1. The Concept and Process of Marketing
Marketing is explained as a combination of behavioural and management sciences, augmented with instinct, imagination, inspiration and innovation. Marketing needs a systematic approach to develop new products and identify new channels.
1.3. Elements of the Marketing Process
Marketing process aims to increase company’s top line. Marketers formulate marketing strategies based on insights gathered through marketing research. Key elements of the marketing process are described below.
Needs and Wants: Needs are the basic human requirements (such as food, shelter and clothing). Wants aren’t required for humans to survive. It is something which consumers wish for.
Products: Product is the core of marketing mix. It is essential to have a clear understanding of the product to decide its placement, promotion and pricing strategy. Packaging, warranty and after sales support are also essential for the marketing of product.
Value and Satisfaction: Customers evaluate the product on the basis of benefits delivered and cost paid in comparison to the other options. Customer satisfaction is defined as products ability to meet customers’ needs and expectations effectively, and deliver value.
Exchange Utility and Transaction: Want, need and value of a product do not ensure successful marketing. The goal of a marketing transaction is to get a product that is more desirable than the one given up.
Markets: It is essential to have a free flow of products/services from seller to buyer, for a market to run successfully. There should be an effective communication between all parties involved in the transaction. The seller should provide all important information to the buyer.
1.4. Benefits and Costs of Marketing Orientation
Key components of market orientation are customer orientation, competitor orientation and inter-functional co-ordination. It also focuses on long-term strategy and profitability.
Marketing orientation is also defined as gathering marketing intelligence on the current and future needs of customers. It also covers dissemination of insight across various departments and the firm’s responsiveness to the same.
Firms that are market oriented experience the following benefits:
Improves sales
Increases market share
Higher success rate of new products
It is often believed that the cost of a market oriented company is high as compared to a traditional environment. This is true but benefits achieved from being marketing oriented are more than the cost incurred.
The costs involved in market orientation are:
Conducting market research either through an in-house research team or through research agencies and consultancies
Designing the segmentation, targeting and positioning strategy
Developing a customised product as per the customer requirements
Undertaking promotional activities (e.g. advertisements)
Developing a distribution network
Researchers have assessed market oriented companies on parameters such as return on equity, profitability and market share. The findings revealed that such companies experience higher growth, are more proactive in terms of planning and work in close coordination with most various departments (e.g. finance).
On the other hand, companies that are not market oriented, have lower operating expenses and hence their profits are higher.

1. In the EMS Communication Centre, I have learnt that it is important to obtain the following information from the caller; the name and the contact number of the caller, the location of the incident, this include; the street name, house, building or office number, the suburb and the landmark of the location. The nature of the incident must also be obtained from the caller, the description of the incident; the caller should be interrogated according to the Medical Priority Dispatch System (MPDS) protocol. And lastly the call taker should allocate priority to the incident of the caller. This information is important for the dispatchers and for the emergency responders as well, the dispatchers use the information gathered by the caller takers to dispatch the emergency responders, but the information is mostly important to the responders because they are the ones who uses the information; they use the address of the caller to locate the patient that they need to attend, they can use the callers contact number to call them back when they get lost on the way to the patient. The nature and the description of the incident is also important because it prepares the responders on what they should expect when they get to the patient and to bring enough equipment to serve the needs of the patient.

