The Amelogenesis Imperfecta Health And Social Care Essay

The Amelogenesis Imperfecta Health And Social Care Essay Your sister has noticed that the teeth of her young son are discoloured and has taken him to the dentist. After a series of tests, the condition of X-linked amelogenesis imperfecta is diagnosed. She asks you, a dental student, to explain the reason for this condition. Particularly, she would like to understand why, in this condition, the enamel is malformed, how the enamel differs from normal and the reason her son, but not her, or her husband is affected. Learning outcomes 1. To explain and understand normal enamel formation. 2. To identify the different types of AI and their presentation. 3. To describe the genetic code and various types of genetic mutations that can be found. 4. To understand and describe the phrases; autosomal dominant inheritance, autosomal recessive inheritance and X-linked recessive inheritance. 5. To identify the genes associated with AI. Introduction Amelogenesis imperfecta is a hereditary disorder that affects tooth development and results in the abnormal formation of tooth enamel. In the above scenario our nephew has been diagnosed with X-linked amelogenesis imperfecta. Below I will explore the proposed learning outcomes and take a closer look at the inherited disease. Explain and understand normal enamel formation. The teeth are composed of three mineralised tissues; enamel, dentine and cementum, which surround the inner unmineralised dental pulp. [1] The dental pulp is the only living part of the tooth and is made up of connective tissue, odontoblasts and nerves. It supplies the outer mineralised layers with a supply of organic compounds and the odontoblasts help with the creation and repair old dentin. The nerves inside the pulp are also very sensitive and alert an individual of any injury or trauma that may occur. If the pulp is exposed to bacteria, infections are likely. [2] [3]http://www.dentalhealth.ie/common/images/legacy/dhp/pic_stuctureoftooth.gif Cementum can be found below the gum line covering the dentin and root of the tooth. It helps to anchor the tooth and protect the root. It is continuously formed through life by cementoblasts in the dental pulp as it prone to destruction. [4] [6] FIG.1 Basic tooth structureDentine is made up of tiny tubules and is the most abundant of the three mineralised tissues. It acts as support beneath the enamel covering and has a protective function to the dental pulp. Dental pulp, cementum and dentine are all derived from the mesencymal origin. [5] [7] FIG.2 Enamel structure The head is orientated superficially and the tail towards the tooth root http://www.kck.usm.my/ppsg/histology/e_2_0.jpg Lastly enamel which is derived from the ectoderm is made up of primarily crystalline calcium phosphate and is the outermost component of the tooth and covers the dental crown. The calcium hydroxyapatite enamel crystals are arranged as keyhole shaped rods that span the full thickness of the enamel layer (see fig.2). The enamel crystals have a parallel orientation and any gaps between the rods are filled with further crystals. Enamel is the hardest most mineralised structure found in the human body. [4] [8] Enamel is formed by the process of amelogenesis after dentine is formed in the process of dentinogenesis. There are four main stages to amelogenesis; Presecretory, secretory, maturation and post maturation. [1] [9] FIG.3 Basic tooth structureThe presecretory stage starts with proliferation of the oral epithelium to form the dental lamina, further proliferation with occur at the site of each future tooth and there will be an outgrowth of cells; this is called the bud stage. This bud of cells then enlarges and develops a cavity in the cap stage and further growth and development will lead to the development of four recognisable layers in the bell stage. Finally the internal enamel epithelium will cease to divide and the dental lamina will degenerate leaving being the early developing tooth. [1] In the secretory stage a partially mineralised enamel matrix is deposited directly on the surface of the previously formed dentin by adjacent secretory stage ameloblasts. [1] The organic partially mineralised matrix is produced as a result of the combined actions of the rough endoplasmic reticulum, Golgi apparatus and secretory granules. The ameloblasts will move away when the first layer of enamel is deposited on the dentine allowing the Tomess process to develop at the secretory pole of each ameloblasts. The Tomess process is responsible for the formation of enamel rods as it lays down the crystals of the enamel matrix. The ameloblasts lie adjacent to the stratum intermedium which contains alkaline phosphotase which is responsible for calcification of the tooth enamel. These ameloblasts continue to produce the enamel matrix until full thickness is reached. [4] Maturation of the partially mineralised enamel matrix involves the removal of organic material