Effect of PRF After Mandibular Third Molar Surgery

Effect of PRF After Mandibular Third Molar Surgery Post extraction wound healing and physiologic sequelae of third molar surgery can significantly affect the patient’s quality of life2. Various methods have been suggested to improve extraction socket healing and to minimize the postoperative sequelae after third molar surgery4,5. PRF is a second-generation platelet concentrate which is known to stimulate wound healing by releasing growth factors directly to the wound5,8,16,17. Recent studies demonstrated the PRF membrane has a very significant slow sustained release of key growth factors for at least 7 and up to 28 day13. Studies on PRF efficacy in enhancing wound healing have yielded differing results and also there is a divergence of opinion on the activity of PRF. Thus, there is the need for more studies to explore its use in oral and maxillofacial surgery. This study was therefore perceived to determine the effect, if any, that PRF has on postoperative sequelae and enhancement of bone healing after mandibular third molar s urgery. Patients and Methods The study sample consisted of 15 young adult volunteers 18 to 22 years old presenting with impacted mandibular third molars bilaterally and in similar positions. Patients using systemic drugs or presenting a medical history positive for any systemic pathology or a history of hypersensitivity to any component used in the methodology were not included. Each patient participated as a volunteer after signing an informed consent form on the study for extraction of impacted right and left mandibular third molars. Ethical clearance was obtained from the Ethics Committee prior to the commencement of the study. The following demographic information was collected: age, gender, occupation, marital status, and educational level. Furthermore, the position and type of impaction were recorded. The two operated sides in each patient were randomly divided into 2 study groups: extraction of an impacted mandibular third molar at first side whose socket was filled with blood clot and wound sutured (cont rol group), and extraction of an impacted mandibular third molar on the other side whose socket was filled with PRF gel and wound sutured (PRF group). A 10-point visual analog scale (VAS) with a score of 0 equals â€Å"no pain† and ten equals â€Å"very severe pain† was used to assess pain. Facial swelling was evaluated using a modification of the method described by Schultze-Mosgau et al9, and this entailed measuring the distances from the tragus to the oral commissure and tragus to the pogonion. The arithmetic sum of the two measurements was used to determine the facial swelling at the time point. The percentage facial swelling was calculated from the difference of the measurements made in the preoperative and postoperative periods divided by the value obtained in the preoperative period and multiplied by 100. (Swelling Postoperatively–Swelling Preoperatively) /Swelling Preoperatively X 100 Digital radiographs were used to evaluate changes in radiographic bone density for each extraction site. Three blinded dental professionals working independently evaluated all radiographs. RVG software was used for radiographic analysis. Radiographs were evaluated by three blinded dental professionals. The radiographs were assessed by obtaining the average density of three independent readings of the 3rd molar extraction socket sites. This was compared to the average of three density outlines of the adjacent tooth. When all radiographs for a patient were assessed, they were normalized to the original radiograph and the same untouched adjacent tooth. The baseline socket average was then subtracted from the normalized average for each tooth extraction socket at the different time points. The final, normalized socket value differences for each PRF-treated and non-PRF treated site for the various time points were compared. All radiographs were taken by a blinded, certified x-ray dental assistant. They were taken immediately post-operatively and at the following time after the day of surgery: 4th week, 8thweek and 12thweeks. Preparation of Platelet-Rich Fibrin PRF was prepared according to the technique described by Choukroun et al1. Twenty minutes before starting surgery, 10 mL of venous blood was collected in a sterilized dry, neutral glass tube without an anticoagulant. After immediate centrifugation at 3000 rpm for 10 minutes, the platelet-poor plasma, which accumulated at the top, was discarded. PRF was removed approximately 2 mm below its connection to the red corpuscle beneath to include remaining platelets, which have been proposed to localize below the junction between PRF and the red corpuscle After 10 minutes, the gel was formed, and autologous PRF was applied immediately in the socket in the PRF group. Surgical Procedure- To standardize the surgical operations, all patients were operated by the same surgeon. The mandibular third molars of which the extraction sockets would receive PRF treatment were selected randomly before surgery and these molars were operated on first. After tooth extraction, the surgical area in the PRF group was isolated with gauze and the socket was filled with PRF gel. In the control group, the socket was not filled with PRF. The flap was repositioned by an interrupted suture with 3-0 silk suture. The patients received oral and written postoperative guidance, and follow-up was scheduled according to the study periods. Because only the bilateral mandibular third molars similarly impacted were selected for the study, there was no significant difference in the time and surgical trauma associated with surgical