Gated DIBH for Left Sided Breast Cancer Patients

Gated DIBH for Left Sided Breast Cancer Patients Chapter III: Methodology 3.1 Research Objectives The research project examines left-sided breast cancer patients receiving therapy with gated DIBH technique using the commercially available RPM system. The primary objective of this research is to evaluate whether left-sided breast cancer patients will benefit from gated DIBH. The interest in performing this research arises from having many left-sided breast cancer patients that have large volume of heart in the treatment field, and hence are at risk for cardiac toxicities in the future. The secondary objectives of this research is to look at patient’s comfort and understanding, and radiation therapist’s workload. This chapter will discuss the sample selection, ethical issues, instrumentation, data collection procedures, data analysis, limitations, expected results, budget and timeline. 3.2 Sample selection and description The expected sample size was calculated using the formula (Chan, 2003) for paired samples as seen below, Total sample size = where c is 10.5 for 90% power, ÃŽ ´ is the standardised effect size, given by the formula (Chan, 2003): where ÃŽ ¼1 and ÃŽ ¼2 are the means of the two treatment groups, and ÏÆ' is the common standard deviation. The 90% power represents the probability of rejecting the null hypothesis when it is false (Chan, 2003). It is postulated that a good treatment difference () between the 2 groups is 0.2 units with an SD (ÏÆ') of 0.5 units (Chan, 2003). With these values, the expected sample size is 68. Sixty-eight left-sided breast cancer patients will be selected for this research using a simple random sampling method. The patient population will be chosen at random to create a diverse group of patients with variable breast and heart volumes. The criteria for this sample would be female patients with left-sided breast cancer below the age of 70. In addition, the patients must be able to hold their breath. These patients will be recruited after being screened by the oncologists. The oncologists will do a simple breath-hold test with patients to determine if they are able to hold their breath for at least 20 seconds. This is because patients will be required to hold their breath during the CT scan for a duration of 18 seconds. This research will require 2 sets of computed-tomography (CT) scans from each patient of which one is at free breathing and the other at DIBH. Both sets will have identical patient setup. Patients will be lying supine with both arms above head on a posirest, having the visual goggles on (see Appendix M, image A) with a 6-reflective markers block on patient’s anterior abdominal surface (see Appendix H). With the goggles, they are able to view the screen, as seen in image B in Appendix M, in order to see their breathing patterns. For each patient, 2 treatment plans will be generated: one using the CT images at free breathing with photon electron match technique and the other using the CT images at DIBH with gated DIBH technique using RPM with 3-mm intervals. 3.3 Ethical Issues and Informed consent Any research involving human subjects conducted in the hospital would require adherence to ethical standards. The procedure requires the collation of a list of investigators in the department that intends to conduct clinical trials (see Appendix N), and to apply and attend the Singapore Guideline for Good Clinical Practice (SGGCP) course. This Course ensures that the conduct of clinical trials follows internationally acceptable ethical and scientific standards (see Appendix O). The ethics review will be carried out by the National Healthcare Group domain specific review board which is an independent committee constituted of medical, scientific and non-scientific members, whose responsibility is to ensure the protection of the rights, safety and well-being of human subjects involved in a research study by reviewing, approving and providing continuing review of research studies, and of the methods and materials to be used in obtaining and documenting informed consent of the research su bjects (National University Health System, 2010). When a principal investigator submits an application via the research online administration and management system, it is automatically routed to the department representative for endorsement, and subsequently the institution representative for endorsement, before it is delivered to the domain specific review board secretariat (National University Health System, 2010). All research studies submitted will be classified under one of the following review categories: exempt review, expedited review, full Board review (see Appendix P) (National University Health System, 2010). Based on the definitions in Appendix P, this study is classified as an expedited review. Ethics approval for research is required for several reasons. Firstly, ethical norms promote the aims of research, such as knowledge, truth, and avoidance of error (Resnik, 2011). Secondly, ethical standards promote the values that are essential to collaborative work, such as trust, accountability, mutual respect, and fairness (Resnik, 2011). For example, guidelines for authorship, copyright and patenting policies, data sharing policies, and confidentiality rules in peer review, are designed to protect intellectual property interests while encouraging collaboration (Poortmans, 2013). Ethical norms in research also help to build public support for research as people are more likely to fund research project if they can trust the quality and integrity of research (Resnik, 2011). Finally, many of the norms of research promote a variety of other important moral and social values, such as social responsibility, human rights, compliance with the law, and health and safety. This also protect the rights and welfare of participants and minimise the risk of physical and mental discomfort and harm from research procedures (Canterbury Christ Church University, 2006). Ethical lapses in research can significantly harm human subjects especially if the researcher fails to abide by the regulations and guidelines relating to radiation or biological safety (Resnik, 2011). Informed consent is the process by which the patient voluntarily confirms her willingness to participate in this research, after being informed of all the aspects of the research that are relevant to her decision-making (National Healthcare Group, 2013). The informed consent is documented by means of written signatures, date informed consent form and the language used during the explanation to the patient by the oncologist. In the consent, there should be 3 signatures: the patient’s, the doctor’s and the witness’ signature. For patients who cannot read and speak English, a qualified translator will be around during the signing of the consent. 