Global Electric Guitar Market Essay Example

Global Electric Guitar Market Paper The electric guitar is not a commodity or a regular good, is an instrument that becomes an extension of the player and helps him to convey emotions, gives him the sense of belonging to a certain group and helps to show his or her own Individuality; customers as well as the brand value, in this respect is similar to a luxury product, with the addition that there is a huge loyalty towards brands. Two companies clearly dominate the market: Fender and Gibson. They were also the pioneers of electric tartars and boast a wide range of products for diverse target markets: their entry- level products range from 1000 and their high standard production models are offered for about 10000, from that price and higher they seek to appeal to the collectors market, going to as high as 800000 for a guitar from a particular year, in this aspect they not Just sell the guitar as an instrument but as an investment. Is it not unusual for guitar players to identify themselves as a Fender guy or a Gibson guy to the extent of attributing personality values to the stated phrases, even if the onto actually possess an instrument from one of this two brands. The Global Electric Guitar Market is highly differentiated, with companies offering a wide palette of colors, materials, sound and features, as well as heroes to promote a particular model. Introduction to Porters Five Forces Framework The Bargaining Power of Suppliers We will write a custom essay sample on Global Electric Guitar Market specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Global Electric Guitar Market specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Global Electric Guitar Market specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Before assessing the impact of suppliers to the manufacture of electric guitars, it is important to know the structure of the guitars, and the materials that have been used. As can be observed in the image, 3 main parts compose the electric guitars: The headstock, the neck and the body, and all are made in wood. There are other small pieces in metal, plastic and the strings. Electric guitar parts Therefore, wood is the main raw material for the manufacture of electric guitars. The wood has a great influence on the sounds the guitar can create so its quality is important. The primary requirements are that the wood must be consistent, flawless, knots or cracks; normally Mahogany, Maple, Basswood, Agates, Alder, Ash, Poplar, Spruce and Walnut are used. Although the quality of the wood is very important for making guitars, wood suppliers eave no bargaining power as firms can easily switch supplier since it is a very common material. Moreover, the production process of electric guitars of some traditional companies such as Gibson or Fender is done manually, and the machinery used does not have any significant level of sophistication. The Bargaining Power of Playing a musical instrument more specifically an electric guitar is not an essential need, in fact could be classified in the last level of Masons hierarchy of needs Self- Actualization which include realizing personal potential and creativity. Consequently, people play the guitar to enjoy, because they like it and nobody forces them. Keeping this in mind, buying the musical instrument is a whole experience to explore, because of the type of good and price, a regular Gibson or Fender electric guitar cost about 1000?, the customers tend to do a very meticulous purchasing process. Electric guitar purchasing process In fact, buying a electric guitar is not spontaneous, there are some crucial factors to the consumers as, the recognition of the brand, the specific characteristics of the product, the quality, the kind of music that is going to be played and among other incinerations. On the other hand, the guitar industry is a unapologetically competitive market (Guitar Center), which means, there is a significant number of companies operating in the market without a dominant control by any of these particular, the key issue in this type of market is product differentiation, not homogeneous goods are presented, ii, the guitars depending on the producer, have variations that allow it to be different. However, the producers must be very active and keep the advantages of the company, because the consumers can easily change the brand if does not fit totally with their expectations. In the same way and according to Porter If the product or service can be easily substituted, and if there is no risk involved, the bargaining power of the buyer is increased which means that the bargaining power of clients in the electric guitar market is high. For instance Fender and Gibson have long been the dominant electric guitar makers, but in the asss the Japanese guitar firm Beanie saw an opportunity and realized that they could make higher-quality products than the American firms, but at very competitive prices. Beanie focused on product innovation, while the American firms seemed to rest on their laurels. Beanie has been a big success, and it is one of the top guitar firms today (Edwards). V. The Threat of New Entrants Another of Porters five forces is the threat of new entrants. This refers to the threats and barriers new competitors of the same product or service undergo to try and succeed in the market amongst already established competitors. In the global electric guitar industry, seeing how it is a very unapologetically competitive market, the entry of barriers is quite moderate. In a monopolistic competition many producers sell products that are differentiated from one another, there are many producers and any consumers in the market, and no business has total control over the market price (Wisped). Globally, there are hundreds of electric guitar manufacturers and According to Guitar Center, There are few barriers to entry in the electric guitar industry, resulting in the ability for small guitar makers to build high quality instruments for reasonable prices. Small customized guitar makers make the inflated prices and poor machine made quality of the large vendors like Gibson and Fender look like robbery However, what the average and ignorant consumer does not know is that small businesses naturally eave an advantage in customization and unique application of products because of its ease of management and close ties with customers. Those startup businesses, which develop new quality products and services in existing markets, are able to enter novel products and markets to broaden their customer base. Many studies support the concept that consistently improved innovation or quality in production can satisfy and help create more customer demand. Although is hard to make a profit when your competitors are already making great revenue, if new entrants to the market focus on having a competitive advantage over he bigger rivals with high quality, personalized yet not too price electric guitars that could possibly be easy to ship to multiple places around the world, the new entrant could have a chance. However, as easy as that sounds, lets not forget the loyalty of already existing manufacturers. Another barrier to entry is the cost to manufacture an electric guitar. If one is based in the United States, the basic cost of building using pre-fabricated parts could cost over $700 (Seymour Duncan). Having the guitars being manufactured abroad might cost you less, if you take a look at Korea or Mexico for example, Mexican-made fenders come with a higher quality and the prices are quite low, yet it is still somewhat expensive, and hard to enter the global market as well. You have to consider the body of the guitar, the neck, the tuners, electronics, such as pots, switch, wires, the pickups, the bridge, neck plate, strap pins, etc. And lets not forget, the labor. And if this wasnt