Fresh Frozen Plasma (FFP) Collection, Preparation and Uses

Fresh Frozen Plasma (FFP) Collection, Preparation and Uses Samuel Good Fresh Frozen Plasma Introduction Fresh Frozen Plasma (FFP) is the name for the liquid portion of human blood, which has been frozen and preserved. It is taken by blood donation and is stored until needed for blood transfusion. FFP has been available since 1941 (Hoffman, et al, 1990), it was used initially as a volume expander (Erber, et al, 2006), but is now used for the â€Å"management and prevention of bleeding in coagulopathic patients† (Ho, et al, 2005). The term FFP is confusing as the plasma cannot be frozen as well as fresh at the same time. What the term implies is that the plasma was frozen rapidly after it was taken and therefore can be considered fresh. The plasma, from a transfusion aspect, contains essential components such as fibrinogen, albumin, globulin and coagulation factors. These allow for specific individual components to be transferred to a recipient who is in need. The most efficient and effective way to make optimum use of blood which has been donated, is to separate it into its individual components. This process allows for a â€Å"wider availability of blood products† (Spence, et al, 2006) and also reduces the risk patients are exposed to â€Å"transfusion-related risks† (Erber, et al, 2006). The use of FFP and its individual products has increased tenfold since its first introduction (Hoffman, et al, 1990). One reason for this may be the declining availability of whole blood because of the trend to use component therapy (Spence, et al, 2006). Collection and Storage When a donor gives a unit of whole blood, the blood is then separated into several components parts. These include; packed red blood cells (pRBC), platelets and FFP. If required the FFP can be further divided into cryoprecipitate and something called cryo-poor plasma. Cryo-poor plasma is rarely used as a therapeutic response (Lauzier, et al, 2007). As mentioned previously, plasma is the non-cellular, liquid part of the blood. It is made up of; water, electrolytes and proteins. The proteins include the clotting factors and intrinsic coagulants (Murray, et al, 1995). The plasma is separated from the blood after donation and then frozen. For the plasma to be considered ‘fresh’ it must be frozen â€Å"within eight hours of collection† (Murray, et al, 1995) and stored at a temperature of minus 18 degrees centigrade or lower. If this fails to happen, the product is known just as ‘frozen plasma’, which like cryo-poor plasma, is rarely used for therapeutic means. However, to maintain coagulation factors to optimum levels the plasma should be stored at minus 30 degrees centigrade (Lauzier, et al, 2007). FFP can be prepared by separation from whole blood or via plasmapheresis. Plasmapheresis is the name given to a â€Å"broad range of procedures† where â€Å"extracorporeal separation of blood components† (Erber, et al, 2006) results in a plasma which is filtered. Preparation To summarise, FFP is collected in citrate-containing anticoagulant solution, frozen within 8 hours and stored at minus 30 degrees centigrade for up to a year. Although every protection is taken to ensure sterility, it is quite possible for the donor to have an asymptomatic bacteraemia at the time of donation (Stanworth, et al, 2004). The bacteria will have its proliferation down-regulated by the plasma being frozen. However, FFP can still sometimes transmit infectious diseases. Therefore, screening and pathogen inactivation may be performed to reduce the risk. FFP contains no RBC’s and also no WBC’s. As there are no WBC’s the plasma is referred to be as being leucodepleted. This is an indication as to why FFP can transmit said diseases. As mentioned pathogen inactivation can be performed and this is done by using either Methylene blue or a solvent/detergent process. The Methylene Blue Technique Methylene blue is a dye that has been shown to be very effective in the inactivation of pathogens. It binds to nucleic acids and, on illumination with white light, singlet oxygen is formed. This then destroys viral DNA and RNA, therefore viral replication cannot take place. Solvent/Detergent Technique This technique is used for the preparation of factors viii and ix as well as immunoglobulins. First, a solvent is added to the plasma which removes the lipid viral envelope. After this is complete, a detergent is added which inactivates the viral contents. The solvent and detergent are then removed by a physical separation technique, in which they are dissolved in oil. Column chromatography can then be used to isolate factors viii and ix. Once any treatment that is required is complete, the FFP is ready for use. It is an accepted practice that FFP is thawed before use (Ho, et al, 2005). The required units of FFP are placed in a water bath set at 30 – 37 degrees centigrade for approximately 20 – 30 minutes. Von Heyman, et al investigated the effects of 2 different thawing machines and running warm water of 43 degrees centigrade, on the activity of clotting factors, inhibitors and activation