Srategic Quality Management Implementation Plan Assignment

Srategic Quality Management Implementation Plan - Assignment Example Citigroup Inc. has always made an effort to marshal as much support as possible to derive a consensus necessary to implement the SQM applicable. The effort would take longer to put in place, but at least it would be moving forward. In some settings, it is often difficult to get consensus on minor issues, and it is almost impossible on change initiatives which impact the whole organization (Peratec, 1995). To move forward the management must develop and distribute an improvement plan which is integrated into the strategic plan for the business. To be the most successful, an excellence or quality initiative should be an integral part of strategic and tactical operations of the business hence the Strategic Quality Management Assess Current Culture, Values and Operating Guidelines Citigroup Inc. uses quality information for improvement, and not to judge or control people, there are rewards for results, authority is equal to responsibility while cooperation, not competition, as a base for working together. Employees have an ownership stake, secure jobs and a climate of fairness. Top most is that compensation is equitable (Peratec, 1995). ISO9000 Broadly ISO9000 series concerns itself with the quality management purpose and it is as such the main focus in ensuring gradual and/or continuous improvement as a process as recognized in this firm. ISO9000 is concerned with quality management. To be able to meet the demands of ISO9000, an organization has to improve quality in at each stage, from design through to delivery, assessment and evaluation, through a formal and rigorous management system to ensure conformity of the product or service to its specification as per the customer wish. It requires that all the activities necessary to produce the product or service be documented if the quality system is to conform to the standard. Everybody in the firm needs to understand its implications and to work to the systems and follow the procedures that have been put in place. T he SQM model There is interplay, back and forth, between the elements; for example, consideration of what strategic actions if taken can provoke discussions of whether and how the strategy can be implemented with real effectiveness (Peratec, 1995). The tasks involved in strategic management are never isolated from everything else that falls within a manager's preview. Strategy has to be formulated and implemented in the midst of a managerial schedule that is fragmented with appointments, meetings, paperwork deadlines, unexpected problems, and momentary crises. It is incorrect to construe the job of managing strategy as the exclusive task of managers, even though it may well be the most important function they perform where organizational success or failure is concerned (Peratec, 1995). Formulating and implementing strategy must be regarded as something that is ongoing and that evolves. What qualifies as a surefire high-performance strategy today is sooner or later rendered stale by events unfolding both inside and outside the enterprise. The task of "strategizing" can never therefore be a one-time exercise. As a consequence, fine-tuning-type changes in strategic plans, and an occasional major change in strategic thrust, are normal and expected. The need to keep strategy in tune with an organization's changing situation makes the strategic management process dynamic and means that the prevailing strategy is

Marketing Strategies of Catering Firms Essay Example for Free

Marketing Strategies of Catering Firms Essay Basically, the Descriptive method of research will be utilized in the study since it is designed for the investigation or to gather information about present existing conditions. [1]This will be done by gathering the descriptive data through the use of researcher-made questionnaires. Manuel and Medel(1990) defined Descriptive Research as a research that describes ‘what is’. It involves the description, recording analysis, and interpretation of the present nature, composition or how a person, group or thing behaves or functions in the present. It often involves some type of comparison or contrast.[2] According to Polit and Hungler(1999), Descriptive Research describes what exists and may help to uncover new facts and meaning. The purpose of Descriptive Research is to discover, describe and document. Aspects of a situation as it naturally occurs.[3] In other words, Dsescriptive Reserch design is a valid method for researching specific subjects and as a precursor to more quantitative studies. Whilst there are some valid concerns about the statistical validity, as long as the limitations are understood by the researcher, this type of study is an invaluable scientific tool.[4] Its common means of obtaining information include the use of the questionnaire, personal interviews with the aid of study or interview schedule, and observation, either participatory or not. Descriptive Research includes studies that gives meaning to the quality and standing of facts that are going on. For instance, the information about a group of person, a number of objects, a set of conditions, a class of events, a system of thought or any other kind of phenomenon or experience which one may wish to study.[5] This method will be appropriate and used in the study because it is concerned with the conditions that exist and help to answer the questions involving the Marketing Strategies of Catering Firms in selected towns in Rizal. SETTING OF THE STUDY This study will be conducted in selected towns in Rizal. Rizal is a province located in the CALABARZON, just 16 kilometers east of Manila. The province was named after the countrys national hero,Josà © Rizal. Rizal Governor Dr. Casimiro Ynares III on June 17, 2008 announced the transfer of the Capitol from Pasig. Its P 270-million capitol building, constructed in Antipolo by Ortigas Co., owner thereof, was completed by December of that year. Built on 5-hectare lot at the Ynares Center, it employs 2,008 employees. The New Capitol was successfully inaugurated on March 4, 2009, bringing back the Capitol Building inside the provincial territory, from which it was absent for 33 years (when Pasig was incorporated into Metro Manila). Rizal is bordered by Metro Manila to the west, the province of Bulacan to the north, Quezon to the east and Laguna province to the south. The province also lies on the northern shores of Laguna de Bay, the largest lake in the country. Rizal is a mountainous province perched on the western slopes of the southern portion of the Sierra Madre mountain range. Antipolo boasts of a wonderful view of Metro Manila and it is where Hinulugang Taktak, a waterfall popular with tourists, can be found. The Rizal Province will be accessed by the future C-6 Road connecting the provinces of Bulacan and Cavite and cities