and the continuous influx of calcium and phosphate. [4] Maturation stage ameloblasts differentiate from secretory stage ameloblasts and they now contain high numbers of mitochondria to carry out their function as a transport epithelium moving substances into and out of the maturing enamel. The maturing enamel matrix contains four main types of protein; amelogenins, ameloblastins, enamelins and tuftelins. The amelogenins are important in maintaining the spaces between the enamel rods and the ameloblasts control the elongation of the enamel crystals, both of these proteins are removed from the mature enamel. Enamelins undergo cleavage as the enamel matures and will only be found on the surface of the crystals.Tuftelins are present in mature enamel and responsible for hypomineralisation. [1] [4] In the final stage of post maturation the enamel organ will degenerate and the tooth will erupt and become exposed to the oral environment. [1][4] Identify the different types of AI and their presentation. Amelogenesis imperfecta is a group of hereditary disease that affects both the primary and secondary dentition. It results in the enamel becoming hypoplastic, hypomineralised, discoloured and sensitive. [10] There are four main types of amelogenesis imperfecta (AI) that have been identified because of their differences in enamel defects that present in patients. In Hypoplastic AI (type1) the enamel is of normal colour but much thinner as the enamel has not formed to normal thickness, the enamel can also have pits and grooves due to the disturbance in differentiation of ameloblastins. In hypomaturation(type 2) AI the teeth are of normal shape but have a mottled, dark, opaque appearance and chip away easily from the underlying dentine because of a change to the rod structure. Hypocalcified AI (type 3) has poor enamel mineralisation and a defect in its matrix structure making it very soft and susceptible to abrasion; its appearance is dark and chips easily. [1] [11] (see fig.4).http://www.ojrd.com/content/figures/1750-1172-2-17-1-l.jpg Finally hypoplasia (type 4) AI is a combination of hypoplastic and hypomaturation AI. It is characterised by a reduction in enamel thickness and the enamel has a yellow brown mottled appearance. [13] [12] FIG.4 Phenotypic descriptions of amelogenesis imperfecta. hypoplastic (a, b, c, d), dysmineralised (e, f), hypocalcified (g, h) hypomineralised form (e and f) The hypomaturation forms (g, h) Describe the genetic code and various types of genetic mutations that can be found. [15] FIG.5 Genetic information is encoded in the base sequence of DNA molecules as a series of genes. The genetic code describes how base sequences are interpreted into amino acid sequences during protein synthesis via transcription and translation. [14] http://sjesci.wikispaces.com/file/view/DNA-to-codon.gif/155543209/DNA-to-codon.gif The DNA sequence of a gene is divided into a set of three bases called a codon (see fig.5). Each codon gives rise to a particular amino acid or a stop signal. The genetic code is referred to as degenerate because each amino acid is encoded by more than one codon; there are 64 possible combinations of codons from the 4 nucleotide bases (Adenine, guanine, cytosine and uracil or thymine) but only 20 different amino acids. (See fig.6)http://2.bp.blogspot.com/-i-CYqAFf61o/TZXYoBQmXrI/AAAAAAAAB5g/5PmMdfOP1PQ/s1600/genetic-code-1.jpg This degeneracy minimises the possible effects of mutations as alterations to the base sequence are less likely to change the amino acid so changes to the protein structure and function are avoided, this is known as a silent mutation. Protein synthesis always starts with the initiation codon AUG which encodes the amino acid methionine but this is later removed. Protein synthesis is terminated by the any of the three stop codons; UAG, UGA and UAA. [14][16] [17] FIG.6 DNA mutations can however cause genetic disorders and cancers. A gene mutation occurs when there is a change in the DNA sequence that makes up a gene; these can be classified as either point mutation which involves the alteration of a single base or gross mutations which often involve the alteration of longer DNA sequences. There are several types of point mutations. Missense mutations occur when a single base is altered or substituted and a different amino acid is produced. Nonsense mutations result in translation ending prematurely because a nucleotide base has been substituted for another resulting in a stop codon and frameshift mutations result after a single base is either deleted or inserted which causes the ribosome to read a new set of codons which will alter the complete amino acid chain produced.(see fig,7) All these changes to the DNA sequence will alter the amino acid chain and subsequently have a serious effect on the protein produced and effect how well it will work or how it will carry out a specific task. Gross mutations have the same implications and also experience insertion and deletion but this is of several bases at a time. [14][18] Figure 4: If the number of bases removed or inserted from a segment of DNA is not a multiple of three (a), a different sequence with a different set of reading frames is transcribed to mRNA (b). [19] FIG.7 Frameshift mutations If the number of bases removed or inserted from a segment of DNA is not a multiple of three (a), a different sequence with a different set of reading frames is transcribed to mRNA (b). Identify the genes associated with AI. Faulty alleles of the genes AMELX, MMP20, KLK-4 and ENAM cause the disease amelogenesis imperfecta. These genes usually provide the genetic instructions for the production of proteins that are essential for the healthy formation of enamel. The mutations of these genes have caused a change in the nucleotide base sequence and as a result the protein structure is altered making them work ineffectively or not at all, in turn this has a variety of effects on the enamel formation. [1] The AMELX gene is located on both of the sex chromosomes, X and Y and provides instructions for the protein amelogenin which is essential for normal tooth development as is separates and supports the hydroxyapatite  crystals as they mature. Mutations in AMELX have been found to cause X-linked amelogenesis imperfecta because of the change in structure to amelogenin. [20] The  ENAM  gene provides instructions for the production of the protein enamelin and mutations of this gene can be found in both patients with autosomal dominant AI and autosomal recessive AI.[21] (see below) MMP20  is responsible for the protein enamelysin mutations in this gene are inherited via the autosomal recessive pathway and KLK-4 mutations are responsible for hypomaturation AI. [22][23] Understand and describe the phrases; autosomal dominant inheritance, autosomal recessive inheritance and X-linked recessive inheritance. Humans have 22 pairs of autosomal homologous pairs of chromosomes and one pair of sex chromosomes; X and Y. Females have two X chromosomes where as males have one X and one Y chromosome. [18] There are three patterns of single gene disorders that allow faulty alleles (version) to be passed between generations. These include autosomal dominant, autosomal recessive and X-linked. [14]Autosomal dominant genes [24] FIG.8 Autosomal inheritance In autosomal dominant disorders only one faulty allele needs to be passed from the parents to the offspring for them to be affected by the disease. The affected child will also have one normal allele of the gene making them heterozygous. The affected childrens offspring will also have a 50% chance of inheriting the affected allele. (see fig.8)[14] In autosomal recessive disorders however the likeliness of being affected by the disease is only 25% and both parents must possess at least one of the mutated alleles. (See fig.9)This is because in recessive orders both inherited alleles must be mutants to show an effect in the offspring. There still is a 50% chance of being a carrier (if you have one healthy and one effected allele). [14]http://retinaaustraliansw.com.au/images/AutosomalRecessiveInheritance.gif [26] FIG.9 [26] FIG.10 X-linked inheritance Illustration showing X-linked recessive inheritance pattern with carrier mother In X-linked disorders the faulty allele is present on the X chromosome. As males only have one X chromosome they only need one copy of the allele to have the disease, they are hemizygous. Females however must have two copies of the faulty allele (homozygous) to be affected and so are in most case carriers. A female carrier has a 50% chance of their daughters being carriers and a 50% chance of their sons being affected by the disease. (See fig.10)[18] Amelogenesis imperfecta has different modes of inheritance. Hypoplastic  (Type I) and Hypomaturation (Type II) AI can be inherited by all three modes of the above inheritance patterns. Hypocalcified (Type III) AI is not inherited via the X-linked pathway and Hypoplasia (Type IV) AI is only passed between generations via the autosomal dominant pathway and only one faulty allele has to be passed to the offspring for them to be affected by amelogenesis imperfecta. [13] Conclusion Our nephew has been diagnosed with X-linked amelogenesis imperfecta. Taking in account the above information we can now conclude the reason why he but not his parents are affected by the disease is because our sister must be a carrier of the faulty allele of the gene AMELX. Males are hemizygous so the possibility of the father possesing the faulty allele has been ruled out or he would too be affected by the disease. One can also assume that he is suffering from either hypoplastic AI or hypomaturation AI as the other two types are not inherited via the X-linked pathway. The treatment of amelogenesis imperfecta will depend on the severity of the condition but it is usually to treat the aesthetic symptoms so crowns may be given to hide the displeasing characteristics of the malformed enamel.

