They are cutting down forests, hunting wildlife in a reckless manner, causing pollution and creating a host of problems. Those engaged in talking about overpopulation have noticed that acts of violence and aggression outside of  a war zone have increased tremendously while competing for resources. Degradation of Environment: With the overuse of coal, oil and natural gas, it has started producing some serious effects on our environment. Rise in the number of vehicles and industries have badly affected the quality of air. Rise in amount of CO2 emissions leads to global warming. Melting of polar ice caps, changing climate patterns, rise in sea level are few of the consequences that we might we have to face due to environment pollution. Conflicts and Wars: Overpopulation in developing countries puts a major strain on the resources it should be utilizing for development. Conflicts over water are becoming a source of tension between countries, which would result in wars. It causes more diseases to spread and makes them harder to control. Starvation is a huge issue facing the world and the mortality rate for children is being fuelled by it. Poverty is the biggest hallmark we see when talking about overpopulation. All of this will only become worse if solutions are not sought out for the factors affecting our population. We can no longer prevent it, but there are ways to control it. Rise in Unemployment: When a country becomes overpopulated, it gives rise to unemployment as there fewer jobs to support large number of people. Rise in unemployment gives rise to crime as people will steal various items to feed their family and provide them basic amenities of life. High Cost of Living: As difference between demand and supply continues to expand due to overpopulation, it raises the prices of various commodities including food, shelter and healthcare. This means that people have to pay more to survive and feed their families. Top 20 thought provoking effects of over population 1.More mouths to feed. 2.Lower standard of living. 3.Poverty. 4.Overcrowded cities. 5.Sickness and spreading of diseases. 6.Insufficient natural resources to provide adequate goods and services. 7.Inadequate facilities, such as housing, medical etc. 8.Problem of starvation and malnourished population. 9.Education facilities may not meet the requirements of the entire population. 10.Unemployment. 11.Higher crime rate due to unequal distribution of wealth and insufficient financial resources. 12.Environmental pollution. Trees are felled to make space for housing facilities. 13.Agricultural production is insufficient to meet the requirements of the entire population, which results in higher prices. 14.Money is diverted to ensure that the population is fed, rather than carrying out fundamental research. 15.Lower life expectancy. 16.People living in rural areas are not provided with employment opportunities. 17.Large number of people lives in unhygienic conditions. 18.Birth rate is high. 19.Due to lack of proper medical facilities death is also very high. People succumb to various diseases. 20.Child labor is common. To sustain themselves families force their children to work, rather than send them to school.

Effectiveness of school-based interventions - Free Essay Example

Sample details Pages: 26 Words: 7949 Downloads: 4 Date added: 2017/06/26 Category Statistics Essay Tags: School Essay Did you like this example? ABSTRACT Introduction Background Don’t waste time! Our writers will create an original "Effectiveness of school-based interventions" essay for you Create order Obesity in both adult and children is fast becoming one of the most serious public health problems of the 21st century in developed and developing countries alike. It is estimated that approximately 10% of school age children. The prevalence of childhood overweight and obesity is ever on the increase in the UK as in the rest of the world. It is estimated that the prevalence of overweight and obesity among 2 10 year old children in the UK rose from 22.7%-27.7% and 9.9%-13.7% respectively between 1995 and 2003; these figures are set to increase unless something is done. School-based interventions offer a possible solution in halting obesity prevalence, because the school setting provides an avenue for reaching out to a high percentage of children (especially in the western world), opportunity for constant monitoring of children and the resources for anti-obesity interventions. Objectives To systematically review the evidence of the impact of school-based interventions to prevent childhood obesity on: Adiposity (primary objective) Knowledge, physical activity levels and diet (secondary objectives) Methods The review was done following the Cochrane collaboration guidelines. In addition to searching electronic databases, first authors of all included studies were contacted. A recognised critical appraisal tool was used to assess the quality of included studies. Results Three RCTs and one CCT met the inclusion criteria for the review. All four studies had a control and intervention group; with various study limitations. While none of the studies found statistically significant BMI changes in intervention groups when compared with control group post-intervention, all of them recorded either a significant change in diet, or an increase in physical activity levels. INTRODUCTION BACKGROUND Obesity is generally understood as abnormal accumulation of fat to the extent that presents health risk (Kiess, Marcus et al. 2004), and was added to the international classification of diseases for the first time in 1948 (Kipping, Jago et al. 2008). The worldwide clinical definition of adult obesity by the WHO is body mass index (BMI) 30kg/m2 (WHO 2006). In children however, because of the significant changes in their BMI with age (Cole, Bellizzi et al. 2000), there is no universally accepted definition of obesity (Parizkova and Hills 2004; Bessesen 2008) and it therefore varies from country-to-country. The most commonly used definition of childhood obesity is the US definition which measures overweight and obesity in a reference population using the cut off points of 85th and 95th centiles of BMI for age (Ogden, Yanovski et al. 2007). In the UK, overweight and obesity are diagnosed using a national reference data from a 1990 BMI survey of British children (Stamatakis, Primatesta e t al. 2005). Children whose weights are above the 85th centile are classed as overweight and over the 95th centile are considered obese (Reilly, Wilson et al. 2002). Recent estimates suggest that obesity has reached epidemic proportions globally with about 400 million adults being clinically obese, a figure projected to rise to about 700 million by 2015 (WHO 2006). In children, the current WHO estimates are that about 22 million children globally under age 5 are overweight (WHO 2008). In the UK, evidence suggests that obesity is set to be the number one preventable cause of disease in a matter of time (Simon, Everitt et al. 2005). In