Acute Care: Care Implementation and Evaluation.

Acute Care: Care Implementation and Evaluation. This assignment will be based around the care that is implemented and evaluated, within a National Health Service (NHS) Foundation Trust (FT). The focus of the assignment will be to discuss two health problems that a selected patient has and has been admitted to the FT with. The selected patient had been admitted into FT with breathing difficulties and also suffering from dehydration. The assignment will focus upon the goals that are set for the patient whilst in FT and the reasons why the goals are set. The patho-physiology of the two problems will also be discussed and also the care that had been implemented to achieve the goals. Throughout the assignment, the patient will be known as Terry with the permission from the patients parents, according to the Nursing and Midwifery Council (NMC, 2008) confidentiality guidelines. The assignment will also aim to discuss the role of the Health Care Professional (HCP) in planning appropriate care for the patient, in particular, using the assessment technique of goal setting by using Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique (Roper et al, 1996). The reasons for planning care can involve the HCP assisting in preventing potential health problems, for example, breathing difficulties for the patient becoming worse and to also assist in solving problems where possible. Care planning can also assist in alleviating possible health problems that cannot be solved by HCP’ s and so will need the assistance of Multi Disciplinary Team (MDT) , for example, consultant, physiotherapists to further improve an develop the care plan. Terry is a 42 year old single man, who lives with his parents, and has suffered from a number of illnesses throughout his life, for example, optical glyoma, Deep Vein Thrombosis (DVT), epilepsy, and also learning difficulties. Terry has difficulty with breathing, and this appears to have been caused by respiratory rhythmicity centre in the medulla and the pons (areas of the brain which can control breathing) and these appeared to not be working in the correct way (MacKenzie, 1996; Waugh et al 2006). Terry’s reduced neurological status was due to trauma that had been suffered in the motor pathways, and the peripheral nerves, in the brain (Iggulden, 2006). Terry was admitted to the Intensive Care Unit (ICU), within the NHS FT, suffering from numerous problems that were mainly neurological. Terry's admission to ICU was due to the increased breathing difficulties that he was experiencing. Due to the breathing difficulties, the nursing team, and Terry's consultant, agreed that it would be best for Terry to have a percutaneous tracheostomy inserted. Due to Terry suffering from a probable cerebellar lesion, severe learning difficulties and poor communication skills; it did appear that Terry could not understand what the nursing team were informing him of, the medication that he needed and the care that was being delivered (NMC, 2008). Due to the fact that Terry appeared not to be able to understand or communicate with the nursing team, and that his parents and family members were with him, the nursing team, and myself, ensured that the parents, and family members, were informed of what was happening regarding the care that had given to Terry. The fact that Terry could not understand the instructions given to him, due to learning difficulties, consent to insert a percutaneous tracheostomy had to be given from Terry’s parents, to the Consultant (NMC, 2008). The tracheostomy that had been inserted into Terry helped the nursing team in the ICU and on the ward, to oxygenate Terry to the optimum level of 98%. The tracheostomy, also ensured that Terry was able to maintain a breathing rate of between 35 and 50 breathes per minute (Bailey, 2008). Although Terry was able to maintain a respiration rate, the normal respiration rate for an adult is normally between 14 and 18 breathes per minute (Bailey, 2008). The nursing care that had been implemented included ensuring that oxygen was flowing through the tracheostomy and this ensured that Terry had enough oxygen in his body for his heart and lungs to function, and that the heart pumped the oxygenated blood around the body (Machin et al 1996; Roper et al, 1996; Bailey et al 2008). Due to Terry’s respiration centre not working properly, and suffering from breathing problems, this meant that gaseous exchange was impaired, and led to a risk of respiratory acidosis. Gaseous exchange is where the oxygen goes into the alveoli capillaries, and the carbon dioxide is moved out of these capillaries (Bailey, 2008). The respiration centre is made up of a group of nerve cells, which are in the reticular endothelial system of the medulla oblongata. These cells send impulses to the motor neurones, via the spinal cord, and are then sent to the intercostal muscles (Bailey, 2008). The trauma that Terry had suffered with, was a possible cerebella lesion when he was a child. When Terry was admitted, his oxygen level was 82% (Bailey, 2008). The goal for this problem was to keep Terry's respiration and oxygenation at a level that was suitable. A suitable level of respiration for an adult is between 14 and 18 breaths per minute, and an oxygen level of around 97 to 98% (Bailey, 2008). The patho-physiology of breathing difficulties includes a lack of oxygen to the tissues of the body, including the brain, and even death (MacKenzie, 1996; Waugh et al 2006). Due to Terry haiving an oxygen saturation level of 82%, we set the goal that we would aim for and set this goal with his parents. The goal that the nurses had set with Terry's parents, due to the fact that Terry had learning difficulties and could not set the goal with the nurses. The goal was set as the nurses aimed to have his oxygen saturation level between 95% and 98% within two hours. The goal had to fit in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique (Roper et al, 1996; Faulkner, 2000). Terry's sitting and lying position had to be carefully planned around him, this ensured that we as a nursing team where able to ensure that his lungs would expand to their optimum and to maintain a satisfactory oxygen saturation levels within his body (Roper et al 1996; Machin et al 1996; Hackman, 2008). The normal oxygen saturation level is between 95% and 98% (Woodrow, 1999). The fact that Terry had an oxygen saturation level of just 82%, the Consultant had to prescribe oxygen for Terry. The oxygen that had been prescribed for Terry, had been increased from 24% to 40% (NMC, 2002). The consultant advised us to ensure that the oxygen was to be humidified. Due to Terry having the tracheostomy, we were able to deliver the oxygen with the use of a tracheostomy mask and what is called a T-piece circuit (Machin et al 1996; Dolan, 2008; Soady, 2008). The consultant also advised the nursing team to ensure that neurological observation's were undertaken, especially the oxygen saturation levels, every 15 minutes until Terry's oxygen saturation levels had risen to 96% (Machin et al 1996; Dolan, 2008; Soady, 2008) The neurological observations with regards to the goal, meant that the nurses were able to deliver oxygen, which would enable the oxygen saturation level to be maintained (Machin et al 1996; Dolan, 2008; Soady, 2008). Once the nursing team had ensured that the oxygen had been delivered to Terry at 40% and was humidified, they then ensured that 15 minute observations were maintained. The Consultant had to ensure that the 40% oxygen that he had verbally prescribed, was documented and written clearly in Terry's medical notes and on his prescription sheet (NMC, 2002; NMC, 2004). The fact that Terry had been prescribed the higher rate of oxygen, this needed to be clearly documented within Terry’s nursing notes (NMC, 2004). The documentation was needed, so that the other nurses were aware of the change. Although the observations had been maintained every 15 minutes, with regards to Terry's oxygen saturation levels, this ensured that the nursing team maintained Terry's neurological observation's (Machin et al 1996; Dolan, 2008; Soady, 2008). The goal that had been set by the nursing team and Terry's parent's, for his oxygenation levels did fit into the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique. The goal was specific, measurable and realistic for Terry and the nursing team caring for him, as well as being achievable in the time frame that had been set by Terry's Consultant (Faulkner, 2000). Due to the fact that the nursing team had achieved this goal for Terry, proved that the nursing care and interventions made by the nursing team, were effective. The nursing care and interventions were effective enough, for this goal to have been met (Roper et al 1996). The goal that had been set for Terry with regards to his oxygen saturation level, had to be documented. The goal had to be documented within the nursing notes, which the nursing team had to document clearly. The nursing team were able to hand over the information about Terry, to the nursing staff that would have been caring for him on the next shift. (NMC, 2004) The second of Terry's problem's is that he was at risk of dehydration, this was due to the fact that Terry could not swallow as he had a reduced neurological status. The fact that Terry could not swallow was due to the motor area of cerebral cortex of his brain, did not work in the way that it should (Waugh et al 2006). The motor area of the cerebral cortex of Terry's brain, was damaged due to the increase in epileptic seizures. Dehydration can cause the cells to deplete, due to not having enough fluids for them to replenish. The cells replenish in the sense that the fluids help the cells to regenerate, regulate the body temperature, to dilute the waste products within the body, and to maintain the level of fluids within the tissue fluid and blood (Waugh et al 2006). The patho-physiology of dehydration includes thirst, the mouth being dry, the tongue would look leathery, and fluid from within the tissues and skin would be withdrawn (Roper et al 1996; Brown, 1997; Day, 1997). Due to Terry not being able to drink fluids, he was not able to regulate his own body temperature, nor was his body able to dilute the poisonous substances in his body (Waugh et al 2006). Due to fluid being withdrawn from the body, this would mean that the body would not be able to maintain its own volume in blood (Roper et al 1996). The patho-physiology of not having enough fluids also includes the kidneys would excrete less than they normally would; a person would be lethargic; the skin would lose its elasticity and would appear to be more wrinkled (Roper et al 1996; Brown, 1997; Day, 1997). If Terry had been suffering from dehydration, his would have looked sunken and his urine output would be reduced as well as being more concentrated. If Terry had been suffering from a severe case of dehydration, his blood volume would be reduced. If the blood volume was to cause a circulation deficiency, this would cause his kidneys to fail to excrete the waste products that they normally excrete (Roper et al 1996; Brown, 1997; Day, 1997). Due to Terry not drinking the recommended two litres of fluids per day, we had to set a goal. The goal that had to be set, had to be set with Terry's parents (Roper et al 1996). The goal for the second problem, was to prevent dehydration during Terry's stay in hospital, through ensuring that Intravenous Saline was delivered through venous access (Dougherty et al 2008). The Intravenous Saline had to be delivered through venous access, due to the fact that this was the most effective way in which to infuse fluids. The fluids had to be infused over a period of 24 hours, due to the volume of the fluids. The Consultant prescribed two litres of Intravenous Saline, and the nursing team ensured that it was delivered (NMC, 2002; NMC, 2004; Dougherty et al 2008). Due to the fact that the fluids needed to be infused, the nursing team ensured that the fluids were delivered through the venous access, by using an infusion pump. The pump that was used by the nursing team, was the volumetric pump. The volumetric pumps allow health care professionals to administer large amounts of infusions, and this is why were used this type of pump to deliver the fluids that Terry needed over a 24 hour period (Sarpal, 2008). Due to the fact that the nursing team were delivering Intravenous Saline to Terry, it was important that this was documented by the nursing team within his nursing notes. The fact that this was documented in Terry's notes, ensured that the information was handed over to the nursing team on the next shift (NMC, 2004). It was important hat a fluid balance chart was also documented, as this would help the nursing team to ensure that the amount of input from fluids, was similar to Terry's urine output. The fact that the nursing team were able to monitor Terry's fluid input and output, ensured that his body was not retaining any of those fluids within a 24 hour period (Hunt et al 2008). The goal for dehydrat ion by providing two litres of Intravenous Saline over a 24 hour period, did fit into the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique. This was due to the fact that the goal was specific, measurable and time set. The goal was achievable and realistic, but only while Terry's venous access was as good as it was. When Terry's venous access for the Intravenous Saline to be delivered was poor, this meant that the nursing team had to find another route to deliver these fluids. The nursing team had to re-set the goal for delivering the Intravenous Saline. (Faulkner, 2000) Due to the fact that the nursing team could not deliver the Intravenous Saline through the venous route, had to be documented. The nursing team had to document the fact that Terry had poor venous access, and that they had asked his Consultant to review Terry (NMC, 2004). When Terry's Consultant had been to review him, the Consultant advised the nursing team to deliver the Saline through Terry's PEG tube. Terry's Consultant had to document the fact, that he had advised the nursing team to deliver the Saline through Terry's PEG tube. The Consultant also had to document that his advice was due to Terry's poor venous access in Terry's medical notes, and he had to document this on the prescription chart (NMC, 2004). Due to Terry having a Percutaneous Endoscopic Gastrostomy (PEG), the nursing team and Terry's parents re-set the goal to deliver the fluids that Terry needed (Faulkner, 2000). The new goal that had been set, was to deliver one litre of Intravenous Saline through Terry's PEG tube. The litre of Saline was delivered to Terry through his PEG tube, over an 8 hour period rather than a 24 hour period. Even though the nursing team had to deliver the fluids through the PEG tube, they had to ensure that the goal did fit into the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique. This goal was specific, measurable, achievable, realistic and time set for Terry and the nursing team (Faulkner, 2000). Before the nursing team could deliver the Saline through Terry's Percutaneous Endoscopic Gastrostomy, the Saline had to be prescribed by his Consultant. The Consultant had to document the Saline on Terry's prescription chart, and also had to document the route that the nursing team were to deliver the Saline (NMC, 2004). The Saline that had been prescribed by Terry's Consultant, also had to document in Terry's medical notes, that he had prescribed this and also document the route that he had advised to the nursing team (NMC, 2002; NMC, 2004). When the nursing staff had commenced the delivery of the Saline through the Percutaneous Endoscopic Gastrostomy (PEG) tube, they themselves had to document this. The nursing team had to document the Saline running through the PEG tube, to enable the nursing notes for Terry to be up-to-date. The nursing team to document the amount of Saline that was to run through Terry's PEG tube, and what time the Saline infusion began. The nursing team also had to document how much of the Saline was to be infused in any one hour, when the Saline was due to finish, as well as document the lot number and expiry date that were on the bag of Saline. NMC, 2002; NMC, 2004) The documentation of the infusion of the Saline running through Terry's Percutaneous Endoscopic Gastrostomy (PEG) tube, ensured that the nursing team could hand over the information to the nursing team that were due to care for Terry on the next shift (NMC, 2004). The goal that had been re-set by the nursing team, and Terry's parents, fitted in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique (Faulkner, 2000). The fact that the goal had to be re-set, ensured that the nursing team had been able to deliver the Saline through the Percutaneous Endoscopic Grastrostomy (PEG) tube. The goal to deliver the Saline through the PEG tube, had been specific, measurable, realistic and time set for Terry and the nursing team. This goal had been achieved, due to the fact that the care that the nursing team had been able to deliver the Saline in the time that they had set with Terry's parents (Faulkner, 2000). Due to the goal being achieved in the time frame that had been set by the nursing team, and Terry's parents, meant that the nursing team had been able to deliver the care that had been needed to achieve this goal (Faulkner, 2000). I am now at the point in this assignment when I can reflect. For my reflection, I will be using the Gibb's Reflective Cycle to reflect upon this assignment, which is documented within his book that was published in 1988 and entitled Learning by Doing: A Guide To Teaching and Learning Methods (Gibb's, 1998). Due to the fact that Terry ad a number of health problems, I had a hard task of choosing which two that I would use. I did have to think long and hard about which two health problems that I would use, but I was given permission from his parents to enable me to write this assignment (NMC, 2008). The two health problems that I had chosen, were breathing difficulties and dehydration. Due to the breathing difficulties that Terry suffered with, meant that his oxygen saturation levels were low. Due to Terry's breathing difficulties, this is why the nursing team, and his Consultant, had to gain consent from Terry's parents, to insert a percutaneous tracheostomy. The fact that the tracheostomy was inserted soon after Terry's admission, enabled the nursing staff within the ITU and the ward of the NHS FT, to ensure that Terry's oxygen saturation levels were maintained. Therefore, this is the reason why a goal was set. Due to a goal being set for Terry's oxygen saturation levels to be maintained, provides evidence to show that the nursing interventions were effective. The effectiveness of these nursing interventions, proves that goals that are set for an individual patient can also be met. The second goal that had been set for Terry by the nursing team, and his parents, had fitted in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique. Due to the fact that this goal was only partially met, did not necessarily mean that the care that had been delivered to Terry, had been ineffective. The care that had been delivered to Terry had been effective, but the goal could no longer be achieved through the venous route, due to the fact that Terry's venous access was poor. Due to Terry's poor venous access, this is why the nursing team had to re-set the goal with his parents. The goal that had to be re-set, fitted in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique. The goal had been re-set, and had also been achieved in the time frame that had been set with Terry's parents. The goal that had been re-set, had been achieved in the time frame that had been set. The goal had been achieved due to the fact that, the nursing team were able to deliver the Intravenous Saline through the Percutaneous Endoscopic Gastrostomy (PEG) that Terry had in place. The fact that the nursing team could not achieve this goal when it had first been set, was not an issue that could have been anticipated. Even though nursing teams can not anticipate why the goals are not met, they can re-set the goal and in time, meet the new goal. Therefore, the nursing care and interventions that are delivered, do make nursing care effective. Documentation of all care from the nursing team was important, due to the fact that the nursing team on one shift, were able to inform the nursing team of the next shift. Documentation also ensures that if the nursing team were unsure of any test results, that they were able to look over the nursing notes to ensure they knew where we were up to with the patient. The Consultants documentation in the patients medical notes, ensured that other doctors or Consultants were also aware of the patients condition and any tests that may have been ordered. Bibliography. Bailey, M. , Crossen, S. , Holland, J. , & Hollis, V. (2008) Observation's in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 25, Pages 496-544. Oxford: Wiley-Blackwell Publishing. Brown, A. (1997) Caring for the Patient Undergoing Surgery in Walsh, M. (ed) (1997) Watson's Clinical Nursing and Related Sciences. 5th ed. Chapter 10, Pages 232-259. Edinburgh, Bailliere Tindall. Day, S. (1997) Caring for the Patient with a Nutritional Disorder in Walsh, M. (ed) (1997) Watson's Clinical Nursing and Related Sciences. 5th ed. Chapter 16, Pages 552-570. Edinburgh, Bailliere Tindall. Dolan, S. (2008) Respiratory Therapy in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 38, Pages 749-765. Oxford: Wiley-Blackwell Publishing. Dougherty, L. , Farley, A. , Hopwood, L. & Sarpal, N. (2008) Drug Administration: General Principles in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 11, Pages 202-251. Oxford: Wiley-Blackwell Publishing. Faulkner, A. (2000) Nursing: The Reflective Approach to Adult Nursing Practice. 2nd ed. Gloucestershire: Stanley Thornes Publishers Limited. Gibb's, G (1988) Learning by Doing: A Guide To Teaching and Learning Methods. Oxford: Further Education Unit, Oxford Polytechnic. Hackman, D. 2008) Positioning in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 34, Pages 668-689. Oxford: Wiley-Blackwell Publishing. Hunt, P. , Kelynack, J. & Stevens, A. M. (2008) The Unconscious Patient in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 44, Pages 849-853. Oxford: Wiley-Blackwell Publishing. Iggulden, H. (2006) Care Of The Neurological Patient. Oxford: Blackwell Publishing Limited. Local NHS Trust (2004) NHS Trust – Recommended Protocol for Care of the Patient with a PEG. Liverpool: Local NHS Trust. Machin, J. , Rhys-Evans, F. (1996) Tracheostomy Care and Laryngectomy Voice Rehabilitation in Mallet, J. , Bailey, C. (eds) (1996) The Royal Marsden NHS Trust – Manual of Clinical Nursing Procedures. Chapter 41, Pages 550-565. London: Blackwell Science Limited. MacKenzie, E. (1996) Respiratory Therapy in Mallet, J. , Bailey, C. (eds) (1996) The Royal Marsden NHS Trust – Manual of Clinical Nursing Procedures. Chapter 35, Pages 474-480. London: Blackwell Science Limited. Nursing and Midwifery Council (2002) Guidelines for the Administration of Medicines. London: NMC. Nursing and Midwifery Council (2004) Guidelines for Records and Record Keeping. London: NMC. Nursing and Midwifery Council (2008) The Code – Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: Nursing and Midwifery Council. Roper, N. , Logan, W. W. , Tierney, A. J. (1996) The Elements of Nursing. 4th ed. America: Churchill Livingstone. Sarpal, N. (2008) Drug Administration: Delivery (Infusion Devices) in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 13, Pages 290-309. Oxford: Wiley-Blackwell Publishing. Soady, C. (2008) Tracheostomy Care and Laryngectomy Care in Dougherty, L & Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 42, Pages 809-829. Oxford: Wiley-Blackwell Publishing. Waugh, A. , Grant, A. (2006) Ross and Wilson Anatomy and Physiology in Health and Illness. 10th ed. Philadelphia: Churchill Livingstone. Woodrow, P. (1999) Pulse Oximetry. Nursing Standard. Volume 13, Number 42. Pages 42-46. Woodrow, P. (2006) Intensive Care Nursing – A Framework for Practice. 2nd ed. Oxon: Rouledge.

