Cool Fiction Essay Topics

Cool Fiction Essay TopicsCool Fiction Essay Topics is a great option for students who want to learn how to be successful in their own Cool Fiction Essay topics. These are the best writing courses on the market today and they make it possible for students to learn how to write cool fiction in the shortest time possible.The best part about these Cool Fiction Essay Topics is that they are designed to be used online by students who have taken the class. Once students complete the course, they are provided with a curriculum that they can utilize in order to get their assignments completed. Students will learn how to take an idea or plot a story in a specific amount of time in order to make sure that they get their work completed in the shortest amount of time possible.The first of the Cool Fiction Essay Topics is taught by a professor and has been designed to be used online. Students will learn how to start a story and continue that story in the shortest amount of time possible. They will also learn how to make sure that they cover the most topics of a story in the shortest amount of time possible.The second Cool Fiction Essay Topic will teach students how to create a conclusion in a story that is as exciting as the beginning of the story. Students will learn how to write a conclusion as if it were the first part of the story that they started, but with the ending that is more exciting than the beginning.The third Cool Fiction Essay Topic will teach students how to outline a story and how to use it to move from one part of the story to another. Students will learn how to use an outline to give them the best idea of where the story is going in the future.The fourth Cool Fiction Essay Topic will help students find the time in the middle of the story to develop a conclusion. They will learn how to take general idea that has been covered by other plots and to go to the next point in the story.The Cool Fiction Essay Topics is one of the best ways to learn how to write a story. Students will learn how to move from one point in the story to another and how to create a conclusion.

How Consumerism Is A Human Behavior - 777 Words

The impact of consumerism is a human behavior stimulating a multitude of neurological functions of individuals globally. The behaviors have been classified in both positive and negative terms dependent on perspective and severity. The neurological connection will be examined through similarities between compulsive shopping and illicit drug addiction, the relationship between brand recognition and attachment, as well as the effect of estimating value in material objects compared to life experiences, to identify the cause of consumerism. ; in some cases leading to a behavior comparable to illicit drug addiction. According to authors Judith S. Brook, Chenshu Zhang, David W. Brook, and Carl G. Leukefeldb, compulsive buying occurs when a person exhibits behavior of chronic, excessive, and repetitive buying habits as a reaction to negative events or feelings (Brook 1). Studies have found similarities in the neurocircuitry of compulsive shopping and illicit drug addiction. Some of the analogous traits include withdrawal, craving, and impulsive behavior. In a recent study, drug addicts viewed pictures of their dependent substance elevating levels of activity in the ventral striatum; the region of the brain connected to the reward system. Compulsive buyers have the same elevated responses when shown pictures of products. The reward activity can include â€Å"immediate relief of stress, anxiety, and depression† (Brook). A compulsive buyer may use shopping to combat underlyingShow MoreRelatedHow The Consumerism Of Buying Changes One s Attitude Towards Others, Ourselves, And Our Behavior Of Responsibility1679 Words   |  7 Pagesthe United States, companies have created the average American to be a consumer. However, the consumerism mentality that most Americans have is akin to Godzilla. Rampaging on deals and the opportunity to take what they think is rightfully theirs. My aim for this project was to discuss how the consumerism of buying changes one’s attitude towards others, ourselves, and our behavior of responsibility. Behavior of Others The Christmas season is upon us, and an event that is always relevant to discuss isRead MoreThe Study Of Human-Environment Interactions Has Been A1384 Words   |  6 PagesThe study of human-environment interactions has been a major focus for environmental sociologists for the past 40+ years. One key line of research has been the investigation into who engages in pro-environmental behaviors, which can range from voting for political officials and pro-environmental legislation (Gruber 2003) to recycling (Bamberg et al. 2007), leaf burning (Dunlap and Van Liere 1978), and even public transportation habits (Carrus et al. 2008). This line of research has given us a clearRead MoreYouth And The Hip Hop Youth Culture1695 Words   |  7 Pagesrevolve around