Profiles of a Spa Customer Essay

Chapter 1 INTRODUCTION Business travelers who want to minimize jet lags, mothers who wants to spend time for themselves, persons with back problems seeking for relief, weekend warriors who are sore from overexertion, an obese man who needs help in controlling his weight, or a couple who wants to reconnect, all come to one place to seek help, the spa. Today’s spa is a center for healing and nourishing mind, body, and spirit. People go to spas for fitness, stress management, peace of mind, pampering and pleasure, and health and wellness. Spas are everywhere. According to the International Spa Association (ISPA), the number of spas in the United States grew at an annual rate of 21% from 1995-1999 and continues to show strong growth. The size of the U. S. spa industry in 2001 was estimated at 9,632 locations; in 2000, that number was 5,689. (Register, 2008). Here in the Philippines, the demand for spa services continues to grow. According to Libarios (2006), as more and more people pine for inner-healing-this and alternative-lifestyle-that, the market for spas and wellness centers has ballooned over recent years. These so-called health-hubs sprouted in the metro like wild mushrooms in the forest—from the most exclusive centers that cater only to society’s well-heeled set down to the modest hole-in-the-wall that offer services at affordable rates. Libarios further adds that even the Department of Tourism (DOT) has sunk its teeth into the trend. Sensing that the demand for spas is not a novelty that would later die a sudden death, it took the initiative to transform the Philippines into the â€Å"sparadise† of Asia. Despite the noticeable dip in the economy, the demand for spas has shown no signs of slowing down. The demand for spa services is driven by personal income and demographic trends. The profitability of individual companies depends on efficient resource use and effective marketing. That is why the profile of spa customers is very essential. This study is intended to determine the profile of spa customers in Bacolod City in order to effectively create an effective feasibility study in putting up a spa business in the future. Statement of the Problem This study tried to determine the profile of spa customers among the selected spa establishments in Bacolod City. Specifically, it tried to satisfy the following questions: . What is the personal profile of spa customers of the selected establishments in Bacolod City in terms of their: a. Gender; b. Marital status; c. Age; d. Employment Status; e. Educational Background; and f. Monthly Income. 2. What is the customers’ prevalence of spa visits in a year? 3. What are the factors that influence their choice of spa to visit? 4. What o ther information may be included in order to support the proposed feasibility study? Operational Framework In this study, the researcher wants to find out the profile of spa customers in the five selected spa establishments in Bacolod City. The personal profile of these spa customers may vary from their gender up to their monthly income. Once their personal profile is established, the next step is to identify the type of spa that they will prefer to avail of once they visit a spa. The researcher is also interested in finding out the influential factors that controls their choice of spa treatments. And finally, the researcher would further sought to find out the necessary information that may be gathered that he deemed were necessary in order to support his proposed feasibility study on the establishment of spa business in Bacolod City. Figure 1 presents the schematic diagram of the operational framework. Figure 1 Schematic Diagram of the Operational Framework Significance of the Study The study is deemed beneficial in the following manner: This study will provide necessary background for future spa entrepreneurs in putting up their own spa establishments. The profile of the customers may also help identify consistency, and repeat purchase and filter posers versus the people who will really come back for not only a 2nd and 3rd massage therapy, but to identify dependable, consistent, steady and reliable customers. The additional information that will be gathered from this study may help ease the possibility that future spa businesses in the city may not suffer the same fate as those business establishments who closed shop early. This study may be replicated by other researchers who are envisioning operating other spa business outside of the city, but on a much wider scope, which may involve other variables not covered in this study. Scope and Limitations of the Study This study was only concerned in finding out the profile of the 5 selected spa establishments in Bacolod City. The respondents of the study were limited only to the customers of the selected spa establishments. The personal profile of the spa customer only covered their age, gender, marital status, educational background, employment status, and monthly income. In the process of conducting this research, the following constraints were identified, namely: the non-participation of some identified respondents in the data gathering and the non-availability of some important respondents during the data gathering. Definition of Terms The following terms were defined operationally for better understanding. Age. This refers to the stage of the life of the spa customers grouped in 6 categories ranging from 18 years and below to over 65 years. Gender. This refers to the sexual characteristics of the spa customers classified as male and female. Educational Background. This refers to highest level of education attained by the spa customers grouped in 4 categories namely: did not complete high school, completed high school, university/college degree holder, and post graduate degree holder. Employment Status. This refers to employment condition of the spa customers grouped in 4 categories: employed full-time, employed part-time, unemployed, and retired. Marital Status. This refers to civil condition of the spa customers grouped in 3 categories namely: single, married, and couple/in a relationship. Monthly Income. This refers to monthly net earnings of the spa customers classified into 6 groups ranging from below Php 20,000. 