enough, throughout the years, electric guitars have decreased in price tremendously. What is happening with electric guitar industry is somewhat complex, but the main factor seems to be that the guitar manufacturers have simply over-produced. They have put far more electric guitars into the marketplace than the present demand for the guitars will bear. However, as a result of the overbuilding, the street prices of electric guitars have fallen dramatically. For the consumer this is a very positive thing in general. For small music stores it is a disaster. Small music stores survived by selling an electric guitar or two at a 30% margin. The extra profit paid their bills. That margin has dropped for them. The guitars stay longer on their shelves. Plus, there is a true critical mass of investment in the guitars before the dealer can create a local market for the attar (Gilligan). One of the main reasons of why the market for electric guitars have dropped is because the trend of now a days is a much different one. Electric guitars used to be real big back in the baby boomers era and it is time that the baby boomers outgrow the electric guitars. The new hip music of today, although electric, contains no electric guitars. Electronic Dance Music is to be known as the music of today globally. News and financial information, Forbes, writes that EDM/Pop is the music of the world now and that type of music has little to no electric guitar in it. So all you kids trying to make the decision whether its better to learn how to make beats or Join a garage band, choose wisely. The music of today might not be the music of tomorrow. Think hard before you give up on that plank of wood with metal wires. The electric guitar may be dead in music today as evidenced by guitarists everywhere scrambling to find new lines of work, but it may Just as likely rise from the musical ashes of tomorrow. Trends are like that If entering the global electronic guitar market was not hard enough, Porter mentions another force that it is essential to take in mind before starting your own company, and that is the threat of substitutes. The Threat of Substitutes The threat of substitutes, according to Porter, is the availability of a product that the consumer can purchase instead of the industry product. This could be seen as another barrier to entry. Like mentioned above, there are hundreds of competitors in the electric guitar market and if your company does not have a solid and strong competitive advantage, itd be really easy for a consumer to Just purchase another brand. However, its not only about consumers buying another brand of electric attar, its also about consumers choosing to buy a complete different guitar, such as an acoustic guitar. An Acoustic guitar offers similar benefits to the consumer as the product produced by the firms within the industry and according to Porters 5 forces, threat of substitutes shapes the competitive structure of an industry. (SCOFF). In the Musical Merchandise Review Current Issue, MI Stats: Guitar Market Breakdown, they give a brief explanation of why is it that Acoustic guitars have been outdoing electric guitars. Electric guitars make up less than half of all guitar sales at 47 percent with acoustic dominating the market by a small margin r the last few years, in our annual 50 Dealer/50 State report that is featured in the December issue, retailers have consistently told us that electric sales have been flat, but acoustics have been growing. In this months At a Glance, Tommy Collette of The Music Zoo seems to back that up. He says that while hes always been known primarily as an electric guitar shop, his increasing embrace of acoustics in the last year has proven to be a winning strategy (Mitchell). Only time when its said for electric guitars to outsell acoustic tartars is when consumers already have in mind paying a high price. High price tends to be associated with high quality and if they are already thinking of purchasing an expensive guitar, they tend to prefer an electric guitar more than an acoustic one. Another high threat of substitution, when trying to localize in different countries is that many countries, especially in Asia, rather spend a few more and purchase an already known brand than purchase a local one. Local brands cant compete with a Martin, Taylor, Fender, or Gibson [Asians] are keen to show that they can afford products of that status (Multidimensional). According to Porter, there is a high risk in threat if Consumer switching costs are high, if the substitute product is more expensive than industry product, if substitute product quality is inferior to industry product quality, if substitute performance is inferior to industry product performance and if there is no substitute product available. The last of the forces that Porter describes is the Extend of Competitive Rivalry. The Extent This is how the different factors impact the competition. The electric guitar market is a monopolistic competitive market because all producers differentiate their products. This means that on this point, the competitive rivalry is not so big as long as the producers keep their differentiation. But on the other hand, there is a big threat for substitutes, partially because of acoustic guitars which will be cheaper than electric guitars, and also guitars mainly coming from Asia, which are cheaper, but the population there would rather buy a brand as a way to show they can afford it. Moreover, the buyers have a high bargain since it is not a need to buy a guitar, and this kind of buying needs to be thought about because the electric guitars are quite expensive. Finally, suppliers dont have so many bargains since it is easy for the producers to choose another supplier (of wood principally). In overall, we can say that the competitive rivalry is quite high because there are a lot of producers, even if they can differentiate their products, and the consumers dont need this product. Moreover, there is not so much rivalry with acoustic guitars which are thought for different customers. And those three factors are more important than the fact that suppliers dont have much bargain. Conclusion From a threat, substitutes and rivalry point of view the guitar market is very interesting, because competition is not seen as a substitute, rather they are seen as a complementary good. Most guitarists aspire to own Fenders, Gibson, Beanie, and other brands whether they are Gibson guys, Fender guys or not. Is not surprising that many superstars own 400 or more guitars average, collecting instruments from several brands and periods. This means that as far as companies maintain their differentiation and be good with it, they will retain their customer base. Both companies have their golden years in which they were particularly revolutionary in heir designs (mostly in the late asss), some of the previously noted collector models are from these years, and both companies have incorporated Reissues Series in order to create standardized replicas of the models of those years, this constitute more expensive products but not prohibitive, for example a brand new Gibson Less Paul 59 Reissue sells for about 5200. We can separate the market into three segments: entry level, professional level, and luxury level. Customers from entry level are people who are starting to play, and considering whether to buy an instrument or not, probably considering the prices a little high and thus struggling with it, when we talked about migration in the threads section we were referring mostly to this segment, this segment could decide to pick up another instrument following the current trend or simply not be that interested in buying a guitar. Customers from the professional level and luxury level already play the guitar for years, have some preferences already and are not likely to quit playing or selecting a this point).