peer groups that stress a definitive style of living as an external designation of affiliation and appearance. In this essay, I will analyse how globalisation, popular culture, and consumerism emerge as factors that influence the part icipation of young people in the hip-hop youth culture in Australia. I will also apply the human ecological theory in order to facilitate the understanding of factors that affect youth participation in the hip-hop culture. Culture is generally describedRead MoreThe Concept Of New Consumerism Essay1444 Words   |  6 PagesThe concept of ‘new consumerism’ has emerged in the contemporary world as one of the biggest determinants of consumer expenditure habits, their lifestyles, and various other aspects that define a society. Juliet Schor, one of the most renowned economists characterizes this concept through the various behaviors that consumers tend to portray such as the up-scaling of their lifestyles, competitive consumption and the imbalance between their earnings and their desires. Consequently, the individual wellnessRead More The Biological and Psychological Drives Behind Consumerism Essay945 Words   |  4 Pages we often erroneously buy products succumbing to strange compulsion. It is a power of consumerism. The term consumerism is defined as the tendency of people to identify strongly with products they consume, particularly of name brands and status-enhancing appeal. Then, how do es the power of consumerism win over our rationality? In this situation, we pretend to regard the primary cause of the impulse consumerism is the commercial seductions. The truth, however, is that the shopping indulgences doesRead MoreNot Just A Love Story1405 Words   |  6 Pagesspiritual lesson†. The movie, Wall-e, portrays the consumer behavior and focuses on the attention of humans to not focus on the problems at hand and to turn away from what is actually going on. In the movie, the ecological parable is the story showing the link among the organisms and the environment. The Pixar movie Wall-e is deserving of the definition of an earnest ecological parable, through generational entitlement, consumerism, and lack of sustainability. With the world changing, and generationsRead MoreRhetorical Analysis Of Consumerism In The Brave New World1050 Words   |  5 PagesHow should you start Creative hook â€Å". (3 characters that spoke to me where†¦.) Facts and stats Quote Rhetorical question We see a society where Mother and Father are seen as foreign words It seems to be a perfect world but when you srtach beneath the surface you see a ugly under belly Hook Imagine a world where happiness is quite literally a finger’s grasp away. But this apparent utopia hides an ugly underbelly where people are controlled through soma and condition. In the brave new world we seeRead MoreA Standard Definition Of Ethics1328 Words   |  6 Pagesbusiness ethics is a topic which has numerous opinions; definitions refer to the rightness or wrongness of behavior. What is morally right or wrong, ethical or unethical is not often agreed upon. (Phillip 1985). A person’s ethically beliefs stem from personal opinion which can include, environmental ethics, political ethics, ethics relating to religion, culture and acceptable norms of behavior in that persons environment. Companies are feeling the effects of market forces, brought on by more ethicalRead MoreSwifts Gulliver’s Travels by Jonathan Swift Essay1267 Words   |  6 Pages In order to address the injustices prevalent in human constructs and behavior, Swift uses literary techniques to induce a state of extreme self-doubt. The satires assessment of humanitys positive and negative traits is developed through Gullivers awkward process of identifying with the loathsome Yahoos and idolising the rational Houyhnhnms. The allegory of a domestic animal portraying more humanity than humans exemplifies the flaws of human nature and the tumultuous, uncertain philosophicalRead MoreThe Great Gatsby By F. Scott Fitzgerald1113 Words   |  5 Pagesswept americans to become part of a â€Å"consumer society†. Throughout this period of time, F. Scott Fitzgerald wrote many modernist novels, including The Great Gatsby, in which he critiques the downfall of the 1920’s society through religio n and consumerism.†¨Ã¢â‚¬ ¨Ã¢â‚¬ ¨ Fitzgerald adresses the idea of spirituality and religion in a very subtle way: the characters’s actions and qualities convey the lack of morals and their unbalanced values. Society’s middle and upper-class lives in excess, pleasure, and madness

Going Live is Not the End of the ERP Journey Sample for Students