3.4 Research design and instrumentation This research is a mixture of qualitative and quantitative research methods (see Appendix Q). Quantitative research corresponds to a deductive scientific method of research which uses data in the form of numbers and statistics to test hypotheses, using a large and randomly selected sample that is a representative of the population (Pearce, et al. 2013; Johnson Christensen 2010). This is in contrast to the qualitative approach which corresponds to an inductive method of research which uses words, pictures or objects to examine a phenomenon, requiring only a small and non-randomly selected sample (Pearce, et al. 2013; Johnson Christensen 2010). Patients will be scanned using Toshiba Aquilion Large Bore CT-simulator (Toshiba, 2014). The treatment plans will be generated using Varian Medical Eclipseâ„ ¢ Treatment Planning System and patients will be treated with DIBH technique using RPM from Varian Trilogy linear accelerator (Varian Medical System, 1999-2014). 3.5 Data collection procedures The same radiation oncologist will perform all the delineation of the clinical target volume, the heart and LADCA for consistency purposes (see Appendix R). The delineation will be done according to radiation therapy oncology group (RTOG) breast contouring recommendations (Goksel, et al., 2013). Patient’s CT images at breath hold will be used to plan for DIBH technique while the one at free breathing will be planned for photon electron match technique. The treatments will be planned such that the clinical target volume’s coverage of the dose distribution is kept between 90% and 110% of the prescribed dose. For each plan, heart and LADCA volumes were calculated in cm3. Dose volumes to the heart and LADCA will be normalized by dividing with the total organ volume. Heart and LADCA volumes receiving 5Gy to 50Gy (V5-V50) will be generated for comparison of treatment techniques. Dose distributions can be presented as DVHs and representing the statistical dose distribution in a volume of interest. These statistical data will be recorded and presented in tables. Patient education is a very important component in DIBH technique using RPM to reduce anxiety and increase their confidence about receiving radiation therapy (Halkett Kristjanson, 2007). Patient education tools can be in many forms such as video or pamphlet (Halkett Kristjanson, 2007). For this research, a pamphlet have been created to educate patients on DIBH technique using RPM (see Appendix S). A qualitative research method such as face-to-face interview is chosen to assess patient’s comfort and understanding at the middle of the treatment and on the last day of treatment as this only require the patients to speak the same language in which the questions are asked, and to have basic verbal and listening skills (Bowling, 2009). The primary objective of this standardised and open-ended interview (Valenzuela Shrivastava, n.d.) is to determine the degree of understanding as well as patient’s comfort. The questions (see Appendix T) will be asked by the oncologist durin g the middle of the treatment and on the last day of treatment. The advantages of face-to-face interviews are that reading and writing skills are not required, interviewers are able to probe fully for responses and clarify any ambiguities, they can ask more complicated and detailed questions, and patients are able to clarify if they do not understand the questions (Bowling, 2009). This would be a better technique than self-administered questionnaires because pre-coded response choices may not be sufficiently comprehensive and patients may be ‘forced’ to choose inappropriate pre-coded answers that might not fully represent their views (Bowling, 2009). This causes the data to be bias as the patient’s replies are influenced by the design of the pre-coded response choices. Self-administered questionnaires also assumed that the questions are worded in a way that is understood by the patients (Bowling, 2009). Patients may misinterpret the questions and reply based on their own interpretation and questionnaires may be a problem for p atients who are unable to read or write (Bowling, 2009). Most importantly, one-to-one interviews with standardised questions appeared to have the highest reliability (University of Leicester, n.d.). The radiation therapist’s workload will be measured in terms of training hours, and the comparison of treatment duration and manpower required for gated DIBH using RPM and photon electron match technique (see Appendix U) will be recorded and presented in charts. 3.6 Data analysis Paired samples t-test will be used to determine whether there is a significant difference between the average dose to the heart and LADCA values made under photon electron match plan and gated DIBH using RPM plan (Norman Streiner, 2008). This is used because the data are measured at the scale level and the data are related (Hawkins, 2009). The amount of radiation received by the heart can be recorded by comparing the DVHs of the photon electron match with gated DIBH using RPM. The statistical figures can be analysed using Statistical Package for Social Sciences (SPSS) (Yavas, et al., 2012). Paired samples t-test will be used to determine whether there is a significant difference between the average dose to the heart and LADCA values made under photon electron match plan and gated DIBH using RPM plan (Easton McColl, 2014). A p-value of Patient’s understanding and comfort The questions (see Appendix T) from the standardised and open-ended interview were developed by a team of 2 radiation oncologists, a nurse and 