Genetics of Obesity Essay

According to the WHO (2010), childhood obesity is one of the most serious public health challenges of the 21st century. Globally, in 2010 the number of overweight children under the age of 5 is estimated to be over 42 million (WHO, 2010). Obesity can be defined in a number of ways, e.g. by population means, BMI and waist circumference (Odgen, 2012). And according to Kleiser et al (2009), obesity may have several short-term consequences (e.g. social discrimination, lower quality of life, increased cardiovascular risk factors, diseases like asthma) and long-term consequences were obesity is likely to persist into adulthood, were individuals are more likely to develop noncommunicable diseases e.g. diabetes and cardiovascular disease at a much younger age. It is due to this that a great body of research within health psychology has focused on not only the consequences of obesity but also understanding the causes of obesity, both genetic and environmental – this is what this essay will explore†¦. Genetics There have been several theories put forward by research to best explain the causes obesity and one major potential causes is genetics. Maffeis et al (1998) found that obesity in parents was the strongest predictor of childhood obesity, regardless of diet or level of activity. Furthermore recent research has found support for this claim. Moreover, Wardle et al., (2001, 2006) reported that, controlling for other environmental factors, children with obese parents preferred fatty foods, had less liking for vegetables, were more likely to overeat had a higher preference for sedentary activities than did children of normal weight parents. This is further strengthened by more recent research by Kleiser et al (2009) who found that the strongest determinant of obesity was obesity in parents. Despite the evidence for this relationship, Odgen (2012) states that parents and children not only share genetic constitution but also share very similar environments, therefore this relationship between child and parental obesity could be contributed to either factor. However, according to Barlow (2013) twin studies have also have clearly demonstrated a genetic influence on body weight, therefore strengthening the argument for the role of genetics in obesity. For instance studies have found 25 – 40 % of BMI is heritable and identical twins raised apart have been found to have a correlation of .7,  only slightly lower than that of twins raised together (Stunkard et al, 1990). Moreover adoption studies have also provided evidence for a genetic component in obesity, Skunkard (1986) found a strong relationship between the weight class of the adoptee and their biological parents and interestingly found no relationship with their adoptee parents’ weight class. Research has also stated that factors such as metabolic rate (Bouchard, 1990) and appetite regulation may also have a role to play in causing obesity. Research in terms of metabolic rate has suggested a low resting metabolic rate is a risk factor for weight gain (Tataranni, 2003), but in fact there is little research to support this. In particular there is no evidence to suggest that overweight people tend to have slightly higher metabolic rates than thin people of a similar height (Garrow, 1987; Odgen, 2012). A genetic predisposition may also be related to appetite control. For instance, the discovery of leptin, ghrelin, adiponectin, and other hormones that inï ¬â€šuence appetite, satiety, and fat distribution provides insight into metabolic mechanisms for physiological risk of obesity (Maes et al, 1997; Gale et al, 2004). Research, although seen to be in its infancy has yielded support, e.g. Farooqi et al (1999) injected 2 participants daily with leptin, which resulted in decreased food uptake and weight loss at a rate of 1-2kg per month. According to Odgen (2012) there is strong evidence for a genetic basis to obesity, but it is how this genetic bias expresses itself that remains unclear, due to the fact research on lowered metabolic rate has been widely refuted and the genetics of appetite control remain in its infancy. Furthermore, genetic studies are not without their criticisms. For instance small sample size, zygosity needs to be confirmed and again the role of environmental factors cannot be ignored. Behaviour & Environmental factors Therefore in light of the above criticisms research has begun to more fully examine the extent to which an individual’s behaviour and/or environment can influence the development of obesity. As Barlow (2013) states that at a population level, the increase in prevalence is too rapid to be explained by a genetic shift; rather, it must result from changes in eating and physical activity behaviours that have shifted. A recent study by Kileser (2009) found independently of other factors, a positive association was observed between obesity and low SES, migration background (up to age 13), parental overweight, high weight gain during pregnancy (when the mother is of normal weight), maternal smoking during pregnancy, high birth weight, and high media consumption, as well as a negative association with sleep duration for 3- to 10-year olds.