extractions. Immediately after the procedure, details of each procedure were recorded, including the duration of surgery in minutes (from the first incision to insertion of the last suture), and any intraoperative complications. Patients were then recalled at 1, 3, 7, and 14-day postoperative intervals. During such visits, data were recorded for postoperative pain,facial swelling and any untoward complications like infection and alveolar osteitis. Sutures were removed 7 days after surgical operation. Patients were also recalled at the 4th, 8th, and 12th week postoperatively for radiographic bone healing assessment. Results The mean age of the sample population was 21.40(range 18 to 35 years). There was no statistically significant difference in the age, gender, and type of impaction between both groups. In both groups, the mean postoperative pain score (VAS) was highest at postoperative day 1 and gradually reduced over the following 14 days. The mean postoperative pain score (VAS) was higher for PRF group than control group at all-time points when compared with the control group and was not statistically significant (P The percentage facial swelling for the PRF group relative to baseline value was 2.55%, 2.22%, and 0.28% on postoperative days 1, 3, and 7 respectively, whereas it was 1.86%, 1.5%, and 0.29%, respectively, in the non- PRF(control) group for the same period. The percentage facial swelling was highest at postoperative day 1 and gradually reduced over the following days for both groups. The mean percentage swelling was also higher for the PRP group at all-time points when compared with the control. However this difference also was found to be not statistically significant. The mean bone density score was higher in the PRF group than the non-PRP group over a 12-week period; and the differences were found to be statistically significant. The results of the present study clearly show that the application of autologous PRF in surgical wounds after tooth extraction allows acceleration of bone healing, as indicated by data with statistical differences (p DISCUSSION This prospective study evaluated the performance of PRF gel when applied to fresh extraction sites. Third molar extractions are often used as a measurement tool for comparing treatments because they are usually performed electively on a younger population that do not present with significant medical problems (e.g., systemic pathologies, multiple medications). Therefore, this study is especially relevant for healthy 18 to 40 year old patients. This study evaluated the effect of PRF gel on postoperative pain, swelling and bone regeneration potential on third molar extraction sockets. The mean postoperative pain score (VAS) and swelling were higher for the PRF group at all-time points as compared with the control group, but the differences obtained were found to be statistically non-significant. This suggests that topical application of PRF may not improve the postoperative sequelae after third molar surgery. Choukroun et al5 in a case report found reduced pain and better mouth opening when topical PRF gel was used in molar extraction sockets ,in contrast to this we observed increased pain and swelling when topical PRF gel was used in 3rd molar extraction socket . Intra-oral digital radiographs taken of the individual surgical sites revealed that the effects of PRF were significantly beneficial (P 6,similarly reported that the PRF induced complete bone filling of a residual cystic cavity in 2 months 2 weeks, a much shorter period than 6 to 12 months of physiologic healing. Choukroun et al7 in a case series on maxillary sinus lifting operations, 3 cases were treated with PRF and freeze-dried bone allograft mixture and 6 cases with freeze-dried bone allograft alone. Histomorphometric results of this study showed that PRF and allograft mixture accelerated bone regeneration, allowing implant placement in 4 months after maxillary sinus lifting procedure. Furthermore, the amount of newly formed bone was equivalent to that achieved with an allograft alone 8 months after surgery. Diss et al10 reported promising results after placing PRF instead of bone graft under the sinus membrane during a closed-sinus lifting technique and demonstrated that an ave rage of 3.2 mm bone gain could be obtained in the sinus after 1-year follow-up. However the results of our study does not correspond with the study from Gà ¼rbà ¼zer et al17 who reported scintigraphically, that platelet-rich fibrin might not bring about promoted activity of osteoblasts in impacted mandibular third molar sockets in 1 or 4 week after extraction. Accelerated bone formation observed is in contrast to the drop in bone density seen at the control site before bone formation began to take place. It took approximately 6 weeks for the control sites to reach the same bone density that the PRF-treated site had reached by 4 weeks. The PRF-induced acceleration in bone formation may be due to the presence of bone morphogenetic proteins (BMPs) in PRF that stimulates mesenchymal stem cells to begin osteoblast differentiation and subsequent calcification12,14,18. The immediate start of bone formation seen with PRF treatment is of clinical relevance because it is the initial 2 weeks following bone manipulation in oral surgery that are important in preventing infection, loss of the blood clot and/or dry socket formation. Digital panoramic radiographs might have been a better choice than digital periapical radiographs, as the 2 surgical sites would be represented on 1 film, eliminating the need for normalization between the sites. The disadvantage of digital panoramic radiographs is that these films have a 20 to 25% distortion factor because it is an extra-oral film, as opposed to the intra-oral individual (periapical) radiographs.The digital periapical radiograph was chosen over the panoramic radiograph due to the lower distortion, which results from being in close proximity to the site being evaluated. The CT scans might have exhibited greater differences between the PRF treated sites and the control sites, had they been obtained. Similarly Digital substraction radiography and histomorphometry have provided more sensitive methods of assessing bone healing but are quite invasive and expensive especially in a resource limited environment. Conclusion The results of the present study suggest that topical application of autologous PRF gel has a beneficial effect on the osseous healing of extraction sockets after third molar surgery but may not minimize the postoperative sequelae after 3rd molar surgery as its use was found to be associated with increased postoperative pain and swelling . However, a larger sample size in a multicenter study may be necessary before its routine use in extraction socket can be justified

Customer Management: Nefab Company

Introduction Customer management has been an integral part of business processes since the early days of business, even before money was introduced. Development of products and services aimed at meeting the needs of the customer is what determines the effectiveness of the customer retention and loyalty strategies (Rao & Perry, 2002). This paper analyses the operational methods and strategies adopted by Nefab Packaging Company- UK in providing products and services and their effectiveness in terms of customer satisfaction Background informationThe main business area for Nefab Company is packaging. It is an international company with global coverage. Its headquarters is in Sweden, but it has numerous subsidiaries in Europe and America including the UK (Nefab Group, 2013) where I happen to be one of the employees. Most of its operations involve working closely with other businesses around the globe with the intent of providing them with the best quality packaging solution for their products. Nefab C ompany has close to 20 major customers around the world with numerous other small customers distributed all over Europe. The company handles its customers using two approaches; its large global customers are all handled by the central management of the organisation while the other small to medium sized customers are handled at the company’s local offices in the respective countries (Nefab Group, 2013). To enhance its competitiveness and sustainability as a global packaging company, it has recently introduced customer relationship management department (Nefab program Manager, 2012). This department operates under the human resource department and is responsible for development and implementation of systems aimed at ensuring the levels of customer satisfaction are high in the company. Some of the main functions of this department are (Nefab program Manager, 2012): Developing and focusing sight on the customers Pay attention to customer lifetime value Develop management support for a customer focussed strategies Developing effective value for data collected from the customer Developing an understanding of the levels of management involvement in customer management Developing flexible business processes to support a wide range of customer needs Advising the IT department on what to develop as an approach of enhancing customer satisfaction The current customer relationship management system operates based on Microsoft’s CRM system. It is currently implemented in most divisions of the company (Nefab program Manager, 2012). Currently, the company is working towards increasing the levels of integration of those services into the business function and ensuring that all the guidelines and strategies are used efficiently to realize maximum benefit from the new department in the organisation (Nefab Group, 2013). The Company’s Customers This company works in the business to business sector and therefore all its customers are businesses seeking for packaging services. The main struggle for the company is to develop long-term relationships with other businesses globally. The fact that the company has very small customers, it is very important for the company to maximise on customer satisfaction as it cannot afford to lose any customer and must struggle to attract more in the global market. The major customers for this company are companies in six global industrial segments: Vehicles, Aerospace, Healthcare equipment Industry, Energy, and Telecom among many other industries. The things that our customers are seeking are packaging products that are reusable and at the same time easily expendable. The packaging should also be designed in such a way that the quality of the products is not affected during transport. Moreover, the current levels of environmental sensitivity by many companies have resulted to companies seeking packaging that are as green as possible and have minimal harm to the environment. Furthermore, the customers require packaging that is optimal in terms of weight to minimize the cost of transportation of the product. These are the main areas that customer relationship management department is focussed on in this organisation. This company has developed an approach that ensures all its customers are well known. The system is based on customer segmentation in terms of products they buy from the company. The segmentation is also done based on regions. This is important since the company has subsidiaries distributed all over the world. The process of product development