2 radiation therapists. The areas of discussion were based on the group’s clinical experience with left-sided breast cancer patients and their extensive knowledge on DIBH using RPM. The interview aims to determine the patient’s level of comfort and understanding of the gated DIBH using RPM. The design of the questionnaire will determine the reliability and validity of the opened-ended interview to measure patient’s level of comfort and understanding. Reliability is defined as the extent to which questionnaire will produce the same results on repeated trials (Miller, n.d.), and is measured by its equivalence and stability. Equivalence reliability assesses the consistency of the judgement of the patient’s answer by the interview (Miller, n.d.). It is improved by pre-empting a range of responses that might be given by the patients and give a pre-determined rating to each response so that the interviewers will have the same level of ‘judgement’ (Miller, n.d.). For example, _____________- Stability reliability is correlated to the repeatability of the patient’s response under the same conditions after a period of time (Miller, n.d.). For this interview, the patients will be interviewed twice, once during mid-treatment and the other on the last day of their treatment. Their responses from both sessions will be compared to determine if there are any deviance. This assumes that the characteristics that is measured doesn’t change with time, and that the time period is long enough that the memories from the 1st interview will not influence the responses of the 2nd interview (Miller, n.d.). The validity of the interview is the extent to which the interview questions measures what it purport to measure, and it generally takes the form of content validity (Miller, n.d.). Content validity is the degree to which the questions fully assess or measure the intention of the interview (Miller, n.d.). This was determined by letting the team review the individual questions for readability, clarity and comprehensiveness and come to some level of agreement as to which items should be included in the final interview questions. The interview questions (see Appendix T) were reviewed and accepted by the team prior to the conduct of the interview. The treatment duration will be recorded as seen in Appendix U and a paired samples t-test similar to appendix V will be used to determine whether there is a significant difference, where the null hypothesis (H0) is there is no difference between the treatment time with photon electron match technique and DIBH using RPM technique. The radiation therapist workload will be analysed based on the minimum number of manpower required for gated DIBH using RPM as compared to photon electron match technique and in terms of training hours. This will be discussed among the radiation therapists and presented in charts. 3.7 Limitation This research can only sample from a small size due to constraint of resources where there is only 1 treatment unit that has the RPM equipment required for DIBH technique. The expected sample size calculated is only an estimate as the treatment difference and standard deviation are never known in advance (Norman Streiner, 2008). As such, the actual sample size may be slightly smaller than 68. 3.8 Expected Results The results from this research are expected to show optimal radiation exposure volumes and doses for the heart and LADCA when treated with gated DIBH using RPM compared to photon electron match technique at free breathing. These results are expected to be compatible with findings from previous studies (Pedersen, et al., 2004; Korreman, et al., 2005; Shim, et al., 2012; Mast, et al., 2013). As such, showing that patients with left sided breast cancer will benefit from gated DIBH using RPM. Treatment time duration for gated DIBH using RPM is expected to have a significant difference and be faster than photon electron match technique. As gated DIBH using RPM is new to the radiation therapists, the workload is expected to be heavier in the beginning. 3.9 Budget There will be no additional cost for this research as the RPM equipment is already available together with the linear accelerator from Varian (Varian Medical System, 1999-2014). There will be no cost for training on the usage for RPM by Varian as it was included in the package when the linear accelerators were bought in 2013. Patients recruited for this research will be charged the same cost as photon electron match treatment technique. 3.10 Expected Timeline This research aims to commence from January 2015 till December 2015. The work plan for both the principal investigator and research assistants can be seen in Appendix W. Chapter IV: Conclusion This research aims to review gated DIBH using RPM as a treatment technique for left-sided breast cancer patients as compared to photon electron match in terms of the radiation dose received by the heart and LADCA. Paired t-test is chosen to measure the significant difference between the dose received by the heart in photon electron match technique and DIBH using RPM technique. Based on literatures that were review, the results are expected to be in favour of gated DIBH using RPM. Interviews will be conducted to assess patient’s comfort and understanding about gated DIBH using RPM. And data collection will be done gauge the workload of the radiation therapist. The results from interview and data collection will allow us to gauge further if it is really practical to implement gated DIBH using RPM in our department. If the results are clinically significant and positive, gated DIBH using RPM will be implemented into our department. 4.1 Recommendation For future recommendation to try contrast-enhanced CT scan in left-sided breast patients so that the LADCA can be seen clearly in the scan and able to be delineated by the doctor effectively (Yu, et al., 2013). This is to increase the accuracy of the delineation of LADCA as well as the accurate amount of radiation dose received by it. After this research, another study can be done in the future on the reproducibility of patient’s breath holding level for every fraction using a cine acquisition mode (CAM) of a linear accelerator during treatment (Goksel, et al., 2013).

