cervical cancer

CERVICAL SPINE DISORDERS

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Table of Contents
CHAPTER ONE 3
1.0 Introduction 3
1.1 Research questions 3
1.2 Research objectives 3
1.3 Research justification 3
1.4 Limitations of the study 4
2.0 CHAPTER TWO: LITERATURE REVIEW 5
2.1 Introduction 5
2.2 What causes these problems? 5
2.2.1 Injury and accidents 5
2.2.2. Growing older 6
2.2.3 Daily life 7
2.2.4 Other disease processes 7
2.2.5 Cervical spondylosis 7
2.2.6 Structural causes of neck pain 8
2.2.7 Activities that cause neck pain 8
2.2.8 Injuries that cause neck pain 9
2.2.9 Medical conditions that cause neck pains 9
2.3 Which machine can diagnose them more efficiently? 11
2.4 What effects do they have on the patients? 13
2.4.1 Effects of spinal cord dysfunction by segmental level and in terms of
location of lesion and the possible effects on the patient 15
2.5 An examination of the troubles of the cervical spine and the ways to
either prevent them or at least decrease them 17
2.5.1 The troubles for the cervical spine disorders 17
2.5.2 The ways to either prevent them or at least decrease the cervical
spine disorders 20
2.6 Study people whose jobs often cause these problems 26
2.6.1 Persons engaging in sporting activities 26
2.6.2 People working in building and construction sites 26
2.6.3 Engineers 27
2.6.4 Farmers 27
2.6.5 Drivers and other road users 27
2.7 To provide good advice based on their way of life 28
CHAPTER 3 34
RESEARCH METHODOLOGY 34
3.0 Introduction 34
3.1 Research Design 34
3.2 Rationale and the approach to the study 35
3.3 Data Collection 35
3.3.1 Data collection Instruments 35
3.3.2 Data Collection Procedure 36
3.4 Data Analysis and Presentation 36
4.0 Conclusion 36






















CERVICAL SPINE DISORDERS

CHAPTER ONE


Introduction


Cervical spine disorders are among the leading diseases affecting the
human populace. These diseases cause a lot of anguish and severe suffering
to the patients. These problems come in the form of paralysis, bowel and
bladder problems, erectile dysfunction and malfunction of other important
body parts. This dissertation looks into the cervical spine disorders in
terms of their causes, the effects they do have on their patients and the
machine that most effectively diagnoses the cervical spine disorders.
Furthermore, this research seeks to meet the objectives of examining the
troubles suffered by the cervical spine disorder victims and the ways of
reducing them, studying of persons whose jobs often cause cervical spine
disorders and finally to provide advice based on the way of life f such
people.

1.1 Research questions

1. What causes these problems?
2. What effects do they have on the patients?
3. Which machine can diagnose them more efficiently?

1.2 Research objectives

1. To examine the troubles of the cervical spine and discover ways to
prevent them or at least decrease them
2. Study people whose jobs often cause these problems.
3. To provide good advice based on their way of life

1.3 Research justification


I have chosen to study the cervical spine because it is a vital part
of our body. The cervical spine is linked to various disorders and can have
many effects, minor and very severe. It can lead to headaches, stiffness
and aggravation of symptoms. Moreover, in a systematic review of the
adverse effects of spinal manipulation suggested that it is related to
frequent mild and transient adverse effects as well more serious
complications which can lead to permanent disability or death. One of the
most often causes for cervical spine problems are car accidents In
addition, other causes of the injuries to the cervical spine can range from
prolonged pain to hard tissue fracture or dislocation, nerve or cord injury
resulting in disability, and severe injuries to the spinal cord which may
be fatal Cervical spine disorders can be diagnosed with the an MRI and CT
The occupations that see relatively high prevalence of neck pain
includes video display terminal (VDT) user, surgeons, sewing machine
operator, and dentist. The work activities by these occupations demand use
of static and/or awkward head–neck postures for sustained durations which
can cause static loading of the musculoskeletal structures. Prolonged
static loading leads to localized muscle fatigue which may impact the
stability of the cervical spine. A less stable spine can be both a cause
and consequence of spinal pain

1.4 Limitations of the study


Just like any other study, this research is also subject to quite a number
of limitations as enumerated below.
1. Lack of enough literature on cervical spine disorders
2. Inadequate time to conduct a detailed research on the subject matter
3. Inadequate studies on the subject of cervical spine disorders for
comparative purposes
4. Inadequate funds to carry out more live interviews to get detailed
information concerning the disorder.

2.0 CHAPTER TWO: LITERATURE REVIEW


2.1 Introduction


Spinal cord diseases can result into permanent cum severe neurological
disability. Nonetheless, for some victims such disability can either be
avoided or rather minimized in the event that both the treatment and
evaluation and are rapid. Spinal cord diseases are mostly a result of
conditions that are extrinsic to the cord for instance compression
resulting from spinal cord stenosis, herniated disc, tumor, abscess or
hematoma. Rarely, the disorders are intrinsic to the cord. Examples of
intrinsic disorders do include infarction, hemorrhage, transverse myelitis,
HIV infection, poliovirus infection, syphilis, trauma, vitamin B12
deficiency, decompression sickness, lightning injury, radiation therapy and
spinal cord tumor. Arteriovenous malefactions may either be intrinsic or
extrinsic. It is also worthy to note that deficiency of copper may bring
about myelopathy that is equivalent to that occasioned by the deficiency of
vitamin B12 (Bailes et al 2007). Spinal nerve roots outside the spinal cord
may be damaged as well. this segment deals with the extrinsic and intrinsic
causes of the cervical spine disorders (Bailes et al 2007).

2.2 What causes these problems?


Cervical diseases or rather neck pains are caused by numerous various
factors. This segment considers some of the few causes of the neck pains.

2.2.1 Injury and accidents

In the event of an auto accident, it is common for a person to sustain
a whiplash injury this is commonly described as a hyperextension and or
hyper flexion injury since the head of the individual who has sustained
this injury is forced to move backward and or forward rapidly (Budelmann et
al. 2013). This rapid movement of the neck is usually beyond the normal
range of motion of the neck. The neck muscles to respond by tightening and
contracting creating muscle fatigue which ends up in not only pain but also
stiffness. This is one of the commonly established causes of neck pains
especially among persons involved in road accidents (Bailes et al. 2007).

2.2.2. Growing older

As one grows older, there are certain diseases associated with the
elderly that are known to affect the spine negatively. As a result of this
the old persons always experience neck pains or rather cervical disorders.
Some of the degenerative diseases that have the negative effect on the
spine include the osteoarthritis, spinal stenosis as well as the
degenerative disc disease to mention but a few. Osteoarthritis is common
joint disorder which has the effect of causing the progressive
deterioration of cartilage. The body reacts by forming a new bone called
osteophytes or bone spurs that affects the movement of the joints. Spinal
stenosis causes the foramen, small neutral passageways to narrow. This has
the possibility of compressing as well as entrapping the nerve roots.
Stenosis may cause neck, shoulder, arm pain and numbness in the event that
the affected nerves are not in a position to function in a proper way.
Degenerative disc disease (DDD) can cause the intervertebral discs to
become less dehydrated or rather to lose only small quantities of fluids.
This has the effect of bringing about decreased elasticity of the disc and
height. As the time progresses, a disc may bulge or rather herniated hence
causing upper extremity pain, tingling and numbness (Budelmann et al.
2013).

2.2.3 Daily life

There are certain activities that we as individuals undertake in our
day to day way of living that gradually lead to a general impact of
disrupting the balance of the spine. This forces the neck of the individual
to bend forward so as to compensate for this effect. In addition to this,
stress and emotional tension have the potential of causing the muscles to
tighten and contract leading to pain and stiffness (Bailes et al. 2007).
These daily activities that we do perform are a potential cause of cervical
pain disorders though we do them without knowing the health repercussions
after that. As such it is advisable for people to shun away from eating
habits that can cause obesity since it is a potential cause of cervical
spine disorder. People should also avoid stressful and emotional situations
as they do lead to neck pains (Budelmann et al. 2013).

2.2.4 Other disease processes

Despite the fact that neck pain is commonly caused by a strain,
prolonged pain and or neurologic deficit may be a warning of something
grave. As such it, therefore, suffices to say that such symptoms should
neither be ignored nor be taken lightly. Spinal infection, spinal cord
compression, tumor, fracture and other diseases can occur. In the event
that one sustains an injury on the head, it is more than likely that the
neck too has been affected and so it is advised that one seeks prompt
medical attention (Budelmann et al. 2013).

2.2.5 Cervical spondylosis

This is the degenerative condition of the cervical spine. It comes as
a result of normal ageing and wear and tear of the cervical discs and the
vertebrae (Fairbank 1998). It's also described as cervical osteoarthritis.
It is commonly found among the old persons. The development of the bone
often spurs this degeneration of the spine. Bone spurs also referred to as
osteophytes are small growths of bone tissue that are formed when the
cartilage covering bone is worn away, and the bone begins to rub on the
adjacent bone (Fairbank 1998). The bone spur is the body's attempt to
protect the surface of the bone. The bone spur can unfortunately at a times
pinch or press upon the roots of the nerves as they leave the spinal canal.
The symptoms associated with cervical spondylosis are neck pains as well as
stiffness that often improve with rest. This has the possibility or high
potential of radiating to the shoulders or rather between the shoulder
blades. In the event, that there is nerve root compression then it follows
that there may be numbness, pain or general weakness in the arms (Fairbank
1998).

2.2.6 Structural causes of neck pain

The neck performs a lot of activities such as carrying around the head
n a daily basis. The neck has several bones alongside discs, tendons,
muscles and nerves. For this reason, even a slight disturbance in the
natural alignment can result in neck pain. In the event that the body of an
individual is under the impact of stress, the muscles of the neck always
react or respond by tightening hence putting additional pressure on the
delicate structures. This can have a tremendous negative impact on the
condition of the nerves hence resulting into neck pains.

2.2.7 Activities that cause neck pain

A majority of the neck pains is as a result of activities that do involve
repeated or prolonged movement of the neck. These have the great potential
of leading in strain or overstretched or overused muscles, a sprain or an
injury to a ligament or a spasm of the neck muscles (Fairbank 1998). These
activities include; holding your neck either in a forward or odd position
for longer time periods while watching television, undertaking studies or
talking on the telephone; sleeping on a pillow that is too high or too flat
or that does not support your neck or sleeping n your stomach with your
neck either twisted or bent; spending lengthy periods of time having your
head rest on your upright fist or arm and lastly performing either work or
exercise that causes the upper body and the arms for instance painting a
ceiling or other overhead tasks. Stress as well as focusing intensely on a
given task can result in neck pain. Tension may develop in either one or
more muscles that do connect the head, neck and the shoulders. As a result,
they may feel not only tight but also painful (Fairbank 1998).

2.2.8 Injuries that cause neck pain

There are certain body injuries that may lead to neck pains. Minor
injuries may result from stripping or falling a short distance or rather
from excessive motion of the cervical spine. Severe neck injuries may
result from whiplash in a car accident, falls from significant heights,
direct blows to the face or to the back or top of the head and lastly
sports related accidents such as rugby falls.

2.2.9 Medical conditions that cause neck pains

Some medical conditions or problems can result in neck pains. These
include; problems associated with ageing for instance narrowing of the
spinal canal. Arthritis of the neck, illnesses such as meningitis which
results in inflammation around the brain and spinal cord tissues, flu which
tends to make the neck and the rest of the body experience aching all over;
chronic conditions such as fibromyalgia, rheumatoid arthritis, ankylosing
spondylitis and torticollis or wry neck. This is as a result of severe
muscle tightness or a shortened muscle on one side of the neck hence
resulting in the head tilting to one side. Torticollis is usually a symptom
of another medical problem. Referred pain results from a problem in one
place in the body that does cause pain in another location. For instance, a
problem with one's jaw commonly known as temporomandibular disorder. Heart
attack can also result in neck pains. An infection r tumor in the neck area
can also result in neck pains. It is worthy to note that some medicines can
cause neck pain as a side effect (Willet et al. 20115).
Spinal cord injuries are usually as a result of the damage to the
vertebrae, ligaments or rather the discs of the spinal column or the spinal
cord itself. Traumatic spinal cord injury may stem from a sudden, traumatic
blow to one's spine that fractures, dislocates, crushes or compresses one
or more of the vertebrae. Consequently, it may be as a result of gunshot or
knife wound that does penetrate and cuts one's spinal cord. Further damage
commonly occurs gradually as the time advances due to bleeding, swelling,
inflammation, and accumulation of fluid in and around the spinal cord. In
the same way, a non-traumatic spinal cord injury may be caused by
arthritis, cancer, inflammation, infections as well as the degeneration of
the spinal cord disk.
The most common causes of spinal cord injuries world over are;
Motor vehicle accidents: both auto, as well as motorcycle accidents,
are the top causes of spinal cord injuries that account for the lion's
share of the spinal cord injuries annually. This results from the
various causes of road accidents such as careless driving and using of
the vehicles that are not roadworthy among other reasons.
Falls. Spinal cord injuries post the age of sixty-five years is most
commonly as a result of falls. Going by the current research findings,
falls account for about 25 percent of all the spinal cord injuries.
Severe falls such as falling from the rooftop or falling off from a
moving object may cause serious spinal cord injury that may render an
individual not be able to perform daily activities and even unable to
walk.
Acts of violence. Violent encounters account for a significant
percentage of spinal cord disorders. Such violent encounters often
involve gunshots and knife wounds going by the research findings of
the studies conducted by the National Spinal Cord Injury Statistical
Center in the United States.
Sports and recreation injuries. There are some sporting activities
that are just too dangerous for one's spinal cord if extreme care is
not taken while an individual is involved in such activities. For
instance athletics activities such as impact sports and diving in
shallow water result into almost 10 percent of spinal cord injuries.
Other dangerous sporting activities include rugby and wrestling.
Alcohol. This is also a factor causing cervical spine disorders in
about one out of four spinal cord injuries. This one implies that the
use of alcohol even without engaging in any other activities is enough
to result in cervical spine disorders.
Diseases. Certain conditions too often end up in cervical spine
disorders such as the arthritis, osteoporosis and inflammation of the
spinal cord. Such diseases should, therefore, be supposed to be
evaluated and treated early enough lest they get into the stage of
dangerously affecting the spinal cord of the affected victim
negatively.
In a nutshell, this segment has highlighted just but a few of the
causes of the cervical spine disorders. The section is not exhaustive as
the causes of neck pains are numerous. Among the reasons highlighted in
this section include medical conditions that do result in neck pains,
injuries that do cause cervical spine disorders, human activities that
cause neck pain, structural causes of neck pain, Cervical spondylosis,
daily life and other disease processes among others. The segment is not
detailed as it highlights only the way these do lead to cervical spine
disorders (Willet et al. 20115).

2.3 Which machine can diagnose them more efficiently?


Innovations and creativities in the information technology have
brought forth some significant relief to patients with cervical spine
disorders. The invention of vertetrac's lumber ambulatory decompression
system is not only an innovative but also a cost-effective approach to the
treatment of lower back pain and sciatica. Meditrac specializes in the
development, production and marketing of innovative medical appliances for
ambulatory, nonsurgical treatment of spinal disorders. This has offered a
novel approach to not only back pain but also neck pain treatment.
Mediatric medical equipment does enable rapid recovery and as well help in
the elimination of the need for hospitalization, drugs and surgery as well
(Yukawa et al 2009).. The Meditrac health appliances are used in the
treatment of a wide range of spinal disorders such as sciatica, herniated
disc, whiplash injury, degenerative changes and spinal stenosis that result
from disc herniation. The products of the Meditrac Corporation have been
distributed in health facilities all over the globe all the way from the
year 1992. All the products of this life saving company have been duly
registered under the United States Food and Drug Administration and the
feature the CE mark (Yukawa et al 2009).
It is clearly brought out in the above highlight that the vertetrac's
lumber ambulatory decompression system is the best equipment in the medical
history best suited to diagnose and treat the cervical spine disorders with
more efficacies. The advantages of this noble medical machine are that it
is cost efficient and, therefore, able to reach all cases of cervical spine
disorders ranging from those living below the poverty line all the way to
the rich in the society (Yukawa et al. 2009). The machine also eliminates
the need for hospitalization, use of drugs and surgery. As such, the costs
that accompany the cases of one being admitted to the hospital, acquiring
medicinal products in the pharmacies and going through the process of
medical operation and the dangers that do accompany such have been
eliminated by the vertetrac's lumber ambulatory decompression system
(Yukawa et al. 2009).. It is, therefore, advisable that all the health
facilities and institutions be equipped with at least one or two of these
machines to tackle cases of patients with cervical spine disorders. In
summary, the vertetrac's lumber ambulatory decompression system is the best-
suited tool currently within the health industry to diagnose and treat the
cervical spine disorders more efficiently since the treatment by this
machine is affordable hence easily accessible, the system further
eliminates the need for hospitalization of the patient, administration of
drugs and lastly removes the need for the medical surgery on patients with
the cervical spinal disorders (Willet et al. 20115). The system furthermore
treats a broad range of cervical spine disorders such as the sciatica,
herniated disc, whiplash injury, degenerative changes and spinal stenosis
that result from disc herniation (Yukawa et al. 2009)..

2.4 What effects do they have on the patients?


The cervical spine disorders are too dangerous to the affected
patients especially in those cases where they are no earlier evaluation and
treatment of these diseases in their early stages. The patients suffering
from these cervical spine disorders do experience certain effects emanating
from these diseases as captured in this segment.
Spinal cord dysfunction causes paresis, loss of sensation, changes in
the reflex as well as automatic dysfunction for instance bowel, bladder and
erectile dysfunction alongside loss of sweating. This dysfunction may be
partial or incomplete. Automatic and reflex abnormalities are commonly the
most objective signs of cord dysfunction while sensory abnormalities are
the least objective. Such are the effects suffered by the victims of these
cervical spine disorders. The impacts are so severe and as such they may
render such patients entirely useless to engage in any human activities
leave alone mere walking (Willet et al. 20115). The effects discussed in
this segment include; the Spinal cord dysfunction causes paresis, loss of
sensation, changes in the reflex as well as automatic dysfunction for
instance bowel, bladder and erectile dysfunction alongside loss of
sweating; Corticospinal tract lesions have the general effect of bringing
about the dysfunction of the motor neuron; Cauda equine syndromes which
involve the destruction of the nerve roots at the caudal end of the cord is
not part of the spinal cord syndromes. Nonetheless, it mimics or takes
after conus-medullaris syndrome hence resulting in distal leg paresis
alongside sensory loss in and around the perineum and anus or saddle
anesthesia; Effects of spinal cord dysfunction by segmental level and in
terms of location of lesion and the possible impact on the patient;
stiffness in the neck and shoulders which ultimately results in severe
headache and lastly Neck issues causing a migraine are rare cares though
they still occur (Fairbank 1998).
Corticospinal tract lesions have the general effect of bringing about
the dysfunction of the motor neuron. Acute and severe lesions such as
infarction and traumatic lesions bring about spinal shock with flaccid
paresis in the form of diminished muscle tone, hyporeflexia and lack of
extensor plantar responses. After a particular period may it be days or
weeks the upper motor neuron dysfunction develops or transforms into
spastic paresis that manifests in the form of increased muscle tone,
hyperreflexia and clonuses. Exterior plantar responses and automatic
dysfunction are present as well. Flaccid paresis that last more than a few
weeks points to the fact that there is lower motor neuron dysfunction
(Fairbank 1998).
Cauda equine syndromes which involve the destruction of the nerve
roots at the caudal end of the cord is not part of the spinal cord
syndromes. Nonetheless, it mimics or takes after conus-medullaris syndrome
hence resulting in distal leg paresis alongside sensory loss in and around
the perineum and anus or saddle anesthesia. This effect extends to the
bladder, bowel and pudendal dysfunction for instance urinary retention,
urinary frequency, urinary or fecal incontinence, and erectile dysfunction,
loss of rectal tone, abnormal bulbocavernosus and anal wink reflexes. In
cauda equina syndrome unlike in spinal cord injury, muscle tone and deep
tendon reflexes are decreased in the legs (Willet et al. 20115).

2.4.1 Effects of spinal cord dysfunction by segmental level and in terms of
location of the lesion and the possible impact on the patient

When the location of the lesion is either at or above the C5, then the
patient is likely to suffer the consequences of respiratory paralysis and
Quadriplegia. When the location of the lesion is between C5 and C6, then
the patient of the cervical spine disorder is apparently experiencing or
going to experience the paralysis of the legs, wrists and hands. Other
possible effects in these circumstances include the weaknesses of shoulder
abduction and elbow flexion, loss of biceps jerk reflex and loss of
brachioradialis deep tendon reflex (Fairbank 1998). When the location of
the lesion is between C6 and C7, the patient of the cervical spine disorder
is either experiencing or about to experience paralysis of the legs, wrists
and hands. Despite this, there is the possibility for the patient to be
still able to have shoulder movement and possible elbow flexion. When the
location of the lesion is between levels C7 and C8, then the patient is to
suffer the effects of loss of triceps jerk the reflex paralysis of legs and
hands. When the location of the lesion is at C8 to T1, then the patient is
to experience homer syndrome in the form of constricted pupil, ptosis and
facial anhidrosis. Another related effect is the paralysis of the legs of
such patients. When the location of the lesion is between T1 and conus
medullaris then the legs of such a patient become completely paralyzed and
as such he or she cannot make body movements with ease. These abbreviations
refer to the vertebrae. The cord is shorter than the spine so that moving
down the spine, cord movements and vertebral levels are increasingly out of
alignment. At all the levels of the cord injury, deep tendon reflexes are
altered below the level of the lesion, bowel and bladder control is
subsequently lost and as such, sensation too is lost below the level of the
injury (Willet et al. 20115).
Another common effect suffered by victims of cervical spine disorder
is stiffness in the neck and shoulders which ultimately results in severe
headache. This kind of headache in medical terms ids described as
cervicogenic headache since is results from the cervical spine or the neck.
This condition accrues since the tightness in the neck muscles as well as
the joints stimulate the nerves in the neck that do travel into the head.
As a consequence, this causes the pain to go all the way to the head hence
causing headache.
Neck issues causing a migraine are rare cares though they still occur. The
exact thing that takes place in the head to bring about migraine is yet to
be completely comprehended or understood but the current theory holds that
migraine is as a result of a combination of changes in the nerves as well
as the blood vessels in the neck of an individual. The neck issues can
bring about a migraine by stimulating the nerves that travel from the head
just like a cervicogenic headache except that when the signals reach the
head they do cause a migraine. This is common especially among those
individuals that are prone to or susceptible to headaches (Fairbank 1998).
In a nutshell, this segment captures and highlights on the various
effects that people with cervical spine disorders do undergo. The cervical
spine disorders do make the patients suffer too much to the great extent
that they potentially become unable or not in a position to undertake
certain activities. Furthermore, the health of such victims deteriorates to
their detriment, and these disorders have the general effect of even
leading to other diseases hence overwhelming the patient. Among the effects
recapitulated in this segment include the Spinal cord dysfunction causes
paresis, loss of sensation, changes in the reflex as well as automatic
dysfunction for instance bowel, bladder and erectile dysfunction alongside
loss of sweating; Corticospinal tract lesions have the general effect of
bringing about the dysfunction of the motor neuron; Cauda equine syndromes
which involve the destruction of the nerve roots at the caudal end of the
cord is not part of the spinal cord syndromes. Nonetheless, it mimics or
takes after conus-medullaris syndrome hence resulting in distal leg paresis
alongside sensory loss in and around the perineum and anus or saddle
anesthesia; Effects of spinal cord dysfunction by segmental level and in
terms of location of lesion and the possible impact on the patient;
stiffness in the neck and shoulders which ultimately results in severe
headache and lastly Neck issues causing a migraine are rare cares though
they still occur. It is also imperative to note that the effects that the
cervical spine disorders do have to the affected patients are not
exhaustive as discussed in this segment since the impacts of these diseases
to the affected patients are numerous.

2.5 An examination of the troubles of the cervical spine and the ways to
either prevent them or at least decrease them

The patients of cervical spine disorders often go through various
troubles all the way from severe body pain and inability to perform
specific acts. This is all due to the severity of this deadly condition.
These victims most often go through various troubles such as paralysis,
headaches, stiffness of the neck muscles, erectile problems among other
troubles (Fairbank 1998). His segment captures two parts. The first one is
the examination of the difficulties suffered by the patients of the
cervical spine disorders and the second part of this very segment handles
the various ways of either reducing or eliminating the prevalence of the
cervical spine disorders among the patients (Tanouchi et al 2014).

2.5.1 The troubles for the cervical spine disorders

Spinal cord malfunction brings about difficulties of paresis, loss of
sensation and changes in the reflex as well as automatic dysfunction for
instance bowel, bladder and erectile dysfunction alongside loss of
sweating. This dysfunction may be partial or incomplete. Automatic and
reflex abnormalities are normally the most objective signs of cord
dysfunction, on the other hand, sensory abnormalities are the least
objective. Such are the troubles suffered by the sufferers of these
cervical spine disorders. The difficulties are so severe and as such they
may render such patients utterly of no use to engage in any human
activities leave alone mere walking (Verlaan et al. 2011). The troubles
enumerated in this part include; the Spinal cord dysfunction causes
paresis, loss of sensation, changes in the reflex as well as automatic
dysfunction for instance bowel, bladder and erectile dysfunction alongside
loss of sweating; Corticospinal tract lesions have the general effect of
bringing about the dysfunction of the motor neuron; Cauda equine syndromes
which involve the destruction of the nerve roots at the caudal end of the
cord is not part of the spinal cord syndromes. Nevertheless, it resembles
or takes after conus-medullaris syndrome hence bringing about distal leg
paresis alongside sensory loss in and around the perineum and anus or
saddle anesthesia; Effects of spinal cord dysfunction by segmental level
and in terms of location of lesion and the possible impact on the patient;
stiffness in the neck and shoulders which ultimately results in severe
headache and lastly Neck issues causing a migraine are rare cares though
they still occur (Tanouchi et al. 2014).
Cauda equine syndromes which involve the destruction of the nerve
roots at the caudal end of the cord are not part of the spinal cord
syndromes. Nonetheless, it mimics or takes after conus-medullaris syndrome
hence resulting in distal leg paresis alongside sensory loss in and around
the perineum and anus or saddle anesthesia. This effect extends to the
bladder, bowel and pudendal dysfunction for instance urinary retention,
urinary frequency, urinary or fecal incontinence, and erectile dysfunction,
loss of rectal tone, abnormal bulbocavernosus and anal wink reflexes. In
cauda equina syndrome unlike in spinal cord injury, muscle tone and deep
tendon reflexes are decreased in the legs (Tanouchi et al. 2014).
Corticospinal tract lesions have the general effect of bringing about
the dysfunction of the motor neuron. Acute and severe lesions such as
infarction and traumatic lesions bring about spinal shock with flaccid
paresis in the form of diminished muscle tone, hyporeflexia and lack of
extensor plantar responses. After a particular period may it be days or
weeks the upper motor neuron dysfunction develops or transforms into
spastic paresis that manifests in the form of increased muscle tone,
hyperreflexia and clonuses. Exterior plantar responses and automatic
dysfunction are present as well. Flaccid paresis that last more than a few
weeks points to the fact that there is lower motor neuron dysfunction. (For
instance due to Guillaine-Barre syndrome) (Verlaan et al. 2011).
Another general trouble suffered by victims of cervical spine disorder
is rigidity in the neck and shoulders which in the end consequences into
relentless headache. This sort of headache in therapeutic terms is defined
as cervicogenic headache because it results from either the cervical spine
or the neck. This state accrues given that the tautness in the neck
muscles, as well as the joints, stimulates the nerves in the neck that do
move into the head. As a consequence, this brings about the pain to travel
all the way to the head hence resulting in headache.
Neck issues causing a migraine are uncommon cares though they still
occur. The precise thing that happens in the head to bring about migraine
is yet to be wholly comprehended or understood but the contemporary
supposition holds that migraine is as a result of a blend of
transformations in the nerves as well as the blood vessels in the neck of
the affected person. The neck issues can bring about a migraine by
stimulating the nerves that travel from the head just like a cervicogenic
headache except that when the signals reach the head they do cause a
migraine. This is frequent especially among those individuals that are
susceptible to headaches (Verlaan et al. 2011).

2.5.2 The ways to either prevent them or at least decrease the cervical
spine disorders

Despite the various dangers and problems posed by the cervical spine
disorders to patients, there is still hope in terms of either minimizing
the continued progression of these deadly health conditions or even
eliminating the cervical spine disorders in totality. This part looks into
some of the ways of either minimizing or eliminating the cervical spine
disorders from the human populace.

2.5.2.1 Exercise and physical therapy for disc disease treatment and pain
management

It is obvious that a routine of back exercises can prevent low back pain.
This can also reduce the severity and duration of any flare-ups. Well
coordinated and progressive back pain exercises can help the back to retain
not only its strength but also flexibility. Furthermore, the movement of
the back does promote or encourage the delivery of nutrient to the spine,
keeping discs, muscles, ligaments, as well as joints in good health
(Verlaan et al. 2011).
Stretching to reduce low back pain
According to the structure of the spinal column and all the other
connected muscles, ligaments and tendons for motion and limitations in the
back's range of motion can result in low back pain. It may take quite a
number of weeks or even months to of regular stretching for one to realize
some significant improvement. Victims with chronic low back pain often find
that a better range of motion in their low back leads to some relief of
their low back pain. Hamstring stretches and psoas major muscle stretching
exercises are very significant in alleviating low back pain. As such it is,
therefore, imperative for people to be enlightened on the usefulness of
these body exercises so as to reduce their chances of suffering from these
cervical spine diseases (Willet et al. 20115).
Stretching the low back to reduce pain
For the purposes of achieving mechanical stability, patients with
degenerative disc disease can engage in dynamic lumbar stabilization
exercises. Such practices are significant in ensuring the stabilization of
the spinal ligaments. Proper muscular control of the spine can help in the
compensation of a degenerated disc and decrease not only the instability
but also the pain. It is, therefore, imperative for people to invest more
in the training of the lumbar extensor muscles. Such exercise is best
learned with the help of a therapist and as such they comprise of; locating
the exact spine position (neutral spine); training the back muscles to keep
the spine in the neutral position and maintaining the neutral position via
a series of movements that do apply more and more levels of freedom of
motion (Verlaan et al 2011). These dynamic lumbar stabilization trainings
are in most cases prescribed for decreasing sciatica type pain from
degenerative disc disease or rather the pain that radiates into the buttock
and down to the back of the leg (Tanouchi et al 2014).
Low-impact aerobic conditioning
These are aerobic exercises that get the heart rate up and the blood
flowing as well. They do so without jarring the spine. These exercises are
imperative for not only rehabilitating but also maintaining the lower back.
Aerobically fit patients will have reduced incidences of low back pain.
Such patients will furthermore experience very less pain in the event that
such an episode happens (Tanouchi et al. 2014). Persons experiencing
chronic low back pain and do not work on aerobic conditioning have higher
chances of losing their capability of engaging in daily activities.
Examples of the low-impact aerobic exercises that are gentle on the low
back include water or pool therapy or aquatic therapy exercises, stationary
exercise biking and exercise walking which also includes walking on a
treadmill (Fei et al 2014).

2.5.2.2 Pain medications for degenerative disc disease treatment

There are quite a number of medications that are useful in relieving
low back pain associated with degenerative disc disease. These medications
should be undertaken subject to the counsel of qualified medical personnel.
Some of the medications however cannot be taken by persons suffering from
certain medical conditions such as diabetics should not use oral steroids
since such medication has the dangerous impact of increasing the sugar
levels. It therefore suffices to say that patients ought to seek the
counsel of their physicians and pharmacists concerning the potential side
effects of any medication. Such medications include (Tanouchi et al 2014):
Acetaminophen
Acetaminophen for instance Tylenol is a pain medication that functions by
dampening the perception of an individual's brain with regards to pain.
This, however, does not treat the inflammation that obviously accompanies
pain from degenerated discs. This is unlike non-steroidal anti-inflammatory
drugs. This treatment is efficient not only in addressing low back pain but
also it has very minimal side effects. Acetaminophen is available without
any prescription. Furthermore, it is considered to be one of the most
efficient pain relievers for treating pain flare-ups that are a consequence
of degenerative disc disease.
Non-steroidal anti-inflammatory drugs
These are a class of pain medications that aid in the reduction of the
inflammation in the low back that is associated with lumbar degenerative
disc disorder. NSAIDs are, but an enormous category of pain relieving drugs
with numerous distinct options. With the exception of aspirin, there are
presently numerous kinds of both non-prescription NSAIDs and prescription
brands of NSAIDs. The most commonly used types to treat the low back pain
from degenerative disc comprise of; ibuprofen such as Advil, Motrin and
Nuprin, Naproxen such as Aleve and Naprosyn and COX-2 inhibitors such as
Celebrex. Consuming NSAIDs on a regular basis and in the proper dose lets
the medicine to build up in the system in order to have the anti-
inflammatory impact. This provides a better healing environment for the low
back. In cases of recurrent episodes of low back pain and chronic pain, it
is of course less efficient to take NSAIDs only during the commencement of
the pain. Doctors in particular circumstances will always recommend both
the acetaminophen and NSAIDs to address both the pain as well as underlying
inflammation.
Anti-seizure medications
These drugs are majorly used in the prevention of seizures. Presently,
they are used to aid in the control of chronic low back pain. A good
example of such a drug is Neurontin. These drugs are extremely healthy to
patients experiencing nerve pain caused by degenerative disc for instance
sciatica or peripheral neuropathy. These drugs are well tolerated and hence
patients can take them for a long period and without suffering side effects
(Verlaan et al. 2011).
Narcotic pain medications
Are particular drugs preserved and administered only in cases of low back
pain? They are administered on a short term basis. Examples include
codeine, propoxyphene, hydrocodone and oxycodone. These set of drugs do
function by having a dissociative impact that aids in pain management among
the patients. Key to note is that these drugs are only applied in cases of
severe episodes of low back pain. This is because these drugs can be
addictive hence making patients become tolerant to their pain-relieving
effects faster and within a range of between one and two weeks (Fei et al.
2014).
Oral steroids
This is a non-narcotic kind of prescription medication. They are very
potent anti-inflammatory drugs that are in some cases an efficient
treatment for instances of low back pain emanating from degenerative disc
disease. In most instances, oral steroids for low back pain from
degenerative disc disease are always prescribed in a Medrol Dose Pack
beginning with a high dose to commence the impact of the entire medication
and provide initial low back pain relief, then tapering down to a lower
dose over five or six days. The use of these drugs is, however, limited to
a short period of between one to two weeks. This is as a result of possible
complications that are likely to result from the use of these drugs.

2.5.2.3 Neck exercises for neck pain

Neck exercises are atypical segment of almost any treatment program for
neck pain. A standard neck exercise will initiative consist of a blend of
stretching and strengthening exercises, aerobic conditioning and possibly
trigger point activities. This portion centers on the exercises of the neck
that help in relieving neck pain brought about by posture problems (Fei et
al. 2014).
Benefits of neck exercises
Chronic neck pain can be severely debilitating and can also come with
another severe neck pain, shoulder blade pain as well as headaches. Such
symptoms along with tight neck muscles and rigid joints can even have the
general impact of making even the simplest daily activities painful. Proper
neck exercises can be a solution to this problem as they can address most
of the highlighted symptoms as follows (Shrier et al. 2014).
Neck Stretches
Flexibility together with stretching exercises can expand or preserve the
range of motion and elasticity in the affected neck joints and thus relieve
the stiffness that leads to pain. As a universal rule, neck stretching is
best done every day, and some stretches should be carried out many times a
day (Shrier et al. 2014).
Neck strengthening
Particular strengthening exercises are significant in the maintaining of
improved posture which will have the positive effect of lessening or
eliminating chronic flare-ups of pain. It's a universal rule that neck
strengthening trainings should be done on a daily basis. This gives the
muscles the allowance to repair themselves.
E-business is more than just establishing an Internet presence or
conducting e-commerce transactions, it concerns redefining old business
models and maximizing business value (Kalakota and Robinson, 1999) .One of
the hard parts of any discussion of E-Business is coming to grips with what
is being discussed. There are several definitions of E-Business. There
are different versions of the history. There are different conceptual
tools that might be used to understand it. In order to understand e-
business it is useful to have a conceptual framework. This includes
understanding the roots, driving forces, and shaping forces behind the
phenomenon. This study will examine the amount of growth in the middle-
eastern countries.
distributed inventory control functions
training of employees
customer support and education
recruiting of new employees
marketing, advertising and public relations
meetings and information resource sharing among employees
intelligence gathering for strategic and tactical planning

Aerobic conditioning
Aerobic exercises have the impact of increasing the flow of blood to the
muscles as well as in the soft tissues of both the neck and the upper back.
This aids in loosening the muscles and increase the range of motion as
well. Furthermore, endorphins are generated after about 30 to 40 minutes of
aerobic exercise. They are the natural painkillers of the human anatomy and
as such they help in the reduction of neck pain. The practice of aerobic
conditioning can be carried out on a daily basis (Shrier et al. 2014).

2.5.2.4 Pain control for neck exercises (Treatment for neck strain or
sprain video)

There are numerous options available for patients suffering from
cervical spine disorders to manage the extensive of the neck pain. Such
options include the application of a heating pad before carrying out any
exercise to warm up the rigid or stiff muscles and joints and make it able
and comfortable to stretch; post the training, the person ought to apply a
cold pad to minimize the inflammation in the joints and the pads; the
application of over the counter medications for instance non-steroidal anti-
inflammatory drugs (example ibuprofen). To alleviate pain and minimize the
inflammation and lastly the use of prescription anti-inflammatory as well
as pain medications such as corticosteroids, COX-2 inhibitors as necessary
to put severe pain under control.

2.6 Study people whose jobs often cause these problems

There are various categories of people whose jobs have a high
potential of making them contract the cervical spine disorders. These kinds
of jobs subject such persons who engage in them to high chances of
suffering from cervical spine diseases. This segment deals with some jobs
whose by their very nature expose the employees or persons engaging in them
the danger of contacting and suffering from cervical spine diseases.
The study of this topic targets to enhance the understanding of the rapid
development of E-businesses or electronic business worldwide. The project
aims to recognize the consumer behaviour of when it shifts to Electronic-
Businesses and the reasons they have been avoiding using this technology.
Besides, this research will specify the factors which would influence the
customers to use electronic business. Objectives of the research will be to
gather relevant information regarding the performance of E-business and
identify the electronic business implementation success through the
available literature.
The final objective of the project will be to critically analyse the
gathered information to answer the research question.
E-business implementation success discusses the influence of e-business
application on firm performance in term of downstream markets, interior
operations and upstream procurement (Zhu, 2004). Abundant information
regards downstream markets empowers organizations to multiply sales
frequencies and improve customer relationships (Lederer et al.,2001). E-
business can advance the business productivity and staff efficiency within
firms when complementary resources exist (Chircu and Kaufman, 2000). The
extensive interactivity and connectivity of the internet upstream can
reduce transaction costs and facilitate firms coordination with business
partners (Malone et al., 1987)
Studies have originated overall IT capability to be absolutely positive
linked to organizational performance (Bharadwaj, 2000; Kearns and Lederer,
2003) and revealed to have the potential of providing a substantial
competitive advantage to organizations (Earl, 1993; Ives and Jarvenpaa,
1991; Kathuria et al., 1999). Correspondingly, organizational integration
has been publicized to have a encouraging impact on performance (Vickery et
al., 2003; Stank et al., 2001). Market intelligence and internal capability
assessment visualizing the aggregation of value to the customers represent
the primary step towards exploring e-business opportunities without
underestimating the threats. Watson and Zinkhan (1997) claimed that if the
organization makes the right choices, the Web can offer the customer with
advanced services, making a one-to-one market feasible, aiding the
communication process, and adding value to the brand image. Porter (2001)
states that e-business takes part to establish a closer and more
interactive relation with their consumers.
2.5 The consumer behaviour
The web is being produced quickly since most recent two decades, and with
pertinent advanced economy that is driven by data innovation additionally
being created around the world. After a long haul advancement of web, which
quickly expanded web clients and profoundly speed web association, and some
new innovation additionally have been created and utilized for web building
up, those lead to firms can advance and upgrade pictures of item and
administrations through site.
Early e-shopping consumer research (e.g. Brown et al., 2003) indicated that
e-shoppers tended to be concerned mainly with functional and utilitarian
considerations. As typical "innovators" (Donthu and Garcia, 1999; Siu and
Cheng, 2001), they tended to be more educated (Li et al, 1999), higher
socio-economic status (SES) (Tan, 1999), younger than average and more
likely to be male (Korgaonkar and Wolin, 1999). This suggested that the e-
consumer tended to differ from the typical traditional shopper. More recent
research, on the other hand, casts doubt on this notion. Jayawardhena et
al. (2007) found that consumer purchase orientations in both the
traditional world and on the Internet are largely similar, and there is
evidence for the importance of social interaction (e.g. Parsons, 2002; Rohm
and Swaminathan, 2004) and recreational motives (Rohm and Swaminathan,
2004), as demonstrated by virtual ethnography (webnography) of "Web 2.0"
blogs, social networking sites and e-word of mouth (eWOM) (Wright, 2008)
Hence, nitty gritty item data and enhanced administration pulls in more
individuals changed their buyer conduct from the customary mode to all the
more depend on the web shopping. Then again, more organizations have
understood that the customer conduct change is unavoidable pattern, and
hence change their showcasing technique. As the late examines have
demonstrated that, the web shopping especially in business to buyer (B2C)
has risen and web shopping turn out to be more prominent an excess of
individuals. There are numerous explanations behind such a quick creating
of web shopping, which principally because of the advantages that web
gives. Above all else, the web offers diverse sort of comfort to
purchasers. Clearly, shoppers don't require go out searching for item data
as the web can help them to seek from online locales, and it additionally
assesses between every destinations to get the least expensive cost for
procurement. Besides, the web can upgrade shopper use item more
productively and viably than different channels to fulfil their
necessities. Through the distinctive internet searchers, buyers spare time
to access to the utilization related data, and which data with blend of
pictures, sound, and extremely definite content portrayal to help shopper
learning and picking the most suitable item.
Web shopping has potential dangers for the clients, for example, instalment
security, and after administration. Because of the web innovation created,
web instalment as of late gets to be common path for buying merchandise
from the web. Web instalment expands immoderate productivity, in the
meantime, as its virtual property diminished web security.
2.6 Consumer Trust in Internet Shopping
Mayer, Davis, and Schoorman (1995) defined trust as, "the willingness of a
party to be vulnerable to the actions of another party based on the
expectation that the other will perform a particular action important to
the trustor, irrespective of the ability to E-business: It's Impact on
consumer Behavior 135 monitor or control that other party" (Cheung and Lee,
2006). This definition is widely recognized and the most frequently cited
(Rousseau, Sitkin, Burt, & Camerer,). People purchase products and services
are the most based on their level of trust in this product or services, and
sellers either in the physical store or online shops. Online trust is the
basic and essential element for building a relationship with customers. A
present research shows that online trust is lower level than the face-to-
face interactions in the physical store (Cassell and Bickmore, 2000), and
the result from Cheung and Lee (2006) shows that trustworthiness of
Internet merchant (perceived integrity, perceived competence, and perceived
security control) and external environment (third-party recognition and
legal framework) have considerable impact on consumer trust in Internet
shopping (see figure 1). The trustworthiness of E-commerce web site is very
relying on the how much privacy security can be provided. For example, a
highly technical competence can be a factor to influence the
trustworthiness (Singh and Sirdeshmukh, 2000). As mentioned above that the
web merchant can provide third-party verification to E-commerce web site,
and while this privacy and security strategies are used, customers will
think their E-commerce transactions through Internet are secure and thus
the site is more reliable to them. Beside this point, if the Ecommerce web
site can provide the information about their customer services, location of
the office, contact telephone number, and a help button on the web site,
customers could also increase their trustiness as they can feel that the
online retailers is truly exist (Lohse and Spiller, 1998).


An Integrative Model of Consumer Trust in Internet Shopping.
2.7 Barriers to E-business
Successful e-business depends on critical threshold of online users, the
precursor to a critical threshold of seller and buyers. While it is not a
precisely defined phenomenon, this critical threshold can be likened to
Metcalfe's law, which explains that the value of a network increases with
the square of the number of participants. This suggests that as more people
go online, the value of the whole network and opportunities for exchange
are limited, but if many are online, the opportunities increase
dramatically. It is important to have many people online for e-business to
work productive. In general, the following major barriers are identified: a
lack of time to implement e-business (Scupola, 2009), the high level of
complexity associated with e-business implementation (Kaynak et al., 2005)
and high implementation cost associated with e-business technologies
(Gunasekaran and Ngai, 2007; Li and McQueen, 2008; Tan et al., 2010). It is
argued that many of these barriers can be successfully addressed by large
organizations due to their resource and expertise availability.


2.6.1 Persons engaging in sporting activities

There are certain sporting activities that do expose the participants
to high chances of contracting cervical spine injuries. Such sporting
activities like rugby expose the participants to high chances of suffering
not only neck but also spine injuries. There ought to be introduced precise
mechanisms that aim at protecting such players while undertaking these
sporting activities (Brembilla et al. 2015).

2.6.2 People working on building and construction sites

These kinds of jobs cause a big threat to the employees. This is due
to the dangers of falling from great heights. The fall may be on a hard
object or surface and as such, the backbone and the neck as well may either
break or be dislocated hence rendering such a person unable to live a
normal life any longer (Battakova and Shraimanov 2013). These very
employees always subject themselves to high chances of contracting cervical
spine problems due to the heavy building materials they do carry such as
building blocks and other heavy metals on either their heads or their backs
(Brembilla et al. 2015).. As such they increase the chances of suffering
from spinal cord and neck injuries as well. Such casual employees ought to
be equipped with protective gear or personal protective equipment that do
shield them from sustaining back and neck injuries in the course of
discharging their contractual obligations (Brembilla et al. 2015).

2.6.3 Engineers

These are people whose jobs put them at a great risk of suffering from
the problems of cervical pain disorders. This is out of the fact that these
persons engage in various activities in the course of their professional
calling that do subject them to great dangers of hurting their backbones
(Battakova and Shraimanov 2013). They engage in operating big and bulky
machines that do call upon them to either bend or subject their bodies to
uncomfortable positions that are dangerous to the well-being of their
spinal cords. Furthermore, these employees engage in carrying heavy objects
and metals in the course of their duties and as such they risk spinal cord
and neck injuries (Brembilla et al. 2015). It is advisable for such persons
to ensure that they have fully functional protective gears or rather the
personal protective equipment that protect them from the dangers of
sustaining spinal cord and neck injuries (Battakova and Shraimanov 2013).

2.6.4 Farmers

Farmers engage in activities that pose them a great danger of
suffering from the cervical spine problems. This is highly likely
especially for those farmers who still use the traditional farming methods
such as farming manually at the expense of using modern farming equipment
and machines such as tractors while cultivating their farms. As such, they
expose themselves to risk of getting cervical spine diseases. They are
always in a bending position for a long time. Furthermore, they engage in
carrying heavy loads on either their back or their head and as such, they
risk injuring not only their spines but also their necks. It is advisable
for such farmers to make use of modern farming equipment to avoid such
risks (Brembilla et al. 2015).
The study of this topic targets to enhance the understanding of the
rapid development of E-businesses or electronic business worldwide. The
project aims to recognize the consumer behaviour of when it shifts to
Electronic-Businesses and the reasons they have been avoiding using this
technology. Besides, this research will specify the factors which would
influence the customers to use electronic business. Objectives of the
research will be to gather relevant information regarding the performance
of E-business and identify the electronic business implementation success
through the available literature.
The final objective of the project will be to critically analyse the
gathered information to answer the research question.
E-business implementation success discusses the influence of e-
business application on firm performance in term of downstream markets,
interior operations and upstream procurement (Zhu, 2004). Abundant
information regards downstream markets empowers organizations to multiply
sales frequencies and improve customer relationships (Lederer et al.,2001).
E-business can advance the business productivity and staff efficiency
within firms when complementary resources exist (Chircu and Kaufman, 2000).
The extensive interactivity and connectivity of the internet upstream can
reduce transaction costs and facilitate firms coordination with business
partners (Malone et al., 1987)
Studies have originated overall IT capability to be absolutely
positive linked to organizational performance (Bharadwaj, 2000; Kearns and
Lederer, 2003) and revealed to have the potential of providing a
substantial competitive advantage to organizations (Earl, 1993; Ives and
Jarvenpaa, 1991; Kathuria et al., 1999). Correspondingly, organizational
integration has been publicized to have a encouraging impact on performance
(Vickery et al., 2003; Stank et al., 2001). Market intelligence and
internal capability assessment visualizing the aggregation of value to the
customers represent the primary step towards exploring e-business
opportunities without underestimating the threats. Watson and Zinkhan
(1997) claimed that if the organization makes the right choices, the Web
can offer the customer with advanced services, making a one-to-one market
feasible, aiding the communication process, and adding value to the brand
image. Porter (2001) states that e-business takes part to establish a
closer and more interactive relation with their consumers.
2.5 The consumer behaviour
The web is being produced quickly since most recent two decades, and
with pertinent advanced economy that is driven by data innovation
additionally being created around the world. After a long haul advancement
of web, which quickly expanded web clients and profoundly speed web
association, and some new innovation additionally have been created and
utilized for web building up, those lead to firms can advance and upgrade
pictures of item and administrations through site.
Early e-shopping consumer research (e.g. Brown et al., 2003) indicated
that e-shoppers tended to be concerned mainly with functional and
utilitarian considerations. As typical "innovators" (Donthu and Garcia,
1999; Siu and Cheng, 2001), they tended to be more educated (Li et al,
1999), higher socio-economic status (SES) (Tan, 1999), younger than average
and more likely to be male (Korgaonkar and Wolin, 1999). This suggested
that the e-consumer tended to differ from the typical traditional shopper.
More recent research, on the other hand, casts doubt on this notion.
Jayawardhena et al. (2007) found that consumer purchase orientations in
both the traditional world and on the Internet are largely similar, and
there is evidence for the importance of social interaction (e.g. Parsons,
2002; Rohm and Swaminathan, 2004) and recreational motives (Rohm and
Swaminathan, 2004), as demonstrated by virtual ethnography (webnography) of
"Web 2.0" blogs, social networking sites and e-word of mouth (eWOM)
(Wright, 2008)
Hence, nitty gritty item data and enhanced administration pulls in
more individuals changed their buyer conduct from the customary mode to all
the more depend on the web shopping. Then again, more organizations have
understood that the customer conduct change is unavoidable pattern, and
hence change their showcasing technique. As the late examines have
demonstrated that, the web shopping especially in business to buyer (B2C)
has risen and web shopping turn out to be more prominent an excess of
individuals. There are numerous explanations behind such a quick creating
of web shopping, which principally because of the advantages that web
gives. Above all else, the web offers diverse sort of comfort to
purchasers. Clearly, shoppers don't require go out searching for item data
as the web can help them to seek from online locales, and it additionally
assesses between every destinations to get the least expensive cost for
procurement. Besides, the web can upgrade shopper use item more
productively and viably than different channels to fulfil their
necessities. Through the distinctive internet searchers, buyers spare time
to access to the utilization related data, and which data with blend of
pictures, sound, and extremely definite content portrayal to help shopper
learning and picking the most suitable item.
Web shopping has potential dangers for the clients, for example,
instalment security, and after administration. Because of the web
innovation created, web instalment as of late gets to be common path for
buying merchandise from the web. Web instalment expands immoderate
productivity, in the meantime, as its virtual property diminished web
security.
2.6 Consumer Trust in Internet Shopping
Mayer, Davis, and Schoorman (1995) defined trust as, "the willingness
of a party to be vulnerable to the actions of another party based on the
expectation that the other will perform a particular action important to
the trustor, irrespective of the ability to E-business: It's Impact on
consumer Behavior 135 monitor or control that other party" (Cheung and Lee,
2006). This definition is widely recognized and the most frequently cited
(Rousseau, Sitkin, Burt, & Camerer,). People purchase products and services
are the most based on their level of trust in this product or services, and
sellers either in the physical store or online shops. Online trust is the
basic and essential element for building a relationship with customers. A
present research shows that online trust is lower level than the face-to-
face interactions in the physical store (Cassell and Bickmore, 2000), and
the result from Cheung and Lee (2006) shows that trustworthiness of
Internet merchant (perceived integrity, perceived competence, and perceived
security control) and external environment (third-party recognition and
legal framework) have considerable impact on consumer trust in Internet
shopping (see figure 1). The trustworthiness of E-commerce web site is very
relying on the how much privacy security can be provided. For example, a
highly technical competence can be a factor to influence the
trustworthiness (Singh and Sirdeshmukh, 2000). As mentioned above that the
web merchant can provide third-party verification to E-commerce web site,
and while this privacy and security strategies are used, customers will
think their E-commerce transactions through Internet are secure and thus
the site is more reliable to them. Beside this point, if the Ecommerce web
site can provide the information about their customer services, location of
the office, contact telephone number, and a help button on the web site,
customers could also increase their trustiness as they can feel that the
online retailers is truly exist (Lohse and Spiller, 1998).



An Integrative Model of Consumer Trust in Internet Shopping.
2.7 Barriers to E-business
Successful e-business depends on critical threshold of online users,
the precursor to a critical threshold of seller and buyers. While it is not
a precisely defined phenomenon, this critical threshold can be likened to
Metcalfe's law, which explains that the value of a network increases with
the square of the number of participants. This suggests that as more people
go online, the value of the whole network and opportunities for exchange
are limited, but if many are online, the opportunities increase
dramatically. It is important to have many people online for e-business to
work productive. In general, the following major barriers are identified: a
lack of time to implement e-business (Scupola, 2009), the high level of
complexity associated with e-business implementation (Kaynak et al., 2005)
and high implementation cost associated with e-business technologies
(Gunasekaran and Ngai, 2007; Li and McQueen, 2008; Tan et al., 2010). It is
argued that many of these barriers can be successfully addressed by large
organizations due to their resource and expertise availability.
According to Turban et al. (2000), e-business includes transactions
carried out in electronic markets, services to consumers, collaboration
with business partners and intra-organizational relationships. E-business
is part of a wider economic context that is responsible for radical
transformations in business and encompasses digital networks and
communication infrastructure. Moreover, e-business provides a global
platform where individuals and organizations interact, communicate,
collaborate and obtain information. E-business web-based systems
increasingly represent a competitive advantage for companies and have
undergone great organizational changes (Currie and Parikh, 2006).
Consequently, companies must develop a strategic plan for IT to improve the
company e-business capabilities. Luftman et al. (1993) suggest that the
success in a global market depends on more agile and flexible business
structures. The dynamic nature of this market brings about changes
regarding competitors, work, suppliers and regulations. Companies reach
more customers, at a compensatory cost, with a change in the traditional
paradigm: from mass production and mass distribution to mass customization
and with faster product development, production, pricing and delivery.
2.9 Advantages and Disadvantages of using Electronic business
The advantages of the e-businesses are: Faster buying/selling
procedure, as well as easy to find products. Buying/selling 24/7. Customers
can easily select products from different providers without moving around
physically. More reach to customers, there is no theoretical geographic
limitations. No need of physical company set-ups. Easy to start and manage
a business.
However, there are several disadvantages that can occur by using the
electronic business: Everyone, Trustworthy or untrustworthy can easily run
a business in any size. And there are many fraud web sites which eat up
customer's money. There is no guarantee of product quality. Mechanical
miscarriages can source unpredictable effects on the whole processes. As
there is least chance of direct customer to company interactions, customer
loyalty is always on a check. There are many hackers who look for
opportunities, and thus an e-business site, service, payment gateways; all
are always prone to attack. (Goldman, 2011)

(Goldman Sachs, 2011)






























3. Methodology
Research methodology plays an important role in any dissertation to
achieve research aims and objective and collect adequate data. A well
define research methodology assist the researcher to conduct an effective
research study and collect reliable and valid information.
This chapter will give us an overview of the methodology with detailed
information on the chosen method. Both primary and secondary dada has been
utilised for the appropriate research method.
3.1 Primary vs. Secondary
Primary research also identified as field research is the original
analysis of data in the detailed research field. It is what several call as
the application of statistical method (GLASS, 1976). Primary research
states the first time of collecting data. This data is collected for some
exact purpose. Primary research is more exclusive and time consuming but it
will give superior outcomes than secondary data (Gratton & Jones,
2010).There are several
research knowledge and its nature (Saunders and Thornhill, 2007).
Research philosophy is also states the help of research paradigm. According
to Cohen, Manion and Morrison (2000), research paradigm can be well-defined
as the broad framework, which involves perception, beliefs and
understanding of numerous theories and practices that are used to conduct a
research. The major issue is not regarding the research being philosophical
however how have we used our selected philosophical selections and defended
them well in compare to all the alternatives (Johnson and Clark 2006).
Positivism philosophy is based on the highly structured methodology to
enable generalization and quantifiable observations and evaluate the result
with the assist of statistical methods. It is an approach that contains the
various philosophy of natural science such as philosophy of unchanging,
universal law and the view of everything that occurs in the nature (Sundars
2003). On the other hand, we have Realism philosophy which this research is
going to use.
This research philosophy mainly focuses in the reality and beliefs
that are already exist in the environment. In this philosophical approach,
two core approaches are direct and critical realism (McMurray, Pace and
Scott 2004). Direct reality refers to what an individual feels, sees,
hears, etc. Additionally, in critical realism, individuals discuss about
their practices for a particular situation (Sekaran and Bougie 2010). This
is connected with the situation of social constructivism, because
individual attempts to prove his beliefs and
Inductive approach permits the researcher to deliver subjective
reasoning with the help of numerous real life examples (Ridenour, Benz and
Newman 2008). Inductive approach works over a specific idea to generalize
the situation as per the research topic, which is linked with the
interpretivism paradigm (Crowther and Lancaster 2009). It allows the
researcher to add up and understand the principle of ''what's going on
rather than reciting what's going on'' (Easterby-Smith et al., 2008 p1-500)
3.4 Quantitative vs Qualitative Data
Quantitative approach takings a distant stance and qualitative methods
assist the researcher get a appropriate understanding of the topic due to
close engagement with the subject. (Bryman & Bell, 2011; Saunders, et al.,
2012) however qualitative data was developed to comprehend the nature of
entrepreneurial orientation through semi-structured interviews.
3.5 Semi-Structured Interview
Data collection methods contain structured/semi-structured interviews,
self-completion questionnaires, asking questions from the target
population, structured observation, content analysis, secondary analysis
and official statistics. For the purpose of this study, semi-structured
interviews were seen as suitable by the researcher. Saunders states semi-
structures interviews are ''non-standardised'' and sometimes known as
''qualitative research interviews'' (king, 2004 p.11-22). This method
incorporates a meaningful conversation amongst two or more individuals
(Kahn and Cannell, 1957). Interviews are discussions, usually one-on-one
between an interviewer and an individual, meant to gather information on a
specific set of topics. Interviews can be con
Sampling is a process of collecting data, when the population is large
for the study. Sampling is research processes of selecting a particular
group from a population so that researcher studying the sample and collect
the information in a particular group. It is less expensive and takes less
time. Sampling may be the only practical method of data collection (Guire &
Pritts, 2007). My research sample size consisted of 5 respondents aged 18+.
The demographic nature of sample insured that the research would attain
rich data consisting from multiple cultural and ethnic groups. Convenience
sampling was the adequate method of choice as the researcher had great
access to many potential respondents, ultimately increasing the time taken
for the data collection procedure. However, the researcher could not
generalise from findings due to the minute nature of the sample (Saunders,
Lewis & Thornhill, 2009; Explorable, 2009). Finally convenience sample
overcomes the restraint of prejudiced consumer responses when uncovering
the factors relating to CE. (Saunders, Lewis & Thornhill, 2009).
3.7 Questions
) What are the current common risks for ecommerce and how do you
mitigate them?
5) How is the electronic business market at the moment and how
competitive is the market?
6) Talk me through your approach to generating strategies for
addressing current and future ecommerce market scenarios and to position a
business to capitalise on them.
7) How do you drive results and what are the processes and methods you
use in your job to successfully deliver your agreed ecommerce Key
Performance Indicators?




3.8 Alternative Method











2.6.5 Drivers and other road users

These people expose themselves to the troubles of suffering from cervical
spine disorders. To begin with, long distance drivers spend much time in a
seating position and as such they risk injuring their spinal cords.
Furthermore, drivers expose themselves to the dangers of road carnage which
is among the leading causes of spinal cord and neck injuries. Other road
users such as cyclists also expose themselves to the risks of spinal cord
and neck injuries that may result from road accidents. There are numerous
cases of road carnages involving motorists and cyclists. For this reason
among others, it is advisable for there to be a proper use of the roads in
a manner likely to reduce incidences f road carnage (Fei et al. 2014).

2.7 To provide excellent advice based on their way of life

The patients suffering from or likely to suffer from cervical spine
disorders are to live their daily lives in a particular way through
undertaking various physical exercises as well as taking various
medications in the event that they are actually suffering from a cervical
spine disease. This segment builds up from the above section that
highlights the different jobs and activities that people do engage into
that are likely to cause them cervical spine disorders. In a nutshell, this
part captures the different lifestyles that should be adopted by the
persons either suffering from the cervical spine disorders or those ones
likely to suffer from these disease pursuant to the nature of their jobs or
the activities they are involved in on a daily basis or rather most
frequently.
Information technology resulting from the scientific revolution has
brought forth some significant relief to patients with cervical spine
disorders. In particular, the invention of vertetrac's lumber ambulatory
decompression system is not only an innovative but also a cost-effective
approach to the treatment of lower back pain and sciatica. Meditrac
specializes in the development, production and marketing of innovative
medical appliances for ambulatory, nonsurgical treatment of spinal
disorders. This has provided a new approach to not only back pain but also
neck pain treatment. Mediatric medical equipment does enable rapid recovery
and as well help in the elimination of the need for hospitalization, drugs
and surgery as well. The Meditrac health appliances are used in the
treatment of a broad range of spinal disorders such as sciatica, herniated
disc, whiplash injury, degenerative changes and spinal stenosis that result
from disc herniation. The persons whose nature of jobs has made them
suffer from cervical spine disorders can make use of this vertetrac's
lumber ambulatory decompression system to counter and manage their spinal
condition as well. This is due to the many advantages that do accompany the
use of this novel medical technology. This machine is affordable and has no
side effects to patients suffering from cervical spine disorders. This is
out of the fact that there is no medical surgery, hospitalization or
administration of drugs (Fei et al. 2014).
This category of persons whose nature of their jobs has exposed them to
the dangers of contracting cervical spine disorders can make use of
acetaminophen for instance Tylenol. This is a pain medication that works by
dampening the sensitivity of an individual's brain with regards to pain.
This, on the other hand, does not treat the swelling that apparently
accompanies pain from degenerated discs. This is unlike non-steroidal anti-
inflammatory drugs. This treatment is efficient not only in addressing low
back pain but also it has very minimal side effects. Acetaminophen is
available without any prescription. In addition, it is considered to be one
of the most effectual pain relievers for treating pain flare-ups that are a
consequence of degenerative disc disease. It is, therefore, advisable that
such people suffering from cervical spine disorders be administered to this
very medication. It is worthy to note that any medication such as this can
only be administered subject to the advice of qualified medical personnel.
The people suffering from cervical spine disorders can also make use of
Non-steroidal anti-inflammatory drugs.
These are a class of pain medications that assist in the diminution of the
swelling in the low back that is connected to the lumbar degenerative disc
disorder. NSAIDs are, but a vast class of pain relieving medicines with
abundant dissimilar options. With the exclusion of aspirin, there are at
the moment several kinds of both non-prescription NSAIDs and prescription
brands of NSAIDs. The most commonly used types to treat the low back pain
from degenerative disc comprise of; ibuprofen such as Advil, Motrin and
Nuprin, Naproxen such as Aleve and Naprosyn and COX-2 inhibitors such as
Celebrex. Consuming NSAIDs on a regular basis and in the proper dose lets
the medicine to build up in the system in order to have the anti-
inflammatory impact. This provides a better healing environment for the low
back. In cases of recurrent episodes of low back pain and chronic pain, it
is of course less efficient to take NSAIDs only during the commencement of
the pain. Doctors in particular circumstances will always recommend both
the acetaminophen and NSAIDs to address both the pain as well as underlying
inflammation (Fairbank 1998).
Chronic neck pain can be severely debilitating and can also come with
another severe neck pain, shoulder blade pain as well as headaches. Such
symptoms along with tight neck muscles and rigid joints can even have the
general impact of making even the simplest daily activities painful. Proper
neck exercises can be a solution to this problem as they can address most
of the highlighted symptoms as follows. As such, it is, therefore,
advisable for the persons suffering from the cervical spine disorders to
get this medication due to its great help in not only diminishing the
effects of this disease but also treating it entirely. This is a great way
of reducing and eliminating neck pain.
The people whose jobs are likely to lead to the contraction of cervical
spine disorders ought to undertake various physical exercises. These
physical exercises are critical to putting the problems suffered by this
category of persons under the control. To start with, such people ought to
engage in physical activities involving neck stretches. Flexibility
together with stretching exercises can expand or preserve the range of
motion and elasticity in the affected neck joints and thus relieve the
stiffness that leads to pain. As a universal rule, neck stretching is best
done every day, and some stretches should be carried out many times a day
(Swartz et al. 2009).
The second physical exercise that should be engaged into by the persons
suffering from the cervical spine disorders is the neck strengthening
exercises. Particular strengthening exercises are significant in the
maintaining of improved posture which will have the positive effect of
lessening or eliminating chronic flare-ups of pain. It's a universal rule
that neck strengthening trainings should be done on a daily basis. This
gives the muscles the allowance to repair themselves (Swartz et al. 2009).
The third physical exercise that ought to be carried out to reduce the
effects of cervical spine disorders is the aerobic conditioning exercise.
Aerobic exercises have the impact of increasing the flow of blood to the
muscles as well as in the soft tissues of both the neck and the upper back.
This aids in loosening the muscles and increase the range of motion as
well. Furthermore, endorphins are generated after about 30 to 40 minutes of
aerobic exercise. They are the natural painkillers of the human anatomy and
as such they help in the reduction of neck pain. The practice of aerobic
conditioning can be carried out on a daily basis (Fei et al. 2014)
The fourth and the last physical exercise is the one involving the oral
steroids. This is a non-narcotic kind of prescription medication. They are
very potent anti-inflammatory drugs that are in some cases an efficient
treatment for instances of low back pain emanating from degenerative disc
disease. In most instances, oral steroids for low back pain from
degenerative disc disease are always prescribed in a Medrol Dose Pack
beginning with a high dose to commence the impact of the entire medication
and provide initial low back pain relief, then tapering down to a lower
dose over five or six days. The use of these drugs is, however, limited to
a short period of between one to two weeks. This is as a result of possible
complications that are likely to result from the use of these drugs (Swartz
et al. 2009).
Ongoing care
Just after the original injury of the spine or the disease has
destabilized, the medics often turn their attention towards the prevention
of the secondary problems that have the potential of emanating from the
injury or the disease. Examples of such secondary problems likely to arise
include the blood clots, respiratory infections bowel and bladder
complications, pressure ulcers, muscle contractures as well as
reconditioning. This is one of the most valuable information that patients
of any cervical spine disorder ought to have full knowledge of. This will
allow the doctors to protect them further from the secondary problems
likely to arise out of the primary spine injury or the disease. The persons
exposed to cervical spine disorders ought to be made aware or be informed
of such medical arrangement for them not to continue living their lives
under the false assumption that once one is healed from either the primary
injury or the original cervical spine disease is good to continue living
life as usual without dangers of further health complications arising from
the original illness or injury (Swartz et al 2009).
Rehabilitation
Furthermore, the people suffering from the cervical spine disorders
ought to be taken through the recovery process. This is usually a preserve
of the special medical personnel, and it is an exercise executed during the
early stages of recovery of patients of cervical spine diseases or spine
injuries. In the initial stages of rehabilitation, there is great emphasis
on the maintenance and strengthening of existing muscle function,
redeveloping fine motor skills and the learning of adaptive techniques to
accomplish the daily tasks. This exercise is helpful as it enlightens the
people with the spinal cord injury and how to curb the complications
(Swartz et al. 2009). This extends to being given imperative pieces of
advice on how to rebuild your life and improve its quality even after
suffering from the previous wounds of spinal cord injuries. During this
rehabilitation period, the persons involved are taught numerous novel
skills. Furthermore, they are introduced to the use of equipment and
technology that will aid them to live their daily lives to the maximum. The
post cervical spine disease patients are also encouraged to return to their
hobbies and participate in social as well as fitness activities and resume
either school or their usual employment activities (Swartz et al. 2009).
Medications
People in the employment activities that bring about cervical spine
disorders can make use of medications to manage the effects of spinal cord
injury. Such medications or drugs include those ones that do reduce the
pain and the spasticity of muscles and by extension drugs that can boost
bladder and bowel control as well as proper sexual functioning (Zhan et al
2010).
New technologies
The inventive medical equipment is of great help to persons suffering
from cervical spine disorders. These techniques help such individuals not
only t become more independent but also more mobile. Some of the devices
have the ultimate affirmative impact of restoring the full function of the
spine. Some of these tools that can be used by such persons include the
modern wheelchairs. These are improved, lighter weight wheelchairs that
make persons with cervical spine diseases more mobile and comfortable.
There are even electronic wheelchairs that may be needed by some people.
Some of these specialized wheelchairs have the ability to climb stairs,
move over rough terrain and elevate a seated person to eye level o as to be
able to reach high places without the need for any help. These people can
also adapt computer technologies. These computer adaptations range from key
guards and voice recognition. The people suffering from these cervical
spine injuries can also be taken through robotic gait training. This is an
emerging technology that is useful or helpful in regaining walking ability
after one has suffered a spinal cord injury.

CHAPTER 3


RESEARCH METHODOLOGY


7 Introduction



This chapter discusses the research design and methodology by looking
at research design, target population, sampling design, data collection
instrument, analysis and presentation of the findings of the study. This
includes details on the research strategy, the different categories of
respondents and how data will be collected during fieldwork.

1 Research Design



The study used a descriptive survey. This is mainly because the
subjects were observed in their natural set up without manipulation of the
environment. Descriptive survey is the process of collecting data in order
to test hypotheses or to answer questions concerning the current status of
the subjects in the study (Venkatesh et al. 2013). It determines and
reports the way things are. It attempts to describe such things as possible
behavior, attitudes, values and characteristics.

Descriptive survey is a method of collecting information by
interviewing or administering a questionnaire to a sample of individuals
(Venkatesh et al. 2013). It can be used when gathering information about
people's attitudes, opinions, habits or any of the variety of education or
social issues. In this case, descriptive survey method was used to find
out te causes of cervical spine disorders and the effects these diseases
bring to their patients. Furthermore, this design was used to establish the
jobs that are likely to bring about the problems of cervical spine
disorders.The study employed both qualitative and quantitative techniques
for maximum effectiveness of data collection. Therefore, the descriptive
survey was deemed the best strategy to fulfill the objectives of this
study.

3.2 Rationale and the approach to the study

Population refers to an entire group of persons or elements that have
at least one thing in common, for instance, the customs officials in this
case. Target population is defined as all the members of the real or
hypothetical set of people, events or objects to which the researcher
wishes to generalize the results of the research study. The target
population for the study consisted of 200 persons suffering from cervical
spine disorders.


3.3 Data Collection


3.3.1 Data collection Instruments

There are two types of data that the study utilized; these were
primary and secondary data. For primary data, the researcher was able to
collect first-hand information from the respondents (Venkatesh et al 2013).
The researcher used the questionnaire to collect primary data from the
various patients. The main data was useful to the researcher because it was
more reliable and accurate as it was being derived from the project
participants. The secondary data also be paramount in the study. The
researcher collected valuable information from the library books, annual
reports, journals and publications from research institutions.

The primary tools for data collection for this study will be the
questionnaires. Questionnaire is a standardized method of data collection
where each respondent is asked the same questions, carrying the same
meaning so that responses are comparable across. The chief advantage of
using a questionnaire is that it is cheap and far quicker to conduct an
investigation but also warns that the response rates are sometimes small
unless the questions engage the respondents' interest or the research is
perceived as being of direct value to the respondent.

3.3.2 Data Collection Procedure

The questionnaires were administered through "drop and pick" later
method. The data collecting instruments were designed so as to collect data
that addressed the problem of the study and achieved the research
objective. Data collection lasted for fifteen (30) days.

3.4 Data Analysis and Presentation

Qualitative data on was analyzed using content analysis; this includes
analyzing words or pictures by collecting data, recording people
experiences not selecting and pre-chosen aspect. Content analysis is "any
technique for making inferences by objectively and systematically
identifying specified characteristics of messages (Venkatesh et al 2013).
The test was done by use of Likert scale (a psychometric scale commonly
involved in research that employs questionnaires). The data to be obtained
in this study was analyzed by organizing them into similar themes and
tallying the number of similar responses.


4.0 Conclusion

In summary, this dissertation looks into the cervical spine disorders
in terms of their causes, the effects they do have on their patients and
the machine that most effectively diagnoses the cervical spine disorders.
Furthermore, this research seeks to meet the objectives of examining the
troubles suffered by the cervical spine disorder victims and the ways of
reducing them, studying of persons whose jobs often cause cervical spine
disorders and finally to provide advice based on the way of life f such
people

































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