the last three decades, the scale as well as the prevalence of obesity have grown rapidly amongst all age, social and ethnic groups in the UK, as well as globally (Table 1)(Kipping, Jago et al. 2008). Estimates suggest that in the UK, between 1984 and 2002/2003, the prevalence of obesity in boys aged 5-10 rose by 4.16%, and by 4.8% in girls (Stamatakis, Primatesta et al. 2005). There is therefore there is an urgent need for the development and implementation of effective intervention strategies to halt the ever increasing obesity prevalence (Summerbell Carolyn, Waters et al. 2005). OBESITY CAUSATION The primary risk factors associated with the increase in prevalence of childhood obesity are ever increasing involvement in sedentary lifestyles and an increase also in the consumption of high energy dense food and drink (Ebbeling, Pawlak et al. 2002; Sekine, Yamagami et al. 2002; Speiser, Rudolf et al. 2005; Topp, Jacks et al. 2009). The underlying mechanism of obesity formation is an imbalance between energy input and expenditure (Moran 1999; Kipping, Jago et al. 2008) Genetic and environmental factors greatly influence the bodys energy balance. Nevertheless, genetic conditions which either cause production of excessive fat in the body or reduce the rate at which it is broken down, of which Prader-Willi syndrome is an example account for less than 5% of obese individuals (Speiser, Rudolf et al. 2005), with environmental factors accounting for a very high percentage (French, Story et al. 2001). The major cause of the rising obesity problem is arguably changes in physical and social environments (French, Story et al. 2001). In recent times, there has been a remarkable shift towards activities that do not promote energy expenditure, for example, most children would travel to school in cars rather walk, in contrast to what obtained in the 1970s (Popkin, Duffey et al. 2005; Anderson and Butcher 2006). There is evidence to suggest that obese children are less active than their non-obese counterparts, hence promoting physical activity such as walking or exercising will help prevent obesity in children (Hughes, Henderson et al. 2006). Media time (television viewing, playing video games and using the computer) has been identified as one of the significant environmental changes responsible for the surge in childhood obesity. Besides promoting physical inactivity, it encourages energy input via excessive snacking and inappropriate food choices as a result of television advertisements (Ebbeling, Pawlak et al. 2002; Speiser, Rudolf et al. 2005). Robinson in his study reveals that between ages 2 and 17, children spend an average of 3 years of their waking lifetime watching television alone (Robinson 1998). Parents play a significant role in where, what and how much their children eat and to an extent, how physically active their children are. In most homes, children make their food choices based on the options they are presented with by their parents, and they characteristically would go for wrong option, more so if they have an obese parent (Strauss and Knight 1999). Other changes within the family such as physical inactivity and working patterns of parents have contributed somewhat to the obesity epidemic. In a family where the parents work full-time, there tends to be very little time for them to prepare wholesome home-made meals and this could possibly explain the increasing demand for eating out (Anderson and Butcher 2006) thereby increasing intake of high energy dense food. Childrens attitude to and participation in physical activities depends largely on how physically active their parents are. Thus children of sporty parents embrace exercise heartily and are therefore less prone to becoming obese.(Sallis, Prochaska et al. 2000). In addition to these family factors, societal factors such as high crime rate, access to safe sports/recreational facilities, transportation and fewer physical education programs in schools significantly impact on energy balance (Koplan, Liverman et al. 2005; Popkin, Duffey et al. 2005; Topp, Jacks et al. 2009). French summarizes the environmental influence on obesity by opining that The current epidemic of obesity is caused largely by an environment that promotes excessive food intake and discourages physical activity (French, Story et al. 2001) CONSEQUENCES OF OBESITY Evidence suggests that childhood obesity and/or overweight has a great impact on both physical and psychological health; causing effects such as behavioral problems and low self esteem, with a higher risk in girls than in boys (Reilly, Methven et al. 2003). Although most of the serious consequences do not become evident until adulthood, research has shown childhood obesity to be linked to metabolic disorders such as insulin resistance and type 2 diabetes, stroke and heart attacks, sleep apnea, nonalchoholic fatty liver disease, higher incidence of cancers, depression, dyslipidaemia, increased blood clotting tendency, etc (Ebbeling, Pawlak et al. 2002; Reilly, Methven et al. 2003; Kiess, Marcus et al. 2004; D. A. Lawlor, C. J. Riddoch et al. 2005; Daniels 2006; WHO 2006). One of the long-term serious consequences of childhood obesity is that obese children are twice more likely to grow into obese adults than their non-obese counterparts (Moran 1999); however, this largely depends on factors such as age of onset, severity of the disease and the presence of the disease in one parent (Moran 1999; Campbell, Waters et al. 2001; Kiess, Marcus et al. 2004; WHO 2006). Other long term consequences include early death and adverse socio-economic consequences such as poor educational attainment and low/no income in adulthood (Reilly, Methven et al. 2003; Fowler-Brown and Kahwati 2004; Kiess, Marcus et al. 2004). Obesity-related morbidity places a huge and growing financial demand on governments. In the UK alone, the Department of Health has reported that obesity costs the NHS and the UK economy as a whole about ÂÂ £1b and between ÂÂ £2.3b ÂÂ £2.6b annually respectively, with the cost to the NHS projected to rise to ÂÂ £3.6b by 2010 (DH 2007). TREATMENT AND PREVENTION The treatment of obesity requires a multidisciplinary approach due to the multi-faceted nature of the condition (Parizkova and Hills 2004). This is aimed at reducing caloric intake and increasing energy expenditure through physical activity (Ebbeling, Pawlak et al. 2002). These interventions are more likely to be successful if the patients family is involved and the treatment tailored to individual needs and circumstances (Fowler-Brown and Kahwati 2004). In extreme cases, options such as surgical and pharmacological treatments could be exploited. These options are very unpopular and usually not recommended because the associated health risks outweigh the benefits by far (Epstein, Myers et al. 1998; Ebbeling, Pawlak et al. 2002). Considering the huge costs and high levels of treatment failure associated with obesity treatment (Stewart, Chapple et al. 2008), the axiom by Benjamin