of Taguig (beside Laguna de bay), Paraà ±aque and Muntinlupa which are located within Metro Manila. [6] The selected towns to be involved in the study are Tanay, Taytay, Angono, Binangonan, and Cainta. Tanay is a first class municipality in the province of Rizal, Philippines. It is located 57 kilometers (35 mi) east of Manila, although a typical commute between Manila and Tanay will take between one to three hours depending upon traffic conditions. It contains portions of the Sierra Madre Mountains and is bordered by Antipolo City in the northwest, Baras, Morong and Teresa in the west, General Nakar (Quezon Province) in the east, and Pililla, Santa Maria (Laguna province) as well as the lake Laguna de Bay in the south. According to the latest census, it has a population of 94,460 people in 15,720 households. The majority of the population consists of Tagalogs who live near Laguna de Bay, though there are also a significant percentage of mountain dwelling people living in the northern portions of the municipality. The towns major trades consist of fishing, agriculture and regional commerce. Tanay is also believed to be the birthplace of the Sambal language. [7] *Continuation of Setting of the Study* The City of Taytay is a first class, densely populated municipality in the province of Rizal, Philippines. It is currently the third most populous municipality in the country. Conurbated with Metro Manila, it is bounded by Cainta on the north, Pasig City and Taguig City on the west, Antipolo City in the East and Angono on the South. It is the Woodworks and Garments Capital of the Philippines.[8] Angono is a first class urban municipality in the province of Rizal, Philippines. It is known as Arts Capital of the Philippines, and located 30 kilometers (19 mi) east of Manila. According to the latest census of August 1, 2007, it has a population of 97,209 inhabitants (or 4.26% of Rizal provinces total population of 2,284,046) in 15,740 households. First created as a pueblo in 1766, Angono was a barrio of its neighboring town Taytay and Binangonan before being legally proclaimed an independent municipality in 1935 by then President Manuel L. Quezon. It is home to the Angono Petroglyphs, the oldest known work of art in the Philippines. [9] The Municipality of Binangonan is a first class urban municipality in the province of Rizal, Philippines. According to the 2010 census, it has a population of 249,872 inhabitants in 38,488 households in census. It has a land area of 64.38 km ². A thriving fish port and fishing industry is found in Binangonan, having a long coast line facing the Laguna de Bay, including the western part of Talim Island. The plant of Rizal Cement and Grandspan are in Binangonan as well. Their main livelihood are fishing and farming. With the continuous expansion of Metro Manila, the municipality is now part of Manilas conurbation which reaches Cardona in its eastern-most part.[10] The Municipality of Cainta (Filipino: Bayan ng Cainta) is a first-class urban municipality in the province of Rizal, Philippines. It is one of the oldest (originally founded on August 15, 1571), and is the town with the second smallest land area of 26.81 square kilometers (10.35 sq. mi) next to Angono with 26.22 square kilometers (10.12 sq. mi).Cainta serves as the secondary gateway to the rest of Rizal province from Metro Manila. Cainta became one of the most urbanized towns due to its proximity to Manila.[11] Subject Of The Study The subject of the study will be twenty five(25) owners or caterers in selected towns in Rizal. The selected towns to be involved in the study are Tanay, Taytay, Angono, Binangonan and Cainta. The researchers will distribute the questionnaire – checklist to the five(5) catering firms in each selected towns. Sources of Data In this study, the researchers will use a questionnaire – checklist as the main tool in gathering the needed data or information on the marketing strategies of catering firms in selected towns in Rizal. The researchers adapted the questionnaire of Caisip et al, with some modifications to suit the type of respondents. The questionnaire – checklist is divided into three parts: Part 1 pertains to the personal profile of the respondents which includes the age, job position, sex, civil status, educational attainment, monthly salary, type of catering, ownership, accreditation, affiliation and location. Part 2 consists of the profile of catering firms that perceived by the respondents which includes the physical facilities, services offered, capacity, number of staff, income per year, price per pax, target market and amenities. Part 3 contains the different marketing strategies used by the caterers to attract customers. These will be answered by the respondents by putting a checkmark on the corresponding space by using the following five-point scales: SCALE| VERBAL INTERPRETATIONS| 5| Very Much(VM)| Always(A)| 4| Much(M)| Frequently(F)| 3| Moderate(MO)| Occasionally(O)| 2| Little(L)| Rarely(R)| 1| Very Little(VL)| Never(N)| This scale will be used to know the effectiveness of the marketing strategies that the catering firms applied. Procedure Of The Study The researchers underwent planning which includes the formulation of the problem, they decided to go on the title â€Å"Marketing Strategies of Catering Firms in Selected Towns in Rizal†. After the research instructors’ approval of the title, the researchers gathered related literature and studies to complete the Chapter 1 and 2. In Chapter 1, the researchers collected the needed information involving the Introduction, Background of the Study, Theoretical Framework, Conceptual Framework, Statements of the Problem, Hypothesis, Scope and Limitation of the Study, and Definition of Terms. The Statements of the Problem will be pattern to the Study of Caisip, Catherine C. et al. While in the Chapter 2, the researchers did the same thing in gathering the data needed, which includes the Research Method, Sources of Data, Setting of the Study, Subject of the Study, Procedure of the Study, and Statistical Treatment. Upon the completion of the 2 chapters, the research instructors will schedule the researches for the colloquium. So, the constructive criticisms will be made by the panelists for the improvement of the study. Statistical Treatment To analyze the data gathered, the indicated statistical treatment below will be used in the study: Problem number 1: Frequency and Percentage Distribution will be used to determine the profile of the respondents in terms of age, job, sex, civil status, educational attainment, monthly salary, type of catering, ownership, accreditation and affiliation, and location. Problem number 2: Weighted mean will be used to determine the marketing strategies of catering firms in selected towns in Rizal in terms of physical facilities. Frequency and Percentage Distribution will be used to determine the marketing strategies of catering firms in selected towns in Rizal in terms of services offered, capacity, number of staff, income per year, price per pax, target market and amenities. Problem number 3: F-Test(One Way ANOVA) will be utilized to determine if there is any significant difference on the marketing strategies of catering firms in selected towns in Rizal with respect to the different aspects in terms of physical facilities, service offered, capacity, number of staff, income per year, price per pax, target market and amenities. End Notes 1http://www.slideshare.net/Angilo/descriptive-research, July 10, 2012 2Rupinta, Sheila Marie G. et. al â€Å"Status of Tourisim Components in the Different Hospitality Industries in Selected Towns in the Province of Rizal.