00 to over Php 20,000. 00. Profile. This refers to personal description of the customers of the selected spa establishments in Bacolod City. Spa Establishments. This refers to five selected spa businesses in Bacolod City such as the Bacolod Spa, Grand Royal Spa, Body and Sole, and Quintessence Spa. Swedish Massage. A kind of massage offered in most spa businesses in Bacolod City. It is a system of therapeutic massage and exercise for the muscles and joints, developed in Sweden in the 19th Century. Shiatsu Massage. A kind of massage offered in spa businesses in Bacolod City. It is a traditional hands-on therapy originating in Japan. Spa. A place of treatment, or is associated with water treatment, which is also known as balneotherapy. Facial. A facial is involving a variety of skin treatments, including: steam, exfoliation, extraction, creams, lotions, masks, peels, and massage. Normally performed in a beauty salon but it is also a common spa treatment. Chapter 2 REVIEW OF RELATED LITERATURE Related Literature According to the Spa Signature (2008) website, the word and concept of spa actually originates from the time of the Roman Empire when battle weary legionnaires tried to find a way to recover from their military wounds and ailments. They sought out hot wells and then built baths so that they could heal their aching bodies; calling these places ‘aquae’ and naming the bathing treatments undertaken there † Sanus Per Aquam† (SPA) which means health by or through water. During this period, the town Spa in Belgium was founded for this purpose, rising to fame in the 14th century and still existing today. Having originated from this time, the culture of Spa developed in different ways throughout Europe, from the ongoing use of mineral water, through to using sea water and marine substances (Thalassotherapy) and a wide range of body and other therapies. Yet even today, the concept of health or healing forms the basis of the spa culture worldwide and hydrotherapy is seen as its defining feature. A spa differs from all other beauty businesses principally through the implied promise that the total experience of being there–everything from the initial greeting to checkout–will be exceptionally serene. The spa is a respite from the pressure and rigors of routine life, a genuine escape, and customers can and do expect almost flawless treatment and care ( Preston, 2008) The Spa Book: The Official Guide to Spa Therapy). According to SpaBoom. com, website, spas are booming due to a surge in stress. The International Spa Association (ISA) says this shows that people feel they should reward themselves for working hard. It is expected that specialized spa services that help people quit smoking, lose weight and treat depression will be a big growth market. In the U. S. , 40 percent of spa customers are men, and spas just for men are emerging in many corners of the nation (English. Chosun, 2007). These days spas come a dime a dozen, and massage parlors are as prolific as muscle aches. If before getting a spa treatment was a luxury only few could afford, the times have changed to adapt to the indulgent desires of an evolving status quo. Today spa treatments come in a range of prices, the spas themselves catering to particular markets. There is bound to be one in your neighborhood, just as likely as there is one off-shore in some fancy beach resort. Student prices now apply to the service of Swedish or Shiatsu, and body scrubs can either polish your resources and leave you dry, or keep you satiated without stripping you clean of your budget. The key is finding the right pressure points without pressuring you with the prices. Because at the end of the day, regardless if you’re rich or poor, everyone could do with a little rest and relaxation (Yu, 2009) www. discoverspas. com/book_store/books. shtml). Get the Best from a Spa According to eHow fashion website (n. d), in order to get the best from a spa, a series of steps must be conducted of which the first is to look at the spa facilities – ideally, the spa must be clean and is up to date with the latest technology. The next step is to pick a spa that has a relaxing atmosphere – an ideal spa must have soft lighting and plays relaxing music. The next thing to do is to get the best package since most spas will offer package deals to their clients. The fourth step is to ask for experienced therapist and talked to them during the session. And finally, relax during the treatment since your body will respond much better if you relax your muscles. How to Enjoy Spa Experience According to Ritajo (n. d), so as to enjoy a spa experience, the following procedures must be followed: first, research the type of spa you are interested in visiting; then, decide what treatments you want to experience; third, plan to take advantage of all that the spa facility offers; next, arrive early (at least 30 minutes) before your first treatment; and finally, enjoy the treatment and ask questions if you need to about what is being done. Related Studies In a 1997 spa-goer market study conducted by Health Fitness Dynamics (HFD) Inc. , clearly indicated women become less stressed as they