Emerging Market-The Challenges And Opportunities Investing In China Essay

Emerging Market-The Challenges And Opportunities Investing In China - Essay Example It is evident that the emerging markets have flexed their muscles in the global arena, and their effect is expected to increase the more. Companies that have invested in these markets have enjoyed and are continuing to enjoy revenues that emanate from these transactions. China is among the emerging markets that has contributed a great mile to the spending of a huge clientele-base, and that has also attracted numerous multi-national companies (MNCs). With the country expected to dominate the global market by the year 2030, challenges are also not devoid from these transactions. This essay shall attempt to discuss the concept of ‘emerging markets’ using the case study of China. Additionally the essay shall keenly analyze the opportunities and threats facing the investors that are likely to invest in this emerging market. 2.0. Body 2.1. Definition of ‘emerging market’ In the thought of Beridze (2008), emerging markets refer to the nations that have actively bee n involved in business activities that have seen their fast growth as well as a huge development in the industrialization process. Among these countries that are termed to be emerging range from Brazil to China. As seen in the research conducted by Palepu & Khanna (2010), China has retained her position as the third in the list of the emerging markets. ... A good example is China that is export-driven with strong capital inflows and investments from well-capitalized banking institutions. Jain (2006) indicates that the markets are expected to stabilize by the day. Additionally, the growth of the world’s economy is expected to emanate from the emerging markets, and 70% of the growth is anticipated according to the economists (Kvint, 2009). Despite the varying interpretations of the term, the fact about the entire aspect is that emerging markets have been instrumental in recording an increase in the capital share in the world economy, and that their GDP is on the increase. As seen in figure 1, China may be defined as an emerging market as emerging markets are ones that are undergoing transformations from third world countries to developed countries, whilst their markets are now reduced to free markets from the state dominated ones (Enderwick, 2012). On another viewpoint, Mody (2004) says that emerging markets are slowly freeing up both internally and externally, due to the processes of economic reforms, that need to incorporate the rapid economic growth. It is evident that the country has opted to increase their role in the market, and minimize the chances that the government will have avenues to control the planning of the market. Pragmatic ideologies have in this case taken the day in the case of China’s economy. Its emergence cannot be alienated from the fact that the country has shed more energy in perfecting its contribution in the manufacturing industry as opposed to other countries that have opted to focus on the service industry whilst others in the agricultural sector. Figure 1: Real GDP growth (%) in the BRIC and US economies Source: IMF, World Economic Outlook (International Monetary

Ethical Conduct in Scientific Research Paper Example | Topics and Well Written Essays - 500 words

Ethical Conduct in Scientific - Research Paper Example Suffering from latent syphilis meant that they had the infection but they showed no sign of the disease until late stages. For about 40 years, the poor men were never told that they were suffering from the disease and were never treated. Instead, they were only told that they had â€Å"bad blood† and were not given penicillin even though it was the standard cure for the disease that was available in 1947. The aim of the study was to find out whether syphilis affected the black men in a different way from the way it affected the white men (Katz & Warren, 2011). For participating in the study, men were given free ride to and from the Tuskegee clinic in Alabama. In addition, they were given hot meals and free treatment for minor ailments. For instance, they were given only aspirin and mineral supplements to cure minor ailments so that the treatment procedure could not interfere with their study. Much worse, even the 250 men from the Second World War drafted from the war to volunteer in the study, arrangements were made to make sure they remained part of the study. When the study ended in 1972, there was a public outcry and only 74 men of the original participants stayed alive. Other negative outcomes involved 28 men who died from syphilis and related complications, while 40 wives were infected with the disease and 19 children suffered from congenital syphilis. Survivors of the study received financial compensation from the United States and President Bill Clinton was forced to declare on behalf of the state that US had done a shameful thing (Katz & Warren, 2011). United States demonstrated heinous acts in the study that were considered to be morally wrong. It was unethical for the Tuskegee clinicians to conduct the study without the consent of the patients, according to the World Health Organizations Declaration of Helsinki of 1964. Clinical centers must conform to the ethical conducts stipulated by the legal structures. However, in Tuskegee case, they

A critique of published research By Anthony Feiler Essay

A critique of published research By Anthony Feiler - Essay Example The result of the analysis is decisive in a complete comprehension of the article as well as its strengths and weaknesses. The research paper has been identified as crucial in arriving at a conclusion regarding the effectiveness of strategies in support of the children who have difficulty in learning, and those struggle with literacy. The primary strategy proposed in the study is the provision of weekly home visits during the first year of the students in school. Anthony Feiler comes up, through the research investigation undertaken, with evidences for the effectiveness of additional support for the children with difficulties in literacy. The test scores and the views of the participants which have been collected through a series of interviews are used to arrive at such a conclusion. The literacy difficulty in children during the primary years of education poses serious challenges in the learning process as they continue the learning activity and this has been a major issue raised in the research paper by Feiler. The research undertaken in the paper concentrates on the evidences for strong and specific family variables which influence the literacy outcome of children at the early years of their education. The quality of the learning environment as well as the role played by the parents in the learning activity of students has great significance in the learning skills of children and the research investigation by Feiler focuses on the family literacy schemes, especially the strategy occupying the parents as well as children. Ultimately, the research study â€Å"explores the impact of providing additional literacy support at home (with some additional support at school), using a Reception teacher’s and head teacher’s predictions to target children c onsidered to be in need of extra help during their first year at school. There is a particular focus on strategies for working with parents whose engagement with