Question: Discuss this Concept a Companys ERP Systems Journey and how Benefits May Vary. Answer: Introduction An ERP is a technology infrastructure that can help the company in integrating information from all the departments within with the customers and suppliers. The technology creates a good customer relation by joining all the functions and the internal departments with the customer. Information can also be shared between different partners, the flow of information is boosted, and the supply chain management is supported. This help the company to grow since the manager will be making a clear decision using up-to-date information (Ram, et al, 2014). Systems like PeopleSoft, Oracle, SAP (system, Application, and product in Data processing) introduced EPR system so as to solve the problem associated with the legacy system, to provide uniform and integrated technology platform so as to boost the companys competitive advantage. And also to enable them to complete worldwide. However, to implement the system will lead to changes in all organization structure and culture, it is expensive, and it takes a lot of time to install and train the employees on how to use it. Therefore, before companies decide to implement the system, they must consider the effect and how they will overcome those effects (Siau, 2014). Since the 1990s most researchers and practitioners have recommended ERP as one of the best development in the field of information technology and as one of the best known IT solution for this decade, this is because, in e-business, ERP has become one of the backbone and prerequisites. In the modern global business, companies have realized that for them to compete efficiently, they must improve their supply chain and also on their organization efficiency. This is because the competition is not with the substitute companies only but with supply chain as well. This as force many companies to make large investments and also to keep up to date in developing and implement better technologies and system as ERP (Jinno, et al, 2017) ERP system can be used by companies as an important tool in enhancing strong information system infrastructure. The system also allows the administration to commence better decision-making relying on information that is accurate and on time. ERP system can advance the quality of the product and responsiveness of the customer and also enhance sharing of information and quality of the information being shared among internal departments as well as external boundaries to the customer, suppliers, and other party involved in the supply chain. Ultimately the business performance is enhanced to achieve competitive advantage in the world market, and the long-term profitability of the company is improved (Katerattanakul, et al, 2014). ERP system journey The implementation of ERP by the companies in their new architectures of information have happened without being planned for. And new function in this architectures has erupted. This shows that ERP is a moving journey. This positions and tasks have erupted in the specific environment that happens without any consideration in the time of implementation and after. For the organizations to grow today, they need first, and accurate information and this can only be achieved through ERP (Nour and Moukket, 2013). The information system today is growing in the line of ERP where almost all process in the company is integrated. Processes like administration, communication and the operation of the business are integrated by both large and small firms to ERP system. Data integration and cross-functionally processes that are supported by the interactive system are on-line to the ERP system. This has led to changes in the development of information system (Galy Sauceda, 2014). During the implementation of ERP, the three common failure factors are the; the poor quality of business process re-engineering, project management effectiveness, and proper consultation was not done. This shows that for ERP to be effective, proper consultation must be done and be maintained well. Again the consultant must have good communication skills not only the knowledge about implementation, as well as the technical knowledge (Schniederjans Yadav, 2013). The success of ERP system implementation deepens on its use by the end users. There for understanding the acceptance of ERP by the end, users is paramount. Most research done indicates that the acceptance of ERP system by the end users is vital to the success of information system. The system must be both efficient and effective. Efficient in the way that the system is reliable and can be used without hitches while efficiency is that the system must serve the needs of the company and its employees well (Holland and light, 2001). Case study of Cadbury and Hershey In our case study, we are going to look at two companies that implemented ERP. One of the company was successful, and the other failed and the reasons leading to their status. The company we are analyzing is the British Cadbury company and the American Herseys chocolate company (Al-Mudimigh, et al, 2001). ERP success implementation in Cadbury In the recent years, Cadbury turns out; Kraft implemented SAP ERP 6.0 in what is regarded as one of the largest global implementation of ERP. The operation cost of the company has been reduced as the