Franklin cannot describe any other condition better than it describes obesity management. An ounce of prevention is worth a pound of cure Dietz et al confirm this by saying that prevention remains the best and most effective management of obesity (Dietz and Gortmaker 2001). Obesity prevention interventions are usually set either in the home or at school with an objective of eliminating peer pressure and, by so doing effect behavioral change (Ebbeling, Pawlak et al. 2002). Literature suggests that the school has so far remained the choice setting for these preventive interventions despite the very limited evidence on its effectiveness (Birch and Ventura 2009). Why is the school setting a good focus of intervention? Approximately 90% of children are enrolled in schools in developed countries (Baranowsk, Cullen et al. 2002) Children spend a substantial amount of time in school and therefore consume a considerable proportion of their daily calories at school (Katz, OConnell et al. 2005) School related activities present an opportunity to educate children on the concept of energy balance, healthy living and how to make appropriate food choices (Ebbeling, Pawlak et al. 2002; Koplan, Liverman et al. 2005) It offers opportunity for continuity and constant monitoring via frequent contact (Baranowski T 2002) Schools have an availability of existing manpower and facilities needed for anti-obesity interventions (Kropski, Keckley et al. 2008) In a nut shell, Schools offer many other opportunities for learning and practicing healthful eating and physical activity behaviors. Coordinated changes in the curriculum, the in-school advertising environment, school health services, and after-school programs all offer the potential to advance obesity prevention (Koplan, Liverman et al. 2005). PREVIOUS SYSTEMATIC REVIEWS Systematic reviews have been conducted on the effectiveness of school-based interventions in the prevention of childhood obesity. Campbell et al (2001), conducted a systematic review of 7 randomised control trials (RCTs) (6 were school-based, varying in length of time, target population, quality of study and intervention approach). The review found that dietary and physical education interventions have an effect on childhood obesity prevalence. However, success varied with different interventions amongst different age groups. Two of the three long term studies that focused on a combination of dietary education and physical activity, and dietary education respectively reported an effect on obesity prevalence reduction. Similarly, 1 out of the 3 school based short-term interventions that focused only on reducing sedentary activity also found an effect on obesity prevalence. While this review shows that dietary and physical activity interventions based at school are effective against th e risk factors of obesity, the question of generalisability and reproducibility arises as the review reports the majority of the included primary studies were carried out in the US. Most of the studies used BMI as a measure of adiposity, and BMI as has been documented varies across ethnic and racial groups (Rush, Goedecke et al. 2007), thus, it will be inappropriate to apply the findings of US-based obesity prevention interventions to children in middle and low income countries where conditions are different. There are also concerns about the methodology and study design. For example the school-based study by Gotmaker et al (1999) had limitations such as low participation rate (65%) and the researchers were unable to adjust for maturity in boys and there was also poor assessment of dietary intake. All these limitations could have been responsible for a high percentage of the reported intervention effect thus affecting the validity of the results of the study (Gortmaker, Peterson et al. 1999). The authors of the review however concluded that there is currently very limited high quality evidence on which to draw conclusions on the effectiveness of anti-obesity programmes. A Cochrane review which is an update of the Campbell et al (2001) study by Summerbell et al (2005) has examined the impact of diet, physical activity and/or lifestyle and social support on childhood obesity prevention. Their review examined the effectiveness of childhood obesity prevention interventions which included school based interventions. Their study included 10 long-term (a minimum duration of 12 months) and 12 short-term (12weeks 12 months) clinical trials (randomised and controlled). 19 out of the 22 studies that met their inclusion criteria were school/pre-school based. The study chose the appropriate study type; more than one reviewer was involved in the entire process of data collection, extraction and selection of included studies. In general, the study found that most of the school-based interventions (dietary and/or physical activity) reported some positive changes in targeted behaviours, but however had very little or no statistically significant impact on BMI. The reviewers stated that none of the 22 studies fulfilled the quality criteria because of some form of methodological weakness which includes measurement errors. For instance, the study by Jenner et al (1989) had no valid method of measuring food intake. The studies by Crawford et al (1994), Lannotti et al (1994) and Sallis et al (2000) had similar measurement errors. Reporting error was identified in studies by Little et al (1999) and Macdiarmid et al (1998). There were also reliability concerns about the secondary outcomes measurement in some of the included studies. The reviewers therefore expressed the need for further high quality research on effectiveness. Kropski et al (2008) reviewed 14 school-based studies that were designed to effect a life style change, a change in BMI, decrease overweight prevalence through a change in nutrition, physical activity or a combination of both. Of the 14 studies, three were done in the UK, one in Germany and 10 in the US. The right type of studies were chosen for this review and the whole process was done by more than one reviewer, however they were unable to draw strong conclusions on the efficacy of school-based interventions because of the limited number of primary studies available and methodological or design concerns which include: small sample size (Luepker, Perry et al. 1996; Mo-suwan, Pongprapai et al. 1998; Nader, Stone et al. 1999; Warren, Henry et al. 2003), no intention-to treat analysis (Danielzik, Pust et al.; Sallis, McKenzie et al. 1993; Sahota, Rudolf et al. 2001; Warren, Henry et al. 2003), possibility of type I (Coleman, Tiller et al. 2005) and type II errors (Warren, Henry et al. 2003), unit of analysis errors (Sallis, McKenzie et al. 1993) and inconsistent results (Mo-suwan, Pongprapai et al. 1998; Caballero, Clay et al. 2003; Coleman, Tiller et al. 2005). Despite their inability to draw a conclusion on effectiveness, overall, the review found that a combination of nutritional and physical activity interventions had the most effect on BMI