2. The EMS service uniform policy, according to the Standard Operations Procedures 2012 of the Emergency Medical Services; their uniform must be worn by all ranks, their uniform display a visibility of competence, accountability, integrity and responsiveness. The operational personnel uniform that is being issued by the employer include; a long medical green cotton shirt or a short-sleeved shirt, it must have two breast pockets and epaulettes. Medial green utility pants and they should not be faded. Black leather ankle boots with rubber sole. All weather jacket, the jacket should be lime green with medical shouldersand lower sleeves, it must have a reflective tape of at least 50mm wide around the chest, upper arm and on the waist, the back of the jacket should have a reflective label of the words ‘Medical’, and the material of the jacket must be breathable, water resistant and non-fading. A black leather belt, navy blue woolen socks. Long sleeved jersey or waist jacket style in medical green with shoulder epaulettes. Reflective vest that is prescribed as reflective utility jacket. A white helmet is required for all clinical ranks that have the qualification as appropriate on both sides of the helmet in letters of 50mm of height. The Doctors should wear a medical green helmet. The peak cap and the beanie must medical green in color and must have the Metro EMS badge on the front of the peak cap and the beanie, and the badge should be clearly visible. The South African flag should be worn on the left sleeve of every shirt and the dimension should be 70mm x 50mm. The name tag or the label must have one initial and the surname of the individual and should be worn above the left breast pocket on every shirt, jersey or jacket, this should be issued once the design has been confirmed. The reason for a name tag is that the patient has the right to be treated by a named health care practitioner. The letters on the name tag should be a minimum of 15mm high and 10mm wide and the letters should be white in color on a navy-blue background. Qualification tag or label should be worn above the right breast pocket as ALS, ILS, BLS and Medical Rescue Technician, the letters should also be white on a navy-blue background. The name and the qualification should be displayed on the right breast of the jackets. Service insignia; the qualification badge or patches should be worn on the upper right sleeve. Jewelry; for safety reasons, jewelry is restricted to a watch and wedding bands, Medic Alert bracelets are permitted, earing studs may be worn in the ears only and by females only. Hair; both for males and females, hair must be neat, for safety reasons; long hair must be tied up, for males; beards must be close shaven.

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3. Nursing Assistant: they do personal hygiene care for, assisting patients use the toilet and dress, move around patients to avoid bed sores, assisting with changeover from bed to wheelchair, communicating information to nurses, examining vital signs and serving meals and helping patients eat.

Registered Nurse: they are medical professionals who have received advanced education and training in the field of nursing and have passed a nursing exam to become licensed. They take detailed patient medical history, administer medication orally, by syringe or through an IV, starting intravenous drips (IVs), charting changes in patient’s medical condition, consulting with and making recommendations to the primary physician, operating specialized medical equipment such as monitors, provide other medical care to patient as deemed necessary and educating patient and family members about management of medical condition after patient returns home.

Nurse Practitioner: they are responsible for making medical diagnoses of illness, providing childhood vaccinations, conducting healthcare physicals, performing certain surgical procedures, developing treatment plan for illness, ordering lab work such as x-rays and blood work and prescribing certain medications.
Certified Nurse-Midwife: they perform physical exams and prescribing medication, ordering lab tests, giving prenatal care, assisting mothers during labor and delivery of births that are low risk and providing education and medical care after birth as necessary.

Doctor of Nursing Practice: they are doctoral degree designed to prepare nursing professionals to perform more responsibilities within their job, making diagnoses in certain circumstances and setting up a course of treatment for patients.

4. A Registrar works in a hospital or medical clinic and spends his or her days registering patients. The forms must be explained, taking payment for appointments, and collecting demographic and health history information.
A Medical officer is a doctor in charge of the health services of a civilian or military authority or other organization.
An intern is a student or trainee who works, sometimes without pay, to gain work experience or satisfy requirements for a qualification.
A specialist is a person who concentrates primarily on a subject or activity; a person highly skilled in a specific and restricted field.