Essay2 Essay Example | Topics and Well Written Essays - 750 words

Essay2 - Essay Example It is saddening for me to watch an additional species disappear completely from the face of the earth because of factors that can be controlled (Bocedi et al 84). However, many of the suggestions that have been placed forth require human beings to be more cautious in the way they interact with the environment. This may mean that human beings need to maintain the natural state of the environment that can support the lives of other species. The greatest challenge of doing this is that human beings need to survive as well. Over the years, the human population has increased at alarming rates. This has served to confirm that human beings are reproductive. In order to sustain reproduction, human beings have to manipulate the environment so that it can favor them in different ways. The rapid climate changes occurring recently are attributable to such manipulations of the environment by human beings (Bocedi et al 85). This situation explains why it has proved difficult for me to define a specific solution that will ensure that different species survive and that human beings have the right amount of resources. After interacting with several sources that discuss the potential solutions to the ongoing climate changes that have threatened the survival of different species, I am compelled by the conviction that human beings can initiate a change. This is possible if they can limit the level of resource, they use on a daily basis. Innovation can serve to save some of the natural resources, preventing them from depletion. Human beings are well aware that natural resources are subject to depletion if not used in a sustainable manner. If only human beings were committed to saving natural resources, and maintaining balance in the natural cycle that ensures regular climatic patterns, then the ensuing problem would be solved effectively. There are potential benefits of this potential solution

Of mice and men Comparison Essay Example for Free

Of mice and men Comparison Essay Of mice and men by John Steinbeck- Consider the character of crooks. How does he contribute to our understanding of the society in which he lives? This essay will answer the question above. I will be looking at the character Crooks and the society and the racial issues at that time. I will also look into the American dream of the majority. John Steinbeck was born in 1902 in Salinas, California, and many of his novels are set in this part of America. Before his career as a writer began, Steinbeck worked as a construction labourer and a caretaker. His first novel Cup of Gold was published in 1929. Of Mice and Men was published in 1939. He died at the age of 66 in 1968. In this paragraph, I will describe the character of Crooks and some of the difficulties faced by the racial minority. Crooks is a Black-American who stands out to the other ranch-men. He has a crooked back, where he has been kicked by a horse. He is known by many names, like the stable-buck negro or nigger. In the time where Crooks was living, Americans treated the Black-Americans very differently because they were niggers. The black people where not allowed in white areas, even though it wasnt a law, it was made this way, but there where laws of the segregation of the black and white people. In the ranch, it was exactly the same, Crooks wasnt allowed in the other ranch peoples bunk house to play blackjack or rummy I aint wanted in the bunk-house and you aint wanted in my room (page 72). He just had to sleep in the barn by himself; he had no rights, except the choice of invitation of his room. He is only allowed to play horse shoes with the other ranch workers because he is so good at it. Although C1rooks is part of the lowest chain of respect, he knows himself as a proud aloof man; he doesnt care what the others say about him. As Crooks is the only black man in the ranch, he has no rights at all, he didnt even have an identity, he was known as Crooks because his real name was not important to the ranch workers. Ku Klux Klan is the name of a number of past and present organisations in America that believed in white supremacy, anti-Semitism, racism and anti-Catholicism. These organisations promoted violence and terrorism, sometimes intimidation like burning a cross. The Klan was founded 1866, it mainly focused on intimidating people, but rapidly adapted to violent methods. This is what happens to crooks as he becomes intimidated and abused by other ranch workers. . A quick reaction set in as the Klans leader left, by the early 1870s. Crooks had a book in his room called the California Civil Code, this tells him what rights he has and what rights he doesnt have, he does this so he can avoid being lynched. Every American worker has an American dream, the base of this is respect the people working in the ranch want to have their own ranch, people working for them and some nice crops. Crooks dream is to be treated equally, and to be respected. Candy wants to relax for his last few years and seeks the opportunity in George and Lennies dream which is to have a big vegetable patch and a rabbit-hutch and some chickens (page 15), Curleys wife wants to star in the movies, wear nice clothes and be rich. All their dreams are quite similar as they all want something for their own and also respect. What Crooks really wants is equality; he wants to be treated as another human being and not differently and to have friends. I tell ya a guy gets too lonely an he gets sick. (Page 77) There are many characters that have disabilities in the story, these people are: Crooks, Candy, Lennie and Curleys wife, these people are affected in their own way. Crooks disability is none other than being black and his crooked back, he has to have his own room in the smelly, cramped barn, and he cannot go to the bunk house and play rummy with the white characters. Lennie has a mental disability which makes him different from the other characters because he still has a mind of a child; this affects him as the others underestimate him. Curleys wife is the only female at the barn, she cannot do the things the boys can do, she is also controlled by Curley as she is a woman because men had more power than women in the past, this mean that she couldnt do what she wanted to do. Candy has the disadvantage of being old, the other guys think that he is useless, he stays behind and cleans up the bunk house, he has also lost a hand which makes that others think of him more useless. This shows us that he is not the only one which is different to the ranch workers. Crooks contributes to our understanding of the society of which he lives by showing us how he lives in separation and inequality, he cannot do any of the things that the white people do, he doesnt even sleep in the same place as them as they think he stinks. The also refer to him as the nigger because he is not respected enough to be called by he real name.