Baz Luhrmanns Interpretation of the opening scene Essay Example

Baz Luhrmanns Interpretation of the opening scene Essay Example Baz Luhrmanns Interpretation of the opening scene Paper Baz Luhrmanns Interpretation of the opening scene Paper Concentrating on the presentation of character, setting and sound, analyse review and comment on what seems to you to be significant features of Baz Luhrmanns style as a film director, with particular reference to Romeo and Juliet Baz Luhrmanns recreation of Shakespeares play Romeo and Juliet, as a film text, has been a great success in todays modern world. Baz Luhrmanns intentions, in making this film, were to take a classic Shakespearean play (something that not that many young people appreciate any more in this modern age) and to modernise it. To translate the image of what would have been an exciting source of entertainment in the 17th century into a fun filled action/romantic movie suitable for the demanding eyes of the modern worlds youth . Baz Luhrmann had ask himself the question: if Shakespeare were alive today, how would he of made the movie. The expression he uses is putting Shakespeare on a billboard in Time Square. The film opens with a picture of a television screen switched off then, with no sound, clicks one with a few credits on the screen as if someone is changing the channel to find something that would interest them then clicks onto this channel with a newsreader reading out what sounds like news but is the prologue of Romeo and Juliet. While the newsreader is reading out this in the background in a box, where you would see a picture of a broken wedding band, which symbolises the broken love between Romeo and Juliet. Then uses a series of camera styles like rapid zoom and whooshing noise as it goes into the image of the newsreader, followed by dramatic music. The images then start whooshing onto other similar images of Verona and with this the prologue is repeated by the priest, with a more stern and authentic voice. Then it shows pictures of the cast with information about them. This is the introduction to Baz Luhrmanns film and with this he catches the viewers attention. He achieves this by giving the viewers a taste of the excitement to come by showing a few short clips of some if the film. This makes them hungry for more. In the first scene of this recreational play we start off with 3 men from the house of Montague, the Montague Boys, which we see at the start of the film accompanied with a big title saying: THE MONTAGUE BOYS and a rap style song repeating the words: the boys, the boys. They are achieving what Shakespeare wanted them to do originally going around being boisterous and rowdy but in a modern days style. In the original play the 2 men are just going around a market place showing off Baz Luhrmann pretty much goes along the same line of what happened in the original play but with cars, tall extravagant buildings, helicopters, sirens etc. Baz Luhrmann puts the Montagues in a petrol station where they meat up with there rivals the Capulets and recreates the confrontations with guns, which just so happen have the brand name of swords, rapiers etc. Its all very clever if youve seen the original play. Even though that Baz Luhrmann has changed the visuals and made the film more modern he hasnt changed the script he has still kept it in that same Shakespearean tong: thus, thou hast, knowest, thow etc. He did this for 2 reasons: 1 because if he didnt keep the script it would virtually be the same as East side story (another recreation of Romeo and Juliet) and 2 to bring a piece of the 17th century and stick it in the film to show people, of the modern world, how Shakespeare made his play. Baz Luhrmann kept the original scripture of the film; he did this so that he still kept the true nature of the play pure. In doing this he had to make the visuals far more stunning, majestic and exaggerated so as to make it so the audience could understand it through the visual image of the film. The characters in Luhrmanns films are very exaggerated so by looking at the way they act and speak you can instantly tell what kind of person they are in the film: The bad guy, the funny guy, the romantic guy etc. For example the two Montague boys are all rough and tough when they are talking behind the Capulets back but when they are face to face with the Capulets they are very jumpy and scared and also very comical at the same time. But the Capulet boys are much more mean and bullish. Abra a big scary looking character who strikes fear into the Montagues he also loses his temper and Tybalt. Tybalt being the main big bad guy of the film is very harsh and cruel he looks like a big gun slinger. He has a very stylised character his movement his whole style gives him a great sense of character even by the way that he speaks you know he is the bad guy. The complexity of the sound involved in Baz Luhrmanns creations is quite fascinating. At any one point in the film there are a lot of sounds being played for all the different types of things, which you can here, even in the simplest scenes. Many of the sounds are synthesized this means the sounds are created by a computer, this allows the editor to add in and take out sound with ease. Youll see an image on the screen and will be listening to a complex layering of sounds, which will all be playing at once. For example: footsteps, gunshots, whooshing and cars in the background, dialogue and much more. The music will change to the emotion of the person or the film. If you were to listen to all the sounds individually and added together you would be able to hear how the affects are achieved and see how complicated it actually is. All the sounds are stored on a sound deck and are then arranged and played at the times required. The film even has its own sound track, which was released into the charts and went number one at one stage or another. People listened to this and were deeply encouraged to go and watch the film because of what they heard from the soundtrack. Sound is used to enhance emotion and interest: the rap style music at the start of the film when the Montague boys are in their car, a cougar roar sound is emitted when the car revs its engine (this is used to give a sense of danger) Silence is also used to increase tension. Exaggerated sounds on small objects are also used for this purpose. Choreography is the word, which means style of the character and the movement of the character i. e. the style of the movement given out gives a sense of character. Tybalts style is very intriguing in the way that he moves almost like hes dancing. Tybalts movement is meant to be a sort of flamenco dance; he moves very fluently and gives a sense that he is an experienced gun fighter. The part when every thing goes silent and Tybalt comes onto the scene and all you see is boots which then crush on a dropped match and emits that horrible grinding sound. The way in which Tybalt moves embellishes his character. The Montague boys are very jumpy and scared and react with great movement this is called Pantomimic exaggeration. In the first scene 170 shots were used. The techniques used in the film were very much the same as the ones used in western films. The film was meant to be in a western genre, a spaghetti western. A spaghetti western is a sought of love story/ western. The camera techniques used in the film are very good at delivering different emotions or to increase/decrease tension. Big wide shots are less dramatic than the suspension given out by a close up shot. In the first scene there is a large variety of camera styles used, such as when Abra is confronting the Montague boys and the camera suddenly zooms in on his teeth with the word S I N inscribed on them, with camera is looking up at him, this terrifies the Montagues and then causes one of the Montague boys falls back into the car and the camera is looking down on him. When a camera is looking up at a character it is much more scarier than when a camera is looking down upon someone. Computer aided technology was used to help design the costumes for the characters in the film a photos was taken of the actor and the designs where then put on to the computer software to be mapped out and used so they could try samples on the actors to see how it looked and see if they liked it or not, in that context. The Montagues wore bright Hawaiian styled open t-shirts while the Capulets wore flat jackets and darker clothing in a more Latino style. They have also spent a lot of time designing the guns for the films, which symbolize the swords in the original play (thats why the gun brand is called swords). You see in the film the two buildings of both Montague and Capulet, this represents the focus on religious iconography shows that religion (the 2 families are both religious families and respect there religious beliefs) and the law are not able to maintain the battle, the confrontation, and the feud between these to households. Miami was used to shoot the film because of its Latino genre and its religious environment hot country- hot blooded. The gas station was used in the film to symbolize modern city life and to keep the scene similar to that of the original play: market square and gas station both places of common publicity.