and prevalence of overweight, with the result largely varying from community-to-community. The nutrition only and physical activity only interventions appeared to have had a change on lifestyles of participants but either had no significant effect on the measures of overweight or no BMI outcomes were measured. Another systematic review on the effectiveness of school-based interventions among Chinese school children was carried out by M.Li et al (2008). The authors included 22 primary studies in their review. The review reported that the primary studies showed that there are some beneficial effects of school-based interventions for obesity prevention; the reviewers however expressed their concerns that most of the studies included in the review had what they considered to be serious to moderate methodological weaknesses. Sixteen of the 22 studies included studies were cluster control trials, and there was no mention by any of the researchers that cluster analysis was applied to any of the 16 studies. In addition to lack of cluster analysis, no process evaluation was conducted in any of the studies. Only one study performed an intention to treat analysis. Twelve studies experienced dropouts, but there was incomplete information on the study population at the end of the trial and the reason f or the dropouts. Additionally, none of the studies explained the theory upon which they based their intervention. There was also potential recruitment and selection bias in all the primary studies as identified by the reviewers. They stated that none of the studies reported the number of subjects that were approached for recruitment into the study. As none of the RCTs included described the method they used in randomization, neither did they state if the studies were blinded or not. The methodological flaws in a high percentage of the included primary studies could impact on the validity of the findings of the review. Again, the authors failed to reach a conclusion on the effectiveness of the interventions because of the intrinsic weaknesses found in the primary studies, and as a result state the need for more primary studies that would address the methodological weaknesses that is highly present in nearly all existing primary studies conducted on this topic so far. The study of the efficacy of school-based interventions aimed at preventing childhood obesity or reducing the risk factors is a rather complex one. Pertinent issues on effectiveness of school-based interventions to prevent the risk factors of obesity remain that there is very limited/weak evidence on which to base policies on. Heterogeneity of primary research (in terms if age of study population, duration of intervention, measurement of outcomes and outcomes measured) makes further statistical analysis nearly impossible. BMI is currently the most widely used measure of overweight and obesity in children. However, BMI has no way of distinguishing between fat mass and muscle mass in the body and might therefore misdiagnose children with bigger muscles as obese. Another disadvantage of using BMI in overweight measurement is its inability of depicting the body fat composition (Committee on Nutrition 2003), other surrogate indicators of adiposity may be needed. Most authors that have carried out a review on this topic so far have expressed the need for further research on this topic to add to the existing body of evidence. RATIONALE FOR THIS STUDY All the systematic reviews on this subject so far have focused mainly on the United States. Lifestyle differences such as eating habits between American and British children possibly affect generalisability and reproducibility of US findings to the UK. For example, in the US, research has shown that 0.5% of all television advertisements promote food, and that about 72% of these food advertisements promote unhealthy food such as candy and fast food (Darwin 2009). In the UK paradoxically, the government in 2007 enforced regulations banning television advertisement of unhealthy foods (foods with high fat, salt, and sugar content) during television programmes aimed at children below 16 years of age (Darwin 2009). Thus US children are at a higher risk of becoming obese than their UK counterparts as a result of higher rate of exposure to TV junk food advertisements. Another lifestyle difference between American and British children is physical activity. In the UK, a high percentage of children aged 2 to 15 achieve at least 60 minutes of physical activity daily (about 70% of males and 60% of females) (DoH 2004), as opposed to the US where only about 34% of school pupils achieve the daily recommended levels of physical activity daily (CDC 2008). These differences highlight the importance of public health policies being based on the local population characteristics rather than on imported overseas figures. There is therefore need to review the evidence of UK school-based obesity interventions to inform policy relevant to the UK population. To the best of my knowledge following an extensive literature search, no systematic review has been conducted on the effectiveness of school-based intervention in preventing childhood obesity in the UK, despite the high prevalence of the condition and its public health significance in this country. This research aims to bridge this gap in knowledge by focusing on UK based studies to evaluate the efficacy of school-based interventions in the UK population. This study therefore stands out insofar as it will be assessing the effectiveness of school-based interventions in the reducing the risk factors of obesity in the UK, with a hope of providing specific local recommendations based on UK evidence. This type of review is long overdue in the UK, considering that the governments target to reduce childhood obesity to its pre-2000 levels by the year 2020 (DoH 2007) will require local evidence of effective interventions to succeed. The next stage of this review will describe in detail the research methodology to be used to conduct the proposed systematic review. Also included will be research strategy details to be adopted, study selection criteria, data collection and analysis. AIMS AND OBJECTIVES The aim of this research is to: Systematically review school-based intervention studies in the UK aimed at reducing the risk factors of childhood obesity among school children. Objectives are: To assess the efficacy of school-based anti-obesity interventions in the UK. To identify the most effective form of school-based interventions in the prevention of childhood obesity amongst school children in the UK. CRITERIA FOR INCLUDING STUDIES IN THIS REVIEW METHODS This review was performed as a Cochrane review. The Cochrane guidance on systematic reviews and reporting format were as far as possible adhered to by the author (Green, Higgins et al. 2008). The entire review process was guided by a tool for assessing the quality of systematic reviews, alongside the accompanying guidance (health-evidence.ca 