Overview of the Consequences of Cognitive Neuropsychology

Overview of the Consequences of Cognitive Neuropsychology The ability to study and understand the brain has evolved dramatically since people were first interested in the brains seemingly miraculous capacities. However, comprehending the input/output nature of the brain (and everything in between) has always been limited to behavioral tasks of healthy individuals. Unfortunately for science, a machine that cant be reverse engineered cannot be fully understood. To truly make sense of the diverse functions of each part of the brain, it is necessary to see the importance of studying individuals with brain damage. The field of cognitive neuropsychology occupies itself precisely with this concept. More or less, it offers the analogy of the brain as a sort of appliance, perhaps a television with lots of wires plugged into it. Assuming that none of the cables functions are labeled (as is obviously the case with the brain), the best way to discover which cable controls each part of the television is to unplug each cable one at a time and observe which parts of the television stop functioning. This analogy works well, given that a lesion in the brain is small enough to only effect a certain function. More diffuse brain damage is like more cables being removed at once; it becomes more difficult to declare, with precision, which cable controls which function. As non-invasive methods of imaging the brain have improved over the decades, it is no longer necessary to limit studies to healthy individuals, non-human animals, and less precise guessing as to the localization and diffusion of brain damage in patients. Techniques like magnetic resonance imaging (MRI) allow researchers to pinpoint where brain damage exists in patients, and, from further behavioral experiments, determine how the damage has affected the brain and, moreover, for which behavioral aspects the damaged part of the brain used to be responsible. Additionally, another technique, transcranial magnetic stimulation (TMS), allows researchers to simulate a momentary lesion on superficial portions of the cortex. Clearly finding a patient with brain damage for every part single part of the brain is a scientific pipedream. Thus, by following the previous analogy, TMS offers the possibility to remove a cable and witness the effects without causing any permanent damage to the brain. This paper will show three cases of brain damage studies from the past, before such technology was available, and three from the present to contrast the difference in techniques and what the studies contributed to the field of neuroscience and demonstrated about brain function. No discussion of brain damage studies is complete without mentioning the case of Phineas Gage. Occurring in the 1840s, and arguably one of the most famous cases of all time, Gages face, skull, and brain were penetrated, through-and-through by a 3cm thick, 109cm long tamping iron. He was momentarily stunned but regained full consciousness immediately thereafter. He was able to talk and even walk with the help of his men (Harlow, 327). John M. Harlow, the doctor who looked after Gage after his accident, made observations about Gages behavior, such as [Gage has] succeeded in raising himself up, and took one step to his chair, and sat about five minutes. , and Intellectual faculties brightening. When I asked him how long since he was injured, he replied, four weeks this afternoon, at 4Â ½ oclock. Relates the manner in which it occurred, and how he came to the house. He keeps the day of the week and time of day, in his mind. Says he knows more than half of those who inquire after him. Do es not estimate size or money accurately, though he has memory as perfect as ever. (Passage of, 282) Assuming Gage had a normally developed brain, such observations essentially prove the concept of functional localization within the brain. Although it is easy to see this retrospectively because of what modern science has shown, Harlow didnt have the luxury of MRI or other techniques, apart from simple observation. By recognizing that Gages memory, speech, movement, and ability to learn were spared, but [h]is respect for the social conventions by which he once abided had vanished [(His abundant profanity offended those around him)] (Harlow, 327), Harlow was later able to connect Gages changed behavior to the frontal regions of the brain, which paved the way for further studies in seeking out the neural basis of various human capacities (ibid.). Understanding that each part of the brain does, in fact, have its own specific function was a crucial discovery in neuroscience and would have likely been impossible without patients such as Phineas Gage. Another patient similar to that of Gage, in terms of fame and selective damage, is Tan (named for the monosyllabic sound the he produced when trying to speak), the aphasic patient of the French surgeon Paul Broca. In 1861, Broca observed that Tan differed from a sane man only in the loss of articulated speech (Broca, 343). Given Tans symptoms, (for later in life he also presented with insensitivity on the right side, paralysis of both right limbs, weakened vision in his left eye ,and incomplete paralysis of the left cheek, in addition to the lack of speech) (347), Broca claimed that the principle cerebral lesion had to occupy the left hemisphere (ibid.). Only years later during the autopsy could Broca precisely observe the extent of the brain damage. In terms of Tans general behavior, however, Broca noted that [it was] certain that Tan understood almost everything that was said to him (345), that [n]umerical responses were those that he could make the best, by opening or closing his fingers (346), and that [t]he tongue was perfectly freethe patient could move it in all directionsThe muscles of the larynx seemed in no way altered, the quality of the voice was natural, and the sounds that the patient made in pronouncing his monosyllable were perfectly clear (345). These observations clearly indicate that Tan was still capable of expressing concepts, even if he was unable to express them strictly verbally, and that there existed a distinction between general