Remuneration of Salesman Essay Example

Remuneration of Salesman Essay Remuneration of Your Sales Force and Customer Service Team Members How do you decide what remuneration packages to adopt? How do you ensure that your remuneration packages incentivise and motivate the right people? How do you make sure that the amount of pay helps your staff with their lifestyle requirements? These questions are vital ones to anybody trying to run a sales team or customer service team, when you have a look at how you can actually reward personal effort as well as maintain service. In looking at any remuneration package, it’s worthwhile to consider a set of scales. In any job description, there is an opportunity to analyse the work required into service aspects whereby these things have to be done to maintain the client, or maintain the client relationship, such as receiving orders, implementing orders, handling queries, general items of customer service, and also perhaps even merchandising or helping with displays, as well as ensuring that stock levels are adequate, these can be called service areas or service responsibilities. On the other hand, a sales person or customer service representative could influence the value of the sale through their personal sales skills, personality, and training, to either make the sale happen, add value to the sale, or sell some specific items that are on special or on bonus, at the point of communication, either by phone, by web, or face-to-face. This particular activity is known as personal contribution. A relatively easy formula to follow is by adopting the scales of remuneration, you can then analyse the input from the people involved. If there is high service requirements and service levels in the performance of the job, and little opportunity to add personal influence, then a wages or base salary system will be the most cost efficient to make the results work. We will write a custom essay sample on Remuneration of Salesman specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Remuneration of Salesman specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Remuneration of Salesman specifically for you FOR ONLY $16.38 $13.9/page Hire Writer If there is a high personal input, whereby the sales person can strongly influence the amount of the sale or the profitability of the sale, then you can reward that personal effort by special commissions, share of profits, special incentives, and special rewards, for the sales as they occur after the event, and lessen the base salary or wages that need to be paid by increasing the risk factor, which of course the personal touch will overcome. Strategies with this personal input can include: Commission on sales, which will drive the sales result but can lead to aggressive discounting. Commission on the profit generated, which will lead to profitable sales above a certain target percentage and encourage the sales people to focus on the profitable lines that need to be sold, profitable added value, and focus on profit. However, this means the company need to disclose in some manner the profit margins or the profitability of certain products or services. The final personal incentive can be a mixture of reward for the team getting their budget achievement through the use of both service and personal effort, but also perhaps 50% of that reward comes from the personal effort of individual members of Article Remuneration of Your Sales Force and Customer Service Team Page 1 the team. This then leads to greater enhanced teamwork in selling the profitable products and services that the company has. If your organization is primarily service based on our scale, then wages and salary with an annual review, perhaps a team result on a quarterly basis, will provide a good remuneration program to keep those service levels being maintained and perhaps even being increased. If your organization needs to be sales driven, then you clearly have to separate the strategies that you are going to employ to either drive sales, drive profitable sales, or drive teamwork amongst the individual members of the sales team. It is worthwhile considering that A category clients could be driven on their profitable sale contribution, B category clients could be driven on the extra added value products or services that have been added to the sales mix, and C category clients could be just driven by sales revenue increases. While it is useful to report results to the sales team members on a regular basis, eg. monthly or even weekly against target, it is preferable to pay out incentives on a quarterly basis so that the sum being paid is larger and also it is seen to be a worthwhile contribution of the efforts over the quarter, which may have had a good trading month, a bad trading month, and a catchup trading month, which over the whole quarter has managed to achieve in excess of the budget performance. Traditionally, New Zealand sales representatives and customer service teams are very comfortable with a 10 to 15% at risk commission factor driven to achieve sales results. When we want to achieve profitable results, you might care to lift the percentage to 20 to 25% at risk in remuneration which is based on the profitability. Full time commission only sales remuneration programs will simply drive sales at any price, perhaps with aggressive discounting with no regard or need to have regard to the profit contribution. New Zealand sales commission representatives can sometimes find it hard to get finance for mortgages and funding because the banks are not comfortable with commission only positions. The basis of a commission only