Alexander the Great Essay

Aristotle is a famous Greek philosopher. Given the name â€Å"The Philosopher,† his ideas were of great importance to Greece during his lifetime. Throughout his life in ancient Greece, he gained popularity because of his many teachings and brilliant logic. His early childhood influenced his scientific thoughts, and his time at the Academy in Athens brought him to the study of philosophy as well. Through many observations, he made large amounts of discoveries that are still proven true in modern times. He wrote over 200 treatises covering various topics such as ethics, biology, psychology, logic and physics. His ideas spread rapidly making him a prominent figure in Western civilization. Not only did Aristotle’s thoughts set the foundation for the development of Greek thought, but also impacted the philosophy and sciences beyond his lifetime. Aristotle was born in a small Greek town called Stagira in 384 BC. His town, like many others in Greece, was one which held non-Greek people. Greece during this time was expanding, and gaining culture. The geography of Greece can be described as rich and fertile. The land was abundant with farmland and ideal for growing grain and fruit. The land also provided space for livestock such as horses, sheep, and cows. This caused the economy to thrive. The main focus of Greece however, particularly in Athens, was politics. Athens’ progression from monarchy to democracy made them more advanced in politics than other civilizations at the time, but the sudden change also weakened Greece. Aristotle would later help to encourage the outlook on life of the majority of Greece and help the overall good of society. Aristotle grew up under the care of his father until his later childhood. His father Nicomachus, was a popular physician at a court in Macedonia, which would later be a strong influence to Aristotle’s career because of his relationship with the king and his family. At the age of ten, Nicomachus passed away and Aristotle was then taken under the care of his uncle named Proxenus. He was raised by him for all of his teenage years. At the age of seventeen, Proxenus sent Aristotle to Athens where he joined Plato’s Academy. Plato was another highly respected Greek philosopher at this time. At the Academy, Aristotle was taught by Plato and he became one of the best students. He studied everything there from astronomy, mathematics, literature, and science. When Plato died, Aristotle left Athens. Being one of the prominent figures in Greece by now, and because of his father’s connections with the court in Macedonia, Aristotle was invited by the king of Macedonia to tutor his son Alexander, who would later become his successor. During Aristotle’s lifetime, he spent a great amount of time thinking about the distinctions between thoughts and actions. This is called logic. He was the first philosopher to study a formal type of logic and his logic remained dominant until the 19th century. He made clear lines between proof and inferences. His type of thinking later became known as Aristotelian logic, named after him. He also set fundamentals for speech, such as sentence structure. Aristotle said, â€Å"Spoken words are the symbols of mental experience, just as written words are the symbols of spoken words† (Farrington, 65). Along with this came the idea of propositions. He taught that each proposition has to have two parts- a subject and predicate. He thought that to make sense of a sentence, something has to be said about a person, or thing. Use of this language helped writers during his time, and is also how people speak today. It seems like common sense to people now, but Aristotle was the first to notice it and that is true of many other observations he made. For example, he believed that the mind and soul are separate from the actual human body. He also believed that humans’ souls still existed after they died. At the time, it set ideas about the afterlife for many people in Greece. His teachings encouraged people to believe in a good life after death. His logic was very complex, which made him a leader in philosophy during his lifetime. His logic also coincides with his ideas about philosophy. One of Aristotle’s major accomplishments during his lifetime was impacting the study of philosophy. He was the founder of Western thought, and his philosophical thoughts are still studied widely in today’s society. His beliefs on philosophy covered various subjects but mainly ethics and politics. The study of ethics is involved with well-being and how people should best live their lives. Ethics addresses individuals rather than a whole community. He taught that humans main goal in life is to reach happiness. He also believed that life should ultimately be about doing what is best to be fully content. He believed in temperance, and says that unlimited wealth is not needed in life. To have an enjoyable life, he believed that wealth is an obstacle to being happy, and people cannot want it too much. This way of thinking was popular because people liked the idea of being happy. His beliefs influenced some of the best medieval scholars, who also believed in the overall good of humans. As for politics, Aristotle examined the growth of society and came to the conclusion that people should work for the common good of their community, and work towards maximum success. To obtain a successful way of life for all people in the community, laws and rules are required. Aristotle wrote, â€Å"‘Youth will not receive a proper ethical training unless brought up under right laws†¦ Speaking generally, we need laws to cover the whole of life’† (Farrington, 88). This quote is an example of one of the many ideas that influenced the philosophy of whole communities. Even today’s society cannot survive without law. He believed that to achieve a civilness, people must fulfill their responsibilities for the good of the whole. â€Å"He sought intelligible definitions of the virtues and employed in the quest the method of induction† (Farrington, 6). This means that he wanted to prove that society was able to thrive with showing high virtue. His philosophy was later named after him, as Aristotelian philosophy. His basic thoughts about life and the Aristotelian philosophy and logic still remains relevant today all over the world. Not only did Aristotle set the philosophical foundation for Greece, but also had an impact on the sciences. His study of biology is important, because it gives people an idea of the history of science. At the Academy, Aristotle had a major interest in anatomy and examined the cycle of the life of man and animals. Through experiments and observations, he made many conclusions. Aristotle dissected about fifty animals in his lifetime and studied over 500 different species of animals, making many discoveries about living things. â€Å"Aristotle thought of a living thing’s inherent potentialities as guiding and controlling what it becomes in its process of growth and development† (Adler, 47). He noticed that species inherit characteristics from their parents, similar to DNA, which is proven today. Aristotle taught that the mind was separate from the rest of the body, and that the mind was not a physical feature. He also distinguished mammals from non-mammals. In his biological research, he focused on mechanical causation as well. He distinguishes the differences between mechanical and chemical changes. Another discovery Aristotle made before modern times even proved it is the ladder of nature. He came to the conclusion that plants are the least complex living thing and humans are the most complex. In society today, that is called a food chain. His order of society remained prevalent for centuries after his death in the West. His thoughts on nature set guidelines for the progress of biology for the future, as well the fundamentals of physical science. The study of physics is one of Aristotle’s main contributions to Western civilization, and to the modern world. His thoughts on physics were originally provoked by earlier scientists, but Aristotle created his own ideas that disagreed with former scientist’s thoughts. He made major improvements on previous knowledge. â€Å"He is conscious of measuring himself against the older thinkers and refers to them mainly in order to disagree with them or at least, to make clear where he has done better† (Farrington, 72). His ideas to science are primary today. One of the major concepts adopted by later scholars that Aristotle discovered was his laws of motion. He taught that the heavier the object is, the faster it will fall, and that the speed of objects falling depends on the density of the surroundings its falling through. For example, a rock falling through a river will be slowed down by the water. He also said that the speed of an object depends on the force being applied to it. For instance, if you stop pushing an object, the object will stop moving as well. Aside from motion, he also studied substances. He noticed the difference between physical mixtures and chemical mixtures. He discovered that when two ingredients are joined together, it creates a new substance, or chemical change. Aristotle also created four forms, or causes of matter. The first is material cause, which explains the chemical and physical appearance of an object, or what is it made out of. The second is formal cause, and this pertains to the characteristics of an object, or what it will develop into. The third cause is called efficient cause. Efficient cause explains how a change is made when objects are in motion, similar to the idea of kinetic energy which is a main principle in science today. The last cause is called final cause, which analyzes why something exists. His four causes are extremely relevant throughout history because they explain the basics of why things are the way they are. Aristotle’s works in physics also involve the study of the Earth.. He taught that the Earth is made of four elements- earth, water, fire, and air. His approach to the basics of matter differs from Plato’s thoughts on what matter consists of because Aristotle relied more on his senses from actual things. Aristotle’s thoughts were more realistic. He studied how his four elements reacted with cold, wet, hot, and dry things. It provided a better understanding of the natural world. Aristotle influenced many people during his lifetime, but one of the most important people to history that he taught was Alexander the Great, who grew up to become one of the greatest military leaders in history. As mentioned earlier, Aristotle’s father was a personal physician to the king of Macedon. When the king decided his son needed a better education, he picked Aristotle because of his connection to the royal family, and he also came to the realization that Aristotle was one of the greatest intellectual leaders in Greece. During his time teaching, Alexander showed many interests in science and medicines. When Alexander invaded Asia, he brought a number of botanists and zoologists, and together they discovered new species. Aristotle also taught Alexander how to be a good public speaker, and how to debate. He taught him poetry, which Alexander had a big interest in. While studying poetry, Alexander even considered one of the gods in Greek poetry as his role model. Aristotle greatly impacted Alexander’s thoughts on ethics and politics as well. He taught Alexander to love all things Greek. He thought that the non-Greeks that were settling should be enslaved, and discouraged Alexander to accept the new people. Alexander had already been skeptical about Persians, and Aristotle’s advice encouraged this thought. Aristotle also wanted Alexander to have self-control and self honor, which helped Alexander to focus on what he needed to do to gain success not only for himself, but for Greece as a whole, coinciding with the type of philosophy that Aristotle believed in. What Alexander learned during this time with Aristotle he took with him on all of his journeys to conquer surrounding lands. He ultimately conquered most of the known world at that time, and united Greece by the young age of twenty-five. Aristotle provided him with the knowledge and skills to become one of the greatest leaders of all time. Without having Aristotle as a teacher, Alexander may not have been as effective in expanding Greece, which could have led to changing the course of history. The impacts that Aristotle had on the philosophy and sciences during his time was great, and the scientific and philosophic world is still learning from him today. His intellect led him to influence every major subject in the ancient world. His type of philosophy gave people a way to manage their problems, and gave them different ways to look at the world. His ideas reinforced people’s faith yet also supported new ideas about faith. In medieval times, his philosophy was used by the majority of the population. It set the basis for medieval scholasticism, which was the philosophy used throughout the middle ages. His philosophy was rediscovered during the beginning of modern scholarship. His philosophy was rediscovered in the late Middle Ages because it pertained to the values of Christianity. His works were also studied by pre-Renaissance scholars, who were some of the greatest in the world. Pope Silvester II advanced his logic by studying Aristotle’s thoughts and influenced him as pope of the Roman Catholic Church. His writings were so successful that they have been translated into dozens of languages and studied by scholars after his death, and even today. As for science, Aristotle was one of the biggest contributors to the growth of the biology and physics during his time. He introduced scientific theories that no one ever studied in the ancient world. By studying animals, he increased the number of animal species, and explained the growth and development of animals, which even led to many discoveries in human anatomy. His contributions were so great that without his research, Europe’s scientific development would be very delayed. Aristotle also tutored one of the most successful leaders who managed to conquer more than half of the known world. Aristotle’s intelligent mind helped to make the ancient world flourish. The underlying reason to why Aristotle was so successful as a philosopher is because he was one of the first to study logic. He studied real life unlike philosophers such as Plato. This is emphasized in a famous Renaissance painting called The School of Athens which portrays an image of Plato pointing upwards, representing his study of the heavens. Aristotle is pointing downwards, representing his study of Earth. His teachings seemed logical to the people of his time because he believed knowledge should be obtained by observation and reasoning, and this made him very popular. Although much of Aristotle’s work was rediscovered during the late Middle Ages and Renaissance, he was incorrect in some areas. For example, he was incorrect about the placement of the Earth in outer space. â€Å"He believed terrestrial elements rise from or fell toward the center of the Earth, which is also the center of the universe†¦ and everything revolves around the Earth† (Langford, 25). The first person to realize Aristotle was wrong was Galileo. He discovered that planets revolve around a physical center other than Earth by studying the moon phases of Jupiter and Venus. He had proved Aristotle wrong. This caused problems with the Church because the christians were so dedicated to Aristotle’s philosophy. They believed that there were no differences between his philosophy and Christianity. When Galileo started to prove Aristotle’s science wrong, people began to believe that Christianity was wrong. This later led to the loss of Roman Catholic authority. Aristotle’s teachings in philosophy was one of his biggest contributions to the world because his philosophical ideas managed to impact the faith of Christianity and also the power of the Church.. â€Å"He was called â€Å"Ille Philosophus† (the philosopher) by his medieval followers, and his work was discussed as the eternal truth† (â€Å"Aristotle of Stagirus†). The Greek philosopher Aristotle was called â€Å"The Philosopher† for a reason. In his lifetime, he made numerous discoveries, wrote hundreds of works, influenced scholars in the middle ages, and taught one of the greatest conquerors in the world. He directly influenced the philosophy of ancient civilizations, and by dedicating his life to his studies and experiments, he set the fundamentals of science. Overall, he built the basis of the philosophy and sciences during his lifetime and beyond.

