by Herman Bailey | Apr 26, 2023 | Essays |
Abstract
The purpose of the study was to find the role of IMA in the diagnosis of myocardial ischemia in ischemic and nonischemic groups amongst different age groups and gender variance. Diagnosis of myocardial ischemia has been done using other biomarkers such as troponin. However, their lower diagnostic accuracy, in addition to lower symptoms specificity has made them unreliable. IMA is present in high levels in cardiac ischemic patients. Many studies have been done on the role of other biomarkers such as troponin to gender and different age groups of ischemic patients (Rodriguez-Ospina, 331; Wiviott et al, 1415). Therefore, further research needs to be done to find out whether there exist differences in the levels of IMA between different age groups, and also in gender in ischemic and nonischemic groups. The results of the study will be a helpful incorrect diagnosis of cardiac ischemia among patients, in addition to the stratification of the patients that suffer from acute chest pains. Correct diagnosis means immediate treatment and management of the cardiac ischemia before it destroys the myocytes.
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Introduction
Cardiac bio makers according to Rodriguez-Ospina et al (14) are substances released by the heart into the bloodstream when it is stressed or damaged. Measurement of the released bio makers in the bloodstream is helpful in diagnosis, monitoring, risk stratification, and management of people suspected to have cardiac ischemia and acute coronary syndrome (ACS). Cardiac ischemia results when the blood supply that goes to the tissues of the heart is not enough to meet the needs of the heart. ACS results from plaque rapture that causes creating awareness. The majority of the employees are not aware they are suffering from certain medical issues, such as high blood clot formation in the coronary arteries. This results in a sudden psychological effects. For example, blood decrease and oxygen that reaches the heart. Rodriguez-Ospina et al (15) highlighted some of the different types of cardiac biomarkers tests but the most used and effective one is the troponin test. However, cardiac troponin is only specific and sensitive for detection of damage in the myocardium but sometimes may not rise if there is reversible myocardial ischemia. In contrast, recent studies have indicated that Ischemia Modified Albumin (IMA) is a very sensitive and effective biochemical marker of ischemia (Wiviott et al, 1414; Sinha et al, 209|). Ischemia-modified albumin (IMA) from different studies have shown that it is an early marker in patients that are undergoing the process of coronary angioplasty for ischemia. Moreover, IMA is very sensitive compared to cardiac troponin (cTn) and 12-lead ECG levels when diagnosing acute coronary syndrome (ACS) in patients that experience chest pain, and within three hours are attending the emergency department at the onset of the pain. During the ischemic attack, IMA is produced and is present in blood in concentrations that is easily detectable. Recent studies have also indicated that there exist differences in the levels of biomarkers in gender but minimal differences in different age groups (Sinha et al, 72; Radha et al, 225). Wiviott et al (1413) indicated that diagnosis of diseases of the coronary artery in women is more difficult. This is because of the lower diagnostic accuracy of the noninvasive tests and lower symptoms specificity. In their study, they found out that in patients with Non-ST-Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA), there existed different patterns of biomarkers presentation. For instance, men had had a higher likelihood of elevated troponins and creatine kinase-MB. Women, on the other hand, had a higher likelihood of having elevated brain natriuretic peptide and C-reactive protein. Similarly, age differences exist in the level of bio makers. The levels of Brain Natriuretic peptide (BNP) are higher in older populations and Women in America. (1990). Black women compared to men (Wiviott et al, 1413). Further research is needed to clarify whether pathophysiological differences that are gender-related exist in acute coronary syndromes presentation. Similarly, further study can be done on real-life populations of the patients to assess the role of IMA in myocardial ischemia as a marker. The study aimed to find out the levels of IMA in ischemic and nonischemic groups amongst different age groups and gender variance.
Methods
Ninety-six patients with acute chest pain between the age group 30-60years admitted in ICCU of hospital participated in the study. Among these subjects, 40 were male and 56 were female. Of the 96 patients, 16 had no evidence of myocardial ischemia. They were categorized as group II. The remaining 80 patients with human society develop. The evidence of myocardial ischemia was categorized into group I. About 41% of the patients of group I was between 50-60 years of age. The control group of healthy subjects was 28, of which 10 were males and 18 females.
Patients were evaluated as being nonischemic or potentially ischemic through standard coronary disease indicators [(CK), CK-MB, LDH, and electrocardiography findings] and were tested by a Co (II)-albumin binding assay for IMA.
Of the 80 ischemic patients (group I) 34 were males and 46 females. The mean±SD age for the males was 50± 6.8 years and the female was 58±10.1 years. The control group was made up of 10 males and 18 females, and the mean±SD age was 45±8.6 years and 56±10.6 years respectively.
The patients of the ischemic group (group 1) were further divided into three groups based on their age &sex as follows; 30-40 years (M&F), 40-50 years (M&F), and 50-60 years (M&F).
Methods
The study was conducted on two groups; ischemic and nonischemic groups. 96 patients with acute chest pain between age group 30-60 years admitted in ICCU of hospital participated in the study. Among these subjects, 40 were male and 56 were female. Of the 96 patients, 16 had no evidence of myocardial ischemia. They were categorized as group II. The remaining 80 patients with human society develop. The evidence of myocardial ischemia was categorized into group I. Of the 80 ischemic patients (group I) 34 were males and 46 females. About 41% of the patients of group I was between 50-60 years of age. The control group of healthy subjects was 28, of which 10 were males and 18 females.
Patients were evaluated as being nonischemic or potentially ischemic through standard coronary disease indicators [(CK), CK-MB, LDH, and electrocardiography findings] and were tested by a Co (II)-albumin binding assay for IMA.
The mean±SD age for the males was 50± 6.8 years and the female was 58±10.1 years. The control group was made up of 10 males and 18 females, and the mean±SD age was 45±8.6 years and 56±10.6 years respectively.
The patients of the ischemic group (group 1) were further divided into three groups based on their age &sex as follows; 30-40 years (M&F), 40-50 years (M&F), and 50-60 years (M&F).
Results
The mean±SD of CK-MB for the age group 30-40 years was normal in both males and females. But for the females of age group 40-50years, it was higher (24±1.6) compared to males. Likewise, in the age group of 50-60 years in females, the CKMB values (56±4.8) had high mean than males (52±6.0).In addition to CK-MB, the LDH values were also higher in females (225±6.4) than males (198±10.6). The LDH levels were normal in the other two groups.
The mean ±SD of IMA in the ischemic group (Group I, n=80) was 0.519±0.086 ABSU which was much higher when compared to control subjects with no evidence of ischemia (Group2, n=16) 0.316±0.092ABSU. This is statistically significant with a P-value of <0.001. The Group 1 patients had high levels than a decision threshold of 0.400 ABSU (ABSU>/=0.400).
Discussion
Many important findings regarding IMA in different age groups and gender variance in Ischemic patients presenting with Co (II)-albumin binding assay for IMA have emerged from the analysis. The ischemic group had higher levels of IMA compared to the nonischemic group. Similarly, skeletal muscles. In a study conducted by (), the findings indicated that HRT improves the functions of muscles in Women had a higher likelihood of having IMA biomarker compared to ischemic men, this is in correlation to a study done by Kazanis et al (). Further analysis indicated that as age increases (from 40 to 60 years) IMA levels get elevated among the ischemic patients. The study also shows a correlation to a study done by Bar-Or et al (12) where myocardial ischemic patients had elevated assay levels ((0.529±0.086)), and for the age group of 50 to 60 years which had higher levels of IMA. The clinical diagnosis was assigned and correlated with standard biomarker (CK, CK-MB, and LDH) test results which were high compared with group II (0.316±0.092) with no human society develops. The evidence of myocardial ischemia (Bar-Or et al, 12).
In a previous study done by Januzzi (116), IMA was positive in four of five patients with pipeline of school to prison. Ecenbarger (2012) believes that that evidence of ischemia in ECG being 16 of 20 patients who had negative ECG but with coronary ischemia (Rodriguez-Ospina et al, 228). The combination of IMA along with the other standard biomarkers among these patients increases the sensitivity for detecting ischemia to 97% (Tousoulis et al, 102). This supports this study in which there is an appropriate setting in which to consider the use of the multimarker combination of IMA plus markers of myonecrosis would be for the rapid assessment of low to intermediate patients with chest discomfort risk.
High levels of the IMA in Women in America. (1990). The Black women and the elderly are an indication that the accuracy of the diagnosis of coronary heart diseases such as cardiac ischemia has been increased (Sinha et al, 89). The application of IMA to detect ischemia before the destruction of the myocardium muscles will help treat the elderly who mostly suffer from cardiac diseases such as cardiac ischemia. Furthermore, it would be helpful in the stratification of the patients who have cardiac ischemic and normal chest pains (Radha et al, 225).
Conclusion
In summary, IMA is an effective marker for ACS diagnosis. High negative predictive IMA values make it an independent predictor of ACS development among patients. Furthermore, IMA is not just specific to cardiac ischemia only. This makes it potential as a biomarker for other acute ischemic events. Similarly, the increase in the level of IMA in women, and as age increases in ischemic patients is a breakthrough for the elderly, and the women who are ailing from cardiac ischemia or just experience chest pain. Correct diagnosis would enable them to get people treatment on time.
Work Cited
Bar-Or, D, E Lau, and JV Winkler. “A Novel Assay for Cobalt-Albumin Binding and Its Potential As a Marker for Myocardial Ischemia-a Preliminary Report.” The Journal of Emergency Medicine. 19.4 (2000): 311-5. Print.
[email protected], Govender, Radha, De Greef, Jacques, Delport, Rhena, Becker, Piet J., & Vermaak, William J.H.” Biological Variation of Ischaemia-Modified Albumin in Healthy Subjects. Clinics Cardiff, 2008.” Internet resource.
Rodriguez-Ospina, LF, CP Rosales-Alvarez, and A Lopez-Mas. “Cardiac Biomakers for the Evaluation of Acute Coronary Syndrome.” Boletín De La Asociación Médica De Puerto Rico. 101.4 (2009). Print.
Sinha, M, Roy, D, Gaze, D, Collinson, P, & Kaski, J. “Role of “ischemia Modified Albumin”, a New Biochemical Marker of Myocardial Ischaemia, in the Early Diagnosis of Acute Coronary Syndromes.” BMJ Group, 2004. Print
Wiviott, Stephen D, Christopher P. Cannon, David A. Morrow, Kausik K. Ray, Marc A. Pfeffer, and Eugene Braunwald. “Differential Expression of Cardiac Biomarkers by Gender in Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction.” Journal of the American College of Cardiology. 46.8 (2005): 1411-1416. Print.
Januzzi, James L. Cardiac Biomarkers in Clinical Practice. Sudbury, Mass: Jones and Bartlett Publishers, 2009. Print.
Tousoulis, Dimitris, and Christodoulos Stefanadis. Biomarkers in Cardiovascular Diseases. Boca Raton: CRC Press, 2013. Print.
Kazanis, K, M Dalamaga, C Nounopoulos, AS Manolis, N Sakellaris, G Jullien, and A Dionyssiou-Asteriou. “Ischemia Modified Albumin, High-Sensitivity C-Reactive Protein and Natriuretic Peptide in Patients with Coronary Atherosclerosis.” Clinica Chimica Acta; International Journal of Clinical Chemistry. 408 (2009): 1-2. Print.
Table No I: Cardiac biomarker in Ischemic and nonischemic groups:
Table No II: Age distribution in ischemic and control groups:
| Ischemic subjects
(n=80) |
Control group
(n=28) |
|
| Males(n=34)
Mean ± SD |
Females(n=46)
Mean ± SD |
Males(n=10)
Mean ± SD |
Females(n=16)
Mean ± SD |
|
| 50±6.8Yrs |
58±10.1Yrs |
45±8.6Yrs |
56±10.6Yrs |
|
Table no III: Age-wise distribution of cardiac markers in Ischemic group
Table no IV Mean ± SD of males & females in Ischemic & nonischemic group
With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.
by Herman Bailey | Apr 25, 2023 | Essays |
Please read carefully the attached case study on ‘Exporting Ford Automobiles to Japan’ and answer all five questions referring to this. The length of the whole document with your answers should range between 3,000 and 3,500 words. Each question should be answered separately.
Exporting Ford automobiles to Japan
The 29-year-old customer wheels his old Toyota onto the lot at the Ford dealership and parks near the showroom. A polite salesman greets him and accepts the Toyota’s keys. After some brief paperwork, the salesman and customer walk to another area outside the showroom. There, the salesman goes through the delivery checklist and then hands the customers the keys to a new dark-green Ford Mustang coupe that sports a 3.8-liter V6 engine.
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What’s so unusual about this story? Well, this scene occurred in Tokyo, Japan, and both the salesman and customers were Japanese. For much of the 1960s, ’70s, and ’80s, Japanese car companies like Toyota and Honda pretty much had their way in the U.S. car market. Meanwhile, American companies either had little interest in exporting to Japan or found the process very difficult.
Ford has decided to change all that. The new Mustang that Seiichi Tsuzuki bought represents Ford’s flagship model in a new line of cars it introduced in Japan in mid-1994. Although Japanese cars have their steering wheel on the right-hand side of the car, Ford’s Mustang is a left-hand-drive model that targets a high-profile niche market. Ford is positioning the Mustang squarely against Nissan’s Z cars and Toyota’s Supra cars that have dominated the ‘muscle car’ niche in Japan. Along with the Mustang, however, Ford is introducing three right-hand-drive models -Probe, Laser, and Mondeo – that will target the compact-sedan market long ruled by Honda’s Accord. This segment accounts for one-third of the Japanese market. Ford produces these new ‘world cars’ as part of a 6 billion dollar development effort. They represent the first time any American car company has offered right-hand-drive cars in Japan.
Mr. Tsuzuki, a manager at a life insurance company, believes that the Mustang is ‘sexy’, and he appreciates the ‘roughness’ of its mystique. The cars running-horse emblem, he notes, is a symbol of the United States,’ and he finds the car’s design very impressive. He also appreciates the fact that the Mustang offers safety features, like airbags and anti-lock brakes that cost much more on Japanese cars. Another recent customer, 72-year-old Tadashi Okabe, points out that ‘People say bad things about foreign cars – that the service is bad and that they don’t run efficiently. But the Mustang is not like that. It is big, cool, and durable, and it also has airbags.”
Although the Mustang offers images and accessories, its real advantage may be price. In recent years, the yen has gained strength relative to the U.S. dollar, falling from about 130 yen to the dollar to about 100. This means that Japanese consumers find American goods about 23 percent cheaper than they had been. For example, Mr. Tsuzuki’s Mustang cost about 2.3 million yen or about USD 22,000. That is at least USD 7,000 lower than a comparable Japanese sports car’s price. Ford is pricing its world cars at USD 2,000 to USD 3,000 below comparable versions of the Nissan Altima or the Honda Accord.
For years, American car companies have complained about their market shares in Japan and asked the Japanese government for concessions. Now, Ford may finally have found the right formula – offer an American icon at a discount price and back it up with other models adapted for the Japanese market.
Taking on the world
This is not Ford’s first attempt to crack the Japanese market. Until 1939, before World War II, the company sold about 10,000 Model A Fords annually in Japan. When Ford reentered the market after the war, in 1953, it imported only a limited number of cars each year. In 1979, Ford brought a 25-percent stake in Mazda Motor Corporation. This affiliation allowed Mazda to produce the Ford vehicles sold in Japan and gave Ford access to Mazda’s 286 dealerships. To disguise the relationship, Ford and Mazda called the dealerships “Autorama.” Despite the joint venture, however, Ford imported only 2,959 vehicles into Japan in 1991 and only 5,407 in 1993.
Ford’s interest in Japan and other international markets is just part of the American auto industry’s growing interest in exporting. The weaker dollar and improved products are helping the companies reverse U.S.-made vehicles’ historically weak export sales. In 1994, analysts estimated that American and Japanese companies would have exported 529,000 cars and trucks from the United States, a 48.5 percent jump from 1993. The “Big Three,” Ford, Chrysler, and General Motors, would account for 382,000 of those vehicles, up from 254,766 in 1993. Japanese companies operating in the United States would also increase their exports in 1994 by over 30 percent, but most of these exports would go to Taiwan.
The stronger yen is also forcing Japanese companies to continue their investments in U.S.-based manufacturing. Toyota recently doubled its Kentucky plant’s capacity to 400,000 vehicles per year. Like Ford, General Motor is also targeting Japan, although it has been less aggressive. In 1993, GM sold 17,400 vehicles in Japan, about one-half of them made in Germany by GM’s Opel unit. By the mid-1990s, GM plans to sell right-hand-drive Saturns and a right-hand-drive van that it manufactures in Georgia. Also, by 1996, it will offer Chevrolet Cavaliers with a Toyota nameplate. GM owns 37 percent of the Japanese auto company Isuzu.
Driving Ford
Just introducing reasonably priced new cars to the Japanese market is not enough by itself. Ford realizes it will need a full marketing mix. Ford is depending on Konen Suzuki, president of Japanese operations, to manage its marketing strategy in Japan. Suzuki stunned his superiors at Toyota when he jumped to Ford in 1991. Suzuki’s first goal was to make Ford more sensitive to the needs of Japanese motorists. He knew that Ford offered roomier cars which the Japanese preferred for family outings and recreation. Improved fuel economy made the cars more attractive in a country with very high gasoline prices. Suzuki also realized that Ford would have to back up its cars with better service than many local rivals provided. He issued Ford’s first recall in Japan to replace broken steering hoses and malfunctioning fuel pumps on Tauruses. Japan’s narrow, twisting roads and constant stopping and starting were too much for these parts, so Ford replaced them with more reliable substitutes. Keeping replacement parts in stock has been one of Ford’s challenges.
The typical Japanese consumer is also less interested in power car drives than in how it looks. Because Japan has such well-developed public transportation, much Japanese use that system for day-to-day travel. The Japanese treat their car as an ornament to be polished and cared for but used only occasionally. Suzuki is also focusing on distribution. He wants to sign up for an additional 1,000 dealers by the year 2000 to supplement the 286 Autorama dealers. He has even enticed one Nissan dealer to offer Fords at many of its dealerships. One problem, however, is that in Japan door-to-door salespeople sell about one-half of the cars sold each year. Because real estate is so expensive in Japan, most auto dealerships do not resemble American dealerships with their large buildings and massive car lots. They serve instead as the basis of operation for the sales force. Toyota alone has a 1,000-person sales force – equal to about one-half of the entire U.S. auto sales force – for a country the size of California. Toyota roving salespeople help it capture two of every five car customers in Japan. The salespeople establish personal relationships with each of the 3,000 or so households in a typical sales area and make their sales pitches in their customers’ living room. The salespeople primarily target homemakers who don’t work outside the home. Because of the door-to-door sales forces, most Japanese never go to an auto dealership, and most are strongly brand loyal. Many Ford dealers don’t like the time and expense involved in the traditional sales approach, but they have yet to develop any better ideas.
To entice customers to visit the dealerships, Suzuki ordered a multimillion-dollar ad campaign that positions Ford’s offerings as fun breast cancer. Ann has been a staunch Christian since childhood just like the rest of her family cars. Two trends may help Suzuki’s efforts. First, more Japanese women are working and are therefore not at home for traditional sales calls. Second, more consumers are willing to go to showrooms to see the latest new cars.
By 2000, Ford and Suzuki want to capture 5 percent of the Japanese market, roughly 200,000 cars. Ford would import about one-half of these if its Mazda affiliate making the balance. Suzuki knows, however, that Nissan, Toyota, Honda, and the other Japanese carmakers will not sit idly by. He also knows that Chrysler and GM will want their shares of the Japanese market.
Case study questions
Q.1 What economic, cultural, political-legal, or other environmental factors should Ford take into consideration in exporting its cars to Japan and why? What specific opportunities and threats can be extracted from the Japanese environment?
Q.2 What features of the Japanese consumer behavior have Ford to take into consideration in selling its goods to the Japanese market? What is the nature and characteristics of the competition faced by Ford in this market?
Q.3 What possible criteria did Ford use in selecting Japan as a market for its cars? What were the possible target segments for Ford in the Japanese market? How did Ford position its Mustang brand in this market?