† 3http://www.reserachproposalsforhealthprofessionals.com/descriptive-research.html 4http://www.experiment-resources.com/descriptive-research-design.html, August 5, 2010 5http://www.slideshare.net/Angilo/descriptive.research, July 10,2011 6http://en.wikipedia.org/wiki/Rizal, August 15,2012 7http://www.wowrizal.com/towns-and-cities/tanay-rizal-facts-location-population-barangays-history/ , April 4 2010 8 http://en.wikipedia.org/wiki/Taytay,_Rizal, August 24,2010 9 http://en.wikipedia.org/wiki/Angono,_Rizal, July 22, 2012 10 http://en.wikipedia.org/wiki/Binagonan,_Rizal, July 7,2012 11

Care of a Confused Parent

Care of a Confused Parent I N T R O D U C T I O N The first FETAC Level 5 Assignment in Care Skills module requires that learners produce an assignment on the care of a confused person. This confusion can be the result of any number of causes – from an illness such as dementia or Alzheimer’s disease or the long term use or an abuse of drugs and /or alcohol. The assignment must be completed answering very specific points (as outlined in the table of contents). This assignment was compiled using various methodologies including: Classroom lectures and feedback sessions Class notes and Manual, hard copy manuals and books One to one sessions with Work Experience Skills Coach Previous life experience of caring for an ill family member Online research and library research For the purpose of this assignment the author has decided to highlight one particular client who is in the Nursing Home in which the author is completing her work experience module. The clients name has been changed in order to respect her rights to privacy and dignity. The client in this example has been diagnosed with Stage 4 Lung Cancer (T4, N3) which denotes that she suffers from a malignant tumour which has invaded the oesophagus, epicardium, pleural cavity, T5 and T6 vertebrae with Metastasis to the supraclavicular lymph node. She also suffers from osteoarthritis of L2-L5 and S1-S5, Type 2 Diabetes and Psoriasis. She is currently on a variety of medications which are listed in her Care Plan, along with creams and ointments for the Psoriasis. Presently she suffers from severe bouts of confusion as a result of her pain medications and needs constant monitoring and care. In conjunction with her family, and a multi-disciplinary team Catherine has decided to move to a Nursing Home where she will receive the type of holistic care she requires. Catherine has also documented her specific wishes regarding her death and funeral arrangements and all of which has to be respected by all involved, the details are listed in her Care Plan along with the emergency contact details if her condition should suddenly decline. INDIVIDUAL NEEDS ASSESSMENT Initial assessment of Catherine’s needs using the Logan Roper Tierney model of assessment an individualised, client-centred holistic approach to Catherine’s care has been devised. Physical Catherine loves the outdoors and she should be encouraged to continue this through gardening – taking her out for walks, especially during spells of confusion. Ensure she has her walking stick and bring the wheelchair as she gets breathless very easily. Shower rails and chair must be available in her room and always ensure that the non-slip mat is on the ground. When she is confused she forgets how to wash herself properly and will need assistance. Intellectual Catherine loves to read and complete quizzes and cross words – these are very good for stimulation and they should be made available to her in her room and in the day room. The news and primetime are two of her favourite programs – ensure that they are on the TV in her room and the day room. Diversional therapy of card games and jigsaws are great for completing when she is confused. Emotional As a result of the illness and her pending death Catherine can become depressed – she must be encouraged, made feel wanted loved, needed and always try to support her decision to move into the nursing home Social/Spiritual Socially, Catherine has a lot of friends with whom she plays cards – they are going to come visit her once a week to continue this tradition, the other residents should be encouraged to join in also as it will help integrate her more. Her large family of 8 children and 63 grand-children/great-grand-children/great-great grand-children all visit her when she is at home and will continue to do so. It is amazing the Catherine remembers all their names and dates of birth – during spells of confusion though she does tend to forget them a little. Catherine is very religious and attends mass every Sunday when she is well – the angelus must be said at 12pm and 6pm and the rosary at 9pm. I D E N T I F Y T H E L E V E L O F A S S I S T A N C E R E Q U I R E D Catherine has very low level needs when she is not confused. She needs help sitting up in the bed and cannot use the remote control as her fingers are very badly damaged from the arthritis and as such will need assistance getting out of bed. She cannot manage small buttons when dressing and most days she just wears t-shirts but on Sundays she wishes to wear a blouse going to mass and will need assistance with that. Catherine dose not wear dentures and is on a chopped diet for now, she can manage to use cutlery but prefers to use a spoon. When she is confused she forgets when to eat and sometimes forgets that she has eaten so she will need monitoring when eating rather than assistance. MAINTAINING A SAFE ENVIRONMENT During confused spells Catherine likes to walk and as such walkways will have to be completely compliant with the Health and Safety Regulations for care as set out by the Health and Safety Authority. (HSA.ie, 2014) It would also be a good intervention to ensure that her walking aid is always within arm’s reach and that her shoes/slippers have rubber soles and are well maintained. For showering, the shower stool must be readily available and ensure that the hand rails are well maintained. The toilet in her room has a raised toilet seat and rail which must be cleaned and maintained regularly. Catherine will also use a commode, but when she is confused does not realise where she is when trying to urinate therefore