vocal tract usage and speech production. These observations coupled with the results of the autopsy led Broca to realize that there existed of faculty of articulated language (as translated from French), lateralized to the left-hemisphere, distinct from comprehended language (35 6). However, the drawback to Tans case is that given the extent of his brain damage, Broca was still left pondering whether the faculty of articulated language depends on the anterior lobe considered as a whole, or especially on one of the convolutions of this lobe (357). Advances in technology in the next century would greatly strengthen his findings. Though in any case, Tans deficits led to the discovery of language in the left hemisphere and the notion that speaking meaningful words is distinct from general expression of concepts or of comprehending concepts as a whole. The case studied by Carl Wernicke greatly added to Brocas findings and strengthened the model of how language was processed in the brain by presenting a double dissociation between speech production and speech comprehension. Basically, Wernicke found a stroke patient in 1873 whose speech and hearing were unimpaired, but he couldnt make sense of what he read or what was said to him (Alic, 666). As it turned out, this condition, which essentially contrasted that of Brocas patient, Tan, was indeed localized to a different part of the brain. Upon autopsy, Wernicke found a lesion in the rear parietal/temporal region of the patients left brain hemisphere (ibid.). However, Wernicke regarded this facet of speech production and posited a connectionist-style theory of language production, thus he postulated that Brocas area and [his] area were connected, anddamage to this connection would cause conduction aphasia, a syndrome wherein a patient could both speak and understand language, but would misuse words (ibid.). From this connectionist notion, Wernicke theorized more deeply about general associations of a concept with language. In 1886, he made the claim that, in order to understand the word bell, the telegram arriving in [the speech comprehension center] must arouse in us the concept of the bell, i.e. the different memory images of the bell deposited in the cortex and localized in accordance with the sensory organs involved in their development. These areacousticoptictactileand finallymotor imagesthe arousal of each one separately is communicated to the others and they constitute a functional unit (Code, 15-16). Unaided by modern neuroimaging technology, Wernicke made a big step forward in connectionist-model theories on semantic associations and language production/comprehension. Together, Broca and Wernicke set the stage for studying language in the brain by having observed patients with specific brain damages and consequently conjecturing about the nature of the healthy human brain. Modern cognitive neuropsychology certainly follows the same principles in terms of assessing brain damage and theorizing about models of information streams. However, contemporary neuropsychologists have the benefit of computers, brain scanners, TMS, and, as seen in the next case, also infrared emitting diodes (IREDs). This next case is another classic, albeit much more recent: the study of patient DF by Goodale and Milner. DF was a middle-aged woman who was plagued by brain damage after carbon monoxide poisoning (Goodale, 154). The researchers could localize the damage without needing an autopsy thanks to MRI, which allowed further testing and studying to occur with knowledge of which structures were afflicted: the ventral and lateral occipital region, and in the parasagittal occipitoparietal region. After beginning neuropsychological testing, the researchers discovered that DF had a visual form agnosia (ibid.). Overall she showed poor perception of shapeorientationcolourintensitystereopsismotionproximitycontinuity, or similarity (Goodale, 154-155). Goodale and Milner ran several tests to discern how profoundly the visual form agnosia affected DF, and they came to realize a striking dissociation between [her] ability to perceive object orientation and her ability to direct accurate reaching movements toward objects (155). In one experiment DF had to indicate the orientation of a slot using a card by orienting the card similarly to the slot. Goodale notes that results here were grossly impaired (ibid), but when [she] was asked to reach out and post thecard through the slother performance was excellent (ibid.). The researchers ran a similar test to measure grip aperture between her index finger and thumb when she would pick up a small plaque. Here they employed the IREDs to measure the distance between the fingers and have numerical data to work with. Such a simple task is rendered quantitative (and thus scientifically measurable) merely by the technology available at the time. This second experiment had results similar to those of the first. Goodale notes that DFs estimates [of her grip aperture] did not change as a function of the width of the plaques (ibid.). However, when DF had to reach for the plaques and grab them, the aperturewas systematically related to the width of the object (ibid.). This profound dissociation arising from DFs brain damage led Goodale and Milner to suggest that at some level in the normal brains the visual processing underlying conscious perceptual judgments must operate separately from that underlying the automatic visuomotor guidance of skilled actions. (ibid). Such a claim of the brain having information that lies at a subconscious level could not have been postulated at the time without the (un)fortunate brain damage that afflicted DF. Building off of this notion of subconscious visual processing, the development of TMS has allowed researchers to test visual awareness (among other things) by momentarily disrupting parts of the brain via a magnetic pulse, effectively creating fake brain damage that is reversible: the immediate benefit being a neuropsychological approach to a question without needing to wait for a patient with precisely the right brain damage to appear. Ro discusses TMS experiments whose behavioral results are similar to those found by Goodale and Milner when