markers in FFP. They discovered no significant differences in the activity of coagulation markers over a 6 hour period post thawing. However, a major conclusion found was that, if FFP is immediately transfused after thawing, the product remained rich in clotting factors. Also, if the plasma is left, the activity of said clotting factors decline gradually and therefore FFP should only be maintained at room temperature for up to 4 hours. If thawed FFP is not used within 24 hours it becomes a separate product known as ‘thawed plasma’ (Murray, et al, 1995). Most clotting factors are stable in thawed plasma, however some labile factors, such as v and viii are not. Their degradation actually accelerates whilst the plasma is in a liquid state (Lauzier, et al, 2007). The only main advantage of having thawed plasma readily available, is that it can be transfused rapidly if a severely injured patient requires it. FFP Blood Type Specific It is widely accepted that O negative is the universal donor for pRBC’s, however for FFP this isn’t the case. A and B antigens of the blood are located on the red cells themselves. Type O individuals are devoid of these proteins on their red blood cells. Plasma does not contain RBC’s, but it contains antibodies to the corresponding absent protein. An example of this is: Type A individual has Anti-B antibodies in their blood. Type O plasma has both Anti-A and Anti-B antibodies and is incompatible with about 55 percent of the population. An individual with type AB blood has neither Anti-A nor Anti-B antibodies. This makes the AB plasma ideal for universal use when the blood type of the patient is unknown. The Rh status is irrelevant because any plasma with Anti-D is destroyed at the manufacturing stage. Recipient blood Acceptable blood groups of donor plasma O O,A,B,AB A A,AB B B,AB AB AB The major problem with blood type AB is that the percentage of the population which has it is only 4 percent. Therefore it is better to use FFP which is blood type compatible, which will be determined at the blood bank. Usage There are very few actual specific needs for the use of FFP (Spence, et al, 2006). Usually FFP is used to treat â€Å"deficiencies of coagulation proteins where specific factor concentrates are unavailable† (Hoffman, et al, 1990). Coagulation deficiencies can occur in a variety of different clinical situations. These include massive blood loss, surgery, and infection or acquired multiple coagulation factor deficiencies. Examples of FFP usage: Replacement of isolated factor deficiencies Reversal of Warfarin effects Massive blood transfusion Antithrombin III deficiency Treatment of immunodeficiency Treatment of thrombotic thrombocytopenic purpura Treatment of Disseminated intravascular coagulation Replacement of isolated factor deficiency FFP can be used to heat deficiencies of factors II, V, VII, IX, X and XI. It is only chosen as a treatment when no specific component therapy is available. Certain factors require a different haemostatic level, for example; severe factor X deficiency only requires a factor level of about 10 percent. Therefore FFP has a range of success when treating factor deficiencies. Reversal of Warfarin effect If a patient is being treated with Warfarin, they have been shown to be deficient in â€Å"functional vitamin K dependent coagulation factors II, VII, IX and X† (Spence, et al, 2006). Usually vitamin K will be administered, however anticoagulated patients will be actively bleeding, and therefore FFP can be used. Massive blood transfusion The use of FFP as a treatment on massive blood transfusion has increased over the decades. Massive bleeding is defined as â€Å"the loss of one blood volume within 24 hours† or as â€Å"50 percent blood loss within 3 hours† or a â€Å"bleeding rate of 150 ml/minute† (Lauzier, et al, 2007). It is indicated for use in patients who have documented blood clotting abnormalities after large blood loss and who are in need of urgent treatment. This is due to the fact that in most emergency situations it is unacceptable to wait hours for lab results to be returned. Antithrombin III deficiency FFP is sometimes used as a source of Antithrombin III in people who are deficient of this inhibitor. Especially if the patients are undergoing surgery or who use Heparin to treat thrombosis. Treatment of Immunodeficiency FFP has been used in children and adults with a humoral immunodeficiency as a source of immunoglobulin. It is also sometimes used for infants when parental nutrition is lacking, and they are suffering with severe protein losing enteropathy (Erber, et al, 2006). Treatment of thrombotic thrombocytopenic purpura The treatment recommended for this condition is a daily plasma exchange (Murray, et al, 1995). Prompt intervention is indicated if development of neurological abnormalities start to appear. This plasma exchange usually continues for at least 2 days after remission (Ho, et al, 2005). Treatment of Disseminated intravascular coagulation Disseminated intravascular coagulation (DIC) is a syndrome where the control of the coagulation system becomes disturbed and out of control. This is usually due to pro-coagulants being dispersed into circulation (Stanworth, et al, 2004). Most of the time this happens secondary to a disease or disorder, such as cancer. In the presence of DIC, fibrinogen, platelets and coagulation factors V and VIII become rapidly depleted. FFP is given as treatment to prevent further problems or progression. Treatment usually involves a patient being infused with a single line of FFP and then coagulation tests performed to assess the clinical benefit (Stanworth, et al, 2004). There are also some conditional uses where FFP can be used but is not the first choice treatment, such as liver disease and Paediatric use. If patients have an abnormal coagulation profile and are suffering from liver disease, they can be treated with FFP. There is varying success and treatment must be monitored by regular transfusion coagulation tests. Clotting times of infants have been shown to be longer than that of adults (Murray, et al, 1995), and even longer in premature babies (OShaughnessy, et al, 2004). Vitamin K deficiency is the most common cause of neonatal bleeding (Murray, et al, 1995). FFP can be used to counter the effects if required. In the case of babies suffering from haemorrhagic disease of the newborn, FFP can be used as treatment. But only if the â€Å"chance of bleeding is greater than the risk of harmful reactions† to the treatment with FFP (Lauzier, et al, 2007). Risks As with any transfusion there is a risk of infection, the main risks identified include: Disease transmission Excessive intravascular volume Anaphylactoid reactions Alloimmunisation Transfusion related acute lung injury The risks associated with viral infectivity of FFP are similar to that of whole blood and RBC’s. As mentioned earlier this risk can be countered by photochemically treating the plasma. Allergic reactions that occur in response to FFP transfusion vary in severity from â€Å"hives to fatal non-cardiac pulmonary oedema† (Stanworth, et al, 2004). Transfusion relate acute lung injury (TRALI) is defined as a â€Å"new episode of acute lung injury within 6 hours of complicated therapy† (OShaughnessy, et al, 2004). It manifests as severe respiratory problems, including hypoxia and other symptoms linked to pulmonary oedema. Symptoms will usually subside 2 days after ceasing FFP treatment (Stanworth, et al, 2004). Alloimmunisation can occur if Anti-Rh antibodies are formed after treatment with FFP. To counter this, plasma containing Anti-D antibodies should not be given to an RhD-positive recipient. There has also been reported incidences of post-transfusion Hepatitis, and depends on a number factors, including donor selection. Also with any intravenously transfused fluid, there is a chance of hypervolemia which could lead to cardiac failure, therefore administration of FFP should not be given in excessive doses. Below is a suggested dosage breakdown: Volume of 1 Unit Plasma: 200-250 mL 1 mL plasma contains 1 u coagulation factors 1 Unit contains 220 u coagulation factors Factor recovery with transfusion = 40% 1 Unit provides ~80 u coagulation factors 70 kg X .05 = plasma volume of 35 dL (3.5 L) 80 u = 2.3 u/dL = 2.3% (of normal 100 u/dL) 35 dL In a 70 kg Patient: 1 Unit Plasma increases most factors ~2.5% 4 Units Plasma increase most factors ~10% Figures taken from (http://reference.medscape.com/drug/ffp-octaplas-fresh-frozen-plasma-999499) Conclusion In conclusion, FFP can be used as an effective treatment for a number of different clinical issues. It also does not come without risk and therefore FFP should be collected, stored, prepared and used in an efficient and safe manner. Below I have summarised the administration of FFP. FFP (Fresh Frozen Plasma) Volume: 240-300ml (mean 273ml) Storage: designated temperature controlled freezer. Core temperature -30 o C Shelf life: 24 months (frozen) Must be ABO compatible, but Rh is not necessary to be considered for transfusion and no anti D prophylaxis is required if Rh-D negative patients receive Rh-D positive FFP. Prior to the transfusion FFP must be thawed under controlled conditions using specifically designed equipment. Thawing usually takes approximately 15-30 minutes Once thawed, FFP must not be re-frozen and should be transfused as quickly as possible. Post-thaw storage results in a decline in the quality of coagulation factors. If stored at 4 degrees centigrade post thawing (in a designated temperature controlled refrigerator), the transfusion must be completed within 24 hours of thawing. Pooled solvent-detergent treated plasma is also commercially available Dose: typically 10-15ml/kg. This dose may need to be exceeded in massive haemorrhage depending on the clinical situation and its monitoring (BCSH 2004) Typical infusion rate 10-20ml/kg/hr (approximately 30 minutes per unit) Rapid infusion may be appropriate when given to replace coagulation factors during major haemorrhage. There is anecdotal evidence that acute reactions may be more common with faster administration rates. (http://reference.medscape.com/drug/ffp-octaplas-fresh-frozen-plasma-999499) REFERENCES Erber WN, Perry DJ: Plasma and plasma products in the treatment of massive hemorrhage. Best Pract Res Clin Haematol 2006, 19:97-112 Hewson JR, Neame PB, Kumar N, Ayrton A, Gregor P, Davis C, Shragge BW. Coagulopathy related to dilution and hypotension during massive transfusion. Crit Care Med. 1985;13(5):387-391. Ho AM, Karmakar MK, Dion PW. Are we giving enough coagulation factors during major trauma resuscitation? Am J Surg. 2005;190(3):479-484. Hoffman M, Jenner P. Variability in fibrinogen and Von Willebrand factor content of cryoprecipitate.  Brief Sci Rep. 1990;93(5):694-697. Lauzier F, Cook D, Griffith L, Upton J, Crowther M: Fresh frozen plasma transfusion in critically ill patients. Crit Care Med 2007, 35:1655-1659. Leslie SD, Toy PT. Laboratory hemostatic abnormalities in massively transfused patients given red blood cells and crystalloid. Am J Clin Pathol. 1991;96(6):770-773. Murray DJ, Olson J, Strauss R, Tinker JH. Coagulation changes during packed red cell replacement of major blood loss. Anesthesiology. 1988;69(6):839-845 Murray DJ, Pennell BJ, Weinstein SL, Olson JD.Packed red cells in acute blood loss: dilutional coagulopathy as a cause of surgical bleeding. Anesth Analg. 1995;80(2):336-342. OShaughnessy DF, Atterbury C, Bolton Maggs P, Murphy M, Thomas D, Yates S, Williamson LM, British Committee for Standards in Haematology, Blood Transfusion Task Force: Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 2004, 126:11-28. Spence RK: Clinical use of plasma and plasma fractions. Best Pract Res Clin Haematol 2006, 19:83-96. Stanworth SJ, Brunskill SJ, Hyde CJ, McClelland DB, Murphy MF: Is fresh frozen plasma clinically effective? A systematic review of randomized controlled trials. Br J Haematol 2004, 126:139-152 Tieu BH, Holcomb JB, Schreiber MA. Coagulopathy:its pathophysiology and treatment in the injured patient. World J Surg. 2007;31(5):1055-1065 http://en.wikipedia.org/wiki/Fresh_frozen_plasma http://www.psbc.org/therapy/ffp.htm http://reference.medscape.com/drug/ffp-octaplas-fresh-frozen-plasma-999499 http://ccforum.com/content/14/1/202

Frank and Ritas Relationship Essay -- Educating Rita Relationships Es

Frank and Rita's Relationship At the start of the play, Frank and Rita can be seen as opposites; Frank is a middle aged academic, whilst Rita is a young, female hairdresser. Any friendship between the two seems unlikely, but they quickly warm to one another as first appearances show. They are both involved in unsatisfactory relationships, and they both want more from life than it seems to offer. The main difference between the characters are that, whereas Rita has recognised her unhappiness and is determined to change it through becoming educated, Frank is more negative and prefers to drown his sorrows in alcohol. Frank and Rita become friends because she needs him to teach her, and he needs the vitality and freshness that she brings to his life. Willy Russell presents Frank and Rita’s relationship, and the changes it goes through, in a variety of ways. The relationship starts off well when they meet each other in scene one and the contrast of personalities is shown very well, Frank leads the boring lifestyle, whereas Rita bursts in and is full of life- their personalities and characters are totally opposite. Frank could do with a bit of something different in his life and this is why he takes to her so warmly. I think that the reader comes under the impression that Frank may want something out of this relationship other than teaching his literary knowledge. RITA: This Forster, honest to God he doesn’t half get on my tits. FRANK: Good. You must show me the evidence. This quote shows that Frank likes to flirt with Rita and shows that literary knowledge is not all that is on his mind. Rita, however, just wants to learn and be good friends with Frank but nothing more. From Rita’s perspective fra... ... goes on to tell Rita how he has changed her and that he doesn’t like the change he sees. Frank in his own words then says that he can’t bare Rita anymore. Through the last few scenes both of them have changed considerably and Frank especially does not like the change that he sees in Rita and due to this he continues to argue with her. The most important thing is that education has given Rita choice. She now has a lot more freedom to what she wants, as she is educated, she can choose form a number of jobs, she can choose which type of people she wishes to socialise with an so on. I think that overall both of them have learned that sometimes times change and people change and In the end I think they both accept this as they get on good ground with each other. At the very end Rita gives Frank a hair cut that she has promised him since Act one scene one. Frank and Rita's Relationship Essay -- Educating Rita Relationships Es Frank and Rita's Relationship At the start of the play, Frank and Rita can be seen as opposites; Frank is a middle aged academic, whilst Rita is a young, female hairdresser. Any friendship between the two seems unlikely, but they quickly warm to one another as first appearances show. They are both involved in unsatisfactory relationships, and they both want more from life than it seems to offer. The main difference between the characters are that, whereas Rita has recognised her unhappiness and is determined to change it through becoming educated, Frank is more negative and prefers to drown his sorrows in alcohol. Frank and Rita become friends because she needs him to teach her, and he needs the vitality and freshness that she brings to his life. Willy Russell presents Frank and Rita’s relationship, and the changes it goes through, in a variety of ways. The relationship starts off well when they meet each other in scene one and the contrast of personalities is shown very well, Frank leads the boring lifestyle, whereas Rita bursts in and is full of life- their personalities and characters are totally opposite. Frank could do with a bit of something different in his life and this is why he takes to her so warmly. I think that the reader comes under the impression that Frank may want something out of this relationship other than teaching his literary knowledge. RITA: This Forster, honest to God he doesn’t half get on my tits. FRANK: Good. You must show me the evidence. This quote shows that Frank likes to flirt with Rita and shows that literary knowledge is not all that is on his mind. Rita, however, just wants to learn and be good friends with Frank but nothing more. From Rita’s perspective fra... ... goes on to tell Rita how he has changed her and that he doesn’t like the change he sees. Frank in his own words then says that he can’t bare Rita anymore. Through the last few scenes both of them have changed considerably and Frank especially does not like the change that he sees in Rita and due to this he continues to argue with her. The most important thing is that education has given Rita choice. She now has a lot more freedom to what she wants, as she is educated, she can choose form a number of jobs, she can choose which type of people she wishes to socialise with an so on. I think that overall both of them have learned that sometimes times change and people change and In the end I think they both accept this as they get on good ground with each other. At the very end Rita gives Frank a hair cut that she has promised him since Act one scene one.

Apollo 11 Mission

Apollo 11 Mission The Apollo 11 mission was the first man mission to land on the Moon. The Apollo 11 team left Kennedy Space Center on July 16, 1969 at 13:32UTC. The mission’s team included Commander Neil Alden Armstrong, Commander Module Pilot Michael Collins and Lunar Module Pilot Edwin Eugene â€Å"Buzz† Aldrin Jr. After being in orbit for 72 hours, Armstrong and Aldrin climbed into the Lunar Module, named the Eagle, and prepared for their descent to the Lunar surface. The Lunar Module â€Å"Eagle† consisted of two parts: the descent stage and the ascent stage. The descent stage had the engine used to land on the Moon, four legs, a storage area for experimental gear and a ladder for the crew to climb down to the Moon’s surface. The descent stage module also served as the launch platform for the ascent stage module when it was time to leave the Moon’s surface and reunite with the Command Service Module. The two Apollo 11 astronauts landed on the Moon at 4:18pm EDT on July 20, 1969 at a site called Mare Tranquillitatis. This site was chosen for many factors which included: smoothness, approach, propellant requirements, free return, and slope. The Lunar Module was equipped with cameras that would provided live television coverage of Armstrong’s first steps onto the moon at 10:56pm EDT and proclaimed: â€Å"That’s One Small Step for Man, One Giant Leap for Mankind†. At 11:16 p. m. EDT, Buzz Aldrin stepped out of the Lunar Module and joined Neil Armstrong on the Moon’s surface. During the time the astronauts were on the surface of the Moon they collect about forty- seven pounds of Lunar surface materials. This material was collected for later analysis by scientists back on Earth. Armstrong and Aldrin stated in communication with Houston that they notice that the Moons gravity was very different than that on Earth. They had to move slowly by leaping of hopping with both feet to keep their balance. Some of the items the astronauts left on the Moon’s surface were an American flag as a reminder of their accomplishments, a disc that contained 73 messages from around the world, a patch from Apollo 1, medals from Russian cosmonauts, and the U. S. symbol that was an eagle carrying an olive branch. The two astronauts were on the Moon for about 2 hours 30 minutes before successfully connecting back with the command ship. After the successful landing, walking, and return to the command ship, Armstrong, Collins and Aldrin prepared for the trip back to Earth after spending 128 hours in space. The decent to Earth took place on July 24, 1969. The astronauts landed in the Pacific Ocean east of Wake Island 195 ? hours after launch. Armstrong, Collins and Aldrin were than quarantined due to landing on the Moon and also the fear that they may have brought back some undiscovered pathogens while they were there. After a three week long quarantine the astronauts were released. On August 13, 1969 the three astronauts excited to be released were met by crowds of cheering Americans. There were parades to honor the astronauts in cities like New York, Chicago and LA on the same day of their release from quarantine. Apollo 11 mission objective was accomplished. They had safely landed men on the Moon and brought them back to Earth again. This mission made many things possible for the future of space travel and what was to come. Works Cited â€Å"Apollo 11. † Lunar science and exploration. Lunar and Planetary Institute. 26 Sept. 2008 . This website source offered the detailed information of the whole Apollo 11 Mission from the take off to the landing on the Moon and back to Earth again. The specifics of every aspect of the astronaut's activities such as experiments, the first steps, details on the landing sites. There were also a variety of pictures of the Apollo 11 Mission and its crew. I found this site very useful because of the great amount of detailed information about what the astronauts went through and how long it took them to complete this mission. Apollo 11. † Science Channel. Comcast Cable. 99, Rockford. 28 Sept. 2008. During this broadcast you witnessed the Apollo 11 crew member Neil Armstrong making his first steps and the famous words that were spoken â€Å"One small step for man one giant leap for mankind. â€Å"It was amazing to see the actual footage from the original broadcast of the first steps on the Moon. I found it exciting to be transport ed to the actual event in history. Garner, Joe. â€Å"Apollo 11 MAN WALKS ON MOON. † We Interrupt This Broadcast. By Joe Garner, Walter Cronkite and Bill Kurtis. Naperville, IL: Sourcebooks, 1998. 68-72. The area of the book that pertained to Apollo 11 Mission told of the take off from Earth and the close call when landing on the Moon. Many of the details in this book were covered more thoroughly in my other resources. There was only one fact that I obtained from this book that was not mentioned in anything else I had read, that was about the plaque left on the Moon. Weaver, Kenneth F. â€Å"The Flight of Apollo 11. † National Geographic Dec. 1969: 752-87. This article tells of the landing in great detail, the events that took place while on the Moon as well as the technology that was used on Earth and in space for this mission. Also included in this article was how this feet had changed the outlook for the future of space travel for the better and how landing on the Moon and safely returning to Earth. I found this article to be one of the most informative resources I used in writing my paper. Wilford, John N. â€Å"MEN WALK ON THE MOON. † New York Times 21 July 1969: 1-2. This newspaper article told the readers about Armstrong's first steps on the Moon. Also it told of the items collected from the Moon's surface for future scientific experiments back on Earth. Finally the article told of the Presidents words of congratulations and pride in the accomplishments and advancements the astronauts made in the vision of future and in peace for all mankind. The New York Times newspaper article summarized key points of the Apollo 11 Mission which informed millions of people that may have missed the broadcast of the events on July 21,1969. I found this newspaper showed how important the Apollo 11 Mission was to the world and how this event changed history.

Critical Appriciation of the Two Minuets Hate in 1984

Write a critical appreciation of pages 16-18 â€Å"in its second†¦ uttering a prayer†. How does the two minutes hate contribute to your understanding of the nightmare world in which Winston lives? The two minutes hate is almost a celebration of a cult, a sort of gathering of religious fanatics to honour their ruler, Big Brother. Orwell uses it to show the expressions of anarchy amongst the ‘leaping and shouting' people and how this would be their only chance to express their human feelings in the nightmare society in which they are forced to live. Winston's dystopian world is displayed in Orwell's unsympathetic parody of the two minutes silence in commemoration of WWII and epitomises the ‘frenzy' of emotions, the terror and violent culture that Winston has to tolerate. His elaborate view of religious or political fanatics scrutinises these kinds of obsessions and demonstrates how it can over-power a person's life. Control is one of the main components of the two minutes hate. The people are helpless, they are ‘like that of a landed fish' in the robotic machine that is Big Brother. They cannot escape from ‘the voice' that ‘continued inexorably' and there is no escapism to be had in the ‘frenzy' of voices yelling at the screen. This reflects a nightmare that is inescapable until we awake. Winston longs to awaken in a society capable of love, without suffering, but it seems he knows that can never arise. The world for Winston is a steady destruction of all good virtues and basic human rights that they are so cruelly being denied, which is shown so clearly through this extract. Winston finds it ‘impossible to avoid joining in'. This reflects the lack of control he has in all elements of his nightmarish life. The sheer violence of the episode overwhelms Winston's mentality and creates an isolation of his mind to the rest of the ‘sheep' and is inescapable. He has the power to rebel, although he submits to a ‘hideous ecstasy of fear and vindictiveness, a desire to kill, to torture, to smash faces in with a sledge hammer'. This juxtaposition of hideousness and ecstasy shows Winston's abhorrence is all towards the party and Big Brother instead of the loathed Goldstein. In Winston's conscious mind he changes into a ‘grimacing, screaming lunatic' and is capable of switching his hate ‘from one object to another'. These images are distinctive of a dystopian novel and relates to the time of obsession and paranoia that was experienced during World War II, when the novel was written. Winston's hate develops into an ‘inescapable' sexual lust for ‘the black haired girl'. He describes his desire to ‘flog her to death' and how it would be a ‘beautiful' sight. This contradiction is Winston's flicker of rebellion against the ‘sinister enchanter' that is Big Brother. This introduces the theme of love versus hate, which is explored throughout the rest of the novel. The pointlessness of the hate strikes Winston as we see Winston's weakness; he has a perplexed mind that cannot comprehend the point to the rage inflicted upon Goldstein. The fickleness of the Party members distresses Winston ‘the sandy haired woman shouting what sounded like â€Å"my Saviour†Ã¢â‚¬Ëœ as he seems to realise the stupidity of the ‘frenzy'. Orwell contradicts the whole of the Party's endeavour to create a ‘perfect' world and stamp out all feelings, as ‘his heart went out to the lonely, derided, heretic on the screen'. Winston is conveying how he is himself a ‘heretic' and rebelling against the beloved Big Brother which we see later in the novel also as Winston recognizes his rebellious potential. This shows his refusal of living ‘in a world of lies'. This ‘world' epitomises the depression of Winston's nightmare and the society he exists in and at this point, Winston becomes ‘at one with the people about him', his mind is distorted ‘and all that was said of Goldstein seemed to him to be true'. Winston's seemingly only flaw it that subconsciously he switches his thoughts from one side to another and it is only ‘the black haired girl' who lays bare his real personality and sets him straight. The two minutes hate represents Orwell's character and his novel as a whole as we see his hate for the outward expression of human feelings and his ultimate desire for control. We find his detestation of religious extremists on course throughout the novel, which replicates its dark and dystopian themes. He has channelled his hate in to his work and through what may indeed be a representation of the author himself, Winston's Character. Every element of hope is lost for Winston during the two minutes hate. This raises our understanding of an embodiment of a nightmare world that hopelessly celebrates a religious cult and its inescapable anarchy, which will ultimately have its revenge on Winston's mutinous mind.

Raising a Child Essay

Both Parents Should Assume Equal Responsibility in Raising a Child A child growing up with both parents and a child growing up in single parent house have significant differences. The well being and development of a child, both psychologically and physically, rely vastly on how well each parent performs their roles. Taking care of a child is not an easy task but it is crucial that both parents assume equal responsibility in raising a child since children gets behaviors, manners from their mother and responsibility and braveness from their father. In a typical house with both parents, father works for income of the family and mother take care of the child so both parents have plenty of time to perform their roles well. For example, a child’s father will work for income to provide the family’s needs whereas a child’s mother will take care of the child for well being. As the result, the child gets care, warmth and wisdom from both parents. These make the child to grow up without any insecurity. Also by having both parents, the child will get the knowledge that only a mother or a father can give. All these factors contribute in raising a strong, healthy and well balanced child. On the other hand, in a typical single parent house since there’s only a person, that person have to be both father and mother at the same time which means supplying the family with resources for surviving and take care of the child. By only having one person doing the job for both parents, always leads to unsuccessful upbringing of a child due to lack of time. For example, a parent who’s working hard to supply the needs for the family won’t have time to take care of the child. As a result, the child will either end up in a day care center, in a friend or relative house who doesn’t give the same amount and quality of warmth and care as a parent can give. Then the child will grow up with insecurity and with weak personality.

Customer Relationship Management Research Paper

Customer Relationship Management - Research Paper Example Rule # 1: The customer is always right. Rule # 2: If the customer is wrong, go back to Rule # 1. A customer is somebody who consumes a particular product or service and in exchange would shell out an amount for the said service or thing. Thus, to be able for any business to sustain, a system called Customer Relationship Management or CRM must established. Care after sales is so important. In fact, call centers are up to heed to every customer’s demand. Research findings from Xu and Walton, (2005) entitled "Gaining customer knowledge through analytical CRM", Industrial Management & Data Systems revealed that current CRM systems are dominated by operational applications such as call centers. The application of analytical CRM has been low, and the provision of these systems is limited to a few leading software vendors. Businesses use this online service provision to continually keep in touch with the customers. The introduction of the internet as part of the communication superhi ghway has helped shorten the gap between the business and its clientele. Thompson (2010) has said that two CRM application types are generating the most interest in 2010: Those focused on supporting revenue growth, and those geared to the trend toward social CRM. Most CRM projects are departmental and channel-specific, although large-scale CRM projects are reappearing. Therefore, CRM is a company-wide business strategy designed to reduce costs and increase profitability by solidifying customer satisfaction, loyalty, and advocacy. Money sent to the Philippines can be conveniently received through participating outlets of two of the biggest pawnshop chains in the country –Cebuana and Mlhullier’s Moneygram service and Xoom. These are just a few of the many possible ways to receive money sent to the Philippines online. The moment that the receiver gets the money, the sender will be sent a text message confirming it. This is to ease his/her worry against fraud and positive feedback has resulted from this service (http://sendmoneytothephilippines.blogspot.com/2010/09/cebuana-lhuillier-m-lhullier-as.html). In addition, the implementation of a customer relationship management system will improve retention rate, say of a school like Everest Online. It has always been a goal of every implementer to have a successful project implementation. Houston (2011) has found that the different measure of project management success can be when the project must have been delivered to the Scope, Time, Cost and Quality and when the customer is happy with the way the project management was carried out which means that the communications in particular, and the various other aspects of the project management, must have been performed professionally. Moreover, Bose (2003) found that businesses dedicate considerable money and resources to research on consumer behaviors in an attempt to understand their target markets. As Drucker (1973) has argued, the purpose of business is t o create and then retain a satisfied customer. Similarly, Sheth and Mittal (2004) have pointed out that a business makes money only if it satisfies its customers by catering for their needs. Customer Relationship Management in its general sense in the part of the business is increasing efficiency while minimizing the cost. As CRM is a widely-implemented strategy for managing a company’s interactions with customers, activities also those for marketing, customer service, and technical support, its overall goals are to find, attract, and win new

Operations management Essay Example | Topics and Well Written Essays - 1500 words - 1

Operations management - Essay Example The company was started in 1906 and the famous model of ‘Silver Ghost’ was launched in 1907 which ran a non-stop 14371 miles before entering the list of legends. The company had its factory in the starting stage in Manchester and later moved into a custom built set up for its operation in Nightingale Road, Derby. After the world war, Rolls Royce started its production of cars again and set up a factory in the US in 1921. It was there that Rolls Royce manufactured the R-engine looking at the Inter-continental sea-plane contest. The engine set a record air-speed and won the trophy (Rolls-Royce plc., 2013, p.1). Later on the engine was developed and used in aircrafts. Rolls Royce developed the new model of Phantom that had the capability to set new benchmarks in the car industry. Several models of cars developed by Rolls Royce over the years are exclusive in their designs, structure of their chassis and innovative body built. Some of the world class and eminent models that have pioneered and shaped the automobile industry are Silver Wraith, Silver Dawn, Silver Cloud, Silver Shadow, Silver Spirit, etc. As a result of expansion of its operations, Rolls Royce, the unique corporation founded in the year 1906 was divided into Rolls Royce. as well as Rolls Royce Motors in the year 1973. After the demerger from the original company, Rolls Royce is a chief provider of power systems as well as services in the world. The Rolls Royce places customer, innovation, growth and profitability at its core values of operation (Rolls-roycemotorcars., 2013, p.1). The company provides integrated power systems and has long term strategic plan of substantial size of order book, entering into long-term service agreements with their customers...While Rolls Royce Motor cars are focused at car manufacturing, Rolls Royce is focused at providing integrated power systems to the world. Introduction: Rolls Royce Rolls Royce was created after a famous lunch between the two eminent founders of the company. As a result of expansion of its operations, Rolls Royce, the unique corporation founded in the year 1906 was divided into Rolls Royce. as well as Rolls Royce Motors in the year 1973. After the demerger from the original company, Rolls Royce is a chief provider of power systems as well as services in the world. The Rolls Royce places customer, innovation, growth and profitability at its core values of operation (Rolls-roycemotorcars., 2013, p.1). Rolls Royce: Its operations Rolls Royce has demerged into Rolls Royce Motor cars and Rolls Royce. While Rolls Royce Motors have focused on the manufacture and operations of its cars, Rolls Royce have since been focusing on operations in aerospace, power systems and the defence sector. The ownership of Rolls Royce Motor cars was taken over by Vickers during 1980 to 1988. Since 2003, the manufacturing rights of Rolls Royce motor cars were handed over to BMW. Rolls Royce Motor cars which now operate as a subsidiary to the German automaker Bentley Motors Limited run a production mix of the Rolls Royce and the Bentley brand of cars.