Why Gun Control is not Enough, by Jeff Mcmahan Essay

Why Gun Control is not Enough, by Jeff Mcmahan - Essay Example This paper tends to summarize the article, with a personal reflection in a later section. Mcmahan emphasizes upon the fact that owning guns makes the matter worse by making self-defense a kind of self-help. Allowing guns will make criminals better instead of eliminating crime. This is because they will become better equipped with better guns and readier to shoot. The more the guns, the more are the chances of accidental shots. Even a slight conflict will make people shoot at each other. The power of government and police will be diminished, because people will not look for help from security agencies and police, and will defend themselves through the use of guns. â€Å"The power of the citizens and that of the police approach parity,† states Mcmahan (2010, par.5). Moreover, it is all a matter of relative safety. Individuals owing guns will feel safe, and those without guns will be the most vulnerable, and will look forward to having guns. The state which will allow guns will f eel safer than that which does not. â€Å"When only one state gets nuclear weapons, it enhances its own security but reduces that of others, which have become more vulnerable,† writes Mcmahan (2012, par.10). This relative safety will disturb the balance of power and peace among people, agencies, and nations. Mcmahan further writes that gun control is a good solution because it limits the use of guns both for the criminals and for common men. He writes, â€Å"†¦we would all be safer if no one had guns — or, rather, no one other than trained and legally constrained police officers† (2012, par.12). With gun control, people will start trusting the police force for domestic defense. Mcmahan asserts that gun advocates present their arguments against gun control, but neither of them is valid, except that the prohibition and effective implementation of gun control is not easy. Mcmahan ends his article by saying that the United States is suffering from much more vio lence and violent incidents that the rest of Western countries because of easy access to firearms, and gun advocates should give their arguments a second thought as to whether guns should be allowed or not. Personal Reflection Mcmahan has very effectively described the importance of gun control and gun prohibition by presenting arguments from both sides, and has efficiently cleared his stance on the topic. Since owning a gun is beneficial and dangerous both at the same time, thus, it becomes important to discuss who should be able to own a gun. Efforts have always been made in order to decrease criminal activity around the globe, among which taking away guns is thought to be one such effort, when it is not. Although Mcmahan asserts that gun control will result in less violence and crime, I believe that common men should be allowed to own guns so that they can protect themselves. The most important point here is how the citizens are going to ensure their safety when they are told to turn in their guns, just as Boylan (2004, p.130) states in his book. People wish to keep guns to enjoy their autonomy and guarantee their safety when they meet robbers, criminals and terrorists. Armed citizens feel their strength in protecting themselves and their families from physically stronger criminals. I disagree when Mcmahan (2012, par.3) states, â€Å"When most citizens are armed, as they were in the Wild West, crime doesn’t cease. Instead, criminals work to be better armed†¦Ã¢â‚¬  I believe that criminals will still get better if guns are banned, because the wrongdoers will still obtain guns and ammunition from whatever illegal sources. And who will be in loss? The common man, because he will have no illegal source of owning a gun. Owning guns is one of people’

HUM WK3 ASSIGNMENT Essay Example | Topics and Well Written Essays - 750 words

HUM WK3 ASSIGNMENT - Essay Example rence for the Vedas as the foundation of Hindu philosophy; (2) A spirit of tolerance, and willingness to understand and appreciate others’ points of view, recognizing that truth has many sides; (3) Acceptance of the belief that vast cosmic periods of creation, maintenance, and dissolution continuously recur; (4) Acceptance of belief in reincarnation; (5) Recognition that paths to truth and salvation are many; (6) Recognition that there may be numerous gods and goddesses to worship, without necessarily believing in worship through idols; and (7) Unlike other religions, absence of belief in a specific set of philosophic concepts† (Fisher, 2005, p. 113). As such, these ingredients form the basis theological framework for Hindu religion and which continues to be observed by contemporary devotees to this particular belief. To exemplify continued belief and practices that conform to these main theological frameworks of Hinduism, devotees are expected to conform to rituals, home puja, seeking the guidance of a spiritual Guru, conformity to fasting and prayers, acknowledging reverence to natural resources such as rivers or trees, going through regular pilgrimages, and observing festivals or holy days of obligation. (1) Ingrained social beliefs that include going through rituals to obtain various favors asked from deities and as a means of purification of one’s supposed journey through life. Rituals were religious practices that were deemed crucial for devotees to the purpose of purifying and sanctifying people in their lifetime. (2) Belief in public worships to acknowledge individual, family and communities’ adoration and worship to their deities. This social tradition has been proven to be exhibited through time as a means to adore, glorify, and worship the deities and to invoke their blessings for personal favors. (3) Manifestation of loving service to their deities by acknowledging them as living proofs of divine being and are therefore treated as living

How to Improve the Customer Service at Starbucks Research Proposal

How to Improve the Customer Service at Starbucks - Research Proposal Example The author of this essay assumes that the Starbucks coffee company grew from a small, regional business into the undisputed leader in the coffee industry by purchasing the best quality of coffee with facilitating an unmatched store experience. The coffee buyers of the company have maintained long-lasting relationships with the farmers and have believed that it paid the premier prices in the industry for top quality beans. With time passing by, Starbucks grew into one of the world’s largest and the most recognizable brands. Starbucks initiated with retail stores where customers could enjoy a relaxing atmosphere and buy the high-quality whole bean coffees which are roasted, modified beverages, food offerings, and other coffee-related products. In addition, Starbucks introduces a diverse selection of music, film, literature and art to its customers. They have always been looking for innovative and exciting ways to expand the coffee-house experience. The fact that Starbucks workme n avail more benefits, stock options as well as promotional opportunities, not only amuses them, but it results in a positive energy which can be experienced by most of the customers who visit their stores. Even though, Starbucks’ performance is terrific, there is always an opportunity to better it. In the company’s race to make more money, it is sacrificing its relationship with the customers, thereby, eroding its brand value. It’s the relationship with the customers and not the innovation in its products, which will form or sever the company.... 2. Need for this research There is no restaurant chain in this world which would be able to take lightly the decline in its customer traffic. However, for Starbucks, it is an indication for all chains to re-examine their positions in the market and take efficient steps towards securing their existent customer base and attract new customers. The Starbucks Company lost its customers for the first time ever in its fourth quarter, with traffic dropping down by 1 per cent through successive years, although, the store sales rose up to 4 per cent simultaneously (Cebrzynsky, 2007). There could be many reasons to this decline. Starbucks grew so rapidly that it ignored the fact that it initiated as a neighborhood coffee-house, and thus, the consumers do not possess the same emotional feeling for Starbucks which they once had. In order to find a solution for that, the company has planned to improve its services in which the field managers shall spend more time in the stores in order to ensure the quality of service, and the new stores receive additional training. The economic context in which Starbucks was forced to act was the promises to improvise services, reduce growth and expand the marketing efforts, being the typical respondents to decline in the customer traffic. The customers of Starbucks gradually realized the impact of this economic slowdown and, as a result, the Starbuck's customer depreciation has a great significance for

Why We Cant Wait Essay Example | Topics and Well Written Essays - 750 words

Why We Cant Wait - Essay Example People of color especially African Americans were seen as people who belonged to the lower or second class in society. As a result, African Americans were not allowed to access certain areas, and were not admitted to same schools as whites. It is clear that Martin Luther stated that African Americans could no longer wait for the followings things; ii. Lack of trust in government and politicians especially after the perceived failures of President Kennedy in that during his reign, Kennedy failed to establish a stance housing desegregation policy and did not address the issue of African American voting rights in states such as Virginia and Texas. It is vivid from the article that the media in American helped to propagate racial sentiments against black people. For instance, the media propagated racial segregation in their articles where they referred to black people as darkies, coons, and niggers. Their messages in the articles spread anti-black information and stereotypes. In schools, white children saw black children as inferior and worthless. All social institutions such as schools and churches reinforced oppression of the people of color particularly African Americans (Luther 56). Many things happening in the American society prompted Luther to write the book. For instance, King argues that the white race mistreated black people. He documents the following practices and norms to depict how pervasive and inclusive racial segregation was entrenched in society. Violence was used to place African Americans at the bottom of the racial hierarchy. For instance, the Jim Crow used war on drug to discriminate black people whereby, police applied excess force to arrest black men on conception that they were drug dealers. This reveals how the criminal justice system in America was racist in trying to connect the dots between earlier forms of social and current system of mass incarceration (Luther 61). There was rebirth of the

Botany Essay Example | Topics and Well Written Essays - 250 words

Botany - Essay Example The research helps the natural scientists to find out things which they have not been able to study and hence the genetic engineering on plants is all the more significant. The third reason is concerned with how the industry has been able to benefit at the hands of the genetic engineering which has taken place over the years on plants. The fourth reason concerns the agricultural basis where genetically modified plants bring to light the genetically modified food forms. The genetically modified crops are also receiving significance because of their uses and advantages that are brought to the notice of all and sundry (James, 1997). The last reason is linked up with the other areas where the genetically engineered plants have been beneficial, mostly comprising of the materials science realms and the construction of the lithium-ion batteries. Hence the genetic engineering of plants is a very renowned area and one which has received attention for a number of different reasons mentioned