The Importance of Communication as a Business Professional Research Paper

The Importance of Communication as a Business Professional - Research Paper Example Organizations that have understood the due role of culture have also realized the extent to which culture can have a positive or a negative effect. If employees from different cultural backgrounds interact with one another, there are bound to be problems that the organization might see. This is because each one of these employees has a separate language that they are expert within, and understand their peculiar nuances than others would. Also they would find it difficult to comprehend the severely different gestures and emotions which are communicated by people at work. Because of this, there could be confusions and grievances amongst the people (Brenton, 2005). This is quite natural because cultural settings are drafted in such a way. What is even more compelling is the manner under which different employees and business personnel have an insight regarding the use of a common language – a language that shall be the medium of instruction. It is the basis of knowing which phras es and sentences will be spoken of at work and what words and syntax to avoid. It will also decipher the proper role of grammar and spelling and not to forget the specific inputs from the people who are experienced at work. Such cultural settings essentially leave an indelible impression on the minds of the employees who are doing their best to communicate with one another. The need is to find out where anomalies are and what best can be done to avoid such shortcomings and mistakes. There is a dire need to have the best possible understanding with regards to different cultures under the aegis of communication because these set the basis for productivity to flourish within the domains of an organization. In entirety, the effects of culture on communication are quintessential to understand because these pinpoint the need to inquire about the kind of work which needs to be undertaken and the expressions that must be avoided at all costs. The balancing act actually makes for a good reas oning of the subject at hand. The Importance of a Business Plan When Starting a New Business A business plan decides beforehand how a business shall be set up. It dictates the essential basis of a business and the dos and don’ts that the business has to undertake. What it also takes into perspective is the amount of inputs that need to be considered for running a business and the stakeholders who shall benefit from it in the long run. A business plan is indeed a formal statement which defines a set of business goals and the objectives that are in close association with one another. It mentions the reasons why these business goals are deemed as attainable and how these shall go ahead and make the business a competitive one within the relevant industrial settings. Also the plans for reaching the desired points are specified beforehand so that the business plans are taken as comprehensive and all-covering from a number of different angles and perspectives (Morden, 1995). The bus iness plan also highlights the background knowledge regarding the business and the manner under which the organization or the business team is doing its best to attain those goals and objectives. It must be remembered here that business plans take care of a number of decisions that are made within their fore. The business plan therefore finds a way to attain the tasks which would have been difficult to analyze and understand when the business was being started. It gives a pathway to define things in an outright way. It also sets the

Self Evaluation Personal Statement Example | Topics and Well Written Essays - 1000 words - 1

Self Evaluation - Personal Statement Example Even a person with no knowledge of health care and no sensitivity to diversity could understand the topic. The sentence from Page 4, "But healthcare is more than just medical equipment, hospitals, and adequate insurance. Healthcare is a competent staff that can relate to the patients and effectively care for them within the context of their own needs and desires", relates a focused thought that can get someone to start thinking differently about our health care system. It could be read by anyone and have the opportunity to inform them or change their mind. This has become a very important part or writing to me. 2.) My weakest essay was "The Literacy Behind Patient Care". The paper opens with a weak line telling the reader what the paper is about. It should have grabbed their attention and made them curious. Many of the sentences are not well constructed. This also holds true for the paragraphs that ramble and jump from idea to idea. Overall, the paper is difficult to read and its intentions are not clear. The essay spends too much time showing specific examples and does not clearly show the results of the examples or why they are important. 3.) To improve "The Literacy Behind Patient Care" I would first determine what I wanted the reader to take away from the essay. I wanted to demonstrate why patient literacy was important, not what it was. I would write a thesis that stated the patient literacy was important because it impacts a patient's well-being. I would then write an outline that explained all the ways that a patient can suffer from improper care. I would then construct each paragraph in the outline before starting to write. I would also spend more time revising the draft. I would have some other people, not necessarily students, read the paper and ask for their reaction. 4.) My revising and editing skills have greatly improved during this class. At the beginning I did not understand the necessity of revising a paper. I didn't even know what to look for when revising. Now, I can look at each paragraph as an independent topic, and how it relates to the paragraphs around it. I can look at the paragraph and see if it flows from opening to closing and is supported by evidence and facts. I also look at each sentence to see if it is grammatically correct and easy to read. These skills were unknown and overwhelming at the beginning of the course, but I now see they are steps in the writing process. Revising and editing each paragraph and each sentence has made the task less of an obstacle. Knowing the key points of transition and relevance has been important to improving my writing skills. I now revise and edit in pieces, rather than the entire paper at once. 5.) My writing was improved most by my concept of the writing process. In the beginning papers, I thought a person could just write their thoughts and that would be the end of the task. I now understand that I can write freely in a draft and go back and edit it. I don't feel pressured to get it exactly right the first time. The drafting and revising process has had a great impact on improving my papers. Also, the feedback and advice from other people has helped me. I am no longer shy about showing my essays and asking for an honest opinion. Making small changes in the language or correcting structural errors have made my papers more clear and easier to read. The writing center has also helped me to develop the technique and

Emerging Markets and Financial Regulation Essay Example | Topics and Well Written Essays - 500 words

Emerging Markets and Financial Regulation - Essay Example There were major obstacles that Shiseido faced in its attempt to implement a globalization strategy. The first obstacle was the cultural differences present in the various countries and regions the company wished to enter, especially in Europe and the United States. These countries had very different cultural practices and preferences that were very different from the Japanese cultural practices and preferences and therefore there were very different cosmetic tastes and preferences in these countries. For instance, American consumers were interested in make-up products while Japanese consumers were interested in natural skin beauty. In addition, consumers from the Latin nations within Europe preferred cosmetics that emphasized color. The other major obstacle was the difficulty in entering these new markets due to legislation prohibiting foreign companies investing within the cosmetic industry within their countries. For instance, the cosmetic industry in France was very important hen ce, the government wanted to protect it from foreign competition and control. Shiseido’s international organization and its actual strategy to expand its market globally were successful as it enabled the company to enter new markets and gain considerable market share over the long-term with limited resources. The company was able to enter foreign markets in Asia, Europe, and the United States using novel strategies that were low cost and effective, enabling the company to introduce its products to these new consumer markets.

Causes of Cardiovascular Disease | Literature Review

Causes of Cardiovascular Disease | Literature Review 2 Abstract 3 Introduction 3.1 Cardiovascular Disease Cardiovascular disease (CVD) is the broad class of diseases that involves the heart or/and blood vessels. CVD includes atherosclerosis, heart valve disease, arrhythmia, heart failure, hypertension, endocarditis, diseases of the aorta, disorders of the peripheral vascular system, and congenital heart disease [1]. However, atherosclerosis accounts for the major part of CVD (up to xx%), and sometimes CVD is misleading used as a synonym for atherosclerosis [REF]. Because atherosclerosis is the underlying disease of several CVD, part of patients, where one diagnosis of CVD became manifest, may present with further co-morbidities, especially other diagnosis of CVD are common. However, the portion of patients with co-morbidities is depending on the baseline disease [2-4]. For example 40-60% of patients with Peripheral Arterial Disease (PAD) also have coronary artery disease (CAD) and cerebral artery disease, but only 10-30% of patients with CAD have also PAD (Figure 1) [2, 4]. Further, the severity of cardiovascular co-morbidities correlates well with each other[5-7]. CVD is today responsible for ca. 30% of all deaths worldwide [8], while heart disease and stroke are the leading causes of mortality and disability in developed countries [9]. Although the mortality rates of CVD has a considerable variation across countries (xx% in xx to xx% in xx) [10], a common trend of increasing rates has been observed worldwide. Before 1900, infectious diseases and malnutrition were the most common causes of death throughout the world, and CVD was responsible for The economic burden and the public health costs are mainly driven by CVD. In terms of combined morbidity and mortality, 148 million Disability-Adjusted Life-Years (DALYs) were lost worldwide (2002), which represents about 10% of all lost DALYs [REF]. In 2008, CVD costs about 192 billion Euros a year alone in the European Union, which results in a per capita cost of 391 Euros [13]. 3.1.1 Atherosclerosis Atherosclerosis is the most frequent and important pattern of Arteriosclerosis, other forms of Arteriosclerosis are Mà ¶nckeberg medial calcific sclerosis and Arteriolosclerosis, which vary in pathophysiological and clinical presentation [14]. As described above (3.1), atherosclerosis is the leading cause of death (up to 30%) in developed countries and represents the major portion of CVD. Atherosclerosis (literal origin from Greek: athero = â€Å"gruel or paste†; sclerosis = â€Å"hardness†) is defined as â€Å"thickening and loss of elasticity of arterial walls† and describes a process, where fatty substances, cholesterol, cellular waste products, calcium and fibrin building up in the inner lining of arteries [14]. These intimal lesions are called â€Å"atheromas†, â€Å"atheromatous† or â€Å"fibrofatty plaques†, which lead into an obstruction of vascular lumens and weakness the underlying media. Even within a given arterial bed, lesions or stenoses due to atherosclerosis tend to occur focally, typically in certain predisposed regions. 3.1.1.1 Pathogenesis of Atherosclerosis Due to overwhelming importance of atherosclerosis, enormous efforts have been spent to discover its cause over the last few decades. Today, the currently accepted concept, so called â€Å"the response to injury hypothesis†, considers atherosclerosis to be a chronic inflammatory response of the arterial wall initiated by injury to the endothelium [15]. Furthermore, lesion initiation and progression are sustained by interaction between lipoproteins, macrophages, T-lymphocytes, and the normal cellular constituents of the arterial wall. This process of developing atherosclerosis, which typically lasts over a period of many years usually many decades, can be divided into several consecutive steps, as illustrated in Figure 2 [REF]. Parallel, a morphological change is observed within the artery wall, where fatty streak represents the initial morphological lesion, even so the pathogenesis has started quite earlier with a chronic endothelial injury [REF]. Figure 2: Illustration of the Pathogenesis and Morphological Development of Atherosclerosis. SMC: Smooth muscle Cell; 6 ÃŽ ¼m thick histology slices of coronary arteries stained with Movats pentachrome. A: pathological intimal thickening with a â€Å"fatty streak†; B: pathological intimal thickening with a macrophage infiltration; C: early fibroatheroma with neoangiogenesis; D: fibroatheroma with thin fibrous cap and a healed rupture; E; late fibroatheroma with a sheet calcification. * demarks necrotic scores. Histology performed by CVPath Laboratory, Maryland, MD. The below described steps of the pathogenesis of atherosclerosis shouldnt been seen as a separated processes. They are interconnected and occur parallel. Further, several mechanism of vicious circles are described [REF]. However, the stratification into the flowing six steps helps to understand the complex pathogenesis and represents the current understanding: (1) Chronic Endothelia Injury As the earliest step in the pathogenesis of atherosclerosis, endothelial activation and chronic injury, also known as endothelial dysfunction, have been described [16]. The following factors contributed in different extent to endothelial dysfunction and are partly known as traditional risk factors for atherosclerosis [17]: advancing age, dyslipidemia, hypertension, increased levels angiotensin, insulin resistance and diabetes, smoking, estrogen deficiency. Several biochemical pathways have been described for those factors increasing the endothelial dysfunction. Other factors like hyperhomocysteinemia, possible infection and especially low or oscillatory shear stress are still discussed whether they significantly contribute to endothelial dysfunction [18-22]. The phenotypic features of endothelial dysfunction are described as the reduced vasodilator and increased vasoconstrictor capacity, an enhanced leukocyte adhesion, an increase of pro-thrombotic and decrease of fibrinolytic activi ty, and an increase in growth-promoting. (2) Accommodation and Oxidation of Lipoproteins In addition and due the endothelial dysfunction lipoproteins, especially low density lipoprotein (LDL), sequestered from plasma in the extracellular space of the arterial intima. Beside the extent of endothelial dysfunction, this process is depending on the concentration of LDL in the blood circulation [23]. Even so several mechanisms have been proposed for transport of LDL into the arterial intima including vesicular ferrying through endothelial cells, passive sieving through endothelial-cell pores, passage between cells, its not finally understand. However, strong evidence exist, that the accommodation of LDL in the arterial intima is not only a passive effect by a â€Å"leaking† vascular endothelium [REF]. Part of the lipoproteins that have entered the arterial wall stay there and are modified subsequently. Especially the modification of the lipoproteins has a trapping function for die selbigen [24]. The most common modification is the oxidation of lipoproteins, giving rise to hydroperoxides, lysophospholipids, oxysterols, and aldehydic breakdown products of fatty acids and phospholipids. But further modification like fusion of lipoproteins, proteolysis, lipolytic degradation and glycation are well known [25]. Such modified lipoproteins or particles of the modification process have inflammatory potential and trigger a local inflammatory response responsible for signaling subsequent steps in the atherogenesis. It includes a further increased endothelial dysfunction, which may cause a vicious circle of LDL accumulation, and activation of various cell types [24, 26, 27]. (3) Migration of Monocytes and Transformation into Macrophages/Foam Cells More important, the inflammatory response induces migration of leukocytes such as monocytes or lymphocytes into the lesion. Leukocytes are attracted by chemoattractant factors including modified lipoprotein particles themselves and chemoattractant cytokines depicted by the smaller spheres, such as the chemokine monocyte chemoattractant protein-1, interleukin 1 (IL-1) or tumor necrosis factor alpha (TNF-ÃŽ ±) produced by vascular wall cells in response to the inflammatory process [REF]. The activated arterial endothelial cells express a number of adhesion molecules and receptors on their surface, which participate in the recruitment of leukocytes from the blood to the nascent lesion [REF]. Macrophages are a key player in atherogenesis [27]. They develop from recruited monocytes, which migrated as described above into the lesion. In the mediator stimulated process of maturation, those macrophages become lipid-laden foam cells by uptake of lipoprotein particles through receptor-mediated endocytosis [REF]. The accumulation of lipid in the macrophages results in the apoptosis and necrosis, which lead first to a boosted expression and secretion of inflammatory cytokines and second to a release of their lipid excess into a necrotic lipid-core [REF]. Macrophages further produce enzymes, such as metalloproteinases, that degrade the extracellular matrix and lead to instability of plaques [REF]. (4) Adhesion of platelets and Release of SMC activating factors The inflammatory process, especially triggered by the necrosis of the foam cells, microscopic breaches in endothelial integrity may occur. Platelets adhere to such sites of limited endothelial denudation owing to exposure of the thrombogenic extracellular matrix of the underlying basement membrane and form microthrombi. Although most of the arterial mural microthrombi resolve without any clinical manifestation, they lead indirectly to lesion progression by pro-fibrotic stimulation [REF]. The platelets, activated by adhesion, release numerous factors that promote a fibrotic response, including platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), insulin-like growth factor 1 (IGF-1), and transforming growth factor alpha (TGF-ÃŽ ±) [28-30]. Thrombin itself generates fibrin that has a pro-fibrotic stimulus [28]. (5) Migration and Proliferation of SMCs The pro-fibrotic response includes first the migration of SMC from the media of the arterial wall, through the internal elastic membrane, and the accumulation within the expanding intima of the arterial wall. Second, stimulate the proliferation of SMC, which is responsible to form the bulk of the advanced lesion. Another part of the advanced lesions is an increased extracellular matrix. TGF-ÃŽ ± and other mediators stimulate the interstitial collagen production by SMC. These mediators may arise not only from neighboring endothelial cells or leukocytes (a paracrine pathway) but also from the same cell that responds to the factor (an autocrine pathway). Together, these alterations in smooth-muscle cells, signaled by these mediators acting at short distances, can accelerate transformation of the early lesion (fatty streak) into a more fibrous SMC and extracellular matrix-rich plaque. (6) Enhanced accumulation of lipids, collagen and proteoglycans The formation of a complex atherosclerotic lesion is characteristic by an extent remodeling process. Further foam cells within the expanding intimal lesion perish, while they phagocytose more and more lipids. The fibrotic cap between the so arisen lipid-rich necrotic core and the vascular lumen may vary in thickness and allows the classification of â€Å"thin cap fibroatheroma†, which correlates with a higher risk for acute luminal thrombosis [REF]. The production of extracellular matrix, as well plaque evolution and complication can be stimulated by diverse growth factors or cytokines like IL-1 or TNF-ÃŽ ±, and can be inhibited by other cytokines (e.g. interferon alpha (IFN-ÃŽ ±)) [REF]. As atherosclerotic plaques advance, they show intimal arterial calcification [REF]. The same proteins, which can be found in bone, are also localize in atherosclerotic lesions, e.g., osteocalcin, osteopontin, and bone morphogenetic proteins [31]. Both, passive and active models are discussed for the development calcification [32]. SMC can, promoted by several cytokines (e.g. transcription core binding factor ÃŽ ±1), acquire osteoblast-like characteristics and secrete bone matrix [33]. These examples illustrate how the pathogenesis of atherosclerosis involves a complex mix of mediators that in the balance determines the characteristics of particular lesions [REF]. 3.1.1.2 The Role of Inflammation The role of inflammation is central, while those inflammatory mechanisms mediate initiation, progression, and the complications of atherosclerotic lesions [26, 34]. Through the inflammatory process, arterial endothelial cells begin to express on their surface selective adhesion molecules that bind various classes of leukocytes, especially monocyte and T lymphocyte which are found in early human and experimental atheroma [REF]. After monocytes adhere to the endothelium, they can first migrate in the intima, largely stimulated by chemokines; and second transform into macrophages and avidly engulf lipoproteins, largely oxidized LDL [REF]. Although the phagocytosis of potentially harmful lipid particles by macrophages and subsequently the transformation into foam cells has an initially protective, this process involves further expression and secretion of inflammatory chemokines like Interleukin (IL)-1, Monocyte Chemotactic Protein (MCP)-1 or Tumor Necrosis Factor (TNF)-ÃŽ ±. Those enhanc e the inflammatory reaction and enable the further migration of leukocytes into the lesion [REF]. Macrophages also produce toxic oxygen species that cause additional oxidation of the LDL in the lesions, and they elaborate growth factors that may contribute to SMC proliferation [REF]. Similary, T lymphocytes (both CD4+ and CD8+) are also recruited to the intima by chemo-attractants. Cross-talk between macrophages and T cells induces a chronic inflammatory state regarding cellular and humoral immune activation characteristics. This state of a chronic inflammation leads also to the next observed steps in the development and progression of atherosclerosis. Thus, it stimulates the migration and proliferation of smooth muscle cells (SMC), as well the proliferation of vascular endothelial cells in the lesion. Through fibrogenic mediators, released from activated leukocytes and intrinsic arterial cells, the replication of SMCs is getting enhanced and contributes to elaboration by these cells of a dense extracellular matrix characteristic of the more advanced atherosclerotic lesion. 3.1.1.3 Vasa Vasorum and Neo-Angiogenesis The vasa vasorum of the aorta is as a plexus in the wall of artery of microvessels, which are functional endarteries [35, 36]. They either originate from major branches, originate from the main lumen of the aorta or drain in concomitant veins [37]. These vessels allow the humoral communication between intravascular lumen, vessel wall and adventitial layer of large arteries including oxygen and nutrients supply [REF]. Several studies demonstrated that hypoxia [38], cytokines (e.g. vascular endothelial growth factor) [39, 40], pro-angiogenic factors (e.g. hypertension or hypercholesterolemia) stimulate the growth of the vasa vasorum [41]. Those increased microvascular network may contribute to inflammation and lesion complications in several ways. First, the vasa vasorum provides an abundant surface area for leukocytes trafficking and may serve as the portal of entry and exit of white blood cells from the established atheroma. Microvessels in the plaques may also furnish foci for intraplaque hemorrhage. Like the neovessels in the diabetic retina, microvessels in the atheroma may be friable and prone to rupture and can produce focal hemorrhage. Such a vascular leak leads to thrombosis in situ and thrombin generation from prothrombin. In addition to its role in blood coagulation, thrombin can modulate many aspects of vascular cell function, as described above. Atherosclerotic plaques often contain fibrin and hemosiderin, an indication that episodes of intraplaque hemorrhage contribute to plaque complications. Multiple and often competing signals regulate these various cellular events. Increasingly, we