result of implementation. By the year 2008, the system was linked to 1,750 application, and more than 11,000 workers were conveying data to the companys SAP resolution (Baxter, 2010). At the start of the year, a glut of chocolate remained at Cadbury, after they installed a new technology offered by SAP the ERP, by the end of 2005, the system led to surplus chocolate bars building up. The new system was the part of Probe (a 5-years transformation project of the IT) aimed at incorporating the supply chain of Cadbury Schweppes supply chain, manufacture, marketing, sales, distribution, and purchasing system in the global, SAP-based ERP platform. The implementation of ERP has been quite smooth for the company, and they are aiming for ultimate saving (Mahara, 2013). Benefits of ERP The growth of Cadbury was first, and it could not cope with the existing technology hence implementing ERP added efficiency and first paced growth. The company strengthen its competitive threat in the industry by acquiring first and reliable system (Ehie and Madsen, 2005). Through the implementation of the ERP, the company emerged with new ways of warehouse management system the structures were moved to the depots and branch offices. The successive implementation took lesser time, and it was cost effective than the previous system. The implementation phase also took less cash compared to the existing technology of the Cadbury. The system was highly welcomed in the company leading to its success and the higher rate of performance (Monk, 2012). A strong consistent feedback system was erected by the company to observer the alterations and to check in if they go giving to the original plans. The whole implementation is a cross function, therefore, it is important to record boost in efficiency. The provider of the system was also selected among the best vendors and those who had good knowledge of the market and the industry hence the process occurred in the rationalized fashion and any probabilities of hiccups in the stage of implementation were avoided (Seo, 2013) mplementation of the system also led to high sales and much profit by the company. Decision-making process was accurate and first since the manager could get all necessary data to make an observation and to comment accurately. ERP Implementation Failures This was implementation done by the largest chocolate manufacturer in Northern America Hersheys. ERP Implementation by Hershey The company resolved in implementing ERP so as to enhance customer service and the competitiveness of the company. The manager of Hershey Company gave endorsement to a project named Enterprise21 in 1996. The system selected by the company so as to manage integration were Manugistics SCM software, SAPs R/3 ERP software, and Seibels CRM software. The company spent a total of $10 million for this project. The project was recommended to be done by four years, but the company needed 2.5 years. They decided to use the Big Bang Approach instead of the recommended Phased approach (Barker and Frolick, 2003). Impact of ERP Failure There was the problem of shipping and processing hence Hershey could not manage to meet its committed delivery dates (Bingi, et al, 1999). The credibility of the company reduced in the market since they could not offer the products as demanded by the clienthe product inventory piled up and by the start of September 2000: the current stock was more than the previous years stock by 25% (Markus, et al, 2000). After Hersheys declaration in the market of its problem due to malfunction of the newly acquired computer system, the stock price of the company plunged by 8% on a day. The company was also cost a total of $150 million in sales due to failure to implement ERP in time. The 1999 third quarter profit and sales dropped by 19% and 12% respectively as indicated in the 1999 annual report (Glover, et al, 1999). Reasons for Failure The implementation schedule was over-squeezedThe company used a wrong approach. They were supposed to use Phase approach, but instead, they used Big Bang Approach. They did a mistake of by sacrificing system testing for the sake of convenience. Go-Live and Cutover activities were schedule during the busiest time of the firms business period (Hossain, 2001). For the implementation to be successful, the following must be considered: Step 1- when implementing ERP, the company must have set goals to determine whether their project is working or not. This will help them to make necessary changes when making decisions. But in the case that the goals of the organization are not clear, it will be hard to know whether achievement has been made or not (Botta-Genoulaz, et al., 2005). When the company is setting a new system there are some binary and quantitative criteria they should make. They include: Doing away with duplication of data entryThe data may be inputted once and used severally The number of excel sheets used in performing a process is reduced Step 2 is choosing the