age and that each age group seeks different results from a spa. Female spa-goers comprised 74% of the 2,332 spa-goers who used a spa while staying at a resort, an increase of 5% since HFD’s landmark 1992 study of the spa-goer. This study further revealed the following account: 59% of the women under 30 years of age go to a spa at a resort when they are stressed; 34% of women over 60 visit spas to exercise and get fit; 48% of the younger women go to a spa at a resort when they feel like splurging. Here is what the study found women want from their resort-based spa experience: Women younger than 40 feel higher stress so they want to exercise and be pampered; In the 40-49 age group, a slight shift occurs since pampering becomes more important and exercise is of secondary importance; the 50-59 year olds are the most vulnerable group in terms of considering leaving spas as this group appears to have the least interest in most spa services, whether these services be exercise and fitness oriented or beauty and pampering oriented. In a study conducted by the International SPA Association (2006), in both the U. S. and Canada, about one quarter of adult consumers (26% of Americans and 25% of Canadians) has visited a spa. These percentages translate into roughly 57 million U. S. adults (aged 18 and older) and 6. 3 million Canadian adults. More recently, 15% of all Americans and 14% of all Canadians have visited a spa within the previous 12 months. These active spa-goers, representing 3. 7 million Canadian consumers and 32. 2 million U. S. consumers, are the focus of this study. When presented with a list of possible benefits sought (or highly valued) on most spa visits, U. S. nd Canadian spa-goers concur on the top five benefits they seek: relaxation, calm/quite/peacefulness, pampering, time out for themselves, and refreshment. When seeking information on which spas to visit, consumers (in both countries) are most likely to trust friends, followed by family members and coworkers. In another study conducted by the ISA’s (2007), it revealed that of the 70% of U. S. spas that offer packag es, the most commonly offered are those for men, couples, pregnant women and teens. According to firstresearch. com, Demand for spa services is driven by personal income and demographic trends. The profitability of individual companies depends on efficient resource use and effective marketing. Larger companies have some economies of scale in marketing and purchasing. Small companies compete by offering unique services, serving a local market, and delivering a superior customer experience. The spa industry is labor-intensive: average annual revenue per employee is less than $80,000. An industry study by Walter Walsh, author of the Book, â€Å"The Spa Apprentice, Major providers of spa services are day spas (70 percent of industry revenue); resort and hotel spas (20 percent); and medical spas (5 percent). Other providers include club spas, mineral springs spas, and destination spas. About 80 percent of the spa facilities in the US are day spas. Medical spas are similar to day spas, but focus on services by healthcare professionals, such as Botox injections and laser hair removal. Destination spas offer lodging and a specific health regime, such as weight loss or detoxification programs. The most popular spa services are full body massages, manicures and pedicures, and facials. Other services include movement classes, body scrubs or wraps. An article from the Sun Star Cebu, (courtesy of their website- www. Sunstar. com. ph,) ,The health and wellness industry in Cebu is expected to grow further this year as more people seek out services offered by local spas. However, Spa and Wellness Association of Cebu Inc. (Swac) president Johnie Lim warned that small establishments and those with less dedicated owners will not survive as competition becomes stiffer this year. â€Å"The industry will explode with growth in the market but many small spas will close,† said Lim, also owner of Body and Sole. â€Å"Those who will survive are those that have captured their own markets. Lim said growth in the industry will be caused by an increase in the number of people who seek the services of spa and wellness centers. â€Å"More people have realized the benefits of going to a spa, even those in the lower middle income (bracket). The trend can be seen even among people who have never been to a spa before,† he said during the first anniversary celebration of Body and Sole Minglanilla, a fran chised outlet. Lifestyle â€Å"It’s becoming a part of the lifestyle of many Cebuanos. (With the growth), Cebu is becoming wellness island,† he added. He said this year’s growth will surpass that of last year, which saw the number of registered spa centers rise to 160 from 90 in 2006. The competitiveness of a spa center would depend on its services, he said, adding that Body and Sole has a good following because it offers value-for-money services. Body and Sole has 41 company-owned and franchised outlets in the Visayas and will be opening another one in Toledo City, Cebu on Jan. 18. It also has three branches in Luzon. While more people now have enough money to pay for an occasional visit to a local spa, Lim said upscale spa centers in Cebu would not have a lot of room for expansion. The middle-end spa centers will expand but (the) high-end (ones), not so much. Cebuanos will still be price-conscious,† he said. Accreditation With this expected growth in the industry, Lim said Swac will ask the Cebu City Council to require new spa and wellness establishments to get an accreditation from the association. â€Å"The accred itation would ensure that spa and wellness centers in Cebu would follow the same standards,† he said. This is in line with Swac’s goal to promote Cebu as a spa and wellness center in the country, he added. Lim said he disagrees with the notion that Cebu’s spa and wellness industry cannot compare to those in Thailand. â€Å"Thailand has been offering spa and wellness services for more than 20 years. We’ve only just started,† he said. He said that while he is â€Å"very positive† about the local industry, the sector could grow further if government, particularly the tourism department, provides more support. â€Å"We in the private sector have been doing most of the promotion on our own. The government should be more supportive instead of critical,† Lim said. (LAP) Related Literature Sources: 1. http://www.dayspamagazine.com/top-10-spa-wellness-trends-2016/ www. researchandmarket. com/reports/spa_industry_profile 11. http://www.spabusiness.com/digital/index1.cfm?mag=;codeid=0;linktype=XY;ref=n;issue= www. willenbooks. co. uk https://ru.scribd.com/document/262580027/1fb8ee5f097d1c7e70cb2caa6010f859 http://www.galleybayresort.com/massage.htm http://www.yeheyjp.com/product-category/mobile-phone http://lubbockonline.com/news/crime-and-courts/2017-03-08/police-1-critically-injured-shooting-near-downtown-lubbock http://www.tandfonline.com/doi/abs/10.1080/19388160.2013.841502?src=recsys;journalCode=wctr20 http://www.spahandbook.com/ http://www.sunstar.com.ph/ https://www.spafinder.com/blog/content/affiliates/ http://www.cdaresort.com/discover/spa/treatments www. firstresearch. om/ http://www.prnewswire.com/news-releases/global-titanium-dioxide-market-research-report-2017—research-and-markets-300401915.html ;

“Age of Iron” by J.M. Coetzee Essay

The extract from the prose â€Å"Age of Iron† written by J.M. Coetzee is about the depiction of different generations conflicting with one another. This extract is set up as an old wise woman a one-way conversation during the 1990’s. This extract illustrates the young boy being forced in listening to the old wise woman’s opinion about the cons of the apartheid, more specifically being the war. Throughout the prose, the young boy refuses to listen to the voice of authority and shows the old wise woman that with stubbornness and self-determination, young children do not accept what they are told from authority. With the portrayal of the two generations conflicting, the extract suggests that the immense amount of influence of authority can play a major role on younger generations leading them to choose the wrong path. This prose is shown as a one-way conversation and is during the time period of the 1990’s which is also known as the South African Apartheid. With the Apartheid regime, the tone of the extract is in a depressed mood because of their struggle to freedom. The old wise woman’s opinions are demonstrated through her stream of consciousness and moves from quick dialogue with the young boy to descriptions showing the vivid imagery of the war. The depressed plot of this extract shows the social activism of the younger generation and the minorities in South Africa fighting for their own rights. The old woman’s advice is however being ignored from the young boy who refuses; due to his stubbornness and goes onto the wrong path putting himself into great danger. The setting of this prose most likely takes place in the old woman’s house because of the depiction that the old woman â€Å"do[esn’t] have bandages in the house.† This shows that the young boy illustrates the dramatic beginning by making â€Å"splashing noises† indicating that it was rainy day outside and he needed to go inside somewhere dry. Since the young boy went inside the old woman’s house without knocking, this shows that there is a family connection between the old woman and the boy however not a strong connection because of the one-way dialogue throughout the prose. However, they do have family connection where the boy visits often because she notices â€Å"the bandage [is] off and with surprise [she] noticed that the stitches were still in.† This line depicts that she cares for the boy and that there is a family connection between the two characters because of the connection of the boy being able to go into her house and the fact that he has visited before with a bandage on. The prose then continues into short dialogue, demonstrating that the narrator is represented as a motherly figure because of the tone of caring in the dialogue such as â€Å"when did you leave the hospital and you must keep that cut covered, otherwise it will get infected†¦Ã¢â‚¬  The protagonist in this prose is represented as a mother figure because of the consecutive questions she asks the boy about his cut and exaggerates that it will leave â€Å"a memento† on â€Å"his forehead for the rest of his life.† The protagonist is shown as a â€Å"hen that loses its chicks† because in the prose, the young boy that steps into the protagonist’s house isn’t blood-related to the old woman however, this line depicts that the old woman will still treat him as her own son because of the theme nature vs. nurture. The old woman also recommends to the young boy to â€Å"go [see] a doctor soon, or a clinic to have the stitches taken out.† This quotation also initiates the spark of the young boy choosing the wrong path in life, leading him into great danger because he cleverly moves away from the topic by saying that he â€Å"must rest [his] arm† and his â€Å"head is not sore.