position also needs to consider that the person needs to be able to earn enough to pay their mortgage and a basic food bill out of everyday, normal activities from their commission payments, and these may have to be paid on a weekly basis. However, as their sales increase then the commission structure should be set, so that they get truly rewarded for tremendous personal effort. Untidy conditions like including holiday pay within commissions, determining people to be contractors rather than employees, are things that cloud the issue and arouse suspicion with the optimist sales person as to what the owner or manager is trying do. The key concept with wages or salary based is that employees must know a set time of the year when their remuneration will be reviewed, and generally a percentage (3-5%) is applied across the board to all individuals, which maintains their points of difference but also ensure that there is little aggrieved talk amongst staff members. Additional rewards, which can include trips away, are ideal as bonus incentives for achieving in excess of a budget. New Zealanders love overseas travel, whether it is to Waiheke Island or to Nelson or Australia or the Pacific Islands, it is certainly a reward. However, remember that quite often there is a partner involved, and the partner would need to know where they are going and whether they would like to go to this particular destination. Article Remuneration of Your Sales Force and Customer Service Team Page 2 Other incentives, like dinners, theatre nights, sports tickets, movie tickets, and entertainment functions, are all very good as they have a perceived higher value than generally their costs, and people can go and enjoy the actual activity as a reward earned for hard work. Even the humble â€Å"Daily Moro Bar† given to the customer service team for the best win of the day is a great incentive for sharing with people the fun involved enjoying some wins and successes. It is very important to communicate to your sales team the basis and process of your remuneration program in writing at the beginning of their employment, and at the beginning of the trading cycle in which you are going to be measuring people, and then there is no avenue for dispute later on. The laws relating to commission payment are no different to the laws relating to wages and salary, and there can be no retention unless it has been agreed to by the employee for sundry items of cost. Of course, at a senior management level, sales management and above, you could include the original concepts of remuneration based around the sales team achieving a budget, you can include travel, and even share options or dividend options, based on performance. However, don’t fall into the trap of the Fortune 500 CEOs and management who were allowed to falsify records to ensure quarterly or 90-day results look good as a way of continuing to achieve their bonus options. Remuneration should always be based on the concept of rewarding individuals for their individual contribution over and above what was expected. Use the scales balance to determine the responsibilities and duties of the job description before deciding on your remuneration program. Enjoy your planning! This article contributed by Richard P. Gee, marketing strategy consultant, seminar presenter and interactive author. More information about Richard can be found on www. geewiz. co. nz. Article Remuneration of Your Sales Force and Customer Service Team Page 3

Mid term break by Seamus Heaney and The identification by Roger McGough Essay Example

Mid term break by Seamus Heaney and The identification by Roger McGough Essay Example Mid term break by Seamus Heaney and The identification by Roger McGough Paper Mid term break by Seamus Heaney and The identification by Roger McGough Paper Essay Topic: Poetry Seamus Heaney Poems In this assignment I will be comparing and contrasting two poems, mid term break by Seamus Heaney and the identification by Roger McGough. Seamus Heaneys poem is auto-biographical and he writes about himself experiencing the reality of death via his younger brother. He describes desctrbes his family suffering from greif and struggling to accept the truth. In the identification Roger to describe what seems to be a single Father identifying the body of a boy believed to be his son, Stephan who has been tragically killed by what is described as an explosion. I will be comparing the similarities and differences of these two gloomy poems by using three topics to organize the comparing. The topics are Subject matter, use of language and poetic technique. Firstly I will be comparing the similarities within both poems. The subject matter between both poems are that they portray family grief for example in mid-term break Seamus describes almost all his family members and neighbors showing signs of grief. His father is described a quite a tough man as it portrays him as always taking funerals in his stride. At this point Seamus is unaware of why he has been pulled out of school but we can gather from the previous quote that he has added all the facts together to realize he has come home for a funeral. His mother is also caught grieving when he describes her holding his hand whilst coughing out angry tearless sighs. This quote suggests two things, firstly it uses the adjective angry which suggests that the Mother may be blaming herself for the loss of her son but the reason for this we are not aware of. Secondly it suggests that in her emotional state she has drained herself emotionally and physically of tears to cry. The family grief in the identification is only portrayed by the father as he is the only person we hear of as it is written in first person, however we are aware his talking to whom is believed to be a pathologist because he asks a series of questions which appear to be answered. I believe that his type of grief is the worst as he has no one to grieve with and is suffering quietly and alone which I believe that in time will take could possibly lead to a decline in the mans health. During the poem the father shows a type of grief through his disbelief that the boy is his son. This is shown by all the questions he asks and which he describes and removing all trace of doubt. In both poems struggling to accept the truth is a big factor as both Seamus (mid-term break) and Stephens Father (the identification) both portray struggling to accept the truth over the death of their loved one. Seamus shows this when he enters his brothers room for the first time after arriving home. The scene is described almost heavenly with snowdrops and candles soothing his brothers bedside. A snow drop is a type of flower which blooms in spring and represents the passing of sorrow which explains why this specific flower is used on this occasion. Seamus describes his brother as almost asleep or ill as his face has become paler and this shows us that Seamus wants to believe that his brother is only asleep and will awake at any moment however this is not going to happen. This is him struggling to accept the truth. He also cannot accept the fact that his brother will never live to celebrate another birthday when he write the very last line A four foot box, a foot for every year. This is a very dramatic as he bluntly buts the facts together it also shows us a twist of fate that the box being the same length as the brothers age. In the identification Stephens father is struggling to accept the truth and this is shown when he asks so many questions and by doing this he is hoping to achieve pulling out every splinter of hope. This shows him hoping to find some evidence that this body is not his son and not wanting to believe the facts he has already been portrayed. The last of the similarities in subject matter is confusion. Seamus portrays confusion when he is brought home from school by his neighbors at an unusual time in the school term, he also not aware of the reason why he has been brought home until the last two stanzas of the poem. He also suffers from confusion when he over hears big Jim Evans saying it was a hard blow Im not certain but I am presuming a lot of questions flooded into his head when he over hears this for example What was a hard blow? In the identification Stephens father gets confused in the first stanza about the color of the boys hair which is black but his sons, Stephens, was fair. It becomes apparent after the father queries this fact it becomes apparent that the explosion that killed the boy would of synched the boys hair and caused it to turn black. He also becomes confused when cigarettes are put before him which were found within this boys pockets. This turns the fathers opinion against this boy being Stephen as he believes that he son would never disobey him. But however he continues to examine the exhibits which force him to believe that this body was the body of his son. The use of language between the two poems are also similar as the both have a non-rhyming structure and would both appeal to the same target audience which in this case would be ranging from mid-teens to adults and they would be able to cope with the high number of grief portrayed in these poems. Children under the age of 12-13 would not have the correct maturity level to read a poem like these and may become upset or overly concerned about the people within the poems. There are no similarities in the poetic techniques used in both poems. The poems also differ in the three topics, subject matter, use of language and poetic technique. In mid-term break Seamus Heaneys little brother we believe was killed in a Road Traffic Accident. We believe this because of what Big Jim Evans says in the second stanza it was a hard blow and the bumper knocked him clear. We know that Seamuss brother must have been killed by a motor vehicle as it suggests in the previous quote the bumper knocked him clear as a bumper is a legal necessity to any car, bus and taxi. In the identification we are led to believe that Stephen was killed in some type of explosion as we find out in the first stanza when he is asking the pathologist about the colour of the boys who is lying before him, hair colour as it does not match to his own sons but he is corrected as the explosion wouldve singed his hair black, the explosion. The way the mourners suffer in both poems also differs in both poems. In mid term break Seamus Heaney suffers alongside his family and neighbors until the last stanza when he finally discovers why he has returned home. This scene is dramatic as it is emotional upsetting as is described well so that the reader can picture themselves in his situation. In the identification Roger describes the father suffering alone as he has no other family member to consolidate with or mourn with. He his not completely on his own though as he has the pathologist with him but he however does not show any reassurance and only answers asked questions. The use of language within both poems also range as they both wrote there poems in a different narrative perspective. Mid-term break is written is first person narrative perspective (me, myself and I). This is used throughout the poem in order to create sympathy for Seamus. This narrative perspective is used to its full extent in the second line of the fifth stanza I saw him this short sentence really hits the reader as this is the first time Seamus actually sees his brother during the poem. This sentence also puts the reader in his position and prepares us for a description of what he is about to see. The identification was written is second person narrative so that you, the reader can see eye to eye with the father of Stephen. He does this so we can feel all the emotions Stephens father goes through. In the last line of the poem the readers becomes emotionally upset as we have already gained sympathy for the father therefore do not want him to go through this experience, like we wouldnt want ourselves to go through it so we hope that he does not suffer the loss in the end, but unfortunately he does Thats our Stephen

Whole Foods & Wild Oats Research Paper Example | Topics and Well Written Essays - 750 words

Whole Foods & Wild Oats - Research Paper Example Thus, it is clear that his comments had the motivation from his self-interest (Debra, 2010). Instrumental and terminal values are vital in the explanation of Mackey’s blog posting behavior, relative to the Wild Oats acquisition. There is a distinction between the two values as elaborated by Rokeach. Instrumental values reflect the means to achieving goals, meaning they represent the most acceptable behaviors to be used in achieving an end state. Terminal values, on the other hand, represent the goals to be achieved or the end states. First, it is remarkably clear that he lacks Honesty Ambition Responsibility where he is not truthful in his hard work to do his duties as CEO, whereby he posts the blogs using his wife’s name to conceal his identity. He has the value of forgiveness, open-mindedness, and courage whereby he has the courage to face the public eye. He does this with a clear perspective that they will forgive him for his mistakes. As see him, he does not deny putting up those posts. He has the value of Helpfulness Cleanliness Competence as his other go al. This is whereby he accepts he has been posting the negative blogs to criticize the Wild Oats Company. He is ready to be helped to free from being guilty of these critics. On the other hand, he has none of these instrumental values: Self-control Affection / Love Cheerfulness, Independence Politeness Intelligence, and Obedience Rationality Imagination. We see John lacking control of his hate of the Wild Oats Company establishing itself as his competitor. He also lacks knowledge of how to show courtesy to other people who may be in competition or poses some danger to his co-existence. He is not submissive to reasoning, according to the perception of most people in the public figure. In his comment that no one would buy products of Oats Company, he does not put himself in the shoes of those benefiting from this new company. In relation to the terminal

Political independence of FED Essay Example | Topics and Well Written Essays - 500 words

Political independence of FED - Essay Example This has been contributed by the fact that politicians like manipulating and controlling these institutions for their own gains. In his lectures, Bernanke (2012) argued that central bank should be allowed to make independent decisions without political interference in order to have sound decisions. Studies have documented that political interference in the financial sector not only hinder how these institutions operate, but also interfere with how regulators enforce regulations. Financial regulators are, therefore, unable to take actions on banks that do not follow the laid down rules and regulations. When political interference is evident in the financial regulatory bodies, recognition of severity of crisis is delayed, intervention needed is also slowed and consequently raise the cost of the crisis to tax payers. Shielding financial sector from political interference helps to improve the quality of regulation and supervision. This helps in preventing financial crisis. Financial regu lators have two main purposes. First, they are mandated to protect the consumer. Second, they are also mandated to maintaining financial stability of financial institutions. When political interferences come in, these two roles of the regulator are abandoned. For instance, in 1997, political interference in the regulatory bodies of East Asia led to postponement of recognition of severity of crisis, which led to increased crisis.

E-book Essay Example | Topics and Well Written Essays - 500 words

E-book - Essay Example The researchers employed survey type of data gathering. E-mail questionnaires were sent which facilitated the survey of researches in the academic and research environment, specifically in the Indian Institute of Science and Technology about their use of e-books on their line of work. This helped the researchers gather the pertinent information on the completion of the research. The survey was done on July 2004 and was drafted according to the objectives drawn by the researchers which gave birth to 27 questions. Of the 101 questionnaires that were completed, 85 (84.15 percent) were from students, 16 (15.84 percent) were from staff. Of the surveyed respondents, 37 were able to use the free trial offer between June and July 2004. This data represents 36.63 percent of the 101 respondents and 1.66 staff as a whole. Meanwhile, the results showed that 29.40 percent or 60 of the 101 had used e-books at least once. Simply put, the responses gathered from the data gathering procedure show that the students are more inclined in this kind of technology more than the faculty members and staff.