right ERP that will serve your business right. According to Umbel et al (2003), each vendor will claim that their system is the best so the business need a third part who understands the flow of the market and the structure of the business so that the ERP can be tailored to suit the business. Alternatively, the organization can engage a partner whom they trust to understand the requirement of the business. In step 3, the implementation partner after getting the flow of the industry and the structure of the business. An ERP will be designed suiting the finance of the business. The business should have a significant input for the system to be implemented. It is also advised that the business nominate some members to be part of internal project team In step 4, all the stages must be ready before moving to the other step. In this stage it is clear that the system is going to work and before starting next stage, you must ensure that you are conversant with the current stage and other members of the business get good orientation about the system. This will enable every member to know what the business expects and understand how and when to solve a given task. Step 5 the business has start to realize the capability of the system and they are implementing it. It is advised that the business maintains the project ideas, budget, timeline and objective and they should not input other great ideas that were not budgeted for. This will help control the project scope (Hossain, 2001). Step 6 This takes us to the next step in the implementation of ERP. The system is now at go-live since the implementation and the use had started. This step show us that the system must be maintained and necessary improvements must be installed. Step 7 this step must be established from the beginning. Some possibility dollars are allowed in the project. However, though analysis of the business, something may come up (Al-Mashari, 2002). Challenges in implementing ERP. During implementation of ERP, the organization experiences different type of challenger therefore a proper communication and adequate planning must be done so that implementation can be successful. Some of the challenges experienced while implementing ERP are: (Botta-Genoulaz, et al., 2005) Implementation must be done in order, it cannot be done at once. Trying to implement everything at the same time will lead to disorganization hence the process will fail. The employee must be trained appropriately after and during implementation. They must be combatable and swift in using the technology because when they are not conversant with the system, most of errors will occur leading to functional inefficiencies. Profitability and productivity of organization can be reduced incase proper analysis is not done. Therefore before implementation, proper analysis must be done. Before transition is made, it must be discussed with the senior management because without their support, operations will delay and ineffective decisions will be made. Compatibility of the system is very essential just like the case of Cadbury where they chose compatible system and they succeeded so before the implementation, the company must look for a vendor which is must proficient in their market so that a good ERP can be tailored. Companies always experience challenge due to poor planning. So before the plan is executed, a proper planning must be put in place with clear breakdown of what will be done at what stage and what is required to fulfil it. Investing in Investment in substructure is very important. Good storage with adequate will be needed for ERP application module. Not allocating appropriate budget for structures may result in reduced application speed and issues with other software it also important to have a strong hardware security so as to avoid cybercrime. The challenges faced by organizations during implementation of ERP varies depending on the market the institution is operating in. therefore, it is important to hire experts who understand the market trend and nature this will ensure implementation is successful without drawbacks. (Hossain, 2001). Pre-evaluation screening: before a company look for a solution, a proper survey must be done to determine the need of the organization. In the initial stage, a thorough investigation of the companies need should be conducted. The individuals from different department that will use the ERP system must be cooperated in this investigation. This will enable the organization to understand their challenges, resources, tools, and needs. Evaluation: during this stage, the companies contrast different vendors through their offers and evaluate the merits and demerits of each vendor. They then match the companys need of ERP to obtain the best vendor who addresses their needs at a relative cost (Glover, et al, 1999). Gap analysis: here, an analysis of the market gap and the desired solution is done. At this stage, the company can go back to the desired vendor to