White Tiger

In current society many books are written based racial or social issues reflecting the past, present or future. The White Tiger by Aravind Adiga is an example that confronts social and racial issues within India, shown through the eyes of servant to wealthy, named Balram. Born in rural part of India with a deceased mother and rickshaw-pulling father, Balram is dedicated to serving others. Whether it was driving the wealthy around, grinding coal, or running behind cars to get a job, Balram’s life was constant and there was no chance of him becoming a man who had servants.He was judged on where he was from and the family he was born into just like Jim was judged in The Adventures of Huckleberry Finn for the color of his skin. They both had nothing to do with what they were born with but they both try to make the best of their lives by making relationships with those of a higher class or skin tone. In comparison to The White Tiger Balram shows how he deals with struggles within g iven class in order to better himself in the modern Indian society. The common apartment buildings in Delhi thrive on the past like caste systems based on the structure of the floors within the apartment.Balram describes his job, as a servant is to drive his masters around and then when they return to the buildings clean the apartment or do anything for his masters waiting for the master to tell him to leave until the morning. When Balram is done with work he goes downstairs to the servants’ quarters in the basement, which is traditional to have in apartment buildings because all residential buildings or homes are built with quarters to house their servants. These living arrangements are a place of â€Å"rest, sleep, and wait.When our masters wanted us an electric bell began to ring throughout the quarters†¦I swept the floor, tied the mosquito net to four nails on the wall, and went to sleep. The wall was covered with cockroaches,†(108-110). While their masters li ved in beautiful, cleanly apartments, their servants sleep on the lowest part of the building full of cockroaches and dirt awaiting the bell to go to their masters. The life in the apartment building represents the Caste System, that was prominent in India but now is illegal all over India, with the poorest, lowest class in basement and then the rising castes follow.Although Balram does not highlight the floor assignments of the building resembling the Caste System; the idea of living below your master is a representation of the ancient but known system. Life as servant for Balram in India means that he can’t be considered or seen doing the same things as his masters suggesting that he is not of the social status to partake in the same activities. The idea that Balram drives his masters to the mall and then not allowed to enter the same mall as them is ridiculous.But its not just Balram who sits and waits outside for his clients but other chauffeurs cannot enter the mall too. Balram describes his desire to go into the mall but knows that the guards will never let him because of the way he is dressed. â€Å"I went to the gateway of the mall in my new white T-shirt. But there, the moment I saw the guard, I turned around- went back to the Honda City†¦Even as I was walking side the mall, I was sure someone would say, Hey! That man is a paid driver! What’s he doing in here,† (128)?Going to the mall is like entering a prestigious club with guards protecting it to make sure those who did not belong get in. This representation of the Caste System is shown by those who were not in the right class would not have the same privilege of shopping in the mall like the upper classes. Balram compares being a servant of the wealthy to a Rooster Coop, where both a servant and rooster are trapped in a controlling world of a master that is useful and beneficial to the master.â€Å"He unloads all this furniture for you, and you give him the money in cash- a fat wad of cash the size of a brick†¦A years salary, two years’ salary, in his hands, and he never takes a rupee of it,† (148). The idea of the Rooster Coop is that these servants have so many opportunities to steal the money of their masters but they do not want to disobey them. They are worried that their families will be harmed and therefore these servants are imprisoned by the rich just the chickens are by farmers. White Tiger In current society many books are written based racial or social issues reflecting the past, present or future. The White Tiger by Aravind Adiga is an example that confronts social and racial issues within India, shown through the eyes of servant to wealthy, named Balram. Born in rural part of India with a deceased mother and rickshaw-pulling father, Balram is dedicated to serving others. Whether it was driving the wealthy around, grinding coal, or running behind cars to get a job, Balram’s life was constant and there was no chance of him becoming a man who had servants.He was judged on where he was from and the family he was born into just like Jim was judged in The Adventures of Huckleberry Finn for the color of his skin. They both had nothing to do with what they were born with but they both try to make the best of their lives by making relationships with those of a higher class or skin tone. In comparison to The White Tiger Balram shows how he deals with struggles within g iven class in order to better himself in the modern Indian society. The common apartment buildings in Delhi thrive on the past like caste systems based on the structure of the floors within the apartment.Balram describes his job, as a servant is to drive his masters around and then when they return to the buildings clean the apartment or do anything for his masters waiting for the master to tell him to leave until the morning. When Balram is done with work he goes downstairs to the servants’ quarters in the basement, which is traditional to have in apartment buildings because all residential buildings or homes are built with quarters to house their servants. These living arrangements are a place of â€Å"rest, sleep, and wait.When our masters wanted us an electric bell began to ring throughout the quarters†¦I swept the floor, tied the mosquito net to four nails on the wall, and went to sleep. The wall was covered with cockroaches,†(108-110). While their masters li ved in beautiful, cleanly apartments, their servants sleep on the lowest part of the building full of cockroaches and dirt awaiting the bell to go to their masters. The life in the apartment building represents the Caste System, that was prominent in India but now is illegal all over India, with the poorest, lowest class in basement and then the rising castes follow.Although Balram does not highlight the floor assignments of the building resembling the Caste System; the idea of living below your master is a representation of the ancient but known system. Life as servant for Balram in India means that he can’t be considered or seen doing the same things as his masters suggesting that he is not of the social status to partake in the same activities. The idea that Balram drives his masters to the mall and then not allowed to enter the same mall as them is ridiculous.But its not just Balram who sits and waits outside for his clients but other chauffeurs cannot enter the mall too. Balram describes his desire to go into the mall but knows that the guards will never let him because of the way he is dressed. â€Å"I went to the gateway of the mall in my new white T-shirt. But there, the moment I saw the guard, I turned around- went back to the Honda City†¦Even as I was walking side the mall, I was sure someone would say, Hey! That man is a paid driver! What’s he doing in here,† (128)?Going to the mall is like entering a prestigious club with guards protecting it to make sure those who did not belong get in. This representation of the Caste System is shown by those who were not in the right class would not have the same privilege of shopping in the mall like the upper classes. Balram compares being a servant of the wealthy to a Rooster Coop, where both a servant and rooster are trapped in a controlling world of a master that is useful and beneficial to the master.â€Å"He unloads all this furniture for you, and you give him the money in cash- a fat wad of cash the size of a brick†¦A years salary, two years’ salary, in his hands, and he never takes a rupee of it,† (148). The idea of the Rooster Coop is that these servants have so many opportunities to steal the money of their masters but they do not want to disobey them. They are worried that their families will be harmed and therefore these servants are imprisoned by the rich just the chickens are by farmers.

Social Media Marketing Essay Example Pdf - Free Essay Example

Sample details Pages: 8 Words: 2347 Downloads: 1 Date added: 2017/06/26 Category Marketing Essay Type Critical essay Level High school Tags: Social Media Essay Did you like this example? A critical discussion on social media marketing and what makes a successful social media strategy Introduction The term social media can be defined as â€Å"Many online tools that allow people with similar interests to share information, learn from others, or network in an open process. The information found on these sites is commonly referred to as ‘user-generated content, which means anyone is able to post with minimal restrictions or oversight.† (Wilson, 2010) There has been a huge explosion in business social media marketing, used to engage effectively with consumers and as such, there is a lot of research and literature on the impact of social media on organisations. This has been brought about by the remarkable increase in the progression and adaptation of technology, demanding that businesses rethink their digital marketing strategies. Don’t waste time! Our writers will create an original "Social Media Marketing Essay Example Pdf" essay for you Create order The aim of this essay is to critically review social media marketing and to analyse the reasons behind its success. The essay further aims to discuss the models and frameworks that support successful social media strategies for organisations, both large and small. This essay offers a platform that would enable the reader to understand the need for this research and also provides a background about recent developments both in the industry and in research circles with respect to social media branding. The rapid development of technology, and the reach of such technologies at affordable costs, have revolutionised the ways in which businesses operate today. The Internet is being used by millions of people at this very moment; therefore these technologies have led to a paradigm shift in the way that communication happens. Business reputation and presence in a market is more driven by ‘social media. (Tuten, 2008) It can also be noted that the shift and focus on social m edia has been drastic and many businesses have been caught off-guard. However, the use of social media has created opportunities for online marketers to engage with customers who they wouldnt otherwise have been able to reach using traditional marketing methods. This reach though, has posed many challenges to businesses that have viewed social media like any other traditional media, such as magazine or television, thus causing wider gaps rather than bringing them closer to the customers (Qualman, 2012). On the contrary, it can be said that more and more retailers and business are becoming increasingly aware of social media and are waiting to exploit the potential that it offers (Olivas-Lujan, 2013). Background Social Media is a relatively new form of marketing that just about every business today is at least aware of, if not already utilising it in some form or another. The global fixation with social media, or social networking as its often referred to, can be easily compared to the hysteria of the Internet revolution in the 1990s. As reported by Mangold and Faulds (2009), this marketing medium differentiates from the traditional communication channels in terms of reach, frequency and immediacy, with the most obvious difference being user-generated content. Business Investment It is perhaps not surprising why businesses across the world are investing in this new form of communication to reach their consumers and stakeholders. Searching on the term ‘social media sites or ‘social networking on any Internet search engine brings up dozens of networks including the popular Facebook, Twitter, LinkedIn, Instagram, and YouTube – the list appears endless. Expenditure on social media by businesses is on the rise. A recent study by the IAB (Internet Advertising Bureau) shows that in the first half of 2014 in the UK alone, there has been a rise of 53% in the spend on social media by businesses, with a total contribution of  £242.5 million (Somerville, 2014). Another study by IAB on FMGC sector, consisting of more than 4500 survey responses and 800 interviews, showed that 90% of customers would use social media to refer the brands to peers, four in five customers would buy products that have good social media coverage and 83% would be willing to try products that are popular in social media (Anon, 2012). Consumer Choice and Motivation A research study conducted by Mass Relevance that provides a social media curation platform to clients found that 59% of consumers will more likely trust a brand that has presence in social media and 64% of the consumers interviewed have already made purchases based on social media presence and reviews (Chaney, 2012). Appendix 1 shows the social media advertising effects on consumers (Source: Neilsen Survey: Anon, 2012) A study for Harvard Business Review by Edelman (2010) discusses how the Internet and social marketing has changed not only the way businesses operate but also how consumers choose their products. It takes the reader through the funnel metaphor that was previously being used by marketers to understand how consumers select their products and how this has moved to a more open-ended approach whereby consumers no longer follow a methodical approach of selecting products. It stresses how important it is for brands to connect with consumers and it also studied the consumers decisions across five different industries, namely automobile, skincare, insurance, mobile telecommunications and electronics, across three different continents. Based on the results of the study, it proposed a four-stage model that focuses on todays consumers