† By saying this to the old woman, she immediately thinks that he is â€Å"running away from someone† and by being silent, she starts to show her caring and loving for the boy by telling him advice. Since she asked the young boy with care and love if he was running away from someone, and with no reply, the old woman got worried and starts to explain to the young boy again that he is â€Å"too young for this kind of thing†. The old woman starts to tell explain to the young boy that it is not a good thing to die and that even though he is fighting for his own rights during the war, he should be careful because â€Å"[they are] throwing away [their] lives before [they] know what life can [really] be.† It is also indicated in the prose, that she is an old person because she says so herself when she is explaining to the young boy. She also talks about â€Å"Bheki†, her son who died at a young age because he fought in the war however when she explained to the young boy that war isn’t a good thing to participate; he didn’t understand because he asked after she had explained about the cons of war. The vivid imagery is brought out into that particular paragraph because she illustrates the war as an â€Å"age of chivalry† where â€Å"men [hack] other men to death.† However her strong opinion against the war didn’t work on the young boy because he wasn’t influenced at all because his desires were very strong about war. In the prose, the young boy has rebelled against the voice of authority (old woman_ by not paying attention to her when she was talking as she explained through dialogue and imagery that war isn’t something to be proud about. However, the young boy’s desire grew and he became more passionate about the war showing that all of the immense influencing she did was a waste of time. Consequently, she gets furious when he asks â€Å"where is Bheki.† This shows that the young boy wasn’t paying attention to the old woman and shows that he is also immature. This specific quotation indicates that the young boy isn’t mature because he didn’t understand her hint when she said that â€Å"I told Bheki so [I’ll] tell you again.† This being the turning point of the prose, the old woman changes her voice of tone from soft and sweet into more of a demanding voice by telling him to â€Å"sit down†. As he follows her orders, she starts to explain that Bheki is actually â€Å"in a box in a hole with earth heaped on top of him.† She says this with great pain and as she quickly brushes that off her shoulders, she then changes her way of explaining to the boy into a more childish way. She starts to use basic terms for the young boy to understand as her diction goes from complex to simple. Her voice changes immediately and the old woman start to explain to the boy as if he was a little child who was learning to ride a bike. As the conclusion starts to approach, her mood also becomes more furious because she knows that compassions is the most important thing and pushes that war is a struggle and pain. With her great influence upon the young boy, â€Å"he threw off [the] talk† and chooses the path of war as a sign of discipline. In the prose â€Å"Age of Iron† the influence of authority is shown throughout the prose. With the old woman trying to lure the young boy out from war is not successful as all the young boys listen to discipline and nothing else. However with him refusing the talk which had â€Å"weighed down the generation of his grandparents and his generation of his parents†; he decided to choose the wrong path leading him into a great deal of danger. Even though, the old wise woman knew what she was talking about and had heard about past experiences through memory and sense-perception, her influence upon the boy was very significant however with the two generations conflicting, the immense amount of influence of the old wise woman wasn’t successful which lead the young boy in choosing the wrong path.

Analyzing The Electromechanical Valve And The Benefits...

CAMLESS ENGINES AND THE BENEFITS THEY PRODUCE The authors of the reviewed article are: Marcello Montanari, Fabio Ronchi, Carlo Rossi, and Alberto Tonielli, all of whom are members of IEEE (Institute of Electrical and Electronics Engineers). Marcello Montanari received the Laurea degree in computer science, engineering, and a Ph.D. in automatic control from the University of Bologna, Bologna, Italy, in 1999 and 2003. Since 2000, he has been with the Department of Electronics, Computer Science and Systems (DEIS), University of Bologna. His current research interests include applied nonlinear and adaptive control techniques, electric drives, and automotive systems. His co-authors are also graduates of the University of Bologna and are members†¦show more content†¦SUMMARY In Montanari’s article first, he addresses and formulates the problem. Second, he creates a mathematical model of the system, and analyzes the requirements for the controlled system. Third, he completes the position reconstruction and the analysis of the sensors. Lastly the reference of trajectories for the pistons, to ensure the stability of the system, is completed. After all this Montanari proposes a control system architecture for the position control of an electromechanical valve actuator. There are two key parts of the controller, specifically, the position reconstruction, and the reference trajectory design. Both of these have been addressed, and the resulting limitations on the system’s dynamic performance explained. Knowledge of these limitations is essential when integrating a valve actuation system within the internal combustion engine management system. Hence, the results presented in this paper are an important step toward the realization of a Camless engin e with electromechanical actuators for commercial vehicles. Camless engines offer a lot of improvements over traditional engines in efficiency, maximum torque and power, and emissions. Electromechanical valve (EMV) actuators are a great way to solve this problem, but electromechanical valves have major