Creatinine Clearance Test to Estimate Renal Function

Creatinine Clearance Test to Estimate Renal Function Introduction: Kidney is a part of group of organs that constitute the urinary tract system which consists of two kidneys, two ureters, bladder and urethra. The kidneys do the major function of the urinary system. The other parts of the system are mainly passageways and storage areas. The kidneys are reddish, bean-shaped structure and located just above the waist between the peritoneum and the posterior wall of abdomen. A typical kidney in an adult is 10-12 cm long, 5-7 cm wide and 3 cm thick and has a mass of 135-150 g. Under normal circumstances the two kidneys are able to do the following functions: Regulating of blood PH; the kidneys excrete an amount of hydrogen ions (H+) and conserve bicarbonate (HCO3-). Regulating blood pressure; the kidneys produce rennin, which activate the rennin-angiotensin-aldosterone pathways. Maintaining blood osmolarity; by regulating loss of water and loss of solutes in the urine, the kidneys maintain constant blood osmolarity. Regulating blood glucose; the kidneys can use the amino acids glutamine in gluconegenesis. So they can release glucose into blood to help maintain a normal blood glucose level. Production of hormones; calctirriol (active form of vitamin D) which helps regulate calcium homeostasis and erythropoietin which stimulates the production of red blood cells. Excreting waste and foreign substances; by forming urine which contains the waste substances that have no useful functions in the body. The above mentioned kidney functions based on the functional unit of the kidney called nephron. Each kidney contains about 1 million nephrons. The nephron is a tube closed at one end and open at the other and in between it consists of Bowmans capsule, Glomerulus, Proximal convoluted tubule, Loop of Henle, Distal convoluted tubule and collecting tubule. About 170-200 liters of water are filtered through the kidneys everyday, but about 1-2 liters are excreted from the body as urine. To produce urine, nephrons and collecting ducts perform three basic processes: Glomerular filtration: water and most blood solutes in the blood plasma move across the wall of glomerular capillaries into the glomerular capsule and then into the renal tubule. Tubular reabsorption: as filtered fluid flows along the renal tubule and through the collecting duct, tubule cells reabsorb about 99% of filtered water and many solutes. Tubular secretion: as the fluid flows along the tubule and through the collecting duct, the tubule and duct cells secrete other materials, such as wastes, drugs and excess ions into the fluid. Each kidney connects to bladder by ureter, which is tube like structure that provides drainage from the kidney to the bladder during the process of urine formation. Bladder acts by means of contraction to expel urine from the body. In order for the kidney to work properly the renal arteries deliver about 25% of resting cardiac out put. Glomerular filtration (GF) normally occurs at rate of about 120-150 ml/min. There are significant forces which are involved in glomerular filtration, glomerular capillary blood pressure which induced a blood pressure within the glomerular capillary depending on the heart contraction and on the peripheral resistance provided by efferent arterioles. The other significant force is the plasma colloid osmatic pressure which occurs due to impermeability to protein through the glomerulus. The permeability depends on the molecular size and the electrical charges. The positively charged molecules easily filtered than the negatively charged one because the glomerular endothelium layer carry negative charges that repel the protein particles and not allowing them to be filtered. In Bowmans capsule hydrostatic pressure, there will be high force to push fluid out of Bowmans capsule into glomerulus. Any changes occur in these forces will lead to change in glomerular filtration rate (GFR). Glomerular filtration rate (GFR) is a measurement of the amount of glomerular filtrate (a substance similar to blood plasma but without proteins) formed in the kidneys each minute. It can be assessed by measuring the excretory ability and the substance level in plasma that freely filtered through the glomerulus. Some of the substances will not appear in the glomerular filtrate unless they have reached a certain concentration in blood. Glucose is such a substance that does not appear in the urine until it reaches high concentration in the blood (11.0 mmol/L). Whereas other substances like creatinine excreted without appreciable reabsorption. Creatinine is an endogenous substance, an end product of nitrogen metabolism formed through a series of enzymatic reaction in the liver. The contraction of skeletal muscle involves both creatine and ATP (adenosine triphosphate) in the presence of creatine kinase enzyme. The creatine formed from phosphocreatine gives the final end product creatinin e which is instantly filtered at glomerulus without any tubular reabsorption. Therefore creatinine can be used to estimate the clearance ability of kidney, but it is not a perfect marker as it is secreted. This involves the measurement of substance concentration in urine and plasma using the following clearance formula: (U/P) * (V/T) = mls/min Renal failure Diseases affecting the kidneys can damage glomerular or tubular function. Failure of renal function may occur rapidly producing the syndrome of acute renal failure