is done through consideration of the specifications of each customer. This is mainly achieved by developing products based on customers’ instructions and directions. The application of customer segmentation allows this company to meet the needs of almost all its customers.Customer ObjectivesThe development of this department will be central in promoting a sense of security, a feeling of being in control and trust among customers. The main reasons behind the development of the customer relationship management department in this organisation were to (Nefab program Manager, 2012): Enhance customer lifetime value; Develop the best strategic information and communication; Develop customer retention strategies; Enhance the levels of customer satisfaction . This company developed this department as a central participant in the process of expanding and maintaining market share successfully. Particularly, retention of customers can be achieved through learning relevant information, such as expectations, preferences, habits, and names about customers (Nefab program Manager, 2012). This department is expected to develop a one-on-one relationship with customers as an approach of ensuring that they come back frequently developing close association between the company and its customers. Furthermore, the department is also expected to increase the level of IT integration into customer management, resulting in high levels of intimacy between customers and the company. The high levels of using IT allow the organisation to a variety of employees in managing customer relationship removing the barrier associated with personalised attention of the customer (Nefab program Manager, 2012). This will result to sustained organisational performance and hence profitability even if certain employees are no longer working with the organisation. Therefore, there are three main customer-related objectives in this initiative; customer retention, customer satisfaction, and customer loyalty (Nefab program Manager, 2012). The introduction of customer relations management department is expected to enhance the level of customer loyalty. By making this company more knowledgeable about its current customers as well as prospective customers will ensure the services offered to them are offered in the best manner available to satisfy the customer positively impacting on the levels of customer loyalty. A similar case is expected in customer satisfaction. Developing a positive experience between this company and the customer has been seen as the main approach towards ensuring the customer is highly satisfied. This department is also focused on ensuring the job done by the company is the best. This will ultimately result to high level of customer retention. For instance, this company has been suffering from numerous instances of confusion and misconceptions especially when employees are unable to tell what has been delivered to a specific customer and what needs to be delivered and when. This has portrayed the company as unresponsive to its customers. This has dealt the company a major blow in the process as it negatively affected customer satisfaction levels. These three objectives are related to one another. For instance, a customer who has a constant repeat purchase is said to be loyal while at the same time, a customer can only be loyal if the products and services are satisfactory. Business Related Objectives This department is focused on not only fulfilling customer related objectives, but also business objectives. In terms of business, objectives are collection and analysis of data to increase the understanding levels of customer. This is important in ensuring the organisation meets the needs of the customer and is in a position to provide current and future customer needs. This is also essential in developing future forecasts for production and sales prospects. The development of process automation is also another important objective of this department. It is necessary for the enhancement of efficiency and ultimately profitability of this organisation. Most investigations agree that the most important objective of customer relation management at organisational level is to gather information. Xu & Walton (2005) clearly explain the main reason for collection of information by an organisation as being to enable the organisation understand its customers, to meet the needs of the customers and also develop effective strategies to meet the company’s future prospects. Customer Relationship Management Strategies There various theories that try to explain the strategies used on customer relationship management. The most common ones analyse customer touch points, front office, back office, and warehousing. To be able to analyse the approach adopted by this company in managing its customers, it is necessary to review this parts. WarehousingThis is the area in organisational processes that has numerous literatures regarding the implementation of customer relation management (CRM). Specifically, Bose has developed a very complex model that analyses all the necessary steps in the process of implementing CRM. This model is simplified by a list developed by David (1999). Thus, David’s list is comprehensive enough to provide guidance of the process of implementing CRM. Another implementation plan that is not as complex as Bose’s was developed by Chase (2004). The most important aspect of this plan is the detailed explanation of the integration levels. Back OfficeThese are functions in a n organisation that the customer cannot view directly (Chen & Popovich, 2003). Many authors put more emphasis on the importance of an organisation using the CRM in determining the value of its individual customers. When analysing customer value, Zikmund provides a detailed review of various theories that analyse this issue. Moreover, Xu and Walton (2005) have developed a very distinct approach to classification of customers based on profit cost matrix. Another important tool that is essential in analysing customer classification is the Identify Differentiate Interact Customize (IDIC) tool (Zikmund et al., 2003). This tool is known to provide detailed information on approaches of customer differentiation and product customisation. According to Zikmund and his colleagues (2003), customisation of the various stages in product development is essential in ensuring the products meet the specific requirements of the customers. Nefab achieves product customisation through the selection of materials and concepts for product development based on the specific customer requirements. This results to production of products that are customised for an individual customer. This is driven by Nefab’s objective that aims to replace its customers packaging departments which requires complete customisation (Nefab program Manager, 2012) Another important tool that is effective on providing insights into the process to customers in terms of areas that data can be gathered from is the analytical model by Xu and Walton (2005). It is essential in developing background on the information that should be looked for. This allows a company to develop usable data from the customers especially for development of the customer based strategies. Nefab has an effective tool for data collection that is based on direct interaction with its customers on a regular basis (Nefab program Manager, 2012). Information is collected on their products on issues, such as the level of customer satisfaction and production requirement of the customer. The company also gathers information on their competitors especially on their prices and the approach to business of their competitors. More so, a better explanation on the uses of customer knowledge is provided by Zineldin (2006). A combination of theories by Xu & Walton and Zineldin is used in the process of seeking information and developing effective use of the information. In a study by Wilson (2006), it was evident that it is very important to analyse the value of a customer in the process of developing long term relationship with the customer. Zikmund et al. (2003) identifies the important values of customer lifetime as the period the customer is expected to last, cost of capital, retention rate, and profit margin. This is the area that Nefab is still struggling with. Its approach is focussed on determining the profitability of each customer based on the contribution margin. However, the company has completely separated loyalty and retention from the approach adopted for determining the profitability of its customers (Nefab program Manager, 2012). According to this company, it is hard to develop a measure for profitability that is not based on income per product is uncertain and hence not realistic (Nefab program Manager, 2012). Thus, according to this company, the process of predicting future customer loyalty is impossible. The company depends on its employees to manage its customers in that the salesperson handles any conflicts or complaints from customers to ensure that they are preserved as customers of the company. In terms of relationships, Peppers & Rogers (2001) suggested that the main objective of CRM is to allow an organisation to manage its customers on an individual basis. This is the area that Nefab is more focussed on. It has established its CRM strategies to ensure that customers are handled at a personal level. This is also coupled with development of personalised relations with its customers. The company strives to ensure that the customer comes back for more products and services. Nefab has established measures that increase the levels of openness between it and its customers. They allow their customers to be partners in the business (Nefab program Manager, 2012). The company has also established a variety of departments involved in management of sales including technicians, design teams and accounts manager. This is necessary to ensure each of its major customers is handled differently by the company. This is sometimes challenging to the organisation in terms of coordinating the numerous departments in the organisation. Front officeThese are firm’s functions that directly interact with the customer (Chen & Popovich, 2003). The IDIC model is also an effective tool for providing a description of the functions of the front office as per CRM (Peppers & Rogers, 2001). The primary role of the front office is to collect information from the customer in an easy was as possible (Peppers & Rogers, 2001). Nefab has tried to develop an effective front office by minimising the number of departments at the front office level (Nefab program Manager, 2012). The company has a centralised workloads and information for its large customers with global coverage. The local branches handle the other smaller customers. This allows the company to store information about all its major customers in a centralised place (Nefab program Manager, 2012). Rao and Perry (2002) explain the importance of digitizing employee knowledge. Another important contribution to this part is the Greenberg (2004), analysis of culture and its importance in the process of implementing CRM as a strategy within an organisation. His analysis is comprehensive and very central in the development of CRM strategies that meet the requirements of a specific organisation. A study by Curry and Kkolou (2004) found out that customer life cycle is very important for an organisation. They further assert that it should be handled while providing detailed information about each and every stage that the company’s customers go through. The common stages identified were targeting, translation, delivery, dissatisfaction management, and winning back lost customers (Curry & Kkolou, 2004). These are the areas that this Nefab Company is struggling with. Its customer’s life cycle is initiated when they visit a customer’s firm as most of my colleagues described. This is then followed by sending of samples of packaging until the final solution is arrived at (Nefab program Manager, 2012). Once the customer has approved the design of packaging, the company delivers that packaging to the customer until when the production of a specific product comes to a stop. During this time, the company expects the customer to approach them again for a new packaging plan. The company completely lacks customer win-back and dissatisfaction management stages in the customer lifecycle. Another important area in the front office, organisational culture is analysed by Greenberg (2004). He asserts that the culture of the organisation must be changed such that it aligns with the objectives of the organisation’s CRM initiative. Thus, the success of an organisation’s CRM depends on the levels to which its objectives align with the firm’s culture. This is the area that Nefab has tried to deal with. The company has implemented an intensive training program for the sales persons with specific reference to behaviour and conduct (Nefab program Manager, 2012). The company has also equipped its workforce with computer skills. The company has endowed its employee’s a heavy responsibility especially in decision making. The company also promotes the development of independent culture at its subsidiaries. However, the cultural independence of its subsidiaries is limited as they operate based on a general cultural framework of the company. This has positively impacted the performance of the company as the decision making paths has been shortened. The negative impact of this approach is on development of a centralised decision by the firm since its subsidiaries work very independently. Customer Touch PointsThese are the interactions that exist between an organisation and its customers (Chen & Popovich, 2003). The touch points are well illustrated in the ‘interact’ phase of the IDIC model (Peppers & Rogers, 2001). This model has a detailed overview of all the necessary areas in the touch points that exist at an organisational level. According to Peppers & Rogers, touch points are essential in the process of organising and streamlining the face of an organisation. Nefab Company has in the recent past involved the touch points in the process of organisational streamlining. This has been enhanced by the introduction of the CRM department as an approach to refining its front end with the endeavour to ensure its customers are well served (Nefab program Manager, 2012). The company has also increased the level of using the web as a customer interaction tool. It currently accounts for the most of the company’s customer leads. A theory by Davids (1999) is comprehensive enough in developing approaches for examining how customers interact with an organisation. Furthermore, Peelen (2005) presents possible interaction points in an organisation that is similar to the work by Davids (1999) as well as Peppers & Rogers (2001). These points identified by Peelen are personal sales, telephone, e-mail, websites, and public media. Nefab Company has tried to develop effectiveness of these channels of interaction. However, the company has limited use of media such as radio and television as it assumes that their customers are less likely to be there for interaction between the company and them (Nefab program Manager, 2012). The major forms through which this company interacts with its customers is through phone calls, email and direct communication. Conclusion and Implications From the analysis, it is evident that the theories analysed by various investigators are applicable at organisational level. It is evident that using CRM in business benefits a business since it offers effective objectives for management of businesses as well as its customers. The most important objectives in this case are customer retention and satisfaction, data organisation, and in-depth understanding of the customer. From analysis of the company, it has been evident that the most important aspect of CRM is the organisation of customer information. The ultimate results of this organisation are high levels of customer satisfaction and retention as witnessed in the organisation. The ability of an organisation to meet customer requests and respond to them in time depends on how organised is the approach to the collection and analysis of customer data. This evidently results to high levels of customer satisfaction. This result because of high levels of efficiency in customer managemen t strategies. From these results, it can be concluded that for an organisation to effectively gather and organise customer information, it requires to develop a customer relation management approaches. This allows an organisation to develop a comprehensive analysis of the customer on an individual basis. This is central to capturing relevant information in an approach that allows availability of the information from all departments in an organisation. Furthermore, the main benefit of CRM is to allow organisations to own and control information about its customers and not specific individuals or departments in an organisation. This is important