Pharmacogenetics And Pharmacogenomics In Pharmacy Practice Biology Essay

Pharmacogenetics And Pharmacogenomics In Pharmacy Practice Biology Essay The study of the interaction between genetics and therapeutic drugs is variously called pharmacogenetics or pharmacogenomics. The differences between the two are the initial approach of the science: Pharmacogenetics starts with an unexpected drug response result and looks for a genetic cause. Pharmacogenomics, on the other hand, begins with looking for genetic differences within a population that explain certain observed responses to a drug or susceptibility to a health problem (The Australasian Genetics Resource Book, 2007). Pharmacogenetics refers to the study of inter-individual specific genetic variation (Zika et al. 2006). The term pharmacogenetics is occasionally used in a limiting sense to describe how different gene variants affect drug-response but it can also be defined more broadly as the study of the effect of heredity on human drug-response (Newton et al. 2007). Factors that influence how an individual responds to medication include their external and internal environments and overall health, as well as their genetic make-up. The goal of pharmacogenetics is to understand the role that an individuals genetic make-up plays in how well a medicine works, as well as what side effects are likely to occur in the individuals body. Understanding this can help tailor drugs in the future best suited for a particular individual (personalised medicine) or group (The Australian Genetics Resource Book, 2007). The small differences in the genes between different population groups, or some families within a population group, that have built up over the generations can mean that they react differently to medicines. However, some diseases, notably cancers, develop in cells which have an altered genetic constitution, so that the genetic make-up of the diseased tissue is no longer the same as that of the person in which it is present. Specific genes present in the diseased tissue may play a critical role in determining the optimum treatment. To establish this, it will therefore be necessary to identify the genetic make-up of the cancer itself: testing the patient before a cancer has developed is of no use, because the genetic changes are only present in the cancer cells and not in the normal host tissues (Nuffield Council on Bioethics, 2003). Some potential benefits of pharmacogenetics include the following: More powerful medicines: Drugs may be developed targeting specific health problems that will maximise therapeutic effects but decrease damage to nearby healthy cells Safer drugs the first time: Doctors could have an idea which drug to use based on a genetic profile versus trial and error, decreasing the likelihood of adverse reactions More accurate methods of determining dosages: Instead of dosages being based on body weight and age, it would be based on an individuals genetics. This would decrease the likelihood of an overdose. Better vaccines: Vaccines made of genetic material could activate the immune system to have all the benefits of existing vaccines but with reduced risks of infections (The Australasian Genetics Resource Book, 2007). Implications of pharmacogenetics in practice are vast and encompass broad areas such as: Drug response the effects of angiotensin converting enzyme inhibitors have been found to be greater in people of European or UK ancestry than African-Americans. Pre-treatment genetic screening of patients will eventually enable this knowledge to be applied in clinical practice. Moreover, variation in the genes that code for receptors (drug targets) may mean that some people may produce receptors that do not interact well with the drug. For example, some people have a lack of response to the drug salbutamol, used in the treatment of asthma, due to genetic variation in the gene that codes a receptor on the surface of smooth muscle cells lining airways of the lungs. Drug targets Genes may also determine how many of the receptors are produced on or within cells and genetic variation may mean that some people produce more of these sites than others. The action of the widely used antipsychotic drug haloperidol (Haldol) depends on its ability to bind to the dopamine (D2) receptor site. In one study, 63% of patients whose genetic make-up caused a large number of these receptor sites to be produced had a response to treatment with haloperidol. About 29% of patients with a smaller number of dopamine (D2) receptor sites responded well to the drug. Drug metabolism Pain relief medications such as codeine require an enzyme produced in the liver called CYP2D6 for the drug to be used by the body, break it down and remove it. Variations in the information contained in the CYP2D6 gene determine how much of this enzyme is produced in the liver (The Australasian Genetics Resource Book, 2007). The implication of variations in genotype on the metabolism of the immunosuppressant azathioprine is