2007a; health-evidence.ca 2007b). TYPES OF STUDY In the search for the effectiveness of an intervention, well conducted randomised control trials (which are the best and most credible sources of evidence) will be the preferred source of studies for this review. However, because of the limited number of RCTs conducted on this topic so far, this study will include controlled clinical trials if there is insufficient availability of RCTs. TYPES OF PARTICIPANTS School children under 18 years of age TYPES OF INTERVENTIONS Interventions being evaluated are those that aim to: Reduce sedentary lifestyle Effect nutritional change Combine the two outcomes above Reduce obesity prevalence Effect an attitude change towards physical activity and diet Studies that present a baseline and post intervention measure of primary outcome. Interventions not included in this study are: Those with no specified weight-related outcomes Those that involved school-age children but were delivered outside of the school setting, as our focus is based on school-based interventions aimed at obesity prevention. Studies done outside the UK Studies with no specified interventions Non-RCTs or CCTs For each intervention, the control group will be school children not receiving the intervention(s). TYPES OF OUTCOMES MEASURED Primary outcomes Change in adiposity measured as BMI and/or skin fold thickness Secondary outcomes Knowledge Physical activity levels Diet SEARCH METHODS FOR IDENTIFICATION OF STUDIES Electronic searches The electronic databases OVID MEDLINEÂÂ ® (1950-2009), PsycINFO (1982-2009), EMBASE (1980-2009) and the British Nursing Index (1994-2009) were all searched using the OVID SP interface. The Wiley Interscience interface was used to search the following databases: Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effects. There was also a general search of internet using Google search engine, in an attempt to identify any ongoing studies or unpublished reports before proceeding to search grey literature sources. Grey literature For references to childhood obesity prevention in schools, the following grey literature sources were searched: British Library Integrated Catalogue (https://catalogue.bl.uk/F/?func=filefile_name=login-bl-list) ISI index of Conference Proceedings (https://wok.mimas.ac.uk/) SCIRUS (https://www.scirus.com/) System for Information on Grey Literature (https://opensigle.inist.fr/) ZETOC (https://zetoc.mimas.ac.uk) Additionally, current control trials database at https://www.controlled-trials.com/ was searched for any ongoing research. The UK national research register was also searched at https://portal.nihr.ac.uk/Pages/NRRArchive.aspx. All the links to the grey literature databases were tested at the time of this review and found to be working. Hand searches It was not possible to conduct a hand search of journals due to pragmatic reasons. Reference lists Reference lists of retrieved studies were searched for other potential relevant studies that might have been omitted in the earlier search. Correspondence First author of all included studies were contacted with a view to seeking more references. DATA COLLECTION AND ANALYSIS Selection of studies The abstracts and titles of the hits from the electronic databases searched were screened for relevance by a single assessor. Those that were thought to be potentially relevant were retrieved and downloaded unto EndnoteTM to make the results manageable and also avoid loss of data. At the end of the search, all databases were merged into one single database and duplicated records of the same study were removed. Subsequently, the assessor then sought and obtained the full text of, and reviewed the relevant studies that were considered eligible for inclusion. Multiple reports of same study were linked together. No further data were sought for studies not included in the review. Data extraction Data extraction from included studies was done by a single reviewer and the data recorded on a data extraction form. A summary of each included study was described according to these characteristics: Participants (age, ethnicity etc.), study design, description of school-based interventions, study quality and details such as follow-ups and date, location, outcomes measured, theoretical framework, baseline comparability and results Assessment of methodological quality of included studies A number of researchers (Jackson, Waters et al. 2005) and the Cochrane guidelines for systematic reviews of health promotion and public health interventions (Rebecca Armstrong, Waters et al. 2007) strongly advise using the Quality Assessment Tool for Quantitative Studies (2008a) developed by the Effective Public Health Practice Project in Canada and the accompanying dictionary (to act as a guideline) (2008b) in assessing methodological quality. Based on criteria such as selection bias, study design, blinding, cofounders, data collection methods, withdrawals and drop-outs and intervention integrity, the tool which is designed to cover any quantitative study employs the use of a scale (strong, moderate or weak) to assess the quality of each study included in the review. Analysis Considering the small number of studies included in the review and heterogeneity in terms of interventions, delivery methods, intensity of interventions, age of participants, duration of intervention and outcomes measured, it was not statistically appropriate to undertake a Meta analysis, which admittedly would have been the preferred method of analysing and summarising the results of the studies. A narrative synthesis of the results was done instead. RESULT DESCRIPTION OF STUDIES Results of the search The search of electronic sources identified 811 citations out of which 97 potential studies were retrieved. A reference management software EndnoteTM was used to search for and remove duplicate citations. Further screening of title and abstract reduced the number of citations to 17 potential studies. Full texts of the 17 studies were sought, 13 were excluded, and four met the inclusion criteria and were therefore included in the review. Authors of the four studies were then contacted in view to obtaining additional references. No relevant papers were retrieved through the grey literature search. There were no ongoing studies at the time of this review Included studies Four school based intervention studies carried out in the UK were included in the review. Intervention The aim of the Active Programme Promoting Lifestyle Education in Schools (APPLES) project in Leeds (Sahota, Rudolf et al. 2001), a multidisciplinary and multiagency programme was to reduce risk factors of obesity in primary schools by influencing dietary and physical activity behaviour, by promoting lifestyle education. The intervention was underpinned by the Health Promoting Schools philosophy and involved the whole school community including parents. In the Southwest of England, the Christ Church Obesity Prevention Programme (CHOPPS) (James, Thomas et al. 2004) aimed to prevent