5. The Maroon epaulette and Council badge worn by a Registered General Nurse. The navy-blue epaulette and Council badge worn by a Registered Psychiatric Nurse. The dark Saxe blue epaulette and Council badge worn by a Registered Mental Nurse. The light Saxe blue epaulette and Council badge worn by a Registered Nurse for Mental Defectives. The yellow epaulette and Council badge are worn by a Registered Fever Nurse. The mauve epaulette and Council badge worn by a Registered Sick Children’s Nurse. The green epaulette and Council badge worn by a Registered Midwife or Accoucheur. Registered nurse, midwife or accoucheur may be registered in more than one category. In such h cases, he /she must wear the specific color epaulettes prescribed in the regulations for such persons. One or more of the following colored bars must be attached to the prescribed epaulettes: the navy-blue bar worn if the person is also a Registered Psychiatric Nurse. The dark Saxe blue bar worn if the person is also a Registered Mental Nurse. The light Saxe blue bar worn if the person is also a Registered Nurse for Mental Defectives. The green bar worn if the person is also a Registered Midwife / Accoucheur. The white bar worn if the person is a Tutor (holds a qualification in Nursing Education). The silver bar worn if the person holds a qualification in Nursing Administration. The yellow bar worn if the person holds a qualification in Public Health Nursing (Community Nursing Science). The Fever and Sick Children’s Nurses have no prescribed bars. The examples of the unique devices that are worn by a Registered Nurse (General, Psychiatric and Community) and Registered Midwife: Registered General Nurse wear maroon epaulette and Council Badge, Registered Psychiatric Nurse wear Navy blue bar, Registered Midwife wear Green bar, Qualification in Community Nursing Science wear Yellow bar. The Distinguishing Devices for Enrolled Nurses and Enrolled Midwives: The white epaulette and maroon badge worn by an Enrolled Nurse. The white epaulette and green badge worn by an Enrolled Midwife. The white epaulette and half maroon / half green badge worn by a person who is both an Enrolled Nurse and an Enrolled Midwife. The brooch worn by an Enrolled Nursing Auxiliary.

6. Level 1 – District hospitals there are limited specialist services. District hospitals are categorized into small, medium and large district hospitals with the following number of beds: small district hospitals with no less than 50 beds and no more than 150 beds; medium size district hospitals with more than 150 beds and no more than 300 beds; and large district hospitals with no less than 300 beds and no more than 600 beds.

District hospital must help a defined population in a health district and support primary health care; deliver a district hospital package of care on a 24-hour basis; have general practitioners and clinical nurse practitioner’s primary health services; provide services that include in-patient, ambulatory health services as well as emergency health services; and where practical, provide training for health care service providers. District hospital receives outreach and support from general specialists based at regional hospitals. District hospital only provide the following specialist services; pediatric health services; obstetrics and gynecology; internal medicine; general surgery; family physician. Eerste River District Hospital is an example.

Level 2 – regional hospitals which have at least two specialist services. A regional hospital must, on a 24-hour basis, provide health services in the fields of internal medicine, pediatrics, obstetrics and gynecology, and general surgery. health services in at least one of the following specialties: orthopedic surgery; psychiatry; anesthetic; diagnostic radiology; trauma and emergency services; short term ventilation in a critical care unit; services to a definite regional drainage population, limited to provincial boundaries and receives referrals from several district hospitals; and where practical, provide training for health care service providers. The regional hospital receives outreach and support from tertiary hospitals. A regional hospital has between 200 and 800 beds. Khayelitsha District Hospital is an example.

Level 3 – academic hospitals which have most specialist services. A tertiary or academic hospital provides specialist level services provided by regional hospitals; provides intensive care services under the supervision of a specialist or specialist intensivist; may provide training for health care service providers; receives referrals from regional hospitals not limited to provincial boundaries; and has between 400 and 800 beds namely Groote Schuur, Red Cross and Tygerberg hospitals.

7. Hemorrhage: antepartum, intrapartum or postpartum
Prolonged/obstructed labor
Postpartum sepsis
Complications of abortion
Pre-eclampsia/eclampsia
Ectopic pregnancy
Ruptured uterus
placental abruption

8. In the EMS service the procedure that needs to be followed when an individual sustains a needle prick injury is as follows; the injured individual is encouraged to squeeze the injured site manually until it bleeds, the injured area must be washed with normal saline, soap or spirits. The injured individual must inform the communication Centre officer immediately. The operational shift manager must immediately bring the post exposure prophylaxis to the scene, the post prophylaxis must be taken within one to two hours of the incident. The individual must report the incident at the hospital and obtain medicines and treatment from the medical staff that is on duty. In cases of rural ambulances whereby the officer may not be able to reach the staff member on time, the PEP check should be carried with on the ambulance. The PEP pack must be stored in a container that protects it from heat.

If the patient is conscious, he/she must be informed of the incident and ask the patients status with respect. The blood sample of the source patient must be taken, but consent must be given by the patient. Blood specimen should be taken by the competent individual and be collected in appropriate receptacle. In the case of a medical case whereby a needle stick injury has occurred, the paramedic or officer on scene must be informed. Permission should be requested from the family members for the blood specimens to be taken. When the individual is unsure of the needle prick, the medical officer should be contacted for advice or transport the patient continuing CPR.

In the case of CPR whereby a needlestick injury has occurred, consent must be obtained from the family for blood specimen. If a family member is not available, then the health care provider should contact the OHS manager or the medic on call. The pathologist that is conducting the post mortem must be reachable to contact the family member to ask for consent to obtain blood specimen. The exposed individual must complete the exposure and WCL 2 forms. For the Metropole, the blood specimen of the source patient and the forms must be taken to GSH staff support clinic or TBH hospital staff clinic during office hours, after hours the individual must report to the GSH or TBH trauma units.
For rural, the blood of the source patient must be taken to the government hospital in the district.
The exposure forms are to be completed and given to the officer after the shift and sent to the Occupational Health and Safety Coordinator. The staff member injured must go for a follow up in 3 months, 6 months and 9 months.

1. Describe Costco’s business model? 20 points
Costco’s business model- to retain prices low, which will then increase sales measurements to lower lost profits via marketing membership. Customer must pay a membership subscription fee in order to gain entry to their low-cost goods accessible only in Costco retail, limited offers preserve Costco customers. Costco’s value proposition outweighs its competitor via providing exceptional customer service, offer excellent products and offering many services in or around its centers to attract customers. These services include food court, one-hour photo centers, pharmacies, print/copy centers, gas station at a low rate etc.

2. What is Costco’s strategy? 5 points
Costco’s strategy- offering low-cost to its customers. It contains sustaining the lowest rate possible, is identified as Cost leadership strategy. Costco’s strategy correspondingly needs membership fee to create a low-cost performance in their stance. The use of this strategy is primarily to gain an advantage over competitors; keeping operating costs and overhead low, supplying goods that sell quickly, and charging at a low price that kept customers loyalty. Generic strategy of cost leadership is essential to strengthen Costco’s business model. (Costco Case)

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3. What are the chief elements of Costco’s strategy? 10 points
The chief elements of Costco’s strategy were ultralow prices, a limited selection of nationally branded and private-label products, a “treasure hunt” shopping environment, strong emphasis on low operating costs, and ongoing expansion of its geographic network of store locations. (Costco Case)

4. Does Costco have a winning strategy? Why or why not? 20 points
Yes, Costco have a winning strategy. Costco’s attracts it’s consumer by keeping the price low and selling goods in bulk. The idea is to keep generating large sales volumes. Keeping operating costs extremely low was a chief element of Costco’s strategy, which is an important key to its modest pricing. Due to Costco’s low pricing, they have a high turnover of products. Sales at Costco’s existing warehouses grew by an average of 10 percent chiefly because members shopped Costco warehouses an average of 4 percent more often and spent about 5 percent more per visit. (Costco Case)

5. How well is Craig Jelinek performing as Sinegal’s successor? 15 points
Refer to Figure 2.1 in Chapter 2 in developing your answers.
In reference to Figure 2.1 in chapter 2, Craig Jelinek performance has reflected the basic vision, core values and mission of Jim Sinegal’s. Jim Sinegal is a successful CEO, who plays a dynamic role in company’s strategic management. Jelinek basically follows the same guide line Sinegals imposes. Jelinek continued Sinegal’s vision and implementing a strategy if needed, making sure that operation production and sales growth continues to be consistent.

1. Introduction
Chronic myeloid leukaemia (CML) is a hematopoietic stem cell disorder characterized by the reciprocal translocation between the long arms of chromosomes 9 and 22 1. Fusion of the breakpoint cluster region (BCR) on chromosome 22 with the Ableson murine leukemia(ABL) tyrosine of chromosome 9 results in a fusion gene called BCR-ABL. This gene is a tyrosine kinase signaling protein that is always on, causing the cell to divide uncontrollably 5. The K562 cell line was derived from a 53-yr-old female suffering from Chronic myeloid leukaemia at the terminal stage of blast crisis 2. Apoptosis is a process that occurs changes in cell include blebbing, cell rounding and shrinkage, nuclear fragmentation, chromatin condensation, shedding of small cellular fragments 3-4.
Thiosemicarbazones (R1R2C2=N3-N2(H)-C1(=S)N1R3R4)6 have been reported that they have many of bioactivities such as antibacterial, antifungal, antitumor, antiviral. Previous studies have been shown that the properties of this family are related to metal ion coordination and their metal complexes have more active than the free ligand.7 Brockman et al were reported the effect of antitumoral of pyridine-2-carboxaldehyde thiosemicarbazone on L1210 leukemia8 but was found this compound can be toxic7. The side effects of these compound can be decreased by comlex with metal7. Hosseini-Yazdi et al synthesized and characterization of methylthiosemicarbazone complex with Zn (II). They showed that this compound has cytotoxic effect on the KG1-a and K562 cell lines9.
In this study, we investigated the growth inhibitory and cytotoxicity effects of methylthiosemicarbazone complex with Zn2+ on human chronic myelogenous leukemia K562. Our results showed that methylthiosemicarbazone complex with Zn2+ inhibits the growth of K562 cells via the induction of apoptosis. Our data indicate that methylthiosemicarbazone complex with Zn2+ has potential role as a therapeutic factor to induction of apoptosis and can be considered for its further development as an antileukemia drug.

2. Materials and methods
2.1 Reagents
Methylthiosemicarbazone complex with Zn2+ was obtained from ……. RPMI-1640 medium and penicillin / streptomycin were purchased from Gibbon (Life Technologies, Paisley, Scotland). The culture plates were purchased from SPL (South Korea). Acridine orange / ethidium bromide (AO/EtBr) and proteinase K were obtained from Sigma Chemical Company (Germany). Annexin V FITC Apoptosis kit were bought from Roche (Mannheim, Germany). Cell Extraction was obtained from Invitrogen (life technologies, USA). Proteinase K, propidiumiodide(PI), dimethyl sulfoxide (DMSO),3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazoliumbromide (MTT) were purchased from Sigma-Aldrich (St. Louis, MO, USA). The K562 cell line was bought from Pasterur Institute (Tehran, Iran).
2.2 Cell culture conditions
Human chronic myelogenous leukaemia K562 cells were cultured in RPMI -1640 medium supplemented with 10% fetal bovine serum, 100 µg/Ml streptomycin and 100 µg/mL penicillin and then incubated at 37ºC in a humidified 5% CO2 containing incubate 15.
2.3 Preparation of stock drug
In brief,

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2.4 Determination of cytotoxic activity
Cytotoxicity of this compound was measured using the 3-(4,5-dimethy-2-thiazoyl)-2,5-diphenyltetrazolium bromide (MTT) assay.The K562 cells (5×104 cells/mL) were cultured in 96-well plates and then exposure to various concentration of metylthiosemicarbazon complex with Zn2+. For IC50 values determination, dimethyl sulfoxide (DMSO) was added to each well and then incubated 4 hours at 37ºc. Cell viability was calculated by measuring the absorbance at 570nm by a multi-well plate reader (Quant Bio-tektruments, USA).
2.5 DNA laddering assay
DNA fragmentation is a feature of apoptosis so that the K562 cells were treated with 100µM (at IC50 value) of metylthiosemicarbazon complex with Zn2+ . After 72h, the cells were collected and washed with phosphate buffered saline (PBS).
2.6 Morphological changes of the apoptotic cells
The K562 cells were treated first with 100µM ( at IC50 value) of the anticancer drug to induce apoptosis for 24-72h. The cells were collected by centrifugation and washed with cold PBS. Subsequently, the cells were incubated with the fluorescent dyes, 100µg/mL of acridine orange and 100µg/mL of ethidium bromide (AO/EtBr). 5µL of cell suspension was placed on a slide and then was analyzed by fluorescence microscopy (Olympus BX 41, Germany).
2.7 Cell cycle studies
Briefly, the K562 cells were cultured in 96-well plates for various time (24-72h). The cells (1×104 cells/well) were treated with IC50 value of metylthiosemicarbazon complex with Zn2+. The cells were harvested and washed twice with cold PBS and then fix cells by adding 70% (V/V) cold ethanol and stored at -20ºC for several weeks until analysis. Afterwards, the control (untreaded) and treated cells incubated with 50 µg/mL propidium iodide (PI) containing 20µg/mL RNase A in the darkroom at 37ºC for 2 h. The stained cells were analyzed by flow cytometry (BD FACSCalibur TM, BD Biosciences, CA, USA).
2.8 cell apoptosis analysis
The K562 cells, seeded on a 96 well plate for 24, 48, 72 hours. The cells were untreated (control) and treated with metylthiosemicarbazon complex with Zn2+ at the indicated concentration (at IC50 value). The total cells harvested and then washed twice with PBS. The Cells were stained with Annexin-v-FITC and PI (eBioscience, CA, USA) for 15 min at room temperature in a dark area then analyzed by a flow cytometry (BD FACSCalibur TM, BD Biosciences, CA, USA).
2.9 statistical analysis
All data of experiments were reported as means ± S.D. Significant differences between the groups were expressed by the unpaired Student´s t-test. P- value less than 0.05 were considered as statistically significant.
3. Results
3.1 Cell viability
The MTT assay is based on the conversion of MTT into formazan crystals by living cells, that determines number of viable cells. The treatment of K562 cells with different concentrations of metylthiosemicarbazon complex with Zn2+ (30, 50, 80, 100, 130, 150 and 200µM) at 24, 48 and 72 h. As showen Fig, metylthiosemicarbazon complex with Zn2+ has cytotoxic activity on the K562 cell line and was able to inhibit the proliferation of the K562 cell line. The IC50 is a measure of the effectiveness of metylthiosemicarbazon complex with Zn2+ in inhibiting of proliferation of K562 cells. The IC50 value of this compound is 100µM in 72 h.

Figure 1: Effect of metylthiosemicarbazon complex with Zn2+ on K562 cells. The K562 cells were treated with various concentrations (30-150µM) of metylthiosemicarbazon complex with Zn2+ for 24, 48, 72 h and then were investigated by MTT assay. Data are shown as mean ± SD.

3.2 Morphological study of K562 cells
In order to evaluate the effects of metylthiosemicarbazon complex with Zn2+ on K562 cells, were studied by fluorescent microscope. The K562 cells were treated 100µM (IC50) of compound for 24, 48 and 72 h to induce apoptosis, then were stained with Acridine Orange/Ethidium Bromide (AO/EB). Metylthiosemicarbazon complex with Zn2+ induced apoptosis in K562 cells. AS shown Fig, the control cells are uniformly green because the plasma membrane of normal cells incorporated just AO. The apoptotic cells are bright green and orange that their nuclei are indicating condensed and DNA fragmentation. Fig shows The number of normal cells decreased and apoptotic cells increased in a time dependent.
3.3 DNA fragmentation assay
Apoptosis is associated with the fragmentation of chromosomal DNA into approximately 180 bp nucleosome fragments. In apoptosis, after activation of the 3 caspase, CAD in nuli actives and casused DNA fragmentation. In normal cells CAD anzyme is inhabited by ICAD enzyme but in apoptotic cells, ICAD enzyme Detection of fragmented DNA following extraction can be performed via a DNA fragmentation assay involving gel electrophoresis.This experiment showed apoptosis in the K562 treated cells. Fig.

3.4 analysis of cell cycle
For more investigated, the K562 cells were treated with 100µM concentration of compound metylthiosemicarbazon complex with Zn2+ for 24, 48, 72 h. The cell cycle distribution in the K562 cells were analyzed via flow cytometry. As displayed in Fig. The cell cycle has two major phases: interphase and the mitotic phase include G0 / G1, S, G2, M. During the cell cycle phases, DNA levels change, DNA dyes such as PI to generate characteristic cellular DNA content profiles. The results demonstrated that metylthiosemicarbazon complex with Zn2+ induced apoptosis in a time-dependent manner. The rate of sub-G1 was increased from 5.01 in the control cells to 3.62, 18.93 and 22.72.