testing DF. In the experiments, TMS suppressed primary visual cortex and despite unawareness of the orientation of a line in one experiment and unawareness of the colour of a dot in another experiment, subjects were nonetheless able to guess the orientation and colour of these stimuli presented within their TMS-induced scotomas at well-above chance levels (111). From this, he concludes that the results suggest a geniculoextrastriate pathway that bypasses V1 and projects directly from the lateral geniculate nucleus (LGN) into extrastriate cortex, likely area V4. [Such] a direct anatomical pathway from LGN to V4 has been demonstrated in lower primates (112). However, Ro further postulates that information relayed through [the aforementioned] pathway is unconscious, at least without a functioning V1 (ibid.), a profound step toward the comprehension of human consciousness and what actually gives rise to the experience of awareness. The final case discussed in this paper is that of Etcoffs 1991 study of LH, a minister who suffered a severe closed head injury in an automobile accident at the age of 18. The accident and the surgical procedures it necessitated[resulted in] bilateral lesions affecting visual association corticesthe right temporal lobe, the left subcortical occipitotemporal white matter, and bilateral perietooccipital regions (Etcoff, 27). Etcoff remarked that predominant resulting behavior change was that LH can recognize most pictures of objects and most objects encountered in daily life, [but] he is unable to recognize the faces of his wife, children, friends, or members of his family of origin (28). Etcoff noted that in various tasks, LH found other strategies to guess the identity of the person. During a famous faces task, he recognize hairstyles, insignias, and uniforms to correctly guess whose face was presented to him, even though he couldnt recognize the face itself (28-29). This indicates that LH still has a semantic connection between, for example Einsteins hair and his identity, but the facial recognition portion of this association network was knocked out. More interestingly, LH was given the task of recognizing impossible faces from normal ones, i.e. duplicate facial features, strangely oriented features, etc., and consequently Etcoff commented that LH was able to distinguish a true from an impossible face with 97% accuracy[he] can truly recognize faces as faces, and is sensitive not just to gross information such as number of features and relative placement, but to subtler relational information about feature orientation (29). This shows a clear distinction between recognizing a face as an object and recognizing the semantic information that each individual face carries with it, thus the human brain must process faces specially, a process that is still studied extensively today. Etcoff even shared that LH likens the experience of looking at a face to attempting to read illegible handwriting: you know that it is handwriting, you know where the words and letters stop and start, but you have no clue as to what they signify (29). These six cases have demonstrated important discoveries about how the brain works through the lens of neuropsychology. From functional specialization and a man surviving a tamping iron blasting through his prefrontal cortex disrupting his personality, to distinct linguistic systems for producing and comprehending speech, to visual information existing in the brain without conscious knowledge of it, to the idea of primary visual cortex leading an essential role in consciousness, to faces being specially processed entities in the human brain, studying damaged brains has arguably led to understanding certain facets of the brain that otherwise might have been unimaginable. Furthermore, these six cases were only a handful of discoveries that have arisen from observing the behavioral results of brain damaged patients, used to illustrate the benefits of taking a neuropsychological approach to unraveling the mysteries of brain. However, every methodology has some amount of drawbacks, and neuropsychology is not excluded. For example, given a lesion in some area of the brain, the resulting change in behavior must be a function of how the damaged area was affected. But what is this function exactly? Why should brain damage cause the output that it does instead of some very similar but sightly different behavioral change? If it is a question of reductionism, then its only a matter of time before the gap between behavior and structure is solved, but at present, neuropsychology doesnt answer this. Secondly, brain damage tends to be accidental, and accidents can be messy (e.g. car crash). Lesions dont tend to be as simple as unplugging a single cable from the television, where only one aspect of the TV is clearly affected. Thus, finding clean, precise lesions that alter only one part of the brain is far less likely then finding diffuse brain damage. Even if a patient tends to have only one predominant behavioral change, it cannot be said with full certainty that other parts of his brain werent affected or arent contributing, to some degree, to the new behavioral output, thus possibly confounding data despite very careful experimental designs. Additionally, there is the question of neural plasticity, which Ro brings to attention in his study by mentioning that reorganisation of brain functionalso complicate[s] examinations of sensory processing and visual awareness (110), which is where the advent of TMS has been very helpful in that, apart from its aforementioned advantages, it drastically reduces or eliminates any opportunities for neural plasticity (ibid.). The issue here is that plasticity in brain damaged patients might result in a level of rewiring that is abnormal or unexpected, thus rendering the way in which parts of their brain function unique only to them. All in all, however, every methodology has its pros and cons, and neuropsychology has provided science with a myriad of profound insights into the brain and its functions. The disadvantages it carries with it serve as a reminder as to how careful one must be when interpreting data about an entity as enigmatic and elusive as the brain.