she should be encouraged to go to the bathroom to protect her dignity. When going on outings with her family Catherine’s wheelchair must accompany her always and kept well maintained and ensure the wheels are pumped. PROMOTE CLIENT INVOLVEMENT IN SOCIAL EVENTS AND THERAPIES Catherine likes to play cards therefore she would enjoy it as part of the available diversional therapies. The HCA can have table quizzes added to the curriculum of activities by the activities co coordinator and help her participate by writing the answers to the questions and holding the cards – when she is confused one to one games such as Patience or Snap are very helpful. Catherine is quite a sociable person and will have loads of visitors – they will help to integrate her with the other residents and they play cards, tell stories, Irish dancing and play music some days she wishes not to have any visitors or participate in activities – in order to keep her from this depression the HCA could encourage her to attend the card game or maybe say some prayers with her as her strong beliefs will help to alleviate the depression. Catherine has refused to attend the Cuisle Centre in Portlaoise which has numerous activities and therapies available to cancer sufferers. The HCA could bring her more information on the services provided and explain what they are in detail and answer any questions she may have in order to encourage her to attend. They offer a Gardening Therapy workshop each week which would really benefit her along with the CranioSacral therapy and Holistic Massage would be beneficial for her also and she should be encouraged to go by bringing her down to the centre and having a talk with other clients that attend. (Cuisle Centre, Cancer Support Centre Laois, Cancer Support Portlaoise, 2014) MOBILITY INDLUDING FALLS AND PRESSURE AREA CARE FALLS The results from the Morse Falls Assessment in Catherine’s Care Plan show that on non-confused days she is at low risk, but during spells of confusion she is moderate risk and as such – should be encouraged to walk around more during lucid days and be accompanied outdoors for short walks if her breathing allows – allow her to push the wheelchair for a while will help and support her. The activities co-ordinator has a great curriculum for mobility and Catherine should be encouraged to participate in order to help keep her arms active. PRESURE AREA CARE As Catherine suffers from Psoriasis she is even more susceptible to pressure sore development. Her skin should be cared for as per her prescribed treatment – creams and lotions to be applied daily. At the moment she is fairly mobile and does not remain in the one spot for too long – if she suffers bad pain during the day she tends to stay in bed and will need assistance turning and should be encouraged to do so – a second HCA may be needed for this as she has had two hip replacements which have to be cared for also – a hoist may be needed on occasion. Gel cushions should be used when she is playing cards with friends as she could be in the one position for hours, to break this she should be encouraged to get up and walk around every hour – even if for a few minutes. EFFECTIVE VERBAL AND WRITTEN COMMUNICATION WITH CLIENT AND HEALTHCARE TEAM Catherine has to attend various appointments for scans and pain medication updates. Any new developments need to be explained in full to her so she can make an informed decision as to what course of action she wants to pursue. Catherine must be kept informed at all times of any changes in her condition and has requested that she be told first so she can decide whether to tell her family. She has stated during meetings regarding her funeral wishes but may want to change these so ensure any changes are documented. All daily charts are to be kept updated immediately and inform the staff nurse of any noted changes in her condition at handover. As her cancer is rapid and fast progressing Catherine’s condition can and will change on a daily basis therefore food and fluid charts are vital. At the moment she is normal on the M.U.S.T scale, but as she tends not to eat when in pain this has to be carefully monitored and reported if she is refusing food or fluids. ASSIST CLIENT WITH ACTIVITIES OF DAILY LIVING Mobility Assistance Catherine needs assistance when getting in and out of bed. She can sometimes sit up on her own but during spells of confusion she forgets how to stand up and should be encouraged and supported to do it herself as long as possible without the aid of a hoist. She may also need assistance getting in and out of the shower and needs her hair to be washed as she can no longer raise her arms above elbow height. If the weather if favourable Catherine likes to go outside – she should be accompanied and ensure her wheelchair is in good working order. Allow her to walk as much as she can pushing the wheelchair but ensure she does not get too tired – encourage her to get into the wheelchair and continue until she wishes to return. Catherine’s pain medication is prescribed by the GP and monitored by the Palliative Care team. She has certain pain killers that are available to her without the nurses supervision – please record when and what she is taking and report it back to the nurse for monitoring. At the moment Catherine is normal on the M.U.S.T scale and we have to endeavour to keep her that way – she is on a chopped diet but needs to be monitored as the tumour is pressing on her oesophagus – it could cause a choking hazard – any noted changes to her swallow must be reported back to the nurse for further investigation by the MDT. When she is confused Catherine needs assistance eating as she forgets how to use the cutlery. PROMOTE THE RIGHTS OF THE CLIENT TO DIGNITY, PRIVACY, INDEPENDENCE, POSITIVE SELF IMAGE As Catherine is very self-conscious about her body – every effort must be made to give her as much privacy as possible when dressing and showering. She will need assistance dressing on occasion especially when she is confused as she gets the order of clothing mixed up. The HCA can discuss her wishes with her and come to an arrangement regarding the assistance she requires. Catherine is very independent and likes to take her own medications and feed herself. She has expressed her wishes numerous times to all her family and multidisciplinary team regarding her funeral wishes and insists that she not be left alone from now on and even when she passes she does not want to be alone until she is buried with her husband. Catherine needs to feel in control of the disease and wants to be informed if there is any changes being made to her medications or if the multidisciplinary team think that she is declining in any way regardless of the news make sure she is kept informed and involved in all decisions – it is best practice to inform Catherine first and let her decide when and how much information he and the rest of the family is to be told. BIBLIOGRAPHY http://www.upledgerclinic.com/conditions_symptoms.html http://www.cuislecentre.com/therapies/ http://www.ahrq.gov/legacy/research/ltc/fallpxtoolkit/fallpxtool3h.htm http://www.clinicaloncologyonline.net/article/S0936-6555(08)00451-2/abstract http://www.nurse2nurse.ie/Upload/NA6762article.pdf http://www.ncbi.nlm.nih.gov/pubmed/19059769 http://www.patient.co.uk/doctor/end-of-life-care-pro REFERENCES Cuisle Centre, Cancer Support Centre Laois, Cancer Support Portlaoise, (2014). Therapies Cuisle Centre, Cancer Support Centre Laois, Cancer Support Portlaoise. [online] Available at: http://www.cuislecentre.com/therapies/ [Accessed 19 Dec. 2014]. Knott, D. (2014). End of Life Care | Doctor | Patient.co.uk. [online] Patient.co.uk. Available at: http://www.patient.co.uk/doctor/end-of-life-care-pro [Accessed 15 Dec. 2014]. 1