appreciate links between atherogenic risk factors, inflammation, and the altered behavior of intrinsic vascular wall cells and infiltrating leukocytes that underlie the complex pathogenesis of these lesions. The present data indicate that vasa vasorum neoangiogenesis and atherosclerosis are seemingly inseparably linked, triggered and perpetuated by inflammatory reactions within the vascular wall. 3.1.1.4 Risk Factors for Development of Atherosclerosis Local shear stress In the coronary circulation, for example, the proximal left anterior descending coronary artery exhibits a particular predilection for developing atherosclerotic disease. Likewise, atherosclerosis preferentially affects the proximal portions of the renal arteries and, in the extracranial circulation to the brain, the carotid bifurcation. Indeed, atherosclerotic lesions often form at branching points of arteries, regions of disturbed blood flow. Age, Gender, HTN, HLP, DM, Smoking, Race/Ethnicity, 3.1.1.5 Atherosclerosis of the Aorta In the characteristic distribution of atherosclerotic plaques in humans the abdominal aorta (Fig. 11-8) is usually much more involved than the thoracic aorta, and lesions tend to be much more prominent around the origins (ostia) of major branches. In descending order (after the lower abdominal aorta), the most heavily involved vessels are the coronary arteries, the popliteal arteries, the internal carotid arteries, and the vessels of the circle of Willis. Vessels of the upper extremities are usually spared, as are the mesenteric and renal arteries, except at their ostia. Nevertheless, in an individual case, the severity of atherosclerosis in one artery does not predict the severity in another. In an individual, and indeed within a particular artery, lesions at various stages often coexist. 2009_Dijk_The natural history of aortic atherosclerosis_A systematic histopathological evaluation of the peri-renal region.pdf 3.1.2 Peripheral Arterial Disease Peripheral Arterial Disease (PAD) is caused by atherosclerosis and represents the most common cause of lower extremity ischemic syndromes in developed countries [42]. Symptoms of PAD are variable including pain, ache, hair loss, thickened nails, smooth and shiny skin, reduced skin temperature, cramp, muscle atrophy, or a sense of fatigue in the muscles. Because of the variability of symptoms, the diagnosis of PDA is frequently missed [43]. In addition, the major part of patients with PAD is asymptomatic [REF]. Beside these diagnostic challenges, PAD affects a large and increasing numbers of patients worldwide. Round 30 million people are diseased in worldwide, but of those only 10 million patients are presenting with symptoms [44]. Further, the prevalence is increasing with age [6, 45], while the prevalence is 10% at the age of 60 years [46]. Association to mortality!!! 3.1.2.1 Pathogenesis of Peripheral Artery Disease The leading cause of PAD is atherosclerosis, especially in older patients (>40 years) and at the lower extremities [42]. Other, but rare causes of PAD include embolism, vasculitis, fibromuscular dysplasia, entrapment, and trauma. Atherosclerotic lesions, which are segmental and cause stenosis, are usually localized to large and medium-sized vessels. The pathology of these lesions is based on atherosclerotic plaques development, as described above (xxx). The primary sites of involvement are the abdominal aorta and iliac arteries (30% of symptomatic patients), the femoral and popliteal arteries (80-90%), and the more distal arteries (40-50%) [REF]. Atherosclerotic lesions have been predominantly observed at arterial branch points. These may be explained by altered shear stress [REF]. However, the involvement of the distal and smaller arteries is more common in elderly individuals and patients with diabetes mellitus [REF]. 3.1.2.2 Risk Factors for Peripheral Arterial Disease While atherosclerosis is the major underlying condition of PAD, the risk factors for PAD are essentially the same as those for other form of atherosclerosis (like e.g. CAD), see Table 1 [47-50]. However, the risk factors smoking and diabetes may have even greater effect for PAD as compared for CAD [51]. Risk Factors Increased risk for PAD Hypercholesterolemia 1- to 2-fold (low) Homocysteinemia 1- to 3-fold (moderate) Hypertension 1- to 3-fold (moderate) Smoking (current and past) 2- to 4-fold (high) Diabetes mellitus 2- to 4-fold (high) Table 1: Risk Factors for Peripheral Arterial Disease 3.1.2.3 Clinical Presentation of Peripheral Artery Disease PAD affects more often the lower extremities (xx times more often than upper extremities) [REF]. The most common symptom of PAD is intermittent claudication, which is defined as presence of pain, ache, cramp, numbness, or a sense of fatigue in the muscles. Those symptoms occur during exercise and are relieved by rest, as result of the increased muscle ischemia during exercise caused by obstruction to arterial flow. Patients with PAD in the lower extremities resulting in ischemia may range in presentation from no symptoms to limb-threatening gangrene. Two major classifications based on the clinical presentations are established, the Fontaine and the Rutherford classification. While the more simple Fontaine classification consists of four stages (Table 2) [52], the Rutherford classification has four grades (0-III) and seven categories (0-6). Asymptomatic patients are classified into Rutherford category 0. Any patient with claudicants are stratified into Rutherford grade I and divided into three categories based on the severity of the symptoms. If patients have pain at rest, they belong to Rutherford grade II and category 4. Any patient with tissue loss are classified into Rutherford grade III and categories 5 and 6, based on the significance of the tissue loss [4]. These two clinical classifications can be translated into each other according to Table 2. Fontaine Classification Rutherford Classification Stage Clinical Grade Category Clinical I Asymptomatic 0 0 Asymptomatic IIa Mild claudication I 1 Mild claudication IIb Moderate to severe claudication I 2 Moderate claudication I 3 Severe claudication III Ischemic rest pain II 4 Ischemic rest pain IV Ulceration or gangrene III 5 Minor tissue loss III 6 Major tissue loss Table 2: Classification of Peripheral Arterial Disease based on the Fontaine Classification in Comparison the Rutherford Classification In the Framingham Offspring Study, the prevalence of PAD was determined in 1554 males and 1759 females from 1995 to 1998.55 The mean age was 59 years. PAD, defined as an ankle-brachial (blood pressure) index (ABI) of ABI Severity of PAD The physician also queried the participant about symptoms of intermittent claudication using a standardized questionnaire [53]. 3.2 Local Adipose Tissue Depots 3.2.1 Variability of Adipose Tissue 3.2.1.1 Anatomy and Morphology SACK: Epicardial, mesenteric, and omental fat all share the same origin from the splanchnopleuric mesoderm associated with the gut.11 Pericardial fat (pericardial adipose tissue [PAT]) is defined as epicardial fat in all these possible locations plus paracardial fat.14 Paracardial fat is situated on the external surface of the parietal pericardium within the mediastinum and has alternatively been termed mediastinal fat.15 Paracardial fat originates from the primitive thoracic mesenchyme, which splits to form the parietal (fibrous) pericardium and the outer thoracic wall.16 Epicardial adipose tissue is supplied by branches of the coronary arteries, whereas paracardial fat is supplied from different sources including the pericardiacophrenic artery, a branch of the internal mammary.17 Lipolysis and lipogenesis have not been measured directly in human epicardial fat. Based on approximately 2-fold higher rates of lipolysis and lipogenesis in guineapig epicardial fat than other fat depots, Marchington et al18,19 proposed that EAT serves to capture and store intravascular free fatty acid (FFA) to protect cardiomyocytes from exposure to excessive coronary arterial FFA concentrations during increased energy intake and, at other times, to release FFA as an immediate ATP source for the myocardium during periods of need. Epicardial fat and the myocardium are contiguous. Islands of mature adipocytes are more frequ ent within the subepicardial myocardium of the RV than the LV13 and may act as more readily available, direct sources of FFA for cardiomyocytes. The thickness of the wall of the right atrium is about 2 mm; the left atrium, 3 to 5 mm; the RV, 3 to 5 mm; and the LV, 13 to 15 mm.20 Possibly, FFAs could diffusebidirectionally in interstitial fluid across concentration gradients from epicardial fat into the atrial and RV walls where EAT predominates and vice versa, but this process in the LV wall can be questioned because the diffusion distance is much longer. Peri-vascular adipose tissue is defined as any adipocytes, which are located close to the vascular wall and has the possibility to secret their biomarkers into the vasa vasora of the wall (see 3.2.1.2). 