also an example. Polymorphisms in the gene encoding for the enzyme thiopurine S-methyl transferase (TPMT) lead to changes in the activity of the enzyme and rate of metabolism of azathioprine. Changes in the activity of the enzyme present clinically as an increased risk of neutropenia or a decreased chance of responding to azathioprine, at normal dose ranges. A genetic test for the polymorphism can identify individuals who are more likely to develop neutropenia. Thus, the aim of a pharmacogenetic test here is to minimise an adverse effect, although in other cases, a pharmacogenetic test may be able to predict an effective responseto a medicine by correlating an individuals genotype with the observed pharmacological actions of medicines (phenotype) (Clemerson et al. 2006). Drug development Excluding from clinical trials those people whose genetic makeup would make the drug being tested harmful or ineffective for them will increase the chance that a drug will show itself useful to a particular population group. This would increase the chance that the same drug will make it into the marketplace. Undertaking pre-genetic screening of those patients taking part in a clinical trial should also make the clinical trials smaller, faster, and therefore less expensive. For example, as seen in clinical trials for developing drugs for Alzheimer disease and other forms of dementia (The Australasian Genetics Resource Book, 2007). The application of pharmacogenetics has two main aspects: improvements in the safety and efficacy of medicines. In improving safety, pharmacogenetics works in the following ways: Pharmacogenetic tests reveal genetic variations already known to be associated with adverse reactions, allowing physicians to avoid exposing patients to medicines that would put them at risk. The majority of adverse reactions are caused because of an exaggerated effect of a medicine in the body. Less often, an adverse reaction may be an idiosyncratic response to the medicine. Adverse reactions to medicines have significant costs, in both human and monetary terms. However, it is difficult to ascertain the impact of genetic variation in response to medicines because data concerning adverse reactions often include problems caused by errors in prescription, and because information about other causes such as interaction between different medicines may be non-existent. Results from pharmacogenetic tests may also inform physicians in selecting the medicine most likely to benefit a particular patient. Many medicines are effective in only a proportion of patients treated. Sometimes, for a medicine to be effective, different doses are required for different patients. In the absence of a pharmacogenetic test for efficacy, the most appropriate medicine or dose is conventionally found by trial and error, although in some cases, tests of renal function may be used to predict the appropriate dose. It has been suggested that a trial and error approach to prescription may reduce compliance for medicines that do work, since patients acquire a general aversion to taking medicines because of the unpleasant side-effects which they might experience. This therefore helps in improving efficacy of medicines (Nuffield Council on Bioethics, 2003). A potential barrier to the development of pharmacogenetic tests concerns the application of intellectual property rights. Pharmacogenetic tests may be developed in a number of ways. The pharmaceutical company which is developing the medicine may also develop the pharmacogenetic test. Alternatively, a third party, such as another company or researchers from the public sector may develop the test independently. Furthermore, while the effect of pharmacogenetics may be to reduce some of the costs of developing new medicines, it would be imprudent to infer from this that the cost of purchasing medicines will necessarily fall (Nuffield Council on Bioethics, 2003). Pharmacogenomics Pharmacogenomics is the study of genetic variations that influence individual response to drugs.   Knowing whether a patient carries any of these genetic variations can help prescribers individualise drug therapy, decrease the chance for adverse drug events, and increase the effectiveness of drugs (AMA, 2013).   Pharmacogenomics holds the promise that drugs might be tailor-made for individuals and adapted to each persons own genetic makeup. Environment, diet, age, lifestyle, and state of health all can influence a persons response to medicines, but understanding an individuals genetic makeup is thought to be the key to creating personalised drugs with greater efficacy and safety. Pharmacogenomics combines traditional pharmaceutical sciences such as biochemistry with annotated knowledge of genes, proteins, and single nucleotide polymorphisms (Human Genome Project Information, 2011). The field of pharmacogenomics is still in its infancy. Its use is currently quite limited, but new approaches are under study in clinical trials. In the future, pharmacogenomics will allow the development of tailored drugs to treat a wide range of health problems, including cardiovascular disease, Alzheimer disease, cancer, HIV/AIDS, and asthma (Genetics Home Reference, 2013). The cytochrome P450 (CYP) family of liver enzymes is responsible for breaking down more than 30 different classes of drugs. DNA variations in genes that code for these enzymes can influence their ability to metabolise some drugs. Less active or inactive forms of CYP enzymes that are unable to break down and properly eliminate drugs from the body can cause drug overdose in patients. Clinical trials researchers use genetic tests for variations in cytochrome P450 genes to screen and monitor patients. In addition, many pharmaceutical companies screen their chemical compounds to see how well they are broken down by variant forms of CYP enzymes. Another enzyme called TPMT (thiopurine methyltransferase) plays an important role in the chemotherapy treatment of common childhood leukemia by breaking down a class of therapeutic compounds called thiopurines. A small percentage of Caucasians have genetic variants that prevent them from producing an active form of this protein. As a result, thiopurines elevate to toxic levels in the patient because the inactive form of TMPT is unable to break down the drug. Today, doctors can use a genetic test to screen patients for this deficiency, and the TMPT activity is monitored to determine appropriate thiopurine dosage levels (Human Genome Project Information, 2011). Similarly to pharmacogenetics, pharmacogenomics  has the potential to  provide tailored drug therapy based on genetically determined variation in effectiveness and side effects (AMA, 2013). This will mean: More powerful medicines   Pharmaceutical companies will be able to produce therapies more targeted to specific diseases, maximising therapeutic effects while decreasing damage to nearby healthy cells. Better, safer drugs the first time   Recovery time will go down and safety will go up as the likelihood of adverse reactions goes down or is eliminated altogether. Improvements in drug discovery, design, and development are obvious applications for pharmacogenomics. A deeper understanding of the genetic factors which cause variance in drug metabolism can aid in the design of drugs with improved potency, reduced toxicity, and fewer side effects. For example, pharmacogenomics can identify potential drug targets (targets are typically enzymes or other proteins), and determine which targets are least prone to genetic variance. By selecting drug targets which are not prone to genetic variance, drug designers can create drugs which are more likely to have standard, expected, and safe reactions in people who take it. More accurate methods of determining appropriate drug dosages   Current methods of basing dosages on weight and age will be replaced with dosages based on a persons genetics how well the body processes the medicine and the time it takes to metabolise it. Pharmacogenomics can also be useful in clinical trials for drugs which have passed through the approval process sufficiently that human trials are possible. Using this approach, a technique called genostratification can be used in selecting participants for clinical trials. This means that clinicians use genetic typing to select participants who are genetically more likely to react positively to the treatment which is under study. This can potentially allow for an improved level of treatment success, and means that proof of concept can be achieved sooner. This technique can also allow for a reduction in the required sample size for the trial, or shortened trial duration. Ultimately, a drug which may help save or improve lives can be used in the general public more quickly than otherwise would be possible. Economic issues from molecule to marketplace Pharmacogenomics eventually can lead to an overall decrease in the cost of health care because of decreases in: the number of adverse drug reactions, the number of failed drug trials, the time it takes to get a drug approved, the length of time patients are on medication, the number of medications patients must take to find an effective therapy, and the effects of a disease on the body (through early detection). Applying pharmacogenomics to patient treatment can help devise individualised treatment regimes, to ensure that patients receive the drugs which are most appropriate for their genetic makeup. In particular, this approach has significant potential in treating cancer, because there is a great degree of variance in the way people react to chemotherapy drugs. Tumors themselves are highly variable in genetic terms, and this partially accounts for the variance in drug responses. Using an approach which individualizes treatment regimes, to accommodate for this variance could improve cancer treatments significantly. Pharmacogenomics is useful in general for patient treatment because it has the potential to identify on an individual basis the drugs which might cause adverse reactions. A person who might experience such a reaction can then be prescribed an alternative drug (Lloyd, 2008). However, there are several potential barriers to pharmacogenomics which have to be overcome before the above discussed benefits of pharmacogenomics can be realised (Human Genome Project Information, 2011). These include the following: Complexity of finding gene variations that affect drug response   Single nucleotide polymorphisms (SNPs) are DNA sequence variations that occur when a single nucleotide (A,T,C,or G) in the genome sequence is altered. SNPs occur every 100 to 300 bases along the 3-billion-base human genome, therefore millions of SNPs must be identified and analyzed to determine their involvement (if any) in drug response. Further complicating the process is our limited knowledge of which genes are involved with each drug response. Since many genes are likely to influence responses, obtaining the big picture on the impact of gene variations is highly time-consuming and complicated. Limited drug alternatives   Only one or two approved drugs may be available for treatment of a particular condition. If patients have gene variations that prevent them using these drugs, they may be left without any alternatives for treatment. Disincentives for drug companies to make multiple pharmacogenomic products   Most pharmaceutical companies have been successful with their one size fits all approach to drug development. Since it costs hundreds of millions of dollars to bring a drug to market, will these companies be willing to develop alternative drugs that serve only a small portion of the population? Educating healthcare providers   Introducing multiple pharmacogenomic products to treat the same condition for different population subsets undoubtedly will complicate the process of prescribing and dispensing drugs. Physicians must execute an extra diagnostic step to determine which drug is best suited to each patient. To interpret the diagnostic accurately and recommend the best course of treatment for each patient, all prescribing physicians, regardless of specialty, will need a better understanding of genetics. Conclusion Despite the various potential barriers to both pharmacogenetics and pharmacogenomics, these fields are rapidly evolving with the promise that someday a simple and rapid DNA test will determine potential risks of adverse effects with a certain drug, and thus turning to another drug which would be more suitable for the patient.

Antidote for the Iron Law of Oligarchy Essay

In every diseases there will always a doctors to help us to cure it. In every illness it has always a medicine to manage the pain. But if we connect it to our society today, maybe it doesn’t have medicine or doctors that cure this kind of illnesses. This kind of attitude maybe we cannot erase to our society. This attitude maybe we can connect to the iron law of oligarchy. What is the iron law of oligarchy? â€Å"The iron law of oligarchy is a political theory, first developed by the German syndicalist sociologist Robert Michels. It states that all forms of organization, regardless of how democratic or autocratic they may be at the start, will eventually and inevitably develop into oligarchies. The reasons for this are the technical indispensability of leadership, the tendency of the leaders to organize themselves and to consolidate their interests; the gratitude of the led towards the leaders, and the general immobility and passivity of the masses.† – From Wikipedia In connection to the definition of iron law of oligarchy, our government is considered as the democratic government. Where in it have presidents that are given a rule in every department and bureaus. Where in this rule are all obey by all the department and bureaus. Another characteristic of our government as a democratic country is that it let people to choose their own leaders. But these actions are not enough to tell that we have our own freedom, but these actions give other people reasons to abuse their powers. Instead of serving us, they use their positions to do the things that they want. What are the reasons why they do those things? What are the things that we need to do so that their actions are change? Here the things that we need to do. If the iron law of oligarchy is the rule of few people or the elite people, we can reverse it so that we can make it the rule of many people. Where in all the rules are all consult to us before they implement it. Another thing is, when it giving us the right information. Sometimes our government is not giving the exact information that we need to know about what happen to our government. And lastly, no oligarchy without material and power perks and bureaucracy. Part of the changes is a constant flow of reliable information among the people. Bureaucracy’s weakness is related to its inability to keep secrets and control the information flows. It is weakened as it loses the power to the flow of the information among us.

salinger Essay - 843 Words

LIFE AND PHILOSOPHY OF J.D. SALINGER J.D. Salinger is one of the most renowned writers of his time. J. D. Salinger is most known for his controversial in the Catcher in the Rye. Salinger is also known for many of his writings such as Franney and Zooey, Nine Stories, and Raise High the Roof Beam, Carpenters. The summer of 1930 he was voted â€Å"The Most Popular Writer†. â€Å"Salinger is a beautifully deft, professional who gives us a chance to catch quick, half-amused, half-frightened glimpses of ourselves and our contemporaries, as he confronts us with his brilliant mirror images† (Lomazoff 1). In the novel, Catcher in the Rye, there is a relationship between the main character, Holden Caulfield, and Salinger. J.D. Salinger’s Catcher in†¦show more content†¦nbsp;nbsp;nbsp;nbsp;nbsp;In the mid-1940’s Zen Buddhism began to influence Salinger’s life and writings. Also, in the early 50’s Salinger met frequently met with teenagers while writing Catcher. These influences, a nd also the fact that he was an â€Å"unknown† writer made him free from clichà ©s and slogans that the rest of the world fell prey to. Salinger only seeked independence, growth, and stability in his life. Because Salinger was not a renowned writer, he did not have to worry about meeting expectations or censorship. Salinger would never try to censor himself, and felt that he should not have to. He frequently speaks of a phony society in which we all live in and in order to be accepted into the adult world, we must become a â€Å"phony†. Being a â€Å"phony† meaning, adjusting yourself to become what is socially acceptable even though it may not be what you desire to achieve. â€Å"His work is a unique phenomenon, important as the voice of a â€Å"silent generation† in revolt against a â€Å"phony world† and in search of mystical escapes from a deteriorating society rather than â€Å"causes† promising political revolution or reform†(French 4). Many of Salingers views for The Catcher in the Rye come from his intense hatred for hypocrisy. In the novel, Holden Caulfield feels that he must not submit to the phoniness of life, but attain an attitude of tolerance, understanding, and live which will make his life endurable. â€Å"From a social economicShow MoreRelated Jd Salinger Essay772 Words   |  4 Pages Salinger, J(erome) D(avid) (1919- ), American novelist and short story writer, known for his stories dealing with the intellectual and emotional struggles of adolescents who are alienated from the empty, materialistic world of their parents. Salingers work is marked by a profound sense of craftsmanship, a keen ear for dialogue, and a deep awareness of the frustrations of life in America after World War II (1939-1945). Jerome David Salinger was born and raised in New York City. He began writingRead MoreJD Salinger Research Paper1671 Words   |  7 Pages Jerome David Salinger, also known as J. D. Salinger, is a fascinating author best known for his novel, Catcher in the Rye. Although Salinger only published one novel, he wrote several short stories for magazines like The New Yorker and Story. A large number of these stories went on to be compiled into books such as Nine Stories, Franny and Zooey, and Raise High the Roof Beam, Carpenters and Seymour: An Introduction. Despite the fact Salinger has not published any stories in over 45 years, his reputationRead MoreThe Catcher in the Rye by J.D. Salinger637 Words   |  3 PagesThe Catcher in the Rye, by J.D Salinger, consists of many minor characters. There are more than about sixty characters in the novel in which only three of them are major characters (Holden, Allie, and Phoebe) and the rest minor. Many of these characters are just mentioned with no lasting impact on either the novel itself or Holden. Salinger uses minor characters in the Catcher in the Rye to tell the readers about Holden and his views about the world. The first minor character seen in the CatcherRead More J.d. Salinger Essay2971 Words   |  12 PagesDavid Salinger was to become one of America’s greatest contemporary authors. In 1938 Salinger briefly attended Ursinus College in Pennsylvania where he wrote a column, amp;quot;Skipped Diploma,amp;quot; which featured movie reviews for his college newspaper. Salinger made his writing debut when he published his first short story, amp;quot;The Young Folks,amp;quot; in Whit Burnett’s Story magazine (French, xiii). He was paid only twenty-five dollars. In 1939, at the age of 20, Salinger had notRead MoreThe