Physical Activity Recommendations for the Elderly

Physical Activity Recommendations for the Elderly Introduction Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 1946). There are many factors which have an impact on health and quality of life, including lifestyle choices of each individual. Diets high in fruits and vegetables and participation in regular physical activity are associated with a lower risk for several chronic diseases and conditions (US department of health and human services, 2005). Physical inactivity is very common globally with 31% of adults over 15 years old being insufficiently active. Insufficient physical inactivity results in about 3.2 million deaths per year (WHO, 2008). Elder adults are generally more vulnerable to malnutrition. This is because both lean body mass and basal metabolic rate decrease with increasing age. It has been found that many diseases suffered by the older people are diet- related. Other factors contributing to malnutrition include dietary, psychosocial, physiological and economic changes (DiMaria-Ghalili, R. A., Amella, E., 2005). Global Recommendations on physical activity for 65 years and above according to the WHO Older adults should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity. Aerobic activity should be performed in bouts of at least 10 minutes duration. For additional health benefits, older adults should increase their moderate intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate-and vigorous-intensity activity. Older adults, with poor mobility, should perform physical activity to enhance balance and prevent falls on 3 or more days per week. Muscle-strengthening activities, involving major muscle groups, should be done on 2 or more days a week. When older adults cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow. Inactive people should start with small amounts of physical activity and gradually increase duration, frequency and intensity over time. Inactive adults and those with disease limitations will have added health benefits when they become more active. (WHO, 2011) Physical activity and bone loss Exercise plays an important role in building and maintaining bone and muscle strength. Physical activity positively influences most structural components of the musculoskeletal system that are related to functional capabilities and the risk of degenerative diseases. Physical activity also has the potential to postpone or prevent prevalent musculoskeletal disorders, such as mechanical low back pain, neck and shoulder pain, and osteoporosis and related fractures. Exercise can contribute to the rehabilitation of musculoskeletal disorders and recovery from orthopedic surgery. Muscles and bones respond and strengthen when they are stressed. This can be achieved by weight bearing or impact exercises which make the bones denser. Physical activity helps prevent weak bones and falls in the elderly. One-third of people over 65 have a fall each year and the risk of falling increases as age rises. People who have suffered fractures can benefit from special exercises and training (under medical supervision) to improve muscle strength and muscle function for greater mobility and improved quality of life. Balance training and Tai chi have been shown to decrease falls by 47% and reduce the risk of hip fracture by approximately 25%. Physical activity and hypertension Hypertension is defined as the constant pumping of blood through blood vessels with excessive force (WHO, 2011). Hypertension prevalence increases with advancing age and is higher in men than in women until the age of 55 years, but is slightly higher in postmenopausal women (Kannel WB, 2003). According to the 2009 NCD report, 38.1% of Mauritian people aged 65 and older were considered as hypertensive but were not on medications. 45.5% were being treated for hypertension. Hypertension is the major risk factor for stroke, heart failure, and coronary artery disease in older adults, while all of these disorders are important contributors to mortality and functional disability. Primary hypertension is the result of multiple conditions, such as genetic, nutritional, psychosocial, and life style factors. One of the life style factors leading to hypertension is obesity, which is usually related to a sedentary life style and inadequate physical activity. Since most elderly people have an inactive routine, they are at a much higher risk of developing high blood pressure. Therapeutic lifestyle changes, such as reduced dietary sodium intake, weight loss, regular aerobic activity, and moderation of alcohol consumption, have been shown to benefit elderly patients with hypertension. Regular aerobic exercise, consisting of a minimum of 30 min of interval training on a treadmill done three times a week, has been shown to be well tolerated and beneficial (Westhoff TH et al., 2007). The physiological effects of exercise on hypertension are complex and not fully understood. Specific mechanisms have been found to be relevant. An immediate (acute) reduction in BP following exercise has been termed ‘post-exercise hypotension’ and is agreed to be caused by reductions in vascular resistance. (Hamer, 2006). The chronic benefits can be partially explained by a decreased systemic vascular resistance in which the autonomic nervous system and renin-angiotensin system are most likely the underlying regulatory mechanisms (Cornelissen and Fagard, 2005). Another factor contributing to this decrease in vascular resistance is the increase of nitric oxide production (from different sites in the body) causing a vasodilation in response to regular aerobic exercise. Physical exercise and diabetes Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood (hyperglycemia). Diabetes is classified in three main categories: Type 1 diabetes (also known as insulin-dependent) Type 2 diabetes (also called non-insulin-dependent) Gestational diabetes 347 million people worldwide have diabetes (Danaei G et al., 2011). The prevalence of diabetes in adults aged 20-74 years was 21.3%: 21.9% in men and 20.6% in women (NCD report, 2009). Physical activity plays an important role in the management of type 2 diabetes, particularly glycemic control (Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, 2003., Zinman B, et al., 2004., Boule NG et al., 2001., Ronnemaa T et al., 1986) and improvements in cardiovascular risk profile such as decreased hyperinsulinemia, increased insulin sensitivity, reduced body fat, decreased blood pressure and better lipid profiles (Lehmann R et al.,1997., Schneider SH et al.,1992). Regular moderate physical activity and cardiorespiratory fitness are also associated with reductions in mortality of approximately 45 to 70% in type 2 diabetes populations (Wei M, Gibbons, et al., 2000) Moreover, regular moderate physical activity can decrease glycosylated hemoglobin (A1C) to a level associated with reduced risk of diabetic complications (Boule NG et al., 2001) and is therefore favorably delaying the onset of type 2 diabetes in high-risk groups (Knowler WC et al., 2002., Lindstrom AM et al., 2003). The decline in insulin sensitivity with aging is relatively due to a lack of physical activity. It is likely that maintaining better levels of fitness in the older population will lead to less chronic vascular disease and an improved quality of life (ADA, 2004). Physical activity and obesity Obesity is defined as an unhealthy excess accumulation of fat in the body, which increases the risk if medical illness and premature mortality. It is due to an imbalance between energy intake and energy expenditure. Physical activity contributes to the creation of an energy deficit by increasing total energy expenditure, and this can promote weight loss. Aging is associated with a decrease in all major components of total energy expenditure (TEE) including resting metabolic rate (RMR; which accounts for ≈70% of TEE), thermic effect of food (which accounts for ≈10% of TEE), and physical activity (which accounts for ≈20% of TEE). Physical activity decreases with increasing age, and it has been estimated that decreased physical activity accounts for about one-half of the decrease in TEE that occurs with aging (Elia M, Ritz P, Stubbs RJ., 2000). Hormonal changes such as reduced responsiveness to thyroid hormone, decreased secretion of growth hormone, decrease in serum testosterone and resistance to leptin that occur during aging can also enhance the accumulation of fat ( American Journal of Clinical Nutrition, 2005). Obesity is associated with a number of complications as decreased survival metabolic abnormalities high blood pressure insulin resistance dyslipidemia pulmonary abnormalities arthritis urinary incontinence cataracts cancer Moderate weight loss in conjunction with physical activity improves physical function and health-related quality of life in obese older persons. Physical activity and cardiovascular health A higher rate of cardiovascular events and a higher death rate have been observed in those individuals with low levels of physical fitness (Pate RR et al., 1995., US Public Health Service, Office of the Surgeon General, 1996). Even midlife increases in physical activity, through change in occupation or recreational activities, are associated with a decrease in mortality (Paffenbarger RS et al., 1993). Despite this evidence, however, the vast majority of adults remain effectively inactive. According to AHA, a sedentary lifestyle is one of the major risk factors for cardiovascular diseases. Evidence from many scientific studies shows that regular exercise decreases the chance of having a heart attack or experiencing another cardiac event, such as a stroke, and reduces the possibility of needing a coronary revascularization procedure (bypass surgery or coronary angioplasty). Benefits of regular exercise on cardiovascular risk factors include: Increase in exercise tolerance Reduction in body weight Reduction in blood pressure Reduction in bad (LDL and total) cholesterol Increase in good (HDL) cholesterol Increase in insulin sensitivity In addition, exercise training positively impacts the above risk factors even in patients older than 75 years (American Family Physician, 2005). There is also evidence that exercise training improves the capacity of the blood vessels to dilate in response to exercise or hormones, consistent with better vascular wall function and an improved ability to provide oxygen to the muscles during exercise. As one’s ability to transport and use oxygen improves, regular daily activities can be performed with less fatigue. This is particularly important for patients with cardiovascular disease, whose exercise capacity is typically lower than that of healthy individuals. Patients with newly diagnosed heart disease who participate in an exercise program report a more positive outlook in terms of quality of life, such as more self-confidence, lower stress, and less anxiety. Importantly, researchers have found that for heart attack patients who participated in a formal exercise program, the death rate is reduced by 20% to 25%. This is strong evidence in support of physical activity for patients with heart disease (Circulation, 2003). Physical activity and cancer The International Agency for Research on Cancer estimates that 25% of cancer cases worldwide are caused by obesity and a sedentary lifestyle. These factors may increase cancer risk by several mechanisms such as increased estrogens and testosterone, hyperinsulinemia and insulin resistance, increased inflammation, and depressed immune function. Several studies have shown that physical activity and diet changes can alter biomarkers of cancer risk (Journal of Nutrition, 2007). There is strong epidemiologic evidence for reduced risk of some cancers with increasing physical activity. The strongest evidence exists for colorectal and postmenopausal breast cancer, with possible associations for prostate, endometrial, and lung cancer (Friedenreich CM, Orenstein MR., 2002). Types of physical activities There are 4 main types of physical activities namely aerobic, muscle strengthening, bone strengthening, and stretching and balance activities. (Dairy Council of California, 2014) (National heart, blood and lung institute, 2011). Aerobic activities also called cardiovascular exercises help improve the condition of lungs and heart, increase stamina, improve blood circulation and burn body fat. Such activities might include walking, jogging, bicycling, climbing stairs, walking on a treadmill, dancing, swimming or jumping rope. These types of activities help to raise your heart rate and increase your breathing for an extended period of time as well as decrease the blood pressure. Muscle strengthening increases the body metabolism by burning more calories after having stopped exercising. This is achieved by an increase in muscle mass. Muscle-strengthening activities improve the strength, power, and endurance of muscles. Doing pushups and sit-ups, lifting weights, climbing stairs, and