TAXATION POLICY AND TAX REFORMS IN VIETNAM Assignment

TAXATION POLICY AND TAX REFORMS IN VIETNAM - Assignment Example The taxation policy of an economy has a major impact on its economic condition. Understanding the taxation policy of a country helps in assessing the role of income taxes on the economic growth. Countries constantly engage in debate to strike the right balance of taxes for the planned economies progress (Miller, & Oats, 2009). Economic analysts suggest that economic policies are very important for the growth of an economy. Taxes are important sources of finance for the governments. Governments implement combination of direct and indirect based to generate effective results and higher revenues for meeting capital and public revenue expenditure (Jones, Rhoades-Catanach, & Lemler, 2010). The governments which have more opportunities for generating finance from revenues of public enterprises besides tax implementation attempt to design the lenient taxation policies which attain effective results. Vietnam was a developing economy and it had shown dramatic development over the years. This dramatic growth of the country with the passage of time is centrally attributed to its economic policies. One major component of these is the taxation reforms. ECONOMIC OBJECTIVES AND TAXATION STRUCTURE OF VIETNAM After the war in 1954-1975, Vietnam adopted a market oriented strategy for development. The process of the reforms was initiated during the mid 1980’s. Before these reforms were proposed, the state was playing a very important role in the economic development of the country. The government’s revenue collection from the enterprises was linked to profit sharing with the organizations. For achieving the objectives of efficiency in government organization, it was mandated for the managers to abide the directives and the policies proposed by the state. This was aimed at improving the performance of the economic performance of the government and private enterprise in local and international market (Yui, n.d.). New legislations were enacted and the promulgations of the company law were also implemented. The changes were made to the foreign Investment Law, Private Enterprise Law and the Company law. During this time the first phase of the reform was implemented. At this time th e government was in dire need of implementing the policies and overcoming the economic challenges such as controlling the effect of hyper inflation. Implementations of the policies were forced with reforms in the import and export taxes, special consumption taxes and profit taxes etc. The enterprises that were non state owned were levied with registration tax, excise tax and agricultural taxes. This in result had direct impact on the FDI and increased the overall productivity of the economy. These reforms were considered for contribution in the economic improvements and these practices made the tax system more transparent. The overall series of measures of growth contributed to the economic development significantly and growth of the Vietnam economy over the years. Through these reforms the overall growth in the revenue of the economy increased by more than five times. The report here after focuses on the reform in the taxation policies of the Vietnam (Yui, n.d.). REFORMS IN THE TAX ATION POLICY OF VIETNAM The taxation system plays a very important and critical role in structuring the macroeconomic conditions of the economy. . The initial measures mentioned above had significant impact on the economy of Vietnam. It contributed towards the success of Vietnam with its social and economic developm

Management Decision Making Coursework Example | Topics and Well Written Essays - 500 words

Management Decision Making - Coursework Example What are some of the drawbacks of having biases? Could there be any advantages to having biases? Explain. What are the implications for decision making? A. Biases may lead to self assumed and irrational analysis of situations thereby resulting into superstitious decisions. When identified and understood, biases may help managers analyse and select various inputs from individuals/groups. Biases tend to limit the thought process of managers thus jeopardising their decision-making skills. A. I would call myself an intuitive thinker. Systematic decision-making approach results in more robust solutions. Whereas, results based on pure intuitions might save on time but can be misleading. Latter approach may, however, prove more creative. Organisations need both A. In today’s world of technological advancements where business has gone borderless and complex, it is humanly not possible to adhere to the conventional model. It is, therefore, economical to simplify the situation using bounded rational model and then follow the steps of rational model for making decisions which can give fine solutions, if not optimal. A. Good managers make bad decisions when they let their personal biases uncontrolled or restrict their decision making skills because of organisation’s culture. Identifying and controlling biases, staying focused on objectives, overcoming inertia against change, and staying on guard against ‘Yes Man’ trap are few ways to improve decision making

Can a solution to persistent conflict in the eastern DRC be found Essay - 1

Can a solution to persistent conflict in the eastern DRC be found through addressing 'local antagonisms' and 'local grievances', as Severine Autesserre suggests - Essay Example Instead of seeking long term solutions, Autesserre (2008) argues, these peace finders have only been making temporary peace trials after which conflicts emerge again. Their role has been to treat the wounds but not focusing on terminating the causative agents once and for all. Autesserre (2008), after providing a comprehensive history of wars and conflicts in the Eastern Provinces of Congo, suggests that permanent solutions can only be found if local antagonisms and grievances are addressed. Autesserre brings forward the view that those intervening have mistaken locally triggered turbulence as a national and or international issue whereof only humanitarian interventions for temporary healing of the casualties have been imposed. This paper attempts to argue in line Autesserre’s standing. The discussion critically addresses the nature of the problem in Congo – as explained by various authors – to estimate the truth in Autesserre’s suggestions. Later, the study defines what exactly the government of Congo needs to ensure local issues – as raised by Autesserre (2008) – are successful tools in pacifying Eastern Congo. The arguments are made in realization that, anyhow, there must be some solution, a unique solution (Yenyi, 2010). In the previous efforts to bring peace in the Congo, there have been various challenges and mammoth spending but in the end, the war starts all over again. It is obvious there are roots to the intermittent animosity that keeps recurring, much to the loss of many lives on a daily basis, loss of properties, misappropriation of natural resources, and the general deterioration of humanity. Therefore, all indications point to the prevalence of speci fic causes of violence that have never been addressed, or at least the wrong approaches have been in use. So the problem is extraordinary and as so, it will call for extraordinary measures as suggested in Autesserre findings (2008). Certainly, Autesserre’s idea is appealing,

Management and Chemical Engineering Essay Example for Free

Management and Chemical Engineering Essay I have completed my Bachelors of Technology in Chemical Engineering at Indian Institute of Technology, Guwahati, India (IITG). I am seeking a position in your organization in order to enhance my skills and practical experience, while being resourceful and innovative. I have worked hard in my undergraduate studies, striking a balance between compulsory courses like Fluid Mechanics, Process Equipment Design, Process Control and Instrumentation, Chemical Engineering Thermodynamics, related wet lab courses and supervised research under the guidance of Dr Chandan Das (Associate Professor, Department of Chemical Engineering, IITG) Dr AK Golder (Associate Professor, Department of Chemical Engineering, IITG). My Bachelor Thesis Project was on Biosorption of heavy metals to purify industrial effluents under the guidance of Dr. Chandan Das (Associate Professor, Dept. of Chemical Eng., IITG) and Dr. AK Golder (Associate Professor, Dept. of Chemical Engineering, IITG). When I look back now, I realize the role of an inspiring mentor in a student’s life. Dr. Das and Dr. Gloder gave me a whole new direction to explore my research skills and the interest in reading research articles while doing my undergraduate courses in mainstream Chemical Engineering. After graduation I joined Jindal Steel and Power Ltd as a Project Engineer where I practiced what I learnt during my educational life. Post completion of one year, I joined SPI Pvt. Ltd. As an Assistant Manager. I choose this as apart from technical skills, I also wanted to gain a good understanding about the business processes and its various elements. While working there my interest became more focused towards managerial skills. It was there where I decided to go for my higher education in Masters in Management as managerial knowledge via a reputed and esteemed university will help me to learn a wider scope of business management skills which was missing in my technical career. In my education thus far, I have been actively involved in sports and co-curricular activities including making manual robot, organized Rock-o-Phonix for three consecutive years (2008, 2009 2010) and represented IIT-Guwahati in Inter IIT sports meet in Football which has helped me to develop upon simplicity in approach, patience, team work, confidence, loyalty, ability to manage loads of stress and adaptability. To work using the in-hand knowledge and indigenous creativity simultaneously is my biggest asset. Education I believe is not just excelling in courses that we take and cracking their exams but a continuous process of development and self-realization. Not just asking â€Å"what to do† or â€Å"how to do† but â€Å"who am i† and â€Å"what is my purpose† too. My long term career goals are to become socially responsible individual and to get the dream job of working in the field of interest. If given the opportunity of pursuing the graduate study in field of management I would be getting involved in a project that will help me grow intellectually and professionally and result in useful outcomes.

Theorieën Motorische Ontwikkeling

Theorieà «n Motorische Ontwikkeling Inleiding Motoriek is heel ruim gezegd, de beweeglijkheid van het lichaam. Om te weten wat er onder de motorische ontwikkeling wordt verstaan zullen wij ons in dit hoofdstuk gaan verdiepen. In dit hoofdstuk worden verschillende theorieà «n over de ontwikkeling van het bewegen en de motorische ontwikkeling beschreven. Enig inzicht in de achtergrond van de motorische ontwikkeling kan ons weer een stapje verder helpen bij het beter observeren en begrijpen van kinderen die zich anders of trager ontwikkelen dan hun leeftijdsgenootjes. De observaties bespreken wij later in hoofdstuk 7 en 8. Hier wordt duidelijk hoe je als leerkracht kunt observeren Hopelijk leidt dit inzicht tot betere antwoorden op het gedrag van deze kinderen, kortom tot beter onderwijs.Daarnaast wordt de globale motorische ontwikkeling van het jongere kind en het oudere kind beschreven. Wat betekent motoriek? De motoriek heeft betrekking op de bewegingen die het lichaam maakt; zoals arm en beenbewegingen. De motoriek bestaat uit een nauwe samenwerking tussen hersenen, spieren en ledematen. Het evenwicht, de ogen, de oren enhet autonome zenuwstelsel zijn er bij betrokken. De grove motoriek wordt als eerst ontwikkeld. Grijpen, rollen, zitten, kruipen, staan, lopen, klimmen en fietsen zijn de bekende ontwikkelingsfasen. Iedere fase van motorische ontwikkeling van een kind is noodzakelijk voor het latere functioneren.De hersenen worden door de motorische ontwikkeling op een bepaalde manier geactiveerd. De hersenen intregeren de motorische handelingen, ook wel automatiseren genoemd. Als dit automatiseren niet ontwikkelt zal een kind altijd de aandacht moeten houden bij de activiteit. Het kind kan dan niet twee dingen tegelijkertijd doen, zoals: fietsen en op het verkeer letten, lopen en praten.Deze sensorische integratie en de automatisering van bewegingen zijn belangrijk om goed te kunnen fun ctioneren. We kennen twee verschillende soorten ontwikkelingen in de motoriek namelijk; de grove motoriek en de fijne motoriek. De grove motoriek zijn alle grote bewegingen die je maakt met je lichaam zoals fietsen, zwaaien of lopen. Bij de fijne motoriek hebben we het over de kleine bewegingen die je bijvoorbeeld met je hand of vingers maakt zoals; schrijven of tekenen. Een voorbeeld van de grove motoriek wanneer deze niet goed ontwikkeld is zou kunnen zijn dat je vaak omvalt of tegen obstakels oploopt, bij de fijne motoriek zou het kunnen zijn dat je moeite hebt om dingen te kunnen oprapen. We kunnen dus wel zeggen dat alleen met een goede motoriekje gecontroleerde bewegingen kunt maken. (http://www.motoriekoefeningen.mysites.nl/mypages/motoriekoefeningen/107693.html) Het verloop van motorische ontwikkeling van het kind Het verloop van de motorische ontwikkeling begint tijdens het eerste levensjaar, daarom wordt in deze paragraaf naast de ontwikkeling van het schoolkind ook de ontwikkeling van babys peuters en kleuters besproken. Hierna wordt door middel van een overzicht, duidelijk welke ontwikkelingen een kind doormaakt per levensjaar. Tijdens het eerste levensjaar van een kind gebeurt er veel op motorisch gebied. Een pasgeboren baby doet veel vanuit reflexen. Zo heeft hij een sterke grijpreflex en een zuigreflex. Al snel gaat het kind bewuster grijpen, draaien, weer later gaat het zitten, etc. In eerste instantie gebeurt dit vanuit een aangeboren drang. Als voorbeeld nemen we het rollen. Eerst rolt een kind vanuit een innerlijke drang. Soms is dit helemaal niet handig, als bijvoorbeeld de nek nog niet zo getraind is, en hij dus steeds met zijn neus op het boxkleed ligt. Terug rollen leert een kind pas wat later, ook heel lastig als je moe wordt van je hoofd alsmaar omhoog houden. Naarmate het kind vaker rolt, wordt het kind er steeds behendiger in. Het kind ontdekt dat het dan ergens dichterbij komt. Weer later leert een baby dat hij dus al rollend ergens naar toe kan gaan, dat hij dus het rollen zelf in kan zetten als hij bijvoorbeeld een speeltje wil hebben dat net buiten handbereik ligt. Het karakter van het ki nd heeft grote invloed op het tempo van zijn ontwikkeling. Het ene kind is banger cq voorzichtiger uitgevallen dan het andere kind. Gelukkig gaat ieder kind uiteindelijk toch draaien of lopen. Dreumesen en peuters zijn dol op helpen bij huishoudelijke taken. Afwassen, schoonmaken, vegen, opruimen. Als ze willen, mogen ze helpen. Slepen met de stoeltjes, het fornuisje en het poppenbedje. Hierdoor wordt de motorische ontwikkeling op allerlei manieren gestimuleerd. De fijne motoriek door puzzelen, kleien, tekenen, schilderen, plakken, bellen blazen etc. De grove motoriek door verkleden, met zn allen stoeien op de matras, buiten spelen in de zandbak, fietsen, rennen, etc. Buiten spelen biedt hierbij vele mogelijkheden. Het leren inschatten van gevaar leren kinderen pas rond de leeftijd van vier jaar. Tot die tijd kunnen ze meestal niet voldoende inschatten wat ze wel en niet kunnen. Peuters hebben de drang in zich om te klimmen. Zij kijken anders tegen de wereld aan dan volwassenen. Als zij een bank zien, daagt dat uit tot klimmen, en hetzelfde geldt voor een vensterbank, een biels en een tuinstoel. De spierkracht neemt in een jaar tijd enorm toe. Bij het schoolgaande kind wor dt de motoriek steeds verfijnder en verder uitgewerkt. De kinderen oefenen al snel hun jas dicht maken, hun veters strikken, tanden poetsen, huppelen, klimrekkeren, steppen enz. Door knutselen en spelen met lego en andere bouwmaterialen wordt de fijne motoriek geoefend. Door timmeren leer je je krachten te bundelen en te gebruiken. Door de vele oefening in de motoriek kunnen de kinderen veel beter hun handen afzonderlijk van elkaar gebruik. De kinderen gaan steeds netter schrijven en gaan hiermee ontdekken. Zo zie je aan het eind van de basisschool periode steeds meer verschillende vormen in handschriften. Daarnaast neemt het uithoudingsvermogen toe doordat kinderen continu in beweging is. Hierdoor wordt ook de motorische ontwikkeling steeds nauwkeuriger, kinderen maken tijdens hun beweging, fijnere en kleinere bewegingen. Doordat de oudere basisschool kinderen erg competief zijn in sportactiviteiten leren de kinderen steeds meer te ontdekken. Ook dit is weer positief voor hun motor ische ontwikkeling, omdat zij bewegingen maken waarbij de motoriek centraal staat, zoals voetbal, klimmen etc. Concreet overzicht motorische ontwikkeling tot 12 jaar 0 tot 4 jaar; Zelf bij babys zie je al heel snel dat er een motorische ontwikkeling plaats vindt. Wanneer babys geboren worden zullen zij al snel knipperen met hun ogen en zuigen zij direct. Wanneer de babys wat ouder zijn zullen zij objecten gaan volgen met de ogen, dit voorwerp moet echter wel groot zijn. Rond 8 maanden leren de babys met hun handen te klappen en worden de oogbewegingen nauwkeuriger. De babys kunnen dan een klein voorwerp met hun ogen volgen. Vanaf 1 jaar gaan de kinderen o.a. zitten, kruipen, oppakken en stapelen. De motorische ontwikkeling wordt steeds verder ontwikkeld. Om deze ontwikkeling mogelijk te kunnen maken groeit het lichaam gelijdelijk en neem de spierkracht toe. Vanaf 2 jaar kunnen de kinderen al wat tekenen zoals een herkenbaar menselijk figuur. Vanaf 3 jaar ontwikkelen de kinderen hun motoriek ook door middel van bewegingesspelletjes, door bijvoorbeeld te schommelen, springen, ballen en/of stoeien. (http://mens-en-gezondheid.infonu.nl/kinderen/26174 -motorische-ontwikkeling-wat-kan-n-kind-op-welke-leeftijd.html) 4 tot 6 jaar; De motoriek wordt steeds beter bij de jonge kleuter. De jonge kleuter krijgt meer controle over de bewegingen die hij maakt. De pols en de vingers maken steeds meer nauwkeurige bewegingen. Jonge kinderen hebben een de drang om te spelen en te bewegen, om dit te kunnen doen hebben zij ruimte nodig zoals bij het spel; hinkelen of op à ©Ãƒ ©n been staan. De fijne motoriek verbeterd, en de jonge kinderen leren allerlei oefeningen om de fijne motoriek te stimuleren zoals binnen de lijntjes kleuren en de knopen dicht maken. Maar ook de grove motoriek wordt steeds beter, het kind kan nu beter met een bal overweg en valt niet meer of minder tijdens het rennen. Rond 5 jaar kunnen de kinderen al hun potlood vast houden en worden de eerste letters en woorden geschreven. Vanaf 6 jaar is het evenwichtsgevoel voortdurend in ontwikkeling en leert het kind bijvoorbeeld touwspringen. (http://mens-en-gezondheid.infonu.nl/kinderen/26174-motorische-ontwikkeling-wat-kan-n-kind-op-welke-lee ftijd.html) 6 tot 9 jaar; Vanaf 6 tot 9 jaar wordt de motoriek, de evenwicht en de coà ¶rdinatie beter. Dee handen kunnen nu afzonderlijk van elkaar worden gebruikt. Doordat de kinderen zoveel bewegen wordt de fijne motoriek nauwkeuriger en de uithoudingsvermogen en behendigheid nemen toe. (zie schema motorische vaardigheidslijnen Bijlage 1) 9 tot 12 jaar; Vanaf 9 tot 12 jaar is het coà ¶rdinatievermogen goed en het uithoudingsvermogen is groter. Dit betekent dus dat ze langer dingen vol kunnen houden. Daarnaast leren de kinderen onderscheid te maken tussen kinderen onderling; het ene kind kan meer dan het andere kind. Hierdoor onstaat er een competitie-element en krijgen de kinderen belangstelling voor sport en wedstrijden. De kinderen koppelen de vaardigheden aan dat de sociale status; zo vinden zij bijvoorbeeld dat behendige kinderen populairder zijn. (zie schema motorische vaardigheidslijnen Bijlage 1) Theorieà «n motorische ontwikkeling Over de motorische ontwikkeling zijn veel verschillende theorià «n. Om een goed beeld te krijgen op de motorische ontwikkeling hebben wij de 3 bekendste uitgelicht, namelijk; Het (neurologisch) ontwikkelingsmodel van Mesker (hfst 1.5) De senso-motorische ontwikkeling van Ayres (hfst 1.6) De ontwikkelingslijnen van Gesel (hfst 1.7) In de volgende paragrafen worden de hierboven genoemde 3 theorià «n toegelicht, waarna wij een conclusie zullen trekken over welke theorie of theorieà «n het meest bruikbaar is/zijn voor ons onderzoek en dan met name voor het te ontwikkelen beroepsproduct; Uitgangspunt blijft hierbij onze onderzoeksvraag; Hoe kan de motorische achterstand van kinderen met schrijfproblemen op de Dialoog worden verkleind? Het neurologische ontwikkelingsmodel van Mesker Mesker gelooft in de relatie tussen de lichamelijke ontwikkeling en de hersenen. Als het zenuwstelsel rijpt verandert ook het bewegingsapparaat. Mesker heeft meerdere dingen uitgevonden onder andere: rechtopstaand schoolbordje psycho-dominantiebord Een kind maakt met beide handen patronen op het bord, veelal ritmisch en met ondersteuning met klanken of woorden (schrijfdans). Dit wordt veel gebruikt door remedial teachers om gelijktijdige bewegingen met de linker- en de rechterhand/kant bij kinderen te verbeteren. Het wordt ook gebruikt bij handschrift verbetering en als remedie bij dyslexie. Hieronder worden de 4 verschillende fasen van Mesker beschreven. Het is handig voor leerkrachten om deze te herkennen. Het geeft een leerkracht de mogelijkheid om te kunnen zien hoe de motorische ontwikkeling van kinderen loopt, zodat men meer begrip krijgt over achterstanden in de totale ontwikkeling van het kind. De antagonistische (tegengestelde) fase of slurffase (tot 4 jaar) In de eerste fase van de motorische ontwikkeling verlopen de meeste bewegingen via een links-rechtsantagonisme. Dit houdt in dat de spierwerking in de ene lichaamhelft antagonistisch is aan die van de andere helft. Het werkt dus tegenovergesteld. Als de ene hand ontspant, spant de andere kant. Als een hand knijpt, spreidt de andere hand zich. Deze tegenbewegingen worden synkinesieà «n(tegenbewegingen) genoemd en zijn dwangmatig. Een impuls in de linkerhersenhelft wordt automatisch doorgegeven als tegenbeweging in de rechter hersenhelft. Slurfbeweging/slurfmotoriek Afgeleid van de slurf van een olifant. Ook wel actie-reactie bewegingen genoemd. In deze fasen zijn twee typen bewegingen. Kinderen leren tegenovergestelde (antogonistische) bewegingen te maken, bijvoorbeeld trappelen. Ook laten kinderen in deze fase tegenbewegingen (synkinesieà «n) zien, zo zal een baby van 6 maanden een vuist maken, terwijl hij zijn andere hand strekt. Voorbeelden van deze fase: ontwikkeling van trappelen, kruipen, lopen Opvallend is dat veel kinderen die niet hebben gekropen motorische problemen hebben. de symmetrische fase of motorische fase (4 6 jaar) Deze fase houdt in dat de hersens- en lichaamsactiviteiten in deze fasen links en rechts identiek zijn, symmetrisch. Ook in deze fase zijn 2 soorten bewegingen. Een kind leert in deze fase veel symmetrische