Skin to skin contact and breastfeeding rate

Skin to skin contact and breastfeeding rate Formulation and theoretical perspectives. Effect of the first two hours after birth skin-to-skin contact for full term infants on first breastfeeding experience and breastfeeding duration: A randomised controlled trial Background It is unquestioned that breastfeeding is the most significant form of providing nutrition for infants. Exclusive breastfeeding for at least the first six month of life, with continued breastfeeding for up to two years or longer is highly recommended by World Health Organization (World Health Organization, 2000). In addition, The American Academy of Paediatrics (1997) stats Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for the first six months after birthà ¢Ã¢â€š ¬Ã‚ ¦It is recommended that breastfeeding continue for at least twelve months, and thereafter for as long as mutually desired. According to The American Academy of Paediatrics (1997) described the benefits of breastfeeding including improved general health, growth, and development of the breastfed infant; decreased incidence and severity of diarrhoea, lower respiratory infections, ear infections, bacterial meningitis, botulism, and urinary tract infections; protection fro m sudden infant death syndrome, childhood cancer, insulin dependent diabetes mellitus, Crohns disease, ulcerative colitis, allergies, and other chronic digestive diseases; and enhanced cognitive development. To compare with other Europe countries, breastfeeding rates in the UK are low (UNICEF, 1999). In 2005, 45% of all mothers in the United Kingdom were breastfeeding exclusively at one week, while 21% were feeding exclusively at six weeks. At six months the proportion of mothers who were breastfeeding exclusively was negligible ( The Baby Friendly Initiative was introduced in the UK in 1992 by the WHO and UNICEF. The purpose of the programme is to encourage hospitals to increase protection, promotion and support breastfeeding and implement the Ten Steps to Successful Breastfeeding (UNICEF 1998). Step four recommends skin-to-skin contact (SSC) in the early postnatal period, which should last until the first feed or for as long as the mother wishes (UNICEF, 1998). The process of skin-to-skin contact was defined as the infant is naked in a prone position and skin-to-skin on the mothers bare abdomen or chest during the first minute postbirth. Apgar scores are assigned and suctioning is done if medically indicated. The infant must be gently dried and covered across the back with a prewarmed blanket. The initial physical assessment is performed while the infant is with the mother skin-to-skin. To prevent heat loss, the infants head must be covered with a dry cap, which is replaced when it becomes damp. Ideally, all other interventions are delayed until at least after the end of the first breastfeeding (Moore Anderson, 2007). The optimal time for newborn babies to develop pre-breastfeeding behaviour, such as rooting and sucking (Gomez, et al., 1998), skin-to-skin contact and provide first breastfeeding is the first two hours postbirth when they are more alert to the environment. In this stage, it may indicate a sensitive period for establish effective breastfeeding. Bornstein (1989) defines sensitive period as a developmental phase of built-in competence for the development of specific behaviour exchanges between the organism and the environment whose consequences presumably endure for the organism. After this sensitive period, the two hours postbirth, many newborn babies go into a drowsy stage which maybe difficult to arouse for up to several hours (Britton, 1998). Purpose of the research Previous studies found that infants were eight times more likely to breastfeed spontaneously if they spent more than 50 minutes in skin-to-skin contact with their mothers immediately after birth, and concluded that the dose of skin-to-skin contact might be a critical component regarding breastfeeding success (Gomez. et al., 1998). Despite numerous documents and randomized control trials have showed the positive impact of skin-to-skin contact on breastfeeding, mother-infant separation by physical assessment and routine care during the first hours postbirth before having the opportunity to start skin-to-skin contact and breastfeeding is still common practice in many healthcare settings. In light of the above, the aim of the study is to examine the effects of skin-to-skin contact for full-term newborn babies during the first two hours postbirth on first breastfeeding experience and exclusive breastfeeding rate in six months postbirth. Two hypotheses will be tested: (1) skin-to-skin contact during the first two hours postbirth has positive impact on first breastfeeding experience; (2) skin-to-skin contact during the first two hours postbirth increases the likelihood of breastfeeding establishment; (3) skin-to-skin contact during the first two hours postbirth increases both breastfeeding establishment and duration. 2. Methods to be used The topic was skin-to-skin contact and breastfeeding rate and the methodology selected was quantitative. This is because breastfeeding rate is to be measured precisely so as to allow comparisons between the various groups. And for relative representativeness and for generalisations made quantitative research a better choice. The study will be conducted by randomised controlled trial comparing the effects of SSC with routine care on first breastfeeding experience and breastfeeding duration. In the control group which receiving routine care, babies will quickly dried and wrapped in a towel before being handed to their mother or father. Mother-baby contact will be interrupted for physical assessment, given a vitamin K injection, weighing, dressing and measuring the baby, or for repairing the mothers perineum wound. After the routine care finish, the baby will be swaddled in prewarmed blankets and return to the mother. And the staff nurse will assist with breast feeding when both mother and baby are ready. In the skin-to-skin care group, the infants will be given to their mothers immediately after birth and will be placed nakedly in a prone position against the mothers skin between the breasts with a large pre-warmed blanket. After the cord cut, the infant will be moved to radiant warmer for the same routine care as the control group then back to their mother again for about 2 hours. And when both mother and baby in skin-to-skin group are ready, the staff nurse also will a ssist with breast feeding. 2.1 Sampling principles and procedures Criteria for including/excluding study participants Eligible participants included pregnant woman who are primiparas mothers, had no pre-existing medical complications and no history of mental illness or illicit drug use, 18 years or older, expecting a vaginal delivery, intended to breast feed, her healthy fetus need to greater than 37 weeks gestation. A woman will be ineligible if their babies weighted less than 2200gm, Sample size In Shiaus study (1997), skin-to-skin contact dyads had better breastfeeding status than control dyads on day 28 (6.16  ± 2.06 vs. 4.0  ± 1.60, P= .004). This computes to an effect size of 1.17. And in Moores study (2007), the author used the data to compute power in her study for the samples were similar in their research. Moore(2007) indicated if the true effect size is 1.17, the probability of detecting significant differences between the two groups is 81% (i.e., 19% of the time significant differences would not be detected). Therefore, 10 participants per group may be adequate to detect statistically significant between-group differences in breastfeeding status and Moore also used minimization to control the influence of the variables, she explained that in small studies, simple randomization procedures are likely to result in groups that are unbalanced with respect to potentially confounding variables. For the above reason, in this research, a sample of 10 participants per group will be appropriate but to avoid possible attrition during the time, 15 participants will be recruited. Recruitment The participants will be recruited through a hospital in Manchester with the help of clinical nurse and maternity consultants. Women who fulfill the inclusion criteria will be contacted by the clinical coordinator at 36-37 weeks gestation. The women will provided with oral explanation about the trial, eligible participants will be recruited and informed consent will be obtained. After birth, mothers and their newborn babies who still remained eligible will be randomized using minimization to either skin-to-skin group or control group. 2.2 Data collection methods Minimization is an assignment strategy, similar in intention to stratification that ensures excellent balance between intervention groups for specified prognostic factors. The next participant is assigned to whichever group would minimize the imbalance between groups on specified prognostic factors. Minimization is an acceptable alternative to random assignment (CONSORT, 2007). The minimization program will be applied to control the following variables: baby gender, birth weight, and gestational age, maternal age, education, marital status, race, smoking history, breastfeeding intention and maternal employment (no, part-time, or full-time employment). When participants admit to the hospital in active labour, the clinical co-ordinator will be contacted for information gathering. And when all the information obtained, the computerized minimization programme will assign randomly either to skin-to-skin group or control group. Demographic, labour and delivery history data (past and current pregnancies) from the records will be collected by the clinical co-ordinator. Post-delivery data collection will be carried out through contact with the mothers before they left hospital. Post-delivery care will be observed by the research assistant as well as assessment of first breastfeeding in the delivery room. The infants first breastfeeding will be score by the research assistant by using the IBFAT. The IBFAT measures 4 aspect of suckling competence: (1) infant state of arousal or readiness to feed; (2) rooting reflex; (3) latch-on; and (4) suckling pattern. Each item has a score of 0 to 3 for a maximum score of 12, indicating competent breastfeeding. Success of the first breastfeeding (score of 10 to 12) will be measured by this tool. The IBS, which assesses the degree of breastfeeding exclusivity; The IBS is a single-item indicator consisting of three major levels of breastfeeding: full, partial, and token. Eight levels are ranked from 1 for exclusive to 8 for weaned. Full is divided into two subcategories: exclusive (the infant consumes only breast milk and no other liquid or solid food [score=1]), and almost exclusive (the infant is given water, juice, vitam ins, and minerals infrequently in addition to breast milk [score= 2]). The partial category, which originally had two subcategories, was subdivided into four subcategories for greater accuracy: high-partial (> 80% of the infants diet is breast milk [score= 3]); medium-high (50% 80% breast milk[score = 4]); medium-low (20% Follow-up assessment will be take place when infants reached 1, 3, and 6 months corrected age. The research assistant will contact to the mother in advance then arrange the visit. 3. Data analysis There will be six stages in data analysis. Stage 1: data preparation. Checking, editing and coding. Stage 2: data entry. Entering the data in the computer. Stage 3: Graphic presentation. Presenting the findings in the form of graphs or tables. Stage 4: data processing and analysis. Conducting statistical analysis. Stage 5: interpretation of the findings. Explaining the meaning of data individually. Stage 6: six- Conclusion. Proposing direct answers to the research question (Saratakos, 2005, p.364). A t-test is an interval/ration test of significance which has the purpose of ascertaining whether or not the findings of a sample-based study are significant, that is also valid for the target population. It checks the degree if generalisability of the findings of the study. the t-test serves the same purpose as chi-square tests, except that it is suitable for interval/ration variables (Saratakos, 2005, p.388) Analysis in this research will follow the intent to treat principle. SPSS computer software (version 15) will be used for data analysis. Differences between groups in demographic and other variables will be determined by using descriptive statistics, t-tests for interval level data, and à Ã¢â‚¬ ¡2 analysis (Fishers exact test) for nominal data e.g. 1.baby gender, 2.birth weight, 3.gestational age, 4.maternal age, 5.education, 6.marital status, 7.race, 8.smoking history, 9.breastfeeding intention and 10.maternal employment (no, part-time, or full-time employment). 4. Probable outputs If the result shows that skin-to-skin contact for full-term newborn babies during the first two hours postbirth has significant effect on first breastfeeding experience and also enhance the exclusive breastfeeding rate in six months postbirth. The result will not only provide support in the Ten Steps to Successful Breastfeeding principle , especially in Step four recommends skin-to-skin contact in the early postnatal period, which should last until the first feed or for as long as the mother wishes but also increase its credibility in enhance breastfeeding establishment. Early skin-to-skin contact can have a positive impact on newborn infants health by establish first breastfeeding well but also increase the mothers satisfaction as well as the bonding and interaction between mothers and newborn babies. The skin-to-skin used to exercise as an intervention for premature babies, with the result, we can apply to generalisation. The intervention can not only use for premature babies but also works in healthy, full term babies. When apply the result into clinical practice, the newborn infant routine care in delivery will changed significantly. Firstly, in many healthcare setting, when delivery comes, the first priority is to dry the baby and keep the airway open and do a range of physical assessment and newborn routine care. Due the complicated tasks, mothers and newborn infants usually have to separate more than one hour which miss the most precious time for bonding between mothers and newborn infants. To implement the intervention, the old practice has to be changed. For clinical practitioners might need some time cope due to the various tasks and duties. If the skin-to-skin contact intervention performs well in clinical practice, maybe researchers can put more effort in this area. For example, let the father or significant other practice the skin-to-skin contact with newborn infants and examine the effect might be operate as good as mothers. 5. Scheduling of the study Month Task Jan Feb Ma r Ap r May Jun Ju l Aug Sep Oc t Nov Dec LITERATURE REVIEW: Identify data sources, archives and specialist library collections.Identify potential case studies.Review theory and methodology, policy and clinical practice. Develop research question Complete research proposal Develop research methodology Sampling and recruitment Data Collection Results, Data analysis and evaluation Research project completed 6. Detailed justification of costs Description Item  ¿Ã‚ ¡/ per year comment Personnel 1. research assistant 2. clinical coordinator  ¿Ã‚ ¡9/ per hour 9*2*20*20  ¿Ã‚ ¡7200~8000 20hours/per person/week About 20 weeks Hard/software computer*1, laptop*1 camera*1, MP3 recorder  ¿Ã‚ ¡890~990 Ccomputer- ¿Ã‚ ¡400 Laptop- ¿Ã‚ ¡350 -camera- ¿Ã‚ ¡100 -MP3 recorder- ¿Ã‚ ¡40 Administrative Expenses  ¿Ã‚ ¡200~ ¿Ã‚ ¡250 Travel, communication, Attend conference, seminar, meeting  ¿Ã‚ ¡500~1000 Accommodation Consumables Stationery  ¿Ã‚ ¡100~ ¿Ã‚ ¡150 Fees and Service Charges  ¿Ã‚ ¡100~ ¿Ã‚ ¡150 Budget  ¿Ã‚ ¡11000  ¿Ã‚ ¡8990~ ¿Ã‚ ¡10540 7. Ethical issues There are some ethical issues we may meet when we do the research. Firstly, start with informed consent, in a research, participants should be fully informed as much information as possible that the participants can decide whether they want to join or not. Therefore , before we establish the research, all the participants will received oral and written information about the nature and purpose of the research study and its potential implications for them. After participants fully understood, inform consent will be obtained before we start the research. And participants also accept that they can stop or withdraw the research at any time they want. Secondly, the issue of the invasion of privacy, in the research project, Confidentiality and anonymous will be guaranteed. Any identification, documents will be separate from the tape recording and transcription. Data also will be stored in a locked and secure container, only the researcher can assess the key. Last but not least, before any act, we have to obtain the approval from Research Ethics Committee. By doing so, everyones right is protected. 8. Reflection on your study Early skin-to-skin contact may not effect on first breastfeeding experience and breastfeeding duration, the reasons are vary. There are many factors influence breastfeeding negatively. For example, for working mother, maybe they experienced a very wonder first breastfeeding while having skin-to-skin contact with her baby when they in the hospital with healthcare providers support and breastfeeding education. However, when the mother and her newborn infant go home, a range of unexpected things happened to them, without healthcare providers help, short maternity leave and stressful work, all these reasons are affecting the decision of breastfeeding establishment and duration. Furthermore, if the intervention of skin-to-skin contact will implement in clinical practice, it will change the long established routine and roles which is difficult when face experience clinical practitioner whom dont like to change. The following questions are from the Critical Appraisal Skill Programme (CASP, 2003). These 10 questions can help us think about these issues systematically. 1. Did the study ask a clearly-focused question? In this research, the population, intervention and outcome are clearly stated. 2 .Was this a randomised controlled trial (RCT) and was it appropriately so? In this research, I want to examine the effect of skin-to-skin contact for full-term newborn babies during the first two hours postbirth on first breastfeeding. To evaluate the effectiveness of skin-to-skin contact, I have to chose randomised controlled trial to test. In Glaszious paper (2001), he stated that to study the effects of interventions, it is necessary to compare a group of patients who have received the intervention (study group) with a comparable group who have not received the intervention (control group). A randomized controlled trial, which is a trial in which subjects are randomly allocated to the study or control groups, is usually the ideal design. 3. Were participants appropriately allocated to intervention and control groups? In the study, I will use computerized minimization to allocate participants, so I assume the participants will be allocated appropriately. 4. Were participants, staff and study personnel blind to participants study group? In this study, participants, staff and study personnel, they wont blind to participants study group, which could make observer bias and possibly a weakness in this study. 5. Were all of the participants who entered the trial accounted for at its conclusion? In the study, I assume all the participants who entered the trial accounted for at its conclusion for avoiding attrition bias. 6. Were the participants in all groups followed up and data collected in the same way? In the study, we have one research assistant dose the post-delivery care observation and assessment of first breastfeeding in the delivery room. And the other clinical co-ordinator responsible for documentation, so I presume the data will collected in the same way. 7. Did the study have enough participants to minimize the play of chance? According to previous studies effect size, in this study, we only recruit 15 participants 8. How are the results presented and what is the main result? 9 .How precise are these results? 10. Were all important outcomes considered so the results can be applied? for question 8-10, it can not answered for the study is not carry out yet.