digging in the garden are some examples. Strength training helps make bones stronger, improves balance and increases muscle strength. All of this helps prevent osteoporosis and lowers the risk of hip fractures from falls. Strength training has also been shown to lessen arthritis pain. Stretching helps to ease movement, improve flexibility and prevent muscle strain and injury. Stretching also helps to warm up the body and prepare for exercise. Balance activities help you maintain posture and balance to keep from falling. This is particularly important for the elderly who are at risk for bone fractures. Levels of physical activities by intensities Intensity refers to the rate at which the activity is being performed or the magnitude of the effort required to perform an activity or exercise (WHO, 2014). The levels of intensities of physical activities are usually expressed in METs, Metabolic Equivalents. MET is the ratio of a persons working metabolic rate relative to their resting metabolic rate. One MET is defined as the energy cost of sitting quietly and is equivalent to a caloric consumption of 1kcal/kg/hour. It is estimated that compared with sitting quietly, a persons caloric consumption is three to six times higher when being moderately active (3-6 METs) and more than six times higher when being vigorously active (>6 METs). One limitation to this way of measuring exercise intensity is that it does not consider the fact that some people have a higher level of fitness than others. Thus, walking at 3 to 4 miles-per-hour is considered to require 4 METs and to be a moderate-intensity activity, regardless of who is doing the activity whether a young marathon runner or a 90-year-old adult. Light-intensity activities require the least amount of effort, compared to moderate and vigorous activities. Light intensity activity is related to energy expenditure of less than 3 METs. It does not increase the heart rate. Moderate-intensity physical activity raises the heart rate, breathing rate and body temperature. During such type of activity, one can talk but not sing. The caloric consumption is from 3 to 6 METS. Vigorous intensity physical activity causes the greatest amount of oxygen consumption. It burns more than 6 METS. A person cannot utter more than a few words without gasping for breath. Examples of physical activities based on intensity Light Activity less than 3.0 METS* (less than 3.5 calories per minute) Moderate Activity less 3.0-6.0 METS* (3.5 – 7 calories per minute) Vigorous Activity greater than 6.0 METS* (more than 7 calories per minute) Casual Walking Bicycling less than 5 mph Stretching Sitting Light weight training Dancing slowly Leisurely sports (table tennis, playing catch) Floating Boating Fishing Golf—using cart Light yard/house work Occupations requiring extended periods of sitting Brisk walking (3 4.5 mph) Walking uphill Hiking Roller skating at leisurely pace Bicycling 5-9 mph Low impact aerobics Aqua aerobics Light calisthenics Yoga Gymnastics Jumping on a trampoline Weight training Moderate dancing Boxing—punching bag Most aerobic machines (e.g., stair climber, elliptical, stationary bike)—moderate pace Competitive tennis, volleyball, badminton, diving Recreational swimming Canoeing Horseback riding Golf—carrying clubs Housework that involves intense scrubbing/cleaning Shoveling snow Carrying a child weighing more than 50 pounds Occupations that require an extended amount of time standing or walking Race walking (more than 4.5 mph) Jogging/Running Wheeling a wheelchair Mountain climbing Backpacking Fast pace in-line skating Bicycling more than 10 mph High impact aerobics Step aerobics Vigorous calisthenics Karate, judo, tae kwon do, jujitsu Jumping rope, jumping jacks Circuit weight training Vigorous dancing Boxing—sparring Most aerobic machines (e.g., stair climber, elliptical, stationary bike)—vigorous pace Competitive basketball, soccer, football, rugby, kickball, hockey, lacrosse Swimming laps or synchronized swimming Treading water Water jogging Water polo Downhill or cross country skiing Pushing non-motorized lawnmower Occupations that require heavy lifting or rapid movement Source: U.S. Department of Health and Human Services. (1999). Promoting physical activity. Champaign, IL: Human Kinetics.

Essays --

This essay will assess research into the impact of globalization on inflation and discuss whether it has weekend the ability of central banks to control the dynamics of inflation. The ability of central banks to control the rates of inflation may be substantially complicated by the increased globalization of the goods markets, factor markets and the financial markets (Woodford, 2007). The ability of national banks to influence the dynamics of inflation through monetary policy may be undermined by globalization. The central bank’s primary goal is to maintain price stability by regulating the level of inflation through monetary policy. Globalization increases trade both within and across countries (Schwerhoff & Sy, 2013). Through communicating their policy intentions regarding the future short-term interest rates, central banks can affect also the current longer-term rates (Tang, 2011). The new consensus (DSGE) Model incorporates four components, the output gap equation, the Phillip’s curve, the exchange rate equation and the Policy Rule (Woodford, 2007). The policy rule incorporates the Taylor rule which stipulates the amount a central bank should change the nominal interest rates in response to changes in inflation, output or other economic conditions. It also incorporates the idea of the inconsistent trinity, (sovereign monetary policy, fixed exchange rate and free capital flow) where only two of these can be possible at any given time. The impact of globalization on the effectiveness of monetary policy is now at the center of international macroeconomics literature with the recent experience of inflation accelerating the large number of industrial and emerging market countries (Ãâ€"zatay & Ãâ€"zmen, 2008). They support the idea tha... ...lely on their domestic economy (The Economist, 2005). Even though this may suggest that globalization has been able to combat the nature of inflation mistakes by central banks could allow it to break out again. (The Economist, 2005). This is partly due to the fact that a number of central banks make their decisions based on the actions of other central banks such as the Federal Reserve in the US (Rogoff, 2006). An example of this would be with number of Asian and oil producing countries will stabilize their currencies against the US dollar, which implies that the policies enacted by the Fed can still have an impact on global interest rates. (Fisher, 2006) Suggests that central banks should be conditioned on changes in foreign potential output and questions why, for instance, the output gap is calculated without taking into account the Chinese and Indian economies.