which is characterized by rapid loss of renal function with retention of urea, creatinine, hydrogen ions and other metabolic products. However chronic renal failure develops often over many years leading to end-stage of renal failure where patients require either long term dialysis or a successful renal transplant to survive. Diabetes and hypertension are the two commonest causes of chronic renal failure with other causes including glomerulonephritis of any type Aim of the test To estimate renal function in two different patients using creatinine clearance test. Materials and method Please refer to medical biochemistry practical book (BMS2). Result: The equation obtained from the graph used for the calculation of creatinine concentration is: Y = 0.0008 X Where: Y = absorbance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  X = concentration of creatinine in umol/L. P 1: X = 0.073/0.0008 = 91.25 umol/L P 2: X = 0.346/0.0008 = 432 umol/L U 1: X = 0.621/0.0008 = 776.25 x 21 = 16301.25 umol/L U 2: X = 0.736/0.0008 = 468.75 x 21 = 9843.75 umol/L Key: P1 is plasma of patient 1. P2 is plasma of patient 2. U1 is urine sample of patient 1 U2 is urine sample of patient 2 Therefore the creatinine clearance is calculated by using the following formula: (U/P) * (V/T) mls/min U = urine creatinine umol/L P = plasma creatinine umol/L V = volume of urine passed in given time T = time of collection Creatinine clearance for patient 1: = 16301.25/91.25 * 1000/1440 = 211.438 * 0.694 = 124 mls/min Creatinine clearance for patient 2: = 9843.75/ 432 * 3000/1440 = 22.786 * 2.083 = 47.46 mls/min Conclusion: From the above results I conclude that patient 1 has got normal renal function whereas patient 2 has renal failure. Discussion The creatinine calibration graph shows good linearity which indicates that the patients results obtained are correct. The clearance test more often concern about how much of a specific substance the kidney can remove from a given volume of blood in a stated period. In this experiment the creatinine clearance test was used to estimate GFR in two different patients based on the principle of Jaffe reaction (picric acid with alkaline solution from red to orange complex). A standard curve was produced using the absorbance reading against the standard concentration. A straight linear relationship obtained which means that as the optical density increase the creatinine concentration will increase. The equation obtained from the graph (Y = 0.0008 X) is used to calculate the plasma and urine creatinine concentration of two patients. The plasma creatinine concentration for patient 1 is 91.25 umol/L, which means it is within the normal reference ranges (adult 60-120 umol/L).Marshal, (2000). Also the urine creatinine concentration (19293.75umol/L) for the same patient support the plasma concentration in which simply means that creatinine excretion by kidney was regularly. In contrast, patient 2 has got increased plasma creatinine concentration when compared with normal reference range which is 432 umol/L. That means the creatinine being not filtered regularly into urine. There is no history of patient is provided and it is not stated whether the patient is male or female which can aid the diagnosis. However, there is not much difference between male and female normal reference ranges (adult 60-120 umol/L). The clinical data are good in detecting the presence of renal disease, by its effect on renal function and is in assessing its progress but they will not assess the determination of the cause of the disease. Therefore several factors should be kept in mind when doing creatinine estimation. These factors are: there will be reduced creatinine concentration in children, women and during pregnancy. Meals which contain meat will raise plasma creatinine, also certain drugs (e.g. salicylates, cimetidine) increase plasma creatinine by inhibiting tubular secretion of creatinine. From the result, it is noticeable that patient 1 has got normal creatinine clearance (124 mls/min) when compared with the reference ranges. This means that this patient got normal GFR and normal renal functioning units. The creatinine clearance for patient 2 is very low (47.4 mls/min) when compared with the normal reference range and with patient 1 who has normal GFR. As mentioned earlier the plasma creatinine was high and the urine creatinine was low for this patient which gives strong suggestion that this patient represent with kidney disorder mostly chronic failure. Although the clinical finding help the diagnosis, but the requirement of further test is needed to identify the cause and to confirm disorder. Renal failure is divided into two types, acute renal failure and chronic renal failure. An acute onset is severe enough to cause kidney failure and is characterized by oliguria (less urine). The major cause of acute failure is tubular necrosis. Other common causes are loss of huge amount of blood during accident or surgery, toxic drugs and poising e.g. lead, or infection. Acute renal failure may develop gradually to a chronic renal failure. Chronic renal failure occurs when disease or disorder damages the kidneys so that they can no longer remove fluids and wastes from the body or maintain proper levels of kidney-regulated chemicals in the bloodstream. The four most common causes of chronic kidney failure are: Diabetes: Diabetes Mellitus (DM), both insulin dependent (IDDM) and non-insulin dependent (NIDDM), occurs when the body cannot produce and/or use