in limiting the implications of employees exiting from an organisation where customer information is readily available for the replacement recruits as compared to the case where there was no CRM. Moreover, CRM is important in the sense that customer information can readily be pulled and reviewed. This is an essential ingredient in organisational efficiency. In fact, new employees can use the stored information to develop an effective background about the customer. More so, CRM allows an organisation to develop approaches of handling objectives such as customer retention, satisfaction, and loyalty at once as they are assessed in terms of their impact on the organisational efficiency of the firm. Implications of the studyThis investigation analysed how customer relationship management is used in Nefab Company. The analysis focussed on the application of CRM in the organisation with relation to available theories that focus on the consumer market. The analysis reveals that it is important for an organisation to focus on developing strong relations with its customers other than focusing on the consumer market loyalty. Development of customer relation automatically results to high levels of customer loyalty. However, this investigation is limited to information gathered by other investigators in reference to one organisation. Further studies need to be done using more than one organisation. The investigations should collect data using quantitative as well as qualitative methodologies to further enhance the available information on the research issue. Other areas that need to be analysed in future investigations are: Analysis of the effect of company culture on customer relations; Investigate on the approaches to evaluating customer loyalty; Examine how price and customer loyalty interact. References Chase, P., 2004. A success model for CRM integration, and how to avoid the most common mistakes, New Hampshire, USA: Scribe Software Corporation. Chen, I., & Popovich, K., 2003. Understanding Customer Relationship Management: People Process and technology. Bradford, UK: MCB Up Limited. Curry, A. & Kkolou, E., 2004. â€Å"Evaluating CRM Contribution to TQM improvement- across-case comparison† The TQM Magazine, 16(5), 314-324 Davids, M., 1999. â€Å"How to avoid the 10 Biggest Mistakes in CRM† Journal of Business Strategy, 20(6):22-26 Greenberg, P., 2004. CRM at the speed of light, essential CRM strategies for the 21st century. New York, NY: MCGraw Hill/Osborne. Nefab Group, (2013). Nefab’s History. Retrieved from http://www.nefab.com/History.aspx Nefab program Manager, (2012). Nefab Business Plan 2013-2017. Retrieved from http://www.nefab.eu/wp-content/uploads/2012/04/NEFAB-BUSINESS-PLAN-2013-2017-v-11.pdf Peppers, E. & Rogers, S., 2001. â€Å"Maximising ROI from your customer based strategy† Insights report 2001. Rao, S., & Perry, C., 2002. â€Å"Thinking about relationship marketing: where are we now†, Journal of business and industrial marketing, 17(7), 598-614 Wilson, R., 2006. â€Å"Developing new Business strategies in B2B markets by combining CRM concepts and online databases†. Customer Relations,16(1), 38 – 43 Xu, M. Walton, J., 2005. â€Å"Gaining Customer Knowledge through Analytical CRM†. Department of Strategy & Business System, Portsmouth Business School. Portsmouth, UK: University of Portsmouth. Zikmund, W., McLeod R., & Fayge, G., (2003). Customer Relationship Management: Integrating marketing Strategy and Information Technology. New York, NY: Wiley. Zineldin, M., 2006. â€Å"The royalty of loyalty: CRM, Quality and retention† Journal of consumer marketing, 23(7), 430-437.

Internet Personal Security Is Not Absolute Essay

Internet is the most trending and most widely used in today’s generation, either it is used for communication, used for sharing files and documents, for making new acquaintances, or just for own enjoyment. People can also use the internet when they want to socialize with others, when they want to share what’s on their mind and the on goings of their lives, when they want to know what the trending topics like news and scandals, or when they want to post some pranks or scum other people. Internet usability can either be a great help to everyone or it can impose a threat to someone or somebody. People think that when they post something online, whether it is good, bad, privately, or publicly, that information is safely sealed and secured. But the truth is, it can be freely access or easily steal from them. Hacking, viruses, trojans, and especially own self are some of the reasons that threaten internet security. Among all of these examples, hacking is on the top list. Even though there are some laws against hacking like the Republic Act No. 10175, also known as the Cybercrime Prevention Act of 2012, it is not enough assurance to protect the people against hackers and it doesn’t improve the internet security. Changes need to be made in the law to increase internet security, and find and punish cyber criminals. Additional laws to stop cybercriminals and necessary, unenforceable, and could infringe upon interest users rights to privacy and the growth of the internet. The issue here is that the internet security is not that secured for users or for people to rely upon. People can hide their files thoroughly or limit the number of people who can access his or her private account but sooner or later that information will be publish and revealed publicly with or without his or her approval. There are different explanations on why this information once hidden and now visible seen by many people, but the most common reason is that â€Å"your file/ information is being hacked†, it can be an expert hacker or you have been chosen for someone’s prank or hobby. In strict definition of â€Å"hacker†, according to Rouse, M. (October, 2006): â€Å"Hacker is a term for â€Å"a clever programmer† who wanted to break into someone’s computer systems. These are people who enjoy learning details of programming language or system. They want to further their knowledge and skills in a particular computer language. Typically, the hacker is either proficient programmer or engineer with technical knowledge on the weakness and vulnerability of the computer system. (Rouse, M. (October, 2006). Definition: hacker. Search Security. Retrieved on January 23, 2013 from http://searchsecurity.techtarget.com/definition/hacker).