excess weight gain by discouraging the consumption of carbonated drinks amongst school children. On the other hand, a pilot study, the Active for life year 5 project in the South Gloucestershire aimed to examine the effects of lessons on physical activity, nutrition and screen viewing on time spent involving in sedentary activities. It also evaluated the feasibility of adapting lessons from a US intervention (Eat well and keep moving) for use in the UK. Fourthly, the aims of the Be Smart intervention in Oxford were to promote healthy diet and/or physical activity in school children and prevent childhood obesity. The development of this intervention was based on the Social Learning Theory. The four intervention programmes employed various media for the delivery of the interventions. The APPLES intervention, over one academic year in September 1996 to July 1997 targeted obesity by promoting healthy eating and physical activity via the school curriculum. The intervention was a multidisciplinary and multiagency programme that embarked on teacher training sessions, modification of school meals to exclude unhealthy foods, and the development of school action plans. Whilst the intervention group received this intervention, the comparison received no intervention. One of the two school based intervention project to involve parents was conducted in Oxford. The Be Smart intervention began in January 2000 and lasted for 20 weeks over four school terms. The intervention involved delivering a 25-minuite interactive and age-appropriate lesson to each intervention group at lunch-time clubs and targeted behavioural change. Four of the authors were involved in the delivery of the lessons, which was delivered weekly in term one and fortnightly in subsequent terms. To ensure continuity, the same author taught the same intervention to the same intervention group for the entire duration of the project. In South Gloucestershire, the Active for life year 5 intervention was conducted over a five-month period from February 2006 to June 2006. This intervention was a multi-component one which was adapted from the Eat Well Keep Moving project in the US. It involved delivering of interactive lessons on nutrition, physical activity and screen viewing by trained primary school teachers. Lastly, the CHOPPS intervention lasted for one school year from August 2001 to October 2002. The intervention was delivered by one of the authors, and was targeted at behavioural change by discouraging the consumption of carbonated drinks. Each class received a one-hour session each term. The first session focused on balance of good health and the ill-effects of carbonated drinks. The subsequent sessions comprised of music competition, presentation of art and a quiz based on a popular television game show. Study design All the four studies had RCT designs. However, the Be smart project (Warren, Henry et al. 2003) did not specify how randomisation was done. All programmes had an intervention and a control group for baseline and post-intervention comparison. The APPLES project (Sahota, Rudolf et al. 2001) was single-blinded and compared outcomes in primary school children aged 7-11 years in Leeds (intervention: n = 314, and control group: n = 322, Boys: 51% and girls: 49%) at baseline and at the end of the intervention. Evaluating outcomes in a slightly similar age group, the Active for Life Year 5 project, a double-blinded cluster RCT compared outcomes in 9-10 year old primary school children in SW England [Intervention schools = 10 clusters (n = 331), control = 9 clusters (n = 348)]. In Oxford, the Be Smart project (Warren, Henry et al. 2003) evaluated its intervention in 5-7 year old school children via a group RCT. There were 3 intervention groups (Eat smart: n = 56, Play smart: n = 54 and Play/E at Smart: n = 54) and a control group (Be Smart: n = 54). Finally, the CHOPPS (James, Thomas et al. 2004) project in SW England was a cluster RCT that assessed its intervention in 7-11 year old school children. There were a total of 19 clusters in the study [Intervention: 15 clusters (n=325); Boys: 169, Girls: 156, and control: 14 clusters (n = 319); Boys: 155, Girls: 164. Outcomes In all the four studies, the effect of the intervention was assessed by collecting the data on growth, measured in terms of BMI (height and weight). There was repeat measure of height and weight in all four studies at baseline, and at the end of the study for Active for life year 5 (Kipping, Payne et al. 2008), APPLES (Sahota, Rudolf et al. 2001) and CHOPPS interventions (James, Thomas et al. 2004). For the Be smart intervention, the repeat measure was taken a month post-intervention (Warren, Henry et al. 2003). Besides weight and height, the individual studies assessed other different outcomes. The Active for life year 5 intervention assessed time spent doing screen-viewing activities (Watching DVDs, television, Videos and playing computer games) and mode of transport to school using questionnaires completed by the children (at baseline and at the end of the study). The APPLES interventions additionally assessed the childrens diet (using a 24hour recall and 3-day food diaries), their knowledge on nutrition and physical activity (via focus group), their psychological state and how physical activity they are (both using questionnaires). In SW England, the CHOPPS project in addition to height and weight assessment, consumption of carbonated drink and water were also assessed (using 3-day diaries completed by the children). Nutrition knowledge, physical activity and diets were also assessed using questionnaires in the Be smart intervention in Oxford. Excluded studies Thirteen published studies were excluded from this review. The reasons for excluding these studies are provided in Appendix 5 and include location (studies carried out outside the UK) and study design (non-RCTs or CCTs). Methodological quality of included studies In terms of overall quality, one of the four included studies has been rated as strong (James, Thomas et al. 2004), two as moderate (Sahota, Rudolf et al. 2001; Kipping, Payne et al. 2008) and one as weak (Warren, Henry et al. 2003). Three of the four studies had cluster RCT study designs (Sahota, Rudolf et al. 2001; James, Thomas et al. 2004; Kipping, Payne et al. 2008) whilst one had a CCT design (Warren, Henry et al. 2003). Of the three RCTs, only one reported blinding of both participants and assessors (Kipping, Payne et al. 2008). Number of participants in all four studies ranged from 213 to 679 school children, and all studies reported follow-up of up to at least 80% of participants. In terms of cofounding, all four included studies reported that there were no significant baseline differences between the intervention and control groups, and as such rated were rated as strong (Sahota, Rudolf et al. 2001; Warren, Henry et al. 2003; James, Thomas et al. 2004; Kipping, Payne et al. 2008). Validity and reliability of data collection tools were addressed by all four