insulin, the hormone which is necessary for the body to process glucose. Long-term diabetes may cause the glomeruli to gradually loss function. In fact, progression may be slow gradual which means the symptoms do not occur until the GFR falls below 15 ml/min. Marshal, (2000). High blood pressure: hypertension is both cause and result of kidney failure. The kidney can become stressed and ultimately sustain permanent damage from blood pushing through them at excessive pressure over long periods of time. Glomerulonephritis is an inflammation of glomeruli, or filtering units of the kidney. The filter in glomerulus is damaged; often small holes are made mostly due to streptococcal infection. Polycystic kidney disease: it is an inherited disorder that causes cysts to form in the kidneys. These cysts impair the regular functioning of the kidney. Less common causes of chronic kidney failure are kidney cancer, obstructions such as kidney stones, pyelonephtitis. Initially, symptoms of chronic kidney failure develop slowly. Even individuals with mild to moderate kidney failure may have few symptoms in spite of increased urea in their blood. Among sings and symptoms that may be present at this point are frequent urination during the night and high blood pressure. Most symptoms of chronic kidney failure are not apparent until kidney disease has progressed significantly. Common symptoms are: Anaemia: The kidneys are responsible for production of erythropoietin, a hormone that stimulates red cell production. If the kidney disease causes shrinking of the kidney, the red cell production is hampered. Bone and joint problems: The kidneys produce vitamin D, which help in absorption of calcium and keeps bones strong. In patients with kidney failure, bones may become brittle, and in children, normal growth may be stunted. Joint pain may also occur as a result of unchecked phosphate levels in the blood. Foamy or bloody urine: Protein in the urine may cause it to foam significantly. Blood in the urine may indicate bleeding from diseased or obstructed kidneys, bladder, or ureter. Hypertension or high blood pressure: The retention of fluids and sodium causes blood volume to increase, which in turn causes blood pressure to rise. Low back pain: Pain where the kidneys are located, in the small of the back below the ribs. Nausea, loss of appetite and vomiting: Urea in the gastric juices may cause upset stomach and this can lead to malnutrition and weight loss. Questions What protein would not be detected by dip sticks, and how would you detect it? Bence Jones proteins are low molecular weight proteins (light chains of immunoglobulin) and found in urine in patient with Myeloma. They are small enough to move quickly and easily through the kidney into urine. These proteins can be detected by doing protein electrophoresis of concentrated urine What is the clinical finding in the unusual condition orthostatic proteinuria? Orthostatic proteinuria is a benign condition that effect children and young adults. The patients are only exhibiting proteinuria after they have been standing up. Orthostatic proteinuria arises as a result of an increase in the hydrostatic pressure in the renal veins. Protein will not be detectable in an early morning sample when tested using dipstick. The patient is instructed to empty the bladder just before going to bed, and the test for protein is performed on a specimen of urine passed the following morning, immediately after getting up the condition is usually observed in only some of the urine samples passed when up and about (with good prognosis). The prognosis is less good in patients in whom proteinuria is always detected when they are up and about. What are the factors predisposing to renal stone formation? A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine and pain in the abdomen. The factors predisposing to renal stone formation are: Reduction of fluid intake Increased exercise with dehydration Medications that cause hyperuricemia (high uric acid) and excessive intake of calcium supplements Diet can also influence stone formation e.g. oxalate (ice tea and colas) Urinary tract infections Family history of urinary calculi Certain diseases :hyperparathyroidism (causes calcium loss from bone), renal tubular acidosis(causes a deficiency in urinary citrate, a stone inhibitor) Urinary stagnation

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Anne Frank also known as Annelies Marie Frank was a sixteen year old girl who got murdered during the Holocaust. She was born in the city of Frankfurt in Germany to her parents Otto and Edith Frank. Anne Frank had an older sister who was three years older than she was and her name was Margot Betti Frank. The Franks were known as a very liberal family who were also classified as a middle class family since their ancestors lived in Germany. In 1933 the Franks decided to move towards Amsterdam since Germany was being overruled by the Nazis. While the family had adjusted to Amsterdam, Otto Frank was really focused on his business since he was new into the city. Anne and Margot were also getting adjusted to the school system and when they were well adjusted they started to have friends who were Jewish and non Jewish. Six years later which was in 1939, Anne’s and Margot’s grandmother decided to join them in Amsterdam as well and be reunited with her two beautiful nieces. In M arch, 1940 a horrible trajedy happened Amsterdam which was that Amsterdam had been attacked by the Nazis who overrul...