using social media for advocating products and also purchasing based on the reviews and backing received. The research takes the reader through the entire customer journey and informs businesses what they should not focus energy and resources on. Providing statistical information about various surveys enables organisations to identify the key areas they should concentrate on in order to build a solid brand image online. From the above, it can be understood that social media has a profound impact on consumer choice in terms of brand and product selection and that it is key to engage effectively with customers. There is a lot of literature that discusses social media impact on consumers and why businesses should engage with customers, exploiting social media to provide value added etc. The main aim of this essay is to look into various key researches in this area and to provide an overview of effective social media marketing strategies for businesses. 2.1 Social Media Strategy While social media has its benefits, it is important that businesses are acutely aware of their own social media strategies. One faux-pas might prove to be detrimental to brand image and performance. For example, an indepth study conducted by BusinessWeek (2009) discusses social media hype and the disadvantages it may have on a business. For instance, the potential risks social media marketing poses if employees waste their time on social networking sites instead of on productive tasks in the interests of the organisation. It also forewarns of blunders that could have a profound negative impact on the business itself. This statement is supported by providing evidence in the study that many social media campaigns fail and it sites the example of one such campaign by Saatchi Saatchis campaign for Toyota Matrix, which led to a lawsuit of $10 million (Groth, 2011). If this happens with a small and medium enterprise, it may reap havoc on the business. The study by BusinessWee k (2009) also says that it is hard to quantify the outcomes that social media creates, such as trust and loyalty. Hence it is important to have a good and well thought out social media strategy tailored to the organisations needs. For example, selecting which social networking sites to subscribe to and what kind of content should be posted, and how frequently, are a key areas of a social media strategy. One global organisation that appears to have mastered its social media strategy is car manufacturer, Ford. In a recent case study the researcher explains how Ford has included the key success elements in its strategy including customised posts, user connectivity through tone of voice and perhaps most importantly, a social media team that reads and responds to every single comment made by followers (Ratcliff, 2014). However, it is worth noting that Ford has worked out what works for its own business, and this exact strategy may not necessarily drive the same achievement for different organisations. Social media is not the responsibility of one single person within the organisation, rather a collective responsibility of all employees. Social media policies and ‘etiquette guidelines need to be developed and strictly adhered to, in order to prevent the risk of employees wasting time and also to clearly define who owns the communication/conversation, the level of transparency in communications, the tone and frequency of messages, building trusting and long-lasting customer relationships etc. The social media strategy should also specifically define the outcomes, the ways in which to measure these outcomes and the total spend on social media activities along with dedicated resources. For a social media strategy to work, it is important that the communication is two-way and that customer opinion is valued. Similarly, it is pivotal to integrate social media marketing with the overall online marketing strategy and share contents with the user s in a social media-friendly ‘pressroom. Effective collaboration and providing value content plays a major role in determining the success of a social media marketing strategy (Evans, 2010). A good social media marketing model should be adopted in order to target the right customers, engage with them, constantly work towards attracting more potential customers and building a good brand image. Figure 2 (Appendix) depicts a three-phased approach in the social media marketing model. Firstly, customers need to be understood from what they perceive about the brand and also their networks. Secondly, the key influencers are analysed to assess what interests customers. The third and final phase is engagement and interaction with the customers. This model gives a broad overview of the social media engagement phases. There are various models in vogue today and each model can work well for a specific business or sector. Depending on the requirements of the business, it is esse ntial to work on a model that would add value to the business and also act as a powerful tool to facilitate the achievement of social media goals for the business. Social media marketing model should be aligned to the social media strategy of the business. Return on Investment Drury (2008) discusses how marketers of various industries and businesses can effectively engage in social media marketing. The paper gives a fairly comprehensive view on what social media is and the role of marketing within it. It discusses how social media can be monetised by the marketers and the researcher talks about how marketing is no longer one-dimensional and it is therefore essential for businesses to engage with consumers to build stronger and lasting relationships. It also suggests that the key to a successful relationship would be to provide consumers with tailor-made promotions and messages that would bring various elements together to reach a larger percentage of the audience. The researcher does however state that it is essential for businesses to benchmark success and to effectively measure return on investment (ROI), otherwise it could become very challenging and difficult to drive growth. Measuring ROI can however be challenging. A recent white paper by Adobe revealed that 88% of the marketers surveyed didnt feel they could truly quantify the success of their social media efforts (Adobe Digital Index, 2012). Some logical starting points would be to use metric tools, measure interactions such as ‘likes and ‘shares and measure traffic to the sites (Burg, 2013). 3.0 Conclusion There is a lot of literature on various aspects including, but not limited to, the effects of social media on small and medium scale enterprises, identification of skill gaps in social media with specific emphasis to certain industries, general studies on implementation challenges, perception of social media on businesses, and barriers to adaptation of social media by businesses etc. Each researcher, however, talks about the importance of measuring the success of the social media activities on the business to enable further growth. They also discuss the importance of being able to fully understand the paradigm shift and having to constantly engage in effective ways of using social media and how any mistakes might jeopardise the business, its image and the reputation that has been built. References Adobe Digital Index (2012) Why Marketers arent giving social the credit it deserves, [Online], Available: https://success.adobe.com/assets/en/downloads/whitepaper/13926_digital_index_social_report.pdf[15 May 2014]. Anon (2012) ‘State of the Media: The Social Media Report, Neilsen, pp. 17-18. Burg, N. (2013) How To Measure Your Social Media Return On Investment, [Online], Available:https://www.forbes.com/sites/capitalonespark/2013/04/25/how-to-measure-your-social-media-return-on-investment/ [10 May 2014]. BusinessWeek (2009) Beware Social Media Snake Oil, [Online], Available:https://scaledinnovation.com/innovation/publications/2009-12-busweek.pdf [10 May 2014]. Chaney, P. (2012) Brands should use social media to engage consumers, amplify messages and promote trust, Digital intelligence today, [Online], Available:https://digitalintelligencetoday.com/brands-should-use-social-media-to-engage-consumers-amplify-messages-and-promote-trust-survey-says/ [10 May 2014]. Drury, G. (2008) ‘Opinion Piece: Social Media: Should marketers engage and how can it be done effectively?, Journal of Direct, Data and Digital Marketing Practice, Vol. 9, p. 274-277. Edelman, D.C. (2010) Branding in the digital age: Youre spending your money in all the wrong places, Harvard Business Review, [Online], Available:https://hbr.org/2010/12/branding-in-the-digital-age-youre-spending-your-money-in-all-the-wrong-places/ar/1 [15 May 2014] Evans, L. (2010): Social Media Marketing: Strategies for engaging in Facebook, Twitter and other Social Media, USA, Que, pp.129-187. Groth, A. (2011) Business Insider: Toyota And Its Ad Agency Are Sued For $10 Million Over A Creepy Publicity Stunt, [Online], Available:https://www.businessinsider.com/toyota-saatchi-and-saatchi-10-million-sued-2011-9#ixzz31m6xt11x [15 May 2014]. IAB UK (2013) IAB Social Media Effectiveness Research, [Online], Available:https://www.iabuk.net/research/library/iab-social-media-effectiveness-research [10 May 2014]. Mangold, W.G., Faulds, D.J. (2009) ‘Social Media: The New Hybrid Element of the Promotion Mix Business Horizons, p.357. Olivas-Lujan, M.R. (2013) ‘Social Media in Strategic Marketing, Emerald Group Publishing Limited Qualman, E. (2012) Socialnomics: How social media transforms the way we live and do business, 2nd Edition, New Jersey: John Wiley Sons. Ratcliff, C. (2014) Why is Fords social media strategy so good?, [Online], Available: https://econsultancy.com/blog/64701-why-is-ford-s-social-media-strategy-so-good#i.1hg85cdq0eeios [10 May 2014]. Somerville, D. (2014): 18 Digital Marketing Trends you may not have heard about, [Online], Available:https://www.freshegg.co.uk/blog/18-digital-marketing-trends-for-2014 [10 May 2014]. Tuten, T.L. (2008) Advertising 2.0: Social Media Marketing in a Web 2.0 World, USA: Greenwood Publishing Group. Wilson, S. (2010): Social Media and Small Business Marketing, USA: University Business Printing and Press

The Declaration Of The Patriot Act - 1260 Words

We use technology every day, all day, for pretty much everything we do. Any information about ourselves, messages we send, or phone calls we make, it all takes place on our phones. However, they are also the biggest risk to our personal security as they are very vulnerable. They are not just vulnerable to scammers and hackers but also to our own government. Following the attacks of September 11, 2001, the president at the time, George Bush, responded by passing an act. This act is known as the Patriot Act. It allows the government unlimited access to phone records, emails, and text messages without a warrant through National Security Letters and Sneak and Peak Searches. Why do they do this, why was this act passed, they claim it’s for our safety. Both can be obtained and carried out without a judge’s approval, without a warrant, and without the knowledge of the person who is being searched. The Fourth Amendment is the right of the citizens to legal and just searches, wi th a warrant, with probable cause. These are not required under the Patriot Act to search through call histories and messages. The Patriot Act clearly infringes on the Fourth Amendment and the rights of the everyday citizen and does not accomplish its original goal of stopping terrorism. The great American patriot Robert F. Kennedy once said in his famous â€Å"Day of Affirmation Address† that the first and most critical element of â€Å"individual liberty is the freedom of speech; the right to express and communicateShow MoreRelatedThe Declaration Of The Patriot Act2055 Words   |  9 PagesWhen we approach people in any country around the globe and ask questions as to who are terrorists and the word terrorism which brought to the Unite States the birth of Patriot Act as well as the controversy surrounding the Act as a whole, we will see that the patriot act went too far because certain provisions seem to violate the constitutional rights of the citizens of this country. First, I see terrorism as war and a terrorist in my view is a soldier going to war for certain purpose and reasonRead MoreThe American Revolution Of America1418 Words   |  6 Pages Introduction The American Revolution was when we break away from the British government and formed our own country. Our country had fought with the strongest nation on the whole until earth back in the 1700s. The Patriots fought and work hard for their freedom and the United states of America. In this book, you will be learning about taxes, important people, battles and women and more in the American Revolution war. Chapter 1 Lives in the thirteen colonies In 1700s, our country was not calledRead MorePersonnel Management Matrix1315 Words   |  6 Pagesof attention on the need for constructive changes in law enforcement intelligence (Peterson, 2005). Ethical debate between individual rights and national security There have been many ethical issues being debated since October, 2001 on the USA PATRIOT Act (PLAW 107-56, 2001) that claimed encroachment of American civil liberties and Constitutional rights. Some Americans oppose the new law because he or she believes it gives the Federal Government and agencies too much freedom to conduct surveillanceRead MoreU.s. History During The Colonial Period928 Words   |  4 PagesOne of the most significant events in U.S. history during the late colonial period was the Boston Tea Party. After the Boston Massacre in spring of 1770, all of the Townshend acts had been repealed except the tea tax, and tensions went down, for the most part, between the colonists and the British. Two years later, however, the Gaspee incident and consequent formation of the Committee of Correspondence brought the tension back, to an alarming degree. Then in 1773, when Lord North tried to help theRead MoreEnsuring Freedom Essay901 Words   |  4 Pagesfreedom in the eyes of Am erican citizens has been surprisingly ambivalent. With the creation of the Declaration and the Constitution early in our country’s lifetime, the element of freedom was undeniably sought. However, looking back at the loosely written intentions of this document, freedom can be assumed unfit for all. The Declaration, promising â€Å"that all men are created equal† (U.S. Declaration Ind.), began as a document causing nothing but civil strife from the voices of ill represented minoritiesRead MoreThe American Revolution, Or First Civil War?997 Words   |  4 Pagesthe british empire would there endow us with being from the same nation, maki9ng the act of war upon ourselves at the time a Civil war.The combatants of this war were The Loyalist, the ones who chose to stay with the british empire, and the Patriots the ones who had taken the riskful path to try to up throw the rule of a tyranny that had have at the time seen little to no loss in the battle field. â€Å"The Declaration of Independence said that by July 1776 the time had come â€Å"for one people to dissolveRead MoreThe Aftermath And Acts That Followed The Boston Tea Party1522 Words   |  7 PagesThe Aftermath and Acts That Followed the Boston Tea Party Karla Valeria Gonzalez Formatted Rough Draft Mr. Isaac G. Pietrzak U.S. History 1301 November 4, 2016 On the Thursday of December 16th of the year 1773, several men began to dump what is now worth over a million dollars of British tea into the Boston Harbor. This later became known as the famous Boston Tea Party. The Boston Tea Party was the initial cause of the American Revolution and the freedom America has gainedRead MoreThe Usa Patriot Act By John Walker841 Words   |  4 PagesSan Diego (UCSD) organization banning the connection to the terrorist site, the USA Patriot Act was translated mistakenly. Their choice to boycott the hyperlink was an infringement of the right to speak freely. A connection to a site ought not to be seen as correspondences gear. Americans, clearly, have a privilege to be worried about terrorists. In sympathy toward the Americans own wellbeing, the USA Patriot Act was passed with great reason. It ought to stay in actuality and ought not to be adjustedRead MoreArgumentative Essay On The American Revolution981 Words   |  4 Pagesevents and random acts, Men and women were forced to make fateful and difficult decisions that ultimately led to the clash! Patriots could be found in in any of the thirteen American colonies, but were found mostly in the city of Boston. It is believed that those against the shipping in Boston’s made the Bostonians oppose and resent the limits that has been put on trade. The city of Boston became the head voice to stand up to the British Authority. Some of the fiercest patriots were citizens of BostonRead MoreThe United States1302 Words   |  6 Pages$900,000 worth of tea at that time In response, Britain passed the Coercive (Intolerable Acts) Massachusetts must pay for the tea, port of Boston was closed until the damages were repaid, MA charter was voided, and town hall meetings were outlawed - British coming down hard on Boston colonists, not being leniant The Continental Congress Responds the continental congress was formed in response to the Coercive Acts 12 colonies (not Georgia) sent representatives to have grievances redressed and a boycott