studies, with a few of them identifying issues with validity. Collection tools used for height and weight in all four studies were reliable and valid. However, there were a few validity issues with the questionnaires used for assessing other outcomes such as physical activity and dietary intake. For example, the Active for Life Year 5 project expressed concerns that the questionnaires used for assessing physical activity though reliable, might not have been sufficiently valid (Kipping, Payne et al. 2008). Similarly, in the CHOPPS intervention, there were issues around validity of self collected diary data owing to the possibility of under-reporting by the children (James, Thomas et al. 2004). Again in the APPLES intervention project, problems with dietary and behaviour change assessments were reported (Sahota, Rudolf et al. 2001) Effects of interventions Only one of the four studies compared effectiveness of different types of school based interventions (Warren, Henry et al. 2003). Adiposity Only two of the four studies measured adiposity using indices other than BMI. The Be smart programme (Warren, Henry et al. 2003) measured skin-fold thickness at five sites using a Holtain skinfold calipers. Waist circumferences were also measured at four sites using a standard tape measure. However, there was no comparison either at baseline or post intervention of adiposity between the intervention and control groups using these measures. Similarly, the CHOPPS programme (James, Thomas et al. 2004) measured waist circumference at the point of flexure as the child bends to one side (deducting 1cm to account for clothing). The scores were converted to z scores and comparisons were made between the intervention and control groups. However, no significant changes were observed. BMI All four studies reported results for BMI in terms of height and weight, and found no significant differences between control and intervention groups at the end of the studies (Sahota, Rudolf et al. 2001; Warren, Henry et al. 2003; James, Thomas et al. 2004; Kipping, Payne et al. 2008). Height and weight measurements were taken using standardised measurement tools in all four studies. Although all the studies reported no significant BMI differences, in terms of the number of overweight children, the CHOPPS intervention (James, Thomas et al. 2004) recorded a 7.5% increase in number of overweight children in the control clusters, compared with a 0.2% decrease in the intervention group (Mean difference 7.7%, 95% CI: 2.2% to 13.1%) at 12 months. At three-year follow-up however, the prevalence of overweight had increased in all the groups (intervention and control), which meant that the significant difference previously recorded at the end of the study was no longer evident. Knowledge Two of the four studies assessed the childrens knowledge about physical and nutritional education at baseline and post intervention. The Be smart intervention(Warren, Henry et al. 2003) assessed nutrition knowledge using a questionnaire where children were shown pictorial representations of different kinds of food and asked to choose the one they thought was healthiest. The end of study analysis showed an increase in nutrition knowledge in both control and intervention groups when compared to the initial stages (p0.01, p0.001). Although unquantifiable, the APPLES programme (Sahota, Rudolf et al. 2001) through a focus group discussion found that when compared to the control group, children in the intervention group had a greater understanding of the health benefits of staying active and healthy eating and were also more able to recall all most of the lessons they were taught during the intervention. Diet Dietary intake was assessed by three of the four studies (Sahota, Rudolf et al. 2001; Warren, Henry et al. 2003; James, Thomas et al. 2004). Sahota 2001, assessed dietary intake using a 24hour recall (using a checklist, where children were required to tick the foods eaten from a list of possible foods) and a free form three day food diary. At the end of the study, an analysis of the 24hour recall showed a 50% increase in vegetable consumption amongst intervention children when compared to the control group (weighted mean difference of 0.3, 95% CI 0.2 to 0.4). However, the three day diary did not show any significant difference; possibly because of the low completion rate of the food diaries. The Be smart intervention (Warren, Henry et al. 2003) similarly reported an overall increase in vegetable (p0.05) and fruit (p0.01) consumption, with no significant differences between the control and intervention groups or genders at baseline or final stage. Intervention group analysis showed that the Eat smart and Be smart groups recorded a significant increase (p0.05) in fruit and vegetable consumption when compared to the other intervention groups. A significant increase in fresh fruit consumption was recorded amongst males (p0.01) when compared to females. No significant changes in consumption of foods high in fat were observed amongst the groups. The CHOPPS intervention (James, Thomas et al. 2004) measured change in diet by assessing the childrens consumption of carbonated drinks using a three day diary. The children were required to record their carbonated drink consumption over two weekdays and one weekend day in a diary. At the end of the study, an analysis of the carbonated drink diaries showed a reduction in the consumption of carbonated drinks in the intervention group compared with the control group (mean difference 0.7 95% CI: 0.1 to 1.3). There was also an increase in water consumption in both the control and intervention groups, but no significant difference between the two groups was recorded. Physical activity levels The Active for life year 5 programme measured physical activity levels by assessing mode of transportation to school and time spent on screen-viewing activities (Kipping, Payne et al. 2008). A questionnaire about the length of time spent of screen-viewing activities (watching televisions, DVDs or playing computer games) was given to the children to complete. The end of study analysis revealed that although the children from intervention groups spent less time on screen- viewing activities when compared to children from the control group, however, the differences between the two groups did not reach a statistically significant level (mean difference at the end of intervention between the two groups adjusted for clustering and baseline: -11.6 minutes, 95% CI: -42.7 to 19.4 for weekday and -15.4 minutes 95% CI: -57.5 to 26.8 for Saturday). The study also found that at the end of the study, children from the control school had higher odds of walking/cycling to school (after adjusting for baseline difference). Similarly, the Be smart intervention (Warren, Henry et al. 2003) assessed physical activity patterns rather than levels by asking the children questions about their mode of transport to school, and activities they undertake a break times. Questionnaires about