bewegingen. Deze bewegingen zijn identiek (gespiegeld) in de linker- en rechter lichaamshelft en/of identiek in het boven- en onderlichaam. Voorbeelden van deze fase: met twee benen tegelijk springen, maken van een rechte koprol (3,5 jaar) met twee handen een bal vangen. recht zitten, staan Aan de andere kant is het nog niet goed mogelijk om een lichaamshelft te bewegen zonder dat de andere (dwangmatig) meebeweegt. Ook deze meebewegingen worden synkinesieà «n genoemd. Synkinesieà «n worden ook wel neurologische associaties genoemd. Bijvoorbeeld: als een kind op zijn hakken loopt, doen zijn polsen en armen mee; die gaan buigen (synkinesieà «n onder/boven) Als een kind de symmetrische fase goed heeft doorlopen dan: laat het kind geen onnodige symmetrische bewegingen zien beheerst het kind de essentià «le symmetrische bewegingsvormen Ook volwassen laten meebewegingen zien en/of nieuwe bewegingen. Het gaat bij kinderen om het laten zien van mee-bewegingen bij alledaagse, eenvoudige bewegingen. Lateralisatie fase (7 jaar) Dit is de fase waarin er verschillen ontstaan tussen de linker- en rechter hersenhelft en daardoor in de linker- en rechterlichaamshelft. Er is een aansturing vanuit het hersenhelft zonder dat de ander meedoet. Hierdoor is het mogelijk verschillende bewegingen van de verschillende lichaamsdelen onafhankelijk van elkaar te laten plaatsvinden. Gekoppelde of associeerde bewegingen vinden plaats in de antagonistische en de symmetrische fase. Losgekoppelde of gedissocieerde bewegen worden mogelijk in de lateralisatie fase. Dissociatie: het tegenovergestelde van associatie, betekent letterlijk: loskoppelen. Voorbeelden van dissociatieve bewegingen: De schoolslag wordt mogelijk, Armen en benen maken na elkaar een andere beweging. Touwtje springen wordt mogelijk; draaien en springen tegelijk. In de lateralisatie ontwikkelt een lichaamshelft zich meer doelgericht. De andere lichaamshelft werkt meer ondersteunend. Dit kan men zien bij de handen en voeten. De schrijfhand en de steunhand en het schietbeen en steunbeen. Lateralisatie is geen ontwikkeling tot eenhandigheid, maar een ontwikkeling tot een consequente taakverdeling en samenwerking in tweehandigheid. dominantie; einde lateralisatie fase(7-8 jaar) Deze fase is het eindproduct van de neurologische motorische ontwikking. De mogelijk bestaat om verschillende lichaamsdelen te laten samenwerken en er is geen sprake van dwangmatig neurologische synkinisieen (bepaalde lichaamsdelen werken niet meer automatisch en symmetrisch mee) bij veel gebruikte dagelijkse bewegingen. Voorbeelden: Het schoppen tegen een bal: Het standbeen moet het lichaam in balans houden terwijl het schopbeen half gebogen in beweging vaart maakt om tegen de bal te schieten. Het schrijven: Een voorkeurshand, waarbij tegelijkertijd meerdere motorische handelingen plaatsvinden. (de schrijfbewegingen vanuit het soepele polsgewricht worden gemaakt met voldoende steun vanuit het lichaam en met stabiele houding.) Voor de gehele paragraaf; Zorg voor beweging, W. van Gelder, M. Berg (1999). Heeswijk-Dinther: Esstede (blz.24-32) Schrijven met zorg, A. van Vledder en E. van Dijk (2000). Baarn:HB Uitgevers (blz. 95-98) Schrijven als een oefenvak, Handboek voor didactiek en praktijk, Drs.A. van Engen. (7e druk 1998). Vries: Van Engen BV.(blz. 30-38) Het neurologische ontwikkelingsmodel van Ayres Theorieà «n motorische ontwikkeling. Enig inzicht in de achtergrond van de motorische ontwikkeling kan men weer een stapje verder helpen bij het beter observeren en begrijpen van kinderen die zich anders of trager ontwikkelen dan hun leeftijdgenootjes. Hopelijk leidt dit inzicht tot betere antwoorden op het gedrag van deze kinderen, kortom tot beter onderwijs. De sensomotorische ontwikkeling van Ayres Motoriek heeft te maken met bewegen. Het woord  ´senso ´ is veel minder bekend. Het woord  ´senso ´ verwijst naar de zintuigen. Een vertaling van sensomotorische ontwikkeling zou kunnen zijn: De ontwikkeling van de samenwerking van de zintuigen en motoriek. De ontwikkeling van de interactie tussen zintuigen en bewegingsapparaat. Van belang bij de sensomotorische ontwikkeling is de sensorische integratie: een samenwerking tussen de zintuigen en de motoriek. Bijvoorbeeld: Oorzaak gevolg : als iemand zijn hand op een hete plaat legt dan trekt hij zijn hand weg. Actie- reactie : als iemand op zijn schouder wordt getikt dan kijkt hij om, zonder na te denken waar de prikkel vandaan komt. Ayres onderscheidt 5 zintuigelijke systemen: Het auditieve systeem: horen. Het vestibulaire systeem: dit systeem zorg dat men in evenwicht blijft en niet omvalt. Het visuele systeem: zien. Het proprioceptieve: geeft informatie door vanuit spieren en gewrichten en geeft men daarmee informatie over de houding en positie van lichaamsdelen. Via dit systeem voel men hoe hard/zacht, groot/klein men moet bewegen. Het tactiele systeem: (de tastzin) geeft informatie over allerlei aanrakingen van de huid. Een goed proprioceptief en het tactiel systeem zorgen voor bewegingsgevoel: balgevoel, mooie gestileerde bewegingen, kleine bewegingen, etc. Als verwerkingsprobleem van de informatie van de verschillende zintuigen noemt Ayres met name het over- of ondergevoeligheid van een systeem. Hier volgen 2 voorbeelden. Voorbeeld 1: Een vestibulaire overgevoelig kind zal bijvoorbeeld snel duizelig zijn. Bij een koprol of in een attractie op de kermis, vaak ook misselijk in de auto. Het systeem raakt snel overprikkeld. Veel van deze kinderen worden voorzichtig. Als het vestibulaire systeem ondergevoelig is, is voor een kind niets te gek. Hij kent zijn eigen grenzen niet. Botst snel, loopt in de rij tegen andere kinderen op, is vaak overmoedig. Een kind wijzen op zijn gedrag met als bedoeling dat dit gedrag veranderd, heeft zelden het gewenste effect. De kans is groot dat deze goedbedoelde aanwijzingen ten koste gaan van het gevoel van eigen waarde van het kind. Voorbeeld 2: Tactiel overgevoelige kinderen houden niet van vieze handen en bijvoorbeeld van stukjes of brokjes in het eten en -in extreme gevallen- zelf niet van kleren aan hun lijf. Het neurologische ontwikkelingsmodel van Gesell De ontwikkelingslijnen van Gesell Gesell beschreef als eerste een systematiek in de ontwikkeling van het kind. Hij onderscheidt de volgende ontwikkelingsvelden: Adaptatie: toepassing van de motoriek in het dagelijkse leven en spel. Klein motorische ontwikkeling: ontwikkeling van kijken tot grijpen en manipuleren. Grootmotorische ontwikkeling: ontwikkeling van hoofdbalans tot lopen. Spraak- en taalontwikkeling: ontwikkeling van communicatieve vaardigheden. Deze velden zijn al aanwezig voor de geboorte. De ontwikkeling wordt vastgelegd en normatieve ontwikkelingsschalen. Genoemd de key ages oftewel sleutelleeftijden, de momenten waarop een mijlpaal wordt bereikt in de ontwikkeling. Adaptatie is het belangrijkste ontwikkelingsveld. Het kind leert door zijn adaptieve gedrag analyseren, integreren en relaties herkennen. Gesell beschouwde adaptatie als de voorloper van de (latere) intelligentie, waarbij eerdere opgedane ervaringen gebruikt worden bij het oplossen van problemen. De vier ontwikkelingslijnen van Gesell met betrekking tot de motorische ontwikkeling: De ontwikkeling van kop naar voet (evenwicht) Een kind dat net geboren is kan op een gegeven moment zijn hoofd rechtop of omhoog (balanceren) houden. Daarna gaat het, als het ongeveer 6 maanden is, zitten (evenwicht in hoofd en romp), vervolgens kruipen (evenwicht in schouders en heupen) en tenslotte staan (evenwicht ook in voeten). Kinderen met een zwak ontwikkeld evenwicht laten vaak zien dat ze een wiebelend los hoofd hebben en/of veel gecorrigeerde bewegingen met de armen maken. In het algemeen leren deze kinderen laat zitten. Niet of laat kruipen en laat fietsen op een fiets zonder zijwielen. De ontwikkeling van binnen (romp) naar buiten (ledematen) De ontwikkeling van binnen naar buiten is een ontwikkeling vanuit de romp via de gewrichten die het dichtst bij de romp zitten (schouders en heupen) steeds meer naar buiten, tot in de vinger en teentoppen. Bijvoorbeeld: Een kind van 3 jaar draait een touwtje rond dat het met à ©Ãƒ ©n hand vasthoud. Hij maakt een hele grote draaibeweging vanuit de schouder. Een kind van 6 jaar zal bij dezelfde beweging slecht de hand/pols bewegen. In het onderwijs gaat men ervan uit dat op ongeveer 6 jarige leeftijd de sturing in de pols en hand plaatsvindt. Er dan met het schrijfproces gestart. Voor veel kinderen kan dit tot frustraties leiden, omdat de basis voorwaarden om tot schrijven te komen nog niet aanwezig zijn. Éà ©n van deze voorwaarden is een voltooide ontwikkeling van binnen naar buiten. De ontwikkeling van enkelvoudige naar samengestelde beweging Het aanleren van een beweging vindt plaats van enkelvoudig naar samengesteld. We kunnen deze volgorde het best voorstellen bij het aanleren van een dansje. Er wordt bijvoorbeeld eerst een (eenvoudige) beenbeweging geleerd. Als deze bewegingen worden beheerst, dan kan men een armbeweging bijmaken. Hierna volgt het hoofd, de mimiek en eventueel kan erbij worden gezongen. Het geheel is samengesteld uit steeds meer componenten. De hoeveelheid componenten die men tegelijkertijd kan uitvoeren is afhankelijk van aanleg en ervaring. Een voorbeeld van een samengestelde beweging is; Stuiten op de plaats naar dribbelen (stuiten en looppas). Voor een groot deel valt deze ontwikkeling samen met de lateralisatiefase van Mesker. In deze fase wordt het mogelijk op verschillende lichaamsdelen onafhankelijk van elkaar te gebruiken. De ontwikkeling van totaal (massaal) bewegen naar lokaal (effectief) bewegen. Het bewegen van jonge kinderen met name babys, kenmerk zich door de totaliteit van de beweging. Als een baby probeert iets aan te raken boven zijn wieg, doen de andere arm, de benen en mimiek mee. Het in zijn totaliteit bewegen gaat geleidelijk over in meer lokaal bewegen. Alleen het lichaamsdeel dat nodig is beweegt. Zo kan een 8 jarige zittend schrijven zonder dat iets anders beweegt dan zijn hand (onderarm) en zijn pen. Voor de meeste 4 jarigen is dat onmogelijk. Voetenschuiven, spanning in de schouder en een meebewegende andere hand zijn vaak te zien. In de theorie van Mesker is deze ontwikkeling te zien in het optreden van synkinesieà «n. Van tegenbewegingen naar meebewegingen naar spanning in de andere lichaamshelft tot ontspanning. In de laatste fase zou je ook kunnen spreken van lokaal, efficià «nt bewegen. Een voorbeeld van massaal naar lokaal: Een peuter van 2 jaar die een bal weggooit, gooit met zijn hele lichaam. Als kinderen 8 jaar zijn, gooien ze een bal door met twee handen een korte beweging te maken, waarna de handennawijzen. Zorg voor beweging, W. van Gelder, M. Berg (1999). Heeswijk-Dinther: Esstede (blz. 24-33) Samenvatting De motoriek heeft betrekking op bewegingen van het lichaam, zoals arm en beenbewegingen Er wordt over 2 soorten motoriek gesproken, namelijk de grove en de fijne motoriek. Bij de grove motoriek, gaat het om de grote, grove bewegingen die je met je lijf maakt. De fijne motoriek zijn meer de kleinere bewegingen die je met je handen en vingers maakt. Over de motorische ontwikkeling zijn veel vesrschillende theorieà «n; namelijk; Het (neurologisch) ontwikkelingsmodel van Mesker De senso-motorische ontwikkeling van Ayres De ontwikkelingslijnen van Gesel Volgens Mesker verloopt de ontwikkeling van de motoriek via een aantal fasen. Bovendien kan men in de schema Motorische Basisvaardigheden aflezen wat een kind op een bepaalde leeftijd zou moeten beheersen. Volgens Ayres heeft de motoriek te maken met bewegen en kijkt vanuit de sensomotorische ontwikkeling. Het woord  ´senso ´ verwijst naar de zintuigen. Een vertaling van sensomotorische ontwikkeling zou kunnen zijn: De ontwikkeling van de samenwerking van de zintuigen en motoriek. De ontwikkeling van de interactie tussen zintuigen en bewegingsapparaat. Gesell beschreef als eerste een systematiek in de ontwikkeling van het kind. Hij onderscheidt de volgende ontwikkelingsvelden: Adaptatie: toepassing van de motoriek in het dagelijkse leven en spel. Klein motorische ontwikkeling: ontwikkeling van kijken tot grijpen en manipuleren. Grootmotorische ontwikkeling: ontwikkeling van hoofdbalans tot lopen. Spraak- en taalontwikkeling: ontwikkeling van communicatieve vaardigheden. Nu er een duidelijkbeeld is gegeven over het verloop van een normale motorische ontwikkeling, zal er worden gekeken naar wanneer de motorische ontwikkeling niet soepel verloopt; waarbij wij ons afvragen welke kenmerken een motorische achterstand heeft.