3.2.1.2 Secretion of Biomarkers by Adipose Tissue Adipose tissue is known to have more functions than lipid storing. Adipose tissue secrets biomarkers and serves as an endocrine organ. Beside hormones, it secrets also different inflammatory cytokines and chemokines. The amount of adipose tissue were associated to xxx, xxx, xxx (FRAMINGHAM?!). Especially peri-vascular adipose tissue like epicardial or visceral adipose tissue demonstrated higher expression of inflammatory biomarkers compared to other adipose tissue depots in the body [REF]. Beside the systemic effect of the secreted cytokines and chemokines, also a local effect/paracrine is hypothesied. Biomarkers secreted of peri-vascular adipose tissue reach over the vasa vasora of the major arteries their adventitia, media, and intima. Therefore it might be involved in the inflammatory process of atherosclerotic plaque. Further, a local effect can be thought by direct diffusion. 3.2.2 Association of Adipose Tissue to Cardiovascular Disease 3.2.2.1 Atherosclerosis 3.2.2.2 Peripheral Arterial Disease 3.2.3 In-Vivo Assessmentof Adipose Tissue 3.2.3.1 Traditional Measures * BMI and WC [54] 3.2.3.2 Imaging-based Assessment * dual energy X-ray absorptiometry (DXA) [55] * magnetic resonance imaging (MRI) [56, 57] * ultrasound [58] * multi-detector computed tomography (MDCT) [59, 60] 3.3 Framingham Heart Study 3.3.1 Historical Origin of the Framingham Heart Study Infectious diseases were prior to World War II the major burden for public health. But through a greater microbiological knowledge and improved sanitation, the morbidity and mortality of infectious disease decreased continuously. When penicillin was introduced in 1942, a dramatic reduction was made in the prevalence and incidence of infectious diseases, especially by controlling tuberculosis and pneumococcal pneumonia [REF]. Replacing infectious diseases, public health was challenged by a mounting epidemic of CVD starting in the 1940s. With World War II over the alarming rise of CVD became increasingly evident. In the United States, 30% of all men developed CVD before reaching the age sixty. The prevalence of CVD was twice of cancer by 1950 and had become the leading cause of death [REF]. Even so the available statistic data from around the world was often crude and inaccurate, it clearly demonstrated a worldwide atherosclerotic CVD problem. Furthermore there was no known treatment to prolong life and to reduce mortality. Added to these distresses was the fact that little was known about etiology, pathogenesis and epidemiology of CVD. The big gap between the enormous public health burden of CVD on the one site and the little understanding of this disease on the other site increased drastically the need for action. At this time, some believed a primary preventative approach was more promising than a search for cures [Dawber, Thomas R. (1980), The Framingham Study: The Epidemiology of Atherosclerotic Disease, Cambridge, Mass.: Harvard University Press.], while the secrets of the etiology of CVD and subsequently for treatment were not being uncovered by basic laboratory and clinical research. Some of these prevention-minded individuals occupied positions of influence and were able to translate their beliefs into actions. The key was to develop a preventive approach, where first of all the characteristics of the host and environment, which lead to the early appearance of the disease, had to be determined. In particular, preventable or modifiable predisposing factors had to be identified. If a practical preventive approach was developed, the hope was that doctors and public health officials would adopt it and so have a widespread impact on the reduction of CVD-based morbidity and mortality. Accordingly to the preventive approach, the Framingham Heart Study was designed given the charge to identify these modifiable characteristics of host and environment for CVD. 3.3.2 Initiation of the Framingham Heart Study By the mid 1940s several striking studies were conducted with an examples epidemiological approach in the fields of nutritional imbalance, metabolic disorders, occupational hazards, accidents, cancer and rheumatic fever under principle investigators (PI) Drs. Dawber, Meadors and Moore [REF, Dawber, Meadors and Moore 1951]. In common, an association between the circumstances and the disease could be identified with-out knowledge of the precise etiology. One of those studies was performed by Dr. John Snow in 1936. He demonstrated that cut-ting off the water supply from contaminated wells, despite incomplete knowledge of the pathogenesis of the disease, stopped cholera. He observed on the one hand the source of the water supply and on the other hand the time and place where the disease occurred. He sufficiently pinpointed based on his observations the major environmental factor for cholera. Further investi

The Ancient Regime :: essays research papers

The Ancient Regime The Old Regime took place during the fifteen hundreds and are conflicted by the enlightenment in the middle seventeen hundreds. The Old Regime thoughts and ways are different politically and economically then the enlightenment world. The Old Regime thoughts are based upon God and the church. The people believed that God was the ruler of everything and God was what makes things happen and work. People of these times had no concepts of science or reason. People believed that things happened because God made them happen. If you had thoughts that were different than that you had to answer to the church and there could be serious penalties to pay. During the period of the Old Regime, there was no other governing other than the church, which caused serious conflicts for the monarchies of this time because there was a constant battle over the power of the people, and who was going to rule over them. The church had the entire rule and the kings of these times would have to discuss with and go through the churches before they could make any decisions. The reason that they had given so much power to the church was out of fear. The thrown was afraid of making God angry so they would do anything in their power to keep God and the church satisfied. One way of making sure God was happy was to give the power to the church, this included money or taxes that were collected. Women's role in society was hardly important to the people of these times. Women in this time were not thought about very highly. They were thought of and treated as property. Women had it hard in these times, because men were so intent on their superiority over the women. There were hardly any times that women were rulers. In the late fifteen hundreds a man named Francois Hotman wrote Francogallia which is his best known work. In this work he discusses women and how he thought of them. He implied that they were not fit to be rulers or even contribute to the thrown. He discusses some of his occurrences with women rulers and how they all seemed to demolish what they had been given, and every thing ended up in destruction including their thrown. Religion was a very serious subject in this time, since everything revolved around God and the church religion was the largest part of people's lives.