† Like the given definition, because of the hacker’s hobby of exploring and gaining more knowledge on his preferred programming language, he will not give a care on whose account he is butchering, as long as he increases his understanding and skills on his chosen subject. He will not consider if it is personally- owned or government-owned accounts, as long as it interests him, he will do anything on his power to hack that website. Like for example the issue of hacking some government and civil society websites in the Philippines. According to Kabiling, G. D. (October 2, 2012): â€Å"The Anonymous Philippines (as what the hackers describe theirselves) hacked different government and civil society websites, namely: Police Community Relations Group (PCRG) of the Philippine National Police (PNP), Maritime Industry Authority (Marina), Intellectual Property Office (IPO), and Department of the Interior and Local Government (DILG). The reason for their attacked is to voice out their pr otest and opinions on implementing the Cybercrime Prevention Act of 2012. (Kabiling, G. D. (October 2, 2012). More Gov’t Websites Hacked: Cybercrime law in effect starting Wednesday. Manila Bulletin Publishing Corporation. Retrieved on January 24, 2013 from http://www.mb.com.ph/articles/375681/more-gov-t-websites-hacked#.UQGDCScUuBw).† There is also a hacking issue on American banks, which according to Staff, R. (September 20, 2012): â€Å"The hacking of websites and corporate networks at Bank of America, JP Morgan Chase & Co and Citigroup began in late 2011 and escalated this year. According to one of their sources, the attacks were in response to U.S. sanctions on Iranian banks.† The two issues are both similar and different. It is similar because they reported about different hacker’s interfere someone’s computer system. Different because on the first issue, hacking the government websites, the hackers introduced their group and post the reason why they block the websites and on the second issue, the hacker denied their involvement even though many evidences are pointing towards them. Hacking is the most dangerous hobby. Even though the Philippine government implemented the Cybercrime Prevention Act of 2012, it cannot give assurance on protecting the people. The Philippine government must change this law and focus more on the most problematic cybercrime issues. Government must strengthen the internet security in order to lessen the attacks of the hackers to the innocent people who freely use the internet. And in order to accomplish the changes they must first know why the internet security is absolute? Who are the people affected and can use the internet security? How someone knows if the internet security they use can either be helpful or can trigger harm to them?

Death in Auden’s Funeral Blues, Forche’s Memory of Elena,...

Death Reflected in Auden’s Funeral Blues, Forche’s Memory of Elena, and Dickinson’s Last Night that She lived Death is a natural and inevitable part of life. Everyone will experience death, whether it is of a loved one or oneself. In W.H. Auden’s poem â€Å"Funeral Blues† (1003), he describes such a catastrophic event and the drastic effect that it has on his life. It is interesting how people choose to accept this permanent and expected event, death. Similarly, Emily Dickinson has written many poems about death, such as â€Å"The last Night that She lived† (843), which describes a family waiting for a woman or girl to die and the dreary and depressed mood that exists within the household. Mourning is considered a perfectly healthy†¦show more content†¦I can easily relate to these lines because it does seem like the world stops completely when a loved one is lost. Auden also writes, â€Å"He was my North, my South, my East and West/My working week and my Sunday rest† (9-10). It is apparent that the person he has lost is everything to him and losing him is a very hard thing to experience. I can still remember feeling a similar way when I lost a close family member. It seems hard to get on with life and try to move on when such a large part of life is taken away, and this is exactly the mourning portrayed as Auden writes about the devastation and confusion of coming to terms with the fact that his loved one is actually gone. Moreover, Auden uses several techniques in â€Å"Funeral Blues,† including a simple aa, bb rhyme scheme and a plethora of hyperboles. The rhyme scheme is effective because it makes the poem flow smoothly. This makes the poem seem to â€Å"pass by† the reader, much like the rest of life passes by someone who is still feeling the hurt of experiencing death. The hyperboles help to signify exactly how much the lost loved one means to the poet. An example can be seen in the lines, â€Å"Let aeroplanes circle moaning overhead/Scribbling on the sky He Is Dead† (5-6). Obviously the entire world is not too concerned with the death of one person, but it is apparent the poet feels that the rest of the world must be put on hold