how physically active the children are after official school hours were issued to their parents to complete. Information on the parental questionnaire included the frequency and duration of their childs habitual attendance of after-school clubs, screen-viewing activities and outdoor play. The post intervention analysis of the questionnaires revealed a slight increase in the number of children that walked to and fro school in both intervention and control groups. For playground activity, an increase was also recorded in all groups, with a higher increase in all intervention groups when compared with the control groups. Overall, there was no significant gender difference in playground activities at either baseline or post interven tion. Similarly, the parental questionnaires reported no intervention effect on activity levels after school hours. The APPLES intervention (Sahota, Rudolf et al. 2001) used a questionnaire to measure physical activity levels and sedentary behaviour in the children. The questionnaire was categorised by how frequent the children were involved in outdoor sporting activities such as swimming and frequency of sedentary activity such as watching television, in the past 24 hours. An analysis of the questionnaires showed no significant difference in physical activity levels in the intervention and control groups. What it however showed, was a 33.3% increase in sedentary activity in overweight children in the intervention group. DISCUSSION Summary and discussion of main results None of the four included studies reported significant short-term changes in BMI at baseline and post intervention. The fact that no significant BMI changes were detected does not in any way imply evidence of ineffectiveness. Possibilities are that small sample/unit sizes and short intervention duration (in all included studies) might have resulted in the inability to detect any weight/height changes. Previous school based intervention studies that have reported significant anthropometric changes in school children both lasted for a minimum duration of two years (Dwyer, Coonan et al. 1983; Gortmaker, Peterson et al. 1999); which is a reasonable time frame to expect any anthropometric changes. Despite the lack of significant anthropometric changes, changes were reported for some other outcomes measured in the primary studies. There was a modest increase in vegetable and fruit consumption in two of the studies (Sahota, Rudolf et al. 2001; James, Thomas et al. 2004). Also a significant reduction in the consumption of carbonated drinks and an increase in water consumption were reported in the CHOPPS project. Although the changes did not reach significant levels, the Active for life year 5 intervention reported a reduction in the time spent on screen viewing activities in the intervention group when compared to the control group. Quality of the evidence Given that this study is a review of intervention effects, the study designs of the included studies were the appropriate types to answer the study question. In terms of global rating, one study was rated as strong, two as moderate and one as weak. However, some caution is required in interpreting findings from this review as all of the studies had some limitations such as small sample/unit sizes and issues around concealment. All these may have introduced a possible systematic measurement bias. Another major issue with all the studies was the short intervention duration. Considering that all the studies measured change in adiposity in terms of weight and height, realistically, it takes a considerable length of time to actually notice a change in either weight or height following an intervention. This shortcoming may have possibly made statistically significant changes difficult to detect. Potential biases in the review process The guidance in Cochrane Handbook for Systematic Reviews of interventions (Higgins and Green 2008) was followed throughout the review process as far as possible. A quality assessment tool for assessing methodological quality of systematic reviews (health-evidence.ca 2007a; health-evidence.ca 2007b) was used in this review to assess the quality of included studies. Judging by the principles set in these resources, a number of potential limitations have been identified in this review. Firstly, in order to minimise errors, limit bias and improve reliability of findings, the Cochrane guidance recommends that key steps of a systematic reviews such as selection of studies and data extraction should be undertaken by more than one reviewer. This was however not possible due to the nature of this piece of work. Although there is strong evidence that RCT is the least bias estimate of effect size (Campbell, Waters et al. 2001) and the preferred method for estimating the effectiveness of interventions (Stephenson and Imrie 1998), there is still a lot of debate around its usefulness in assessing the effectiveness of lifestyle and behavioural interventions (Campbell, Waters et al. 2001). Nevertheless, a majority of the studies included in the review have Randomised controlled trial designs. During the search for studies, efforts were made to comprehensively search all relevant sources such as RCT register and social science databases. Additionally, firs authors of all included studies were contacted. Grey literature sources were also searched. Despite these efforts, it is possible that hand searching of key journals may have identified additional potentially relevant studies. No language restriction was imposed during the search, and as such, no potentially relevant studies were excluded on a language basis. Agreements and disagreements with other studies or reviews AUTHORSS CONCLUSION Implications for practice Despite the need for more research identified by this review, some evidence that school based interventions could have some positive impact on lifestyle behaviours that places children at risk of becoming obese was also found. Although positive effects in terms of adiposity were not shown, no harmful effects of the interventions were shown either. School based anti-obesity interventions should therefore be promoted by local public health authorities and encouraged by schools for long term prevention of obesity and its associated adverse health effects. Considering that children do not have any say at home in terms of purchasing food, involving parents actively in school based interventions could produce a sustained positive effect on children outside of the school setting. Although the study concludes that there is insufficient evidence on the efficacy of school based intervention in preventing childhood obesity, this does not mean evidence of ineffectiveness of these interventions. Given that some positive changes were reported in all the included studies, promotion of school based anti-obesity interventions is greatly encouraged at this time, as these interventions have demonstrated the potential to be beneficial on the long run. Implications for research