Catcher in the Rye by J.D. Salinger983 Words   |  4 PagesCatcher in the Rye Essay Throughout Catcher in the Rye there are a lot of small parts of the story where it would be linked to the book and to the text all together. J.D. Salinger created a lot of important passages that would be associated with what type of message that he was trying to convey to the audience. Salinger would develop certain characters like Phoebe through her description and actions to have a influence on Holden, thus causing him to change as a character and reveal sides of himRead MoreThe Laughing Man by J.D. Salinger878 Words   |  4 PagesJ.D. Salinger (Jerome Davis Salinger) was said by some people to be one of the best American Authors of past century. Salinger’s works reflects the many experiences he had as a child. One of the more common focuses tends to be his fascination with protecting the innocence in children. Salinger was born in New York City an attended public school until he switched to the exclusive McBurney School. In attending this school, Salinger was called an â€Å"academically unexceptional student†. After this heRead MoreThe Catcher in the Rye by J.D. Salinger944 Words   |  4 PagesMany people have different aspects and impressions on a teenager’s life. 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After failing out of prep school, Holden retires to theRead MoreThe Catcher in the Rye by J.D. Salinger654 Words   |  3 Pagesthe first questions that came to my mind when I received the first assignment notice that we would be reading The Catcher in the Rye for English class. The title is most likely the single most important word choice that the author must make. J.D. Salinger uses the title in the book to allude to more than just when Holden sees the young child singing. J.D. Salingers title, The Catcher in the Rye, alludes to the conflict Holden faces of sexuality when growing up. The first reference made to the titleRead MoreThe Story of J.D. Salinger2489 Words   |  10 PagesThe Story of J. D. Salinger J. D. Salinger became one of the most popular and known American authors in America today. Up to this day students from all over the country have read and purchased the novel â€Å"The Catcher in the Rye† which was a novel that was not so long ago controversial due to vulgar language, sexual references, and unacceptable behavior; parents were concerned that J. D. Salinger’s novel was going to influence their children. Salinger was one of many authors that stood out more

Manufacturing Sector in India - 1909 Words

ARTICLE ON MANUFACTURING SECTOR IN INDIA Manufacturing key to growth above 6.5%, says RBI http://www.tribuneindia.com/2012/20120806/biz.htm#1 India needs to focus more on manufacturing in order to achieve GDP growth more than 6.5 %, Reserve Bank of India has said. The manufacturing sector has the scope for creating jobs for millions of people who leave other sectors such as agriculture, RBI Governor D Subbarao said in his keynote address here at Centre for Economic and Social Studies yesterday. His remarks assume significance in the backdrop of dwindling contribution of manufacturing sector to the GDP. India s economic growth rate slipped to 5.3 % in the fourth quarter of 2011-12, the lowest in nearly nine years, following†¦show more content†¦Other emerging economies have higher share to GDP such as Thailand, at 40 %, and in China, around 35 %. India is facing the unemployment problem largely because of lack of proper growth in manufacturing sector. In an economy at this stage development, a large chunk has to come from manufacturing. In the next 1520 years, India will see the largest migration in history that has ever happened from rural to urban areas. To feed the growing population, we have to increase our food productivity. Second, today 55 % of employment is still in agriculture, of which a large part of it is disguised unemployment. To increase agricultural productivity, we have to reduce this; where, then, will these people go? So India needs manufacturing to grow. It is also clear that manufacturing has to grow a couple of percentage points higher than that of GDP, to be able to increase its share and create the jobs. Keynesian theory: When we talk about Keynesian model, we have learned that government intervention is necessary for the economy to grow when the market fails to bring itself to equilibrium. The manufacturing sector has been stagnant for a long period now. 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