Comparing the Message of The Rhodera, Each and All, and Hamatreya :: comparison compare contrast essays

The Message of The Rhodera, Each and All, and Hamatreya We hear every day that we don’t appreciate nature and that we try and conquer it but I don’t think anyone actually thinks about what that means. These three combine to tell of nature and what Emerson appreciates about it. They also let nature have a "say" about what she thinks of humans. In "The Rhodora" a simple flower makes the speaker of the poem consider his own creation. He talks of the beauty of this flower and how it rivals the rose. As Sidney stated, "Emerson was really in touch with the beauty of nature." In other words, many people in their discussion focused on the fact that these poems brought to our attention the incredible beauty of nature that we often overlook. To me, it goes much farther. Finally he states, "in my simple ignorance, suppose The self-same Power that brought me there brought you." You can almost feel the light bulb go off over the speaker’s head when he realizes that he is a part of a larger creation. He isn’t separate from this flower; the same force brought both of them to this world. He states that he was ignorant. Most of us are ignorant of the fact that we are a part of a world that is made up of interlocking parts. We consider ourselves "the top of the food chain." (In reality if a lion got hungry enough he’d eat us too.) Plants thrive off of the carbon dioxide that we produce and we thrive off of the oxygen that they produce. Nature depends upon itself. We are part of that creation, not rulers over it. The speaker here finally realizes that both man and flower were put on this earth by the same force and we depend upon each other. Nature makes him reflect upon his own creation.(This is similar to the idea brought up in the web hypertext on Nature—"most people define nature as Not-human but we are natural beings." This poem is the realization of this statement.) In "Each and All" this idea is taken one step further. The speaker states, "Thy life to thy neighbor’s creed has lent. All are needed by each one." In other words, all parts of life depend upon other components of life. He also talks of how he removed things from nature and got them home and all of a sudden they don’t seem the way they were.

Welfare: A Government Program in the US

In the United States, the word â€Å"welfare† is familiar to everyone. People usually consider welfare as government programs that distribute public assistance to the poor and low income people. However, some people, who are able to work, take advantage of or depend too much on welfare, and they consider welfare as their main source of income. To stop their dependence on welfare, the government should put those who are on welfare into the labor area and keep them there. Besides, the government should change their way of thinking about welfare and make recipients realize the goal of work and self-sufficiency. In order to accomplish this change, the government should replace the existing welfare by education and training programs. Some welfare recipients depend too much and take advantage of welfare. The sponsors of immigrants must be responsible for taking care of their family. However, they refuse to take their responsibility, and they consider that welfare must help them. For example, one sponsor in Orange County, California placed her parents on welfare even though she owned a $450,000 home and easily could afford to provide for their well-being. However, she notified the welfare agency that her elderly parents either would have to start paying rent or move out (Smith 31). Besides, welfare pays substantially more than recipients could earn from entry-level job (Tanner et al. 22). That is the reason why welfare recipients do not likely to look for job. As a result, if people can earn the same income by either working or not working, most people will choose not to work. In contrast, other people such as elders, retarded or disabled individuals, and single parent deserve to receive government assistance; however, they do not get as much as they need because the government provides welfare to both deserving and undeserving people. This will create an unbalancing gap between people. Those who really need welfare can not get enough; meanwhile, others receive more than what they need. Therefore, the government should provide welfare to deserving people who really need assistance and jobs to those who are able to work. In the article â€Å"Welfare Pays Better, So Why Work? † of USA Today Magazine, the authors state â€Å"Nearly everyone agrees that a major goal should be to encourage recipients to leave the welfare rolls and enter the workforce† (Tanner et al. 22). In order to encourage recipients to enter the workforce, the government should limit welfare because welfare is a source of income which recipients do not have to work to earn, so why do they have to work? Besides, welfare recipients must realize that welfare only helps them in short period of time. After that they have to be on their own because there is no one else can help them forever. If there is less welfare, working becomes the only source of income which they can depend on. Indeed, limiting welfare is parallel with seeking job. Once welfare is limited, labor force is the only place where they can get help. In order to encourage recipients to work, the government should create employment programs which assist recipients to look for job, to train and to gain skills. Although the employment programs might cost the nation more money in short term, they will be worth it in the long term. First, the government should persuade private employers to create more job opportunities for welfare recipients, and also welfare recipients should be required to participate in education and training programs. Besides, more employment services and job search assistance should be establish to help welfare recipients to have an easier time finding jobs. In addition, welfare money should be used to subsidize for education and training programs because these programs can provide skills and train them in order to meet the new demands of the labor market and meet the employer's specific needs. Furthermore, unemployment offices would no longer distinguish between those who were recently laid off and those who have been on welfare. Each person would be evaluated on the basis of what services she or he needs in order to obtain employment. Hence, everyone all has same opportunity to enter the workforce. Instead of improving the welfare programs, the government should look at them as an opportunity to create a more comprehensive employment programs that would replace the old welfare and public assistance programs. For this to occur, the government should create education and training programs to provide skills and train people in order to ensure all those who want to work are able to do so. Besides, more employment services should be established to assist people to look for job easier, and private employment creates more jobs to encourage people to work. Also, equal opportunity should be applied to everyone. As a result, all these programs should be shared a single goal: to enable people to work.