Logistics Manager Role and Responsibilities

Logistics Manager Role and Responsibilities Question 1 The activities that a logistics manager might be responsible are: 1- Traffic and Transportation: It is physical movement of goods. Transportation has an important role in the supply chain and it can amount to high costs. The logistic managers need to choose the most effective combination of transport to improve value to the company and customers. The forms of transportation are: Pipeline, sea, railway, air, etc. 2- Warehousing and storage: Warehousing are the activities of storing, receiving shipping materials for production and distribution centers. It also includes managing human resources. 3- Material/Product Handling: Allocation and movements of product and materials and its distribution within the warehouse. This includes order procedures, picking up and shipment areas on warehouse. The logistic manager needs to coordinate the type of equipment and storage devices used to handle the product. 4- Inventory control and management: The logistic manager has the responsibility to assure that inventory levels are balanced and make sure the inventory is accurate. The inventory levels needs to be checked for replenishments either by monitoring shipments of orders, schedule of production or placement of new orders. The inventory accuracy needs to be check against system. Logistic managers need to schedule physical inventory checks and cross those numbers against the system. If there is any inaccuracy those needs to be adjusted on the system and inventory replenished if needed. Inventory control minimizes inventory and reduce cost. 5- Order fulfillment: Those are the activities of filling and shipping of customer orders. The lead time for order fulfillments are important to control and minimize customers lead times. 6- Demand forecasting: Forecasting is important efficiency of inventory. Forecasting needs to be accurate and reliable and logistic managers need to develop the forecast with marketing department at the most accuracy, as high inventories are attributed to poor forecasting. 7- Production planning and scheduling The logistic manager needs to work closely with production planning in order to coordinate shipments and market demand. 8- Procurement: Procurement negotiates contracts deliveries for product and also selects suppliers. The logistic manager control the transportation costs based on location and cost of materials necessary for production. 9- Customer service: The logistics managers need to ensure the customer receives the product at the right time, place and with quality. The logistic manages needs to be concern with inventory levels and locations to assure right time and place can be met. Also that order fill in rate are complete. All 15 listed activities are connected and affect customer satisfaction. 10- Plant and warehouse site selection: The Logistic manager needs to choose, location, size and quantity if warehouses based the inventory size. 11- Part and Service support: This activity is especially important for technical product. The replacement of spare parts and repair are also part of the customer support and service as sales to customers do not ends with the delivery of products. 12- Reverse logistics: The main focus of reverse logistics is to reduce costs by managing the reuse of materials. Those include returns, reuse, repair, recycling and disposal of those in the reverse journey from the customer to the firms warehouse and or supplier. 13- Protective Packing: The packing is related to the type of packing needed for each mode of transportation and also the storage of product. Each mode of transportation might need different packing and that needs to be designed to minimize risk of damaging the product and reduce costs. 14- Information Maintenance: Analysis control, manipulation collections, maintenance and storage of data related to logistics is one of the responsibilities of a manager. The data is important as it drive the decision process. 15- Salvage and Scrap disposal: Salvage and scrap material have to be disposed and the logistic managers needs to manage that those are properly handled and sold to specialized companies. Today there are more and more public concerns with environment and companies to responsibly address their waste. Question 2 The four dimensions of customer services and how these elements affect the cost centers of both buyer and sellers are: A). Time: For the buyer perspective time means lead times, the order cycle and replenishment. As for the sellers time means the order management process and Bill to Cash process. The factors that affect time are the degree in which logistics control the elements of lead time. Seller need to control processes of order picking, shipment of orders and order processing. Consequently, Logistics manager needs to control consistence across the order cycle especially length and duration. If that is not controlled it will impact inventory levels for the buyers. The sellers need to work on improvements of cost centers that will result in the cost effective savings for the company and give the highest customer service returns. Lead times will affect both buyers which expect lower inventories and sellers that aim for productivity savings and improvements. Therefore, time is very important for customer service. B). Dependability: From buyers prospective dependability and trust is important because it a minimize inventory levels considering the lead time is stable. The buyers that can rely on orders arriving at stable time could adjust their inventory based on those times and reduce or eliminate their safety stock quantity. As for sellers dependability it is important as they can rely on buyers to run logistic department with stable lead times. Cycle time directly affects buyers inventory level and stock out costs. If lead time is stable will reduce uncertainty of buyers. In the other hand if cycle time is unstable it will create delays and loss of sales for buyers in which will increase costs. As for sellers if they can provide stable and reliable lead time to buyers it will create a differentiation in product and create competitive advantage against other competitors. In the other hand, if cycle time is unstable and create extra costs for buyers. The sellers might receive claims due to buyers delays and loss of revenue. That is why dependability is so important and both buyers and sellers need to rely on stable cycle times. Safe delivery is another important part of any logistic system. If products are lost or arrive damaged the buyers wont be able to sell or use the product. When damaged product happens it will affect several buyers departments such as inventory, marketing and production and those can create high costs. Another important point is if buyers receive damage products they will need to increase inventory levels for the future to account for damaged product risks which would generate further costs to buyers. Correct orders are another important part of the logistic system, buyers needs to trust that filling orders will be accurate. If there is an inaccuracy it might cause loss of sales and or production. If customer is unsatisfied with the inaccuracy and they will need to reorder the product and they might choose other competitors to order from. As for the sellers the correct orders results in high dependability from buyers. If there is inaccuracy buyers might claim the sellers causing increase of costs. Further it might cause loss of sales and trustability. C). Communications Communication with buyers is important to monitor the customer service level and dependability. The communications needs to be both ways buyers to sellers and vice versa and constantly open. As regular communication is needed to ensure efficiency on physical distribution. There are three types of communications and those can be performed manually, electronically or through an information system. Pre- transaction: It includes current product availability, delivery dates. Pre- transition provides buyers with information in which decisions are made. This communication is directly related to the companys police towards customer service. Transaction: This provides both sellers and buyers with information about order filling, process of picking the product out inventory including time required. Buyers need information on their orders and the update state of those. They will then communicate with sellers to have an update on the information. During communications sellers can assess inventory availability and if any product is not available they then communicate with buyers. Buyers and sellers can also communicate on status of shipments. Pos- transaction This type communication is after sales service for buyers. It is related to returns, assembly or repairs. The sellers need to be efficient and provide response quickly to differentiate from other competitors even if that includes returning product because buyers are not unsatisfied. D). Convenience Buyers might have different requirements and sellers need to be flexible to accommodate those. They might require different packing, mode of transportation, carriers or delivery dates. Seller or more specifically logistic manager need to factor buyers requirements in terms of costs and provide service level as reasonably required. Flexibility allows for sellers to be perceived as convenient and accommodating. Although, flexibility is needed sellers need to carefully analyze those requirements and try to create a pattern among those. Customer service activities are costly and sellers need to examine those carefully to improve revenues and or address any loss of profit. Logistic managers need to determine the right level of customer service as it is more difficult to imitate, the cost associated with each activity must be beneficial for the seller the ideal is that the level of customer service costs equal to its profit return and also provide competitive advantage. Question 3 Marketing interfaces with logistics in terms of physical distribution and or outbound. As logistics is responsible for the transportation, storage and on time delivery of product to customers. In which interface with marketing in terms of being the key ability to provide product at the right quantity, time and place. The four basic concepts of market mix and how logistic interface are: Price: In term of prices logistic needs to adjust quantities in order to receive the most competitive prices for transportation modes. The price discount received for bulk volumes shipments offered by shippers are important and logistics need to manager those in order to have competitive prices. As customer might also might be offered discount price on bulk volume the transportation rates discount in terms of weights or volume are beneficial for both customer and seller as reduce total transportation costs. It is not always possible to benefit from the transportations rates however logistics needs to manager to investigate those in the market. As per inventory logistics will also be part of the volume sold in different prices ranges and those will also affect the inventory levels and repleshiment times. Marketing will also inform logistics of the of the different sales projects in particular times of the year and special price rates that is needed to meet projected demand. Product: Marketing main concern is product and its physical characteristics. such as their size, weight and type of packing. All those are physical properties that affect the logistics system as they will be responsible to move and store .Physical dimensions affect movements system and transportation such as equipment handling, pallets, packing and others. Consequently, it is important that logistics managers work with marketing in terms of giving an input when marketing is working on physical characteristics of a product. Logistics also needs to work with marketing on creating specifications for new packing in terms of sizes and weight in order to minimize transportation issues such as inefficiently use of container space, use of size pallets on any issue that might cause damaged product. If marketing works with logistics managers they can recommend changes that could make product friendly to the logistics system and reduce costs that would have an effect on product sales. It is important also that marketing works with logistics in term of developing consumer packing, as it might influence sales. Marketing is concern with its appearance and the information provided to the customers. For logistics they are concern if the consumer packing fits the external packing, basically all dimensions that influence the logistics system including the protection of the product. The consumer packing will affect materials handling, transportation and warehouse. Promotion: Marketing spend millions in promotion such as campaigns and advertising l that will increase sales. Marketing works with push and pull sales strategies which means marketing can push to the distribution channels to the customer or pull it or a combination of both. The pull approach usually caused a high quantity random product demand by customers; therefore Marketing should work with logistics as those promotions which affect inventory levels as logistics managers need to ensure that quantities are available for sales. Although push strategy allows for marketing to predict the consumers respond to product in a more organized way, the interface of marketing and logistics is still important because allows for logistic to work in advance to have the optimal inventory level needed. Place: Place is directly related to the distribution channels. Marketing work on decisions such as selling product to wholesale or to retails or both. For logistics managers those decisions directly affect the logistics system requirements. In my opinion, the most important component of the marketing mix is Product, most specifically consumer packing. With the growing consumer demand on Eco friendly packing, reduces, reuse and recycle marketing is forced into a position of redesign their consumer packing. The interaction between marketing and logistics is particular important, because the different trades off that need to be made when choosing a new packing. While logistic will be concern with reducing storage, weight and sizes, marketing will be concern with attracting consumers attention and reinforce brand image. Product also has distribution and storage that directly affect costs, performance and lead times. Therefore, Marketing and logistics poor cooperation in terms of product consumers packing can lead to higher packing costs, transportation costs and longer transit lead times. References: The open university of Hong Kong , Unit 1 Unit 2 MKTB371 Logistics