Q.4 Which specific method did Ford use to enter the Japanese market? What are the possible advantages and disadvantages encountered by Ford using this method? What other entry method (s) to Japan would you suggest to Ford and why?
Q.5 What adjustments has Ford made on each of the elements of its marketing mix in exporting to the Japanese market and why? What marketing strategy recommendations would you make to Ford to help it to be successful in this market?
With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.
by Herman Bailey | Apr 25, 2023 | Essays |
1.0 Introduction
Harris & Emberley (2014) defined sex hormones as a class of steroid hormones regulating the function and growth of the reproductive organs or stimulate secondary sexual characteristics development. They include estrogen, testosterone, and Dihydrotestosterone (DHT). Sex hormones, estrogen, and testosterone play a fundamental role in the function and regulation of skeletal muscle (Griggs et al, 1989).
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There are two types of skeletal muscles, type I fibers and type II fibers. Type I fibers also referred to as slow oxidative fibers or slow-twitch fibers contain many mitochondria and large amounts of myoglobin and many capillaries of blood. These fibers have a slow velocity of contraction, split ATP at a slow rate, and are resistant to fatigue. On the other hand, Type II fibers also referred to as fast oxidative fibers or fast-twitch fibers have very many mitochondria, large amounts of myoglobin, and many capillaries of blood. Moreover, Type II fibers split ATP at a rapid rate, has a high capacity of ATP generation through oxidative metabolic processes, are resistant to fatigue, and have a faster velocity of contraction.
The female sex hormone estrogen is secreted by the ovaries. Testosterone, a male sex hormone, is secreted by the testis. Estrogen is the dominant hormone in females and testosterone is dominant in males (Griggs et al, 1989). Estrogen hormone has protective effects on different types of skeletal muscle injuries. Enns & Tiidus (2010) indicated that estrogen may influence the contractile properties of muscles and attenuate post-exercise muscle damage indices. Moreover, estrogen stimulates muscle repair and the regenerative process such as proliferation and activation of the satellite cells. Enns & Tiidus (2010) further asserted that estrogen may exert its protective effects on the skeletal muscle by playing the role of an antioxidant hence limiting the oxidative damage; binding to the receptors of estrogen hence governing the downstream genes regulation and molecular targets, and acting as a stabilizer of the membrane by intercalating within the membrane phospholipids. The estrogen concentration in women declines as women enter menopause, and this results in negative outcomes including delay in recovery from skeletal muscle injuries and greater injury of skeletal muscles. Muscle mass and strength decrease is believed to occur faster in women with menopause than in older men and this is due to differences in hormonal levels where estrogen levels in women tend to decrease with a mean age of 51yrs compared to men (Harris & Emberley, 2014). Women in the menopausal period stop producing eggs which mark the ends of their menstrual cycle and fertility. Menopausal periods are categorized into two phases; pre-menopausal and postmenopausal. During pre-menopausal periods, estrogen levels slowly drop even though women are still experiencing regular menstrual periods and are capable of giving birth (Hickey, Elliott & Davison, 2012). During the postmenopausal period, women experience a fast and constant drop in estrogen levels. In this period, women stop ovulating marking the end of their fertility and they also experience a lot of discomfort in their bodies (Hickey, Elliott & Davison, 2012). The decreasing estrogen levels in these two phases convey a direct effect on peripheral tissues like a skeletal muscle (Maltais, Desroches & Dionne, 2009). A current study conducted by Pöllȧnen et al (2011), suggested that women in pre-menopausal stages have better muscle strength, power, and larger muscles than women in post-menopausal periods. This suggested that estrogen might have a direct effect on skeletal muscle, but this research is still uncertain.
According to Herbst & Bhasin (2004), the testosterone hormone decreases fat mass and increases lean body mass in young men. Testosterone hormone in young men induces hypertrophy of the skeletal muscle leading to improved leg power and muscle strength. As the men age, they lose muscle mass because of the natural decline in testosterone levels. A significant reduction in testosterone hormone can also result in sarcopenia (Pöllȧnen et al., 2011). Sarcopenia is characterized by muscle weakness and is caused by decreasing circulating levels of sex hormones in skeletal muscles and bones. Sarcopenia in men (mass weakness) is associated with a decrease in testosterone (Pöllȧnen et al., 2011). Similarly, Dihydrotestosterone (DHT) is a male sex hormone that is converted to testosterone using 5-α reducates enzyme. It is 90% responsible for changes and the development of male sex characteristics (Phillips et al, 1993). In skeletal muscle, through the non-genomic pathway, physiological levels of DHT affects the fast twitch and slow twitch fibers of skeletal muscle by increasing tetanic contractions and twitching of the fast-twitch fibers but then it decreases them in slow-twitch fibers (Phillips et al, 1993). Skeletal muscles are also capable of converting estrogen to androgens through a pathway involving steroidogenic enzymes (Prentice et al, 2009).
As people, age, steroid sex hormones like estrogen, testosterone, and DHT are said to affect muscle strength and power. This proposal will address: first the influence of estrogen replacement therapies on skeletal muscle in both post-menopausal and pre-menopausal women. Second, the effects of testosterone replacement therapy on older men and athletes.
2.0 Body: comparison and analysis of relevant research articles
1. The use of HRT and why women use HRT
Hormonal replacement therapy (HRT) is a medication that contains hormones that the body of a woman stopped producing after menopause and is used to treat the symptoms of menopause. HRT is normally given to some of the women whose progesterone and estrogen levels significantly dropped because of menopause. Bagger (2004) stated that when the levels of estrogen and progesterone drop especially when the women approach menopause, some women may boost their levels of hormones artificially to reduce certain symptoms of menopause. Estrogen hormone helps maintain bone density, regulate vaginal moisture, and skin temperature. Therefore, a drop in the levels of estrogen can cause urinary problems, vaginal dryness, thinning hair, night sweats, sleep problems, moodiness, irregular periods, lower fertility, memory and concentration difficulties, hot flushes. Fat accumulation in the abdomen and breast getting smaller. Bakour & Williamson (2015) pointed out that some of these symptoms may occur in peri-menopause before the start of menopause. The main function of the Progesterone hormone is to prepare the womb of a woman for possible pregnancies in addition to protecting the endometrium. There is a higher risk of developing endometrial cancer when the progesterone levels go down (Enns & Tiidus, 2010).
Even though several studies Goldstein (2010) has linked HRT with life-threatening conditions such as ovarian cancer, breast cancer, and other illness conditions, doctors still prescribe it in some conditions. There are several benefits as to why women use HRT, key among them being the treatment or prevention of osteoporosis, and the relief of menopausal symptoms.
(a) Improvement in skeletal muscles function and reduction in osteoporosis risks
According to Hickey, Elliott & Davison (2012), HRT improves the functions of the skeletal muscles. In a study conducted by Hickey, Elliott & Davison (2012), the findings indicated that HRT improves the functions of muscles in women, up to the muscle fibers. Even though women showing the symptoms of menopause, Hickey, Elliott & Davison (2012) found out that even though the muscle fibers did not show any change in size, the HRT users’ muscles showed greater strength by generating maximum force than the non-HRT users. It is believed that at least in part, using HRT reduces modifications of the contractile proteins of the muscle linked to aging. In addition to skeletal muscles, HRT is effective in the preservation of the mineral density of the bone. Stevenson et al (2006) stated that taking HRT amongst women leads to osteoporosis reduction in the hip and spine and this could explain why women use HRT.in a study conducted by Marjoribanks et al (2012), taking HRT by women have decreased significantly the incidences of fractures with the long-term use of HRT. According to Hickey, Elliott & Davison (2012), HRT is the first line of treatment for the management and prevention of osteoporosis in women with the symptoms of menopause and who are aged below 50 years. Even though the density of the bone declines after HRT discontinuation. Bagger (2004) in their study demonstrated that women taking HRT for a few years around menopause have a long protective effect for several years after stopping using HRT. To determine whether HRT administration for 2- 3 years in the early years of postmenopausal provide long-term visits, such as prevention of bone fractures and prevention of bone Loss, Bagger (2004) studied a group of 347 healthy women in post menopause with normal bone mass who had completed earlier one of four HRT trials that are placebo-controlled and who were reexamined after stopping HRT for 5, 11 or 15 years. 263 of those women received either placebo or HRT for 2-3 years with no further treatment of bone sparing until follow-up. Moreover, the remaining 84 women in the study reported either current or prolonged HRT use at reexamination. The mineral density of the bone at the spine (L1 to L4) and mineral content of the bone in the forearm was then measured at baseline, the end of the trial, and follow-up. Bagger (2004) assessed, at the follow up the radiological presence of the vertebral fracture and collected new information on the non-vertebral fractures incidences. When a comparison was done with that of women treated with placebo, bone mineral content and bone mineral density in women treated with HRT continued to show higher values significantly (>5%) even several years after the HRT stoppage. After the treatment stoppage, the rate of loss of bone returned to normal rates of post-menopause. In summary, limited HRT administration in the early years of post-menopause offers long-lasting benefits for postmenopausal bone loss prevention and osteoporotic fractures (Bagger, 2004).
(b) Urogenital symptoms improvement
Women in premenopausal or menopause also use HRT to improve their urogenital menopause symptoms. Several studies have indicated that HRT improves vaginal dryness significantly and also sexual function. Moreover, HRT is very much effective in improving the related symptoms of vaginal atrophy (Sturdee et al, 2010). Panay et al (2013) indicated that women also use HRT in relieving the symptoms of urinary frequency since it has a proliferative effect on the urethral and bladder epithelium. Goldstein (2010) also observed that HRT improves vaginal symptoms, decrease the vaginal pH, and vaginal atrophy. Moreover, there is an improved maturation of the epithelia with HRT compared to non-hormonal gels and placebo and that could explain the reasons why women use HRT. In a study conducted by Goldstein (2010) on how to recognize and treat urogenital atrophy in postmenopausal women, Goldstein (2010) observed that it results from menopausal estrogen deficiency and has several clinical effects which include sexual dysfunction, vaginal dryness, recurrent urinary infections, and urinary incontinence. Goldstein (2010) further asserted that estrogen therapy either administered systematically or locally provides significant relief. Local vaginal estrogen therapy in low dose, in the form of rings, creams, and vaginal tablets has been shown to reduce vaginal dryness and dyspareunia, restore normal cytology of the vagina, and restorative the vaginal pH
(c) Reduction in cardiovascular diseases
HRT also reduces the risks of heart attack and heart failure. Bakour & Williamson (2015) asserted that women who receive the HRT immediately after the commencement of their menopause have a lower likelihood of developing heart failures and heart attacks. This could also explain the reasons why women use HRT. Even though the relationship between cardiovascular diseases and HRT is still controversial, Hickey, Elliott & Davison (2012) asserted that the duration and timing of HRT and the pre-existing cardiovascular disease have a likelihood of affecting the outcomes. A study conducted by Prentice et al (2009) quoted trial research done by Women health initiative (WHI) found out that there was a slight increase in coronary heart disease incidences in the first year after commute enforcement of HRT. The women in the trial were taking the conjugated equine estrogens without or with medroxyprogesterone acetate (Prentice et al, 2009). In another recent study by Schierbeck et al (2012), the results demonstrated that HRT reduces coronary heart disease incidences by around 50% if it commenced within years of the menopausal years. Similarly, Schierbeck et al (2012) showed that women who receive HRT early after menopause had a significant reduction in mortality risk without any apparent increase in the risk of stroke, venous thromboembolism, or cancer.
2. How HRT effects, skeletal muscle of post-menopausal women compared to pre-menopausal women
In the previous randomized controlled trials, post-menopausal HRT administration for 6 to 1 year has shown improvement in mobility and an increase in the strength of the muscles in young postmenopausal women (Sipilä et al, 2001; Skelton et al, 1999, Taaffe et al, 2005). However, 27 and 46 in their studies documented that amongst the older women there was no improvement in mobility and muscle strength with HRT treatment. Skeleton et al (1999) on their randomized controlled trials investigated the effects of HRT on muscle composition and muscle cross-sectional areas. The results indicated no change in the cross-sectional area of the muscle adductor policy after one year of cyclical norgestrel and estrogen treatment amongst women with a mean age of 61 years although there was a significant strength gain on the same muscle.
Similarly, Sipilä et al (2001) also did a double-blind randomized controlled test among early post-menopausal women and the results showed a significant mean increase of 6% in the cross-sectional area of the knee extensor muscle after continuous treatment with combined progestin and estradiol compared to the controlled subjects. In the same study, Sipilä et al (2001) examined the thigh muscle density by CT and recorded an increase after HRT. This suggested decreased intramuscular content. Additionally, the relative fat proportion within the knee compartment of the extensor muscle remained unchanged in the women under HRT, while it increased amongst the controlled group (Sipilä et al, 2001).
Pöllänen et al (2015) conducted a study to examine the relationship between characteristics of muscles in pre-menopausal (n=8) and intramuscular steroid hormones and in the postmenopausal pairs of monozygotic twin sisters (n=16, eight pairs of twin sisters), discordant for estrogen use based on the replacement of hormones. Pöllänen et al (2015) assessed the isometric strength of the skeletal muscles by measuring the strength of knee extension. Moreover, the explosive muscle power of the lower body was assessed as the height of the vertical jump. From the study. Intramuscular estrogen, testosterone, DHEA, and DHT proved to be independent, significant predictors of power, and strength explaining the variation of 59-64% in the strength of knee extension and 80-83% of the vertical jumping height variation in women. The study by Pöllänen et al (2015) suggests that intramuscular sex steroids are associated with power and strength regulation in muscles of women.
3. Changes in muscle mass after menopause
Menopause is linked with the natural estrogen decline which increases the fat mass of the visceral, decreases the mass density of the bones, muscle strength, and muscle mass. In their study review, Maltais, Desroches & Dionne (2009) examined the menopause transition role and associated decrease in the status of hormone regarding the changes. Furthermore, the study overviewed the efficiency of nutrition and physical exercise on sub-characteristics of muscle.
According to Harris & Emberley (2014), the role of estrogen in the maintenance of muscle mass remains unclear. For instance, in a study done by Trenkle (1976), estrogen was reported to stimulate the growth of muscles in developing cattle and sheep. However, in a study done by Ihemelandu (1980), estrogen was found to be hindering the growth of the skeletal muscles of the developing rodents. In women, Petrofsky et al (1976) and Seeley et al (1995) found that estrogen does not affect muscle mass. Similarly, in a study done by Philip et al (1993), the results indicated that women who are deficient in sex hormones which includes the post-menopause women had less specific strength in their adductor pollicis muscle (force/muscle cross-sectional area), compared to their aged-matched women who were under HRT.
Pamela (n.d) pointed out that an average woman during their menopausal transition can expect to gain 2-5 pounds of muscle, especially in the lower tummy. The major reason for weight gain among women is estrogen decline. Healthtalk.org. (2015) also elaborated that fat cells in the buttocks, thigh, and hip have estrogen receptors. In most women, estrogen drives most storage of fat to the lower body parts, and therefore as the levels of estrogen begin to decline, it loses its hold on the storage of fat below the waist. Instead, the fat begins to be deposited around the waistline
4. The use and why athletes use testosterone replacement therapy
According to Gregory et al (2003), there is an increasing number of males using testosterone therapy to help in the treatment of erectile dysfunction, fatigue, and loss of sex drive, and also to enhance their physical performance as these are the most common symptoms of low testosterone in the body. Testosterone therapy is normally used in treating male hypogonadism or simply low testosterone. This is a condition where the body fails to make hormones that are enough because of a problem with pituitary glands or the testicles (Griggs et al, 1989).
Athletes tend to use testosterone replacement therapy to enhance their physical performance during sports. This is because testosterone hormone allows the athletes to increase their muscle mass and also performance (Herbst and Bhasin, 2004). Herbst and Bhasin (2004) indicated that bodybuilders and athletes use supplements that boost testosterone to increase their strength as well as improve their recovery time. This practice is also referred to as doping (Herbst and Bhasin, 2004).
Leaner body mass helps control weight and increases energy which athletes require. Evidence shows that testosterone treatment can increase muscle strength and size and decrease fat. This effect is much greater where testosterone therapy is combined with strength training exercises. In a study done by Snyder et al (1999) on 108 men who are aged over 65 years and under the treatment of testosterone for 36 months, the results indicated that testosterone therapy decreased fat significantly. Especially in the legs and arms. Moreover, these same men under the study have an increase in their lean mass majorly around their trunk.
Another reason why athletes tend to use testosterone replacement therapy is for stronger bones which help in supporting their internal organs and muscles hence boosting their athletic performance. A drop in testosterone levels leads to a drop in bone density, and this raises the risk of osteoporosis or weaker bones among the athletes. The argument is echoed by another study by Snyder (1999) which indicated that testosterone replacement therapy can make older men with low testosterone levels increase their bone density.
5. The effects of testosterone replacement therapy in athletes’ skeletal muscles
Testosterone replacement therapy has the ability to increase muscle mass and muscle strength on the skeletal muscle of the athletes. It works by increasing the protein synthesis of the muscle. Griggs et al (1989) conducted a study on the effects of testosterone on muscle protein synthesis and muscle mass. The researchers the pharmacological dose effect of testosterone enanthate on total body potassium and muscle mass, and muscle protein synthesis, and whole body in normal male subjects. Among the 9 subjects, estimated muscle mass by creatine exertion increased. Estimation of the total body potassium by 40k counting increased among all participants. A primed infusion protocol that is continuous with L-[1-13C] leucine was applied in determining the whole body oxidation and leucine flux. Furthermore, the estimation of the protein synthesis of the whole body was done from nonoxidative flux. Lastly, the synthesis rate of the muscle protein was determined by measuring the incorporation of [13C] leucine into the obtained muscle sample by needle biopsy. The results from the study indicated that testosterone therapy increased protein synthesis of the muscle in all subjects, leucine oxidation slightly decreased, but a whole-body synthesis of protein did not significantly change. Additionally, muscle morphometry did not show significant increases in the diameter of the muscle fiber. This study suggested that testosterone increases muscle mass is by increasing the synthesis of the muscle protein (Griggs et al, 1989).
Gregory et al (2003) also conducted a study on the effects of testosterone replacement therapy on the skeletal muscle after injury of the spinal cord. Using a randomized controlled study design and settings in Georgia, USA, and Athens, Gregory et al (2003) took soleus, gastrocnemius, tibialis anterior, vastus lateralis, and triceps branch muscles from 12 young Charles River male rats after sham surgery or complete SCI after 11 weeks. The rats were given TRT after surgery and their muscle samples sectioned and fibers quantitatively analyzed for alpha-glycerol-phosphate dehydrogenase (GPDH), succinate dehydrogenase (SDH), and actomyosin ATPase (qATPase) and qualitatively analyzed for myosin ATPase activities. The results of the study showed a decrease in the average size of fibers in affected muscles. Additionally, there was an SDH decrease and an increase in qATPase and GPDH activities across the muscles of the four hind limbs of the SCI animals. Moreover, the size of fiber in the TRI was increased by SCI (31+/-2%). This shows that TNT has an effect on muscle mass, and it increases muscle mass (Gregory et al, 2003).
3.0 Conclusion
In summary, the literature review looked at the effects of sex hormones on skeletal muscles during aging. It discussed the role of each sex hormones in the skeletal muscles before discussing the muscle reduction in pre-menopause and post-menopause period and how estrogen hormone is associated during these periods. Similarly, the literature review briefly highlighted the reduction of muscle mass as men age and how testosterone is associated with muscle reduction. Additionally, the paper reviewed several articles by comparing and analyzing their data under five different groupings. That is the use of HRT and why women use HRT; How HRT affects the skeletal muscle of post-menopausal women compared to pre-menopausal women; Changes in muscle mass after menopause; the use and why athletes use testosterone replacement therapy; and the effects of testosterone replacement therapy in athletes’ skeletal muscles.
References
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Bakour, S. H., & Williamson, J. (January 01, 2015). Latest evidence on using hormone replacement therapy in menopause. The Obstetrician & Gynaecologist, 17, 1, 20-28
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Goldstein, I. (March 01, 2010). Recognizing and Treating Urogenital Atrophy in Postmenopausal Women. Journal of Women’s Health, 19, 3, 425-432.
Gregory, C. M., Vandenborne, K., Huang, H. F., Ottenweller, J. E., & Dudley, G. A. (January 01, 2003). Effects of testosterone replacement therapy on skeletal muscle after spinal cord injury. Spinal Cord, 41, 1, 23-8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12494317
Griggs, R. C., Kingston, W., Jozefowicz, R. F., Herr, B. E., Forbes, G., & Halliday, D. (January 01, 1989). Effect of testosterone on muscle mass and muscle protein synthesis. Journal of Applied Physiology (Bethesda, Md. : 1985), 66, 1, 498-503. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/2917954
Harris, R. H., & Emberley, M. (2014). It’s perfectly normal: Changing bodies, growing up, sex, and sexual health.
Healthtalk.org. (2015). Menopause: Changes in the body and keeping healthy. Retrieved April 22, 2015, from http://www.healthtalk.org/peoples-experiences/later-life/menopause/changes-body-and-keeping-healthy
Herbst, K.L., Bhasin, S. (May 07, 2004).Testosterone action on skeletal muscle. . Retrieved April 20, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/15075918
Hickey, M., Elliott, J., & Davison, S. L. (January 01, 2012). Hormone replacement therapy. BMJ (Clinical Research Ed.), 344.
Ihemelandu, E. C. (January 01, 1980). Effect of estrogen on muscle development of female rabbits. Acta Anatomica, 108, 3, 310-5.
Maltais, M. L., Desroches, J., & Dionne, I. J. (January 01, 2009). Changes in muscle mass and strength after menopause. Journal of Musculoskeletal & Neuronal Interactions, 9, 4.)
Marjoribanks, J., Farquhar, C., Roberts, H., & Lethaby, A. (January 01, 2012). Long term hormone therapy for perimenopausal and postmenopausal women. The Cochrane Database of Systematic Reviews, 7.
Pamela M. P. (n.d). Menopause and Your Changing Body | HealthyWomen. Retrieved April 22, 2015, from http://www.healthywomen.org/content/article/menopause-and-your-changing-body?context=ages-and-stages/36
Panay, N., Hamoda, H., Arya, R., Savvas, M., & British Menopause Society and Women’s Health Concern. (January 01, 2013). The 2013 British Menopause Society & Women’s Health Concern recommendations on hormone replacement therapy. Menopause International, 19, 2, 59-68.
Petrofsky, J. S., LeDonne, D. M., Rinehart, J. S., & Lind, A. R. (March 01, 1976). Isometric strength and endurance during the menstrual cycle. European Journal of Applied Physiology and Occupational Physiology, 35, 1, 1-10.
Phillips, S. K., Rook, K. M., Siddle, N. C., Bruce, S. A., & Woledge, R. C. (January 01, 1993). Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy. Clinical Science (London, England: 1979), 84, 1, 95-8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8382141
Pöllänen, E., Kangas, R., Horttanainen, M., Niskala, P., Kaprio, J., Butler-Browne, G., Mouly, V., … Kovanen, V. (January 01, 2015). Intramuscular sex steroid hormones are associated with skeletal muscle strength and power in women with different hormonal status. Aging Cell, 14, 2, 236-48. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364836/
Prentice, R. L., Manson, J. E., Langer, R. D., Anderson, G. L., Pettinger, M., Jackson, R. D., Johnson, K. C., … Rossouw, J. E. (January 01, 2009). Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause. American Journal of Epidemiology, 170, 1, 12-23.
Schierbeck, L. L., Rejnmark, L., Tofteng, C. L., Children, L., Eiken, P., Mosekilde, L., Køber, L., … Jensen, J. E. (January 01, 2012). Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: a randomized trial. BMJ (Clinical Research Ed.), 345.
Seeley, D. G., Cauley, J. A., Grady, D., Browner, W. S., Nevitt, M. C., & Cummings, S. R. (January 01, 1995). Is postmenopausal estrogen therapy associated with neuromuscular function or falling in elderly women? Study of Osteoporotic Fractures Research Group. Archives of Internal Medicine, 155, 3, 293-9. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7832601
Sipilä, S., Taaffe, D. R., Cheng, S., Puolakka, J., Toivanen, J., & Suominen, H. (January 01, 2001). Effects of hormone replacement therapy and high-impact physical exercise on skeletal muscle in post-menopausal women: a randomized placebo-controlled study. Clinical Science (London, England: 1979), 101, 2, 147-57.
Skelton, D. A., Phillips, S. K., Bruce, S. A., Naylor, C. H., & Woledge, R. C. (January 01, 1999). Hormone replacement therapy increases isometric muscle strength of adductor pollicis in post-menopausal women. Clinical Science (London, England: 1979), 96, 4, 357-64.
Snyder, P. J., Peachey, H., Hannoush, P., Berlin, J. A., Loh, L., Lenrow, D. A., Holmes, J. H., … Strom, B. L. (January 01, 1999). Effect of testosterone treatment on body composition and muscle strength in men over 65 years of age. The Journal of Clinical Endocrinology and Metabolism, 84, 8, 2647-53.
Snyder, P. J., Peachey, H., Hannoush, P., Berlin, J. A., Loh, L., Holmes, J. H., Dlewati, A., … Strom, B. L. (January 01, 1999). Effect of testosterone treatment on bone mineral density in men over 65 years of age. The Journal of Clinical Endocrinology and Metabolism, 84, 6, 1966-72.
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Sturdee, D. W., Panay, N., & International Menopause Society Writing Group. (January 01, 2010). Recommendations for the management of postmenopausal vaginal atrophy. Climacteric: the Journal of the International Menopause Society, 13, 6, 509-22.
Taaffe, D. R., Sipilä, S., Cheng, S., Puolakka, J., Toivanen, J., & Suominen, H. (September 01, 2005). The effect of hormone replacement therapy and/or exercise on skeletal muscle attenuation in postmenopausal women: a yearlong intervention. Clinical Physiology and Functional Imaging, 25, 5, 297-304.
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With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.
by Herman Bailey | Apr 25, 2023 | Essays |
Overview of the paper.
The Amazon Company; which forms the biggest cloud in the giant US economy amongst other companies is flourishing in selling online books. Amazon has had a tremendous season in the market comparing it with other competitors in the business of books and other online stores. The current status of the company is that, it is the leading online books store with income generation on the rise year in, year out. The current value of the company stands at over $ 88.99 billion in net sales in the year 2014. Amazon has experienced growth in its product sales and expansions are inevitable. The expansion was not limited to the original plan of online books and contents but added more merchandise that included; acquisition of other companies that still operate online with their products. The inclusion of these other companies was to diversify the products and control the majority of the market population. The target group of the company can be classified into two mainstream levels. The primary and the secondary market targets formed the basis of the company’s growth and expansion. The decision was to bring more inventory into the company led to the double growth of the gross revenue over a short period of time (Suzaki, 2002).
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The company initiated ambitious research on the target markets and found who formed the basis of the clientele that originally was the repeat, customers. The estimated registered customers globally are 270 million who have active accounts with the Amazon Company. The repeat clients have made Amazon products be most valuable brands in the world. The quality and availability have been the backbone of the success of the company evident in the gross revenues witnessed by the rate of sales of the products. The varieties in terms of products have risen optimal mark to include the biggest American brands in the markets (Hsieh, June 1, 2010).
The research is based on the primary market targets that have been those that access online services within the United States and across borders. The company has invested heavily through acquit ion of other companies such as Zappos worth $1,200 million. The secondary targets come in the other company’s interest in the strategy of diversification where the Company offers other products that include electronics etc.
Primary and secondary target markets.
Amazon Company is an online shop for books and content merchandise dealings which has its market targets population clearly cut out within the global stage. The primary source of the market is those who can access the online books and other content materials who make use of the products placed online. The targets are the male and the female that believe in the quality of products found in the Amazon sites as well as those subsidiary companies, like Zappos Company and others companies. Amazon Company has its customers at the age bracket as those between 24-35 years but this may go beyond the bracket given the followers that Amazon group has within the American market and hence may stretch to above the age of 18-35 to over 50’s in terms of age. All of its clients are residents of the United States and the world at large given the accessibility of its online networking leads to connections of bad groups. (George 1989) commented that these groups end up sharing information that has no good content. It has a different taste for all groups since the books and other content products spread across race, region, and profession. These figures run to over 270 million customers that are active on-site accounts and another 14 million that can access the products on mobile services platforms (American Management Association, 1956).
• Primary market targets
Amazon Company has risen above other companies that offer similar online-based shops within the American and global markets due to its resourcefulness. The primary target has been those that saw the revenue rise to a high of over $ 88.99 billion in sales revenue in the year 2014 only. They are the bulk buyers and are using the various avenues provided by the company to acquire the products. Handling such a huge number of clients requires proper skills and etiquette. This group has its products made within a press of a button and hence the company decided to have other outlets in different countries reach more and more of its customer base. The taste and sense of its contents amongst this primary group are critical to the company strategy. To enhance the relationship and the link that the company has to this group population, the development of enhanced online spots was adopted, and more can get satisfactory services.
• Secondary market targets
The success of how the company has managed its primary target group has brought another phenomenon aspect of the markets that is the secondary target. This forms the basis of future and potential customers. The diversification and pursuing other ventures has enabled the group to expand. The introduction of other subsidiary companies has witnessed another dimension of the company’s target population. The Amazon decision to buy out other relevant companies and introduction of other products have developed the secondary target that was originally the books and content delivery services. This idea developed another interest from those who wanted more than just purchases of the books. The number of the primary targets also forms part of these numbers because through them the company has managed to advertise beyond the usually estimated figures.
Target group.
• Students
. The Amazon Company has had a smooth business given its original plan and has stuck to the plan for some time, but a decision was made to diversify. The plan included the introduction of professional content to the users and this was due to their growth that was made through analysis of the orders made. The demand for the institutional books and content material for users in higher institutions of learning that is the universities and colleges across the globe pushed the company to enhance and hastened the decision to include more into the system. The various product designs that are mostly books and content material are tailored to attract more clients, and the products are enormous in terms of the varieties. Of students orientation, the varieties run to over 100 million products and that makes a huge market that the company so wise to exploit. Any company with sound and sensitive management, therefore, can’t ignore such a massive market target (Rivlin, 2005).
2. Market position.
The total population of over 400 million residing within the boundaries of the United States and another 5 billion people across the world are potential users of Amazon products. The followed up figures that the company records who visit the Amazon sites are estimated to be 182.62 million per month. The Amazon Company has managed to convince the population of over 270 million on accounts and another 14 million on mobile who visit their site for products that are offered by the company. In the world, the Amazon Company holds the biggest share in the online business compared to other staggering competitors.
Its market brand worth is estimated to be $ 45.76 billion and is supported with some of the statistics that include over 152,100 employees across the globe equal to some cities population in Africa. The making of over $ 88.99 billion in revenue as currently estimated, with an anticipation of an increase is expected within the organization due to the diversification of the products and computer literacy. This will facilitate the introduction of the ICT curriculum in the college that is can be comprehended by the Dubbo teaching staff. The acquisition of other diversified companies (Wilkes 1971).
Amazon Company has major shares in the market that run into hundreds of billions. The entire customer base can access the products that are even estimated to be more than the figures showed.
A quick check in the category I with blue shade representing the Amazon Company and the other represent the other competitors. It is evident that in terms of customer base the company registers is more than its competitors combined. This is itself evidence that Amazon controls the market for online shopping for various products available in the market share.
Conclusion
The research done indicates how Amazon Company shows the extent to which online business has managed to generate billions of sales and revenue. The Amazon group has survived the market competition, and that comes with various strategies involved in capturing and concurring the markets. The fraternity of the online products offered to give the customers the chance to shop for a variety of the documented graphic design because it can employ motion, light and audience interaction. My favorite part in designing websites are in creating the best themes, organizing the content under one site. The power of social networking has not been underestimated, and the company is strategizing on how to spread under the same line (Nosowitz, 2010).
The reception of the markets of these products offered online under the banner of Amazon was enhanced through the embracing of the advancement of technology. The technology aspect of business worldwide recognizes the trends of the age bracket that has incorporated the online designs of running their daily activities.
The entire world economy has been recognized the market trends, and most of the organizations are not left behind. The innovations and the investment being undertaken by various companies is an indication that the social media orientations of operations and activities are cropping into the departments of organizations.
Several companies have gone a notch higher and have formed a team to provide them with the online aspect of the functions. Such includes banks, medical institutions, learning centers, and manufacturing sectors. Amazon Company has wavered through hard times and once experienced the threat of hacking and interference in its products. It forced the company to assemble an elite team to handle such threats that almost cost them diamond (Byers, 2006).
References
Byers, Ann (2006), Jeff Bezos: the founder of Amazon.com, The Rosen Publishing Group
Hsieh, Tony (June 1, 2010). “Why I Sold Zappos”. Inc. Retrieved June 8, 2010.
Nosowitz, Dan.2010 Zappos Loses $1.6 Million in Six-Hour Pricing Screw Up. Fast Company.
Rivlin, Gary (July 10, 2005). “A Retail Revolution Turns 10”. The New York Times. Retrieved August 4, 2011.
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Suzaki, K. (2002). Results from the heart: How mini-company management captures everyone’s talents and helps them find meaning and purpose at work. New York: Free Press.
The United States. (2008). Installation Management Company. Washington, DC: U.S. Govt. Accountability Office.
With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.