inquire how the gaps can be addressed or if the ERP system can be tailored to suit the desire of the business (Umbel, et al, 2003) Training: after the company has adopted the ERP system of their choice. A training program should be scheduled to enlighten the employee on how the business will operate with the new system. Training will depend with the number of employees available and the size of the organization. A refresher is also important for the employees Testing: before the company roll out the system, a thorough test must be done to ensure that the information and the data collected by the company are accurate (Ngai, et al, 2008). Accurate data will help the manager in making accurate decisions. After the process, the system is now rolled out. It is advisable for the company to have one expert who will be taking notes of the question asked, problems or any other issue. The expert will address the questions or contact the vendor for answers. According to Vandaie (2008) data across all the department are shared by the ERP system into data and reports that can affect or improve every aspect of the company. Some of the departments that benefit from the new system are finance, sales, supply chain, marketing, human resource and operation. Once the system is in place, data and silos break down enables everyones contribution to the organization transparent. Positive contribution to this gain are many since there is no guess work in making business decisions. Decisions are made based on data. Success leaves clues, and companies who have been successful in the past with ERP implementation left us a blueprint to follow. These five steps can help you smoothly transition into the world of ERP. Conclusion From the case study, it is clearly noticed that an ERP implementation project should not be forced into a difficult timeline. To look for critical issue, the company should over squeeze implementation. And it is also realized that during busy schedule cut down should not be scheduled unless the business will fail. Instead the company should test the phrases to be implemented. There is no implementation that will have 100% efficiency so companies should expect operation performance deep and learning curves. Companies should implement their policies during off peaks because during this time, they give their employee and customers good time to interact and to learn the system. It is also noticed that the number of activities during implementation should reduce so that the number of services exposed to risk are reduced in case of an error (Ngai, et al, 2008). References Al-Mashari, M., 2002. Enterprise resource planning (ERP) systems: a research agenda. Industrial Management Data Systems, 102(3), pp.165-170. Al-Mudimigh, A., Zairi, M. and Al-Mashari, M., 2001. ERP software implementation: an integrative framework. European Journal of Information Systems, 10(4), pp.216-226. Barker, T. and Frolick, M.N., 2003. ERP implementation failure: A case study. Information Systems Management, 20(4), pp.43-49. Baxter, G., 2010. White paper: Key issues in ERP system implementation. Large Scale Complex IT Systems, pp.3-9. Bingi, P., Sharma, M.K. and Godla, J.K., 1999. Critical issues affecting an ERP implementation. IS Management, 16(3), pp.7-14. Botta-Genoulaz, V., Millet, P.A. and Grabot, B., 2005. A survey on the recent research literature on ERP systems. Computers in industry, 56(6), pp.510-522. Ehie, I.C. and Madsen, M., 2005. Identifying critical issues in enterprise resource planning (ERP) implementation. Computers in industry, 56(6), pp.545-557. Galy, E. and Sauceda, M.J., 2014. Post-implementation practices of ERP systems and their relationship to financial performance. Information Management, 51(3), pp.310-319. Glover, S.M., Prawitt, D.F. and Romney, M.B., 1999. Implementing ERP. Internal Auditor, 56(1), pp.40-46. Holland, C.P. and Light, B., 2001. A stage maturity model for enterprise resource planning systems use. ACM SIGMIS Database, 32(2), pp.34-45. Hossain, L. ed., 2001. Enterprise Resource Planning: Global Opportunities and Challenges: Global Opportunities and Challenges. IGI Global. Jinno, H., Abe, H. and Iizuka, K., 2017. Consideration of ERP Effectiveness: From the Perspective of ERP Implementation Policy and Operational Effectiveness. Information, 8(1), p.14. Katerattanakul, P., J. Lee, J. and Hong, S., 2014. Effect of business characteristics and ERP implementation on business outcomes: An exploratory study of Korean manufacturing firms. Management Research Review, 37(2), pp.186-206. Mahara, T., 2013. PEST-Benefit/Threat Analysis for selection of ERP in Cloud for SMEs. Asian Journal of Management Research, 3(2), pp.365-373. Markus, M.L., Tanis, C. and Van Fenema, P.C., 2000. Enterprise resource planning: multisite ERP implementations. Communications of the ACM, 43(4), pp.42-46. Monk, E. and Wagner, B., 2012. Concepts in enterprise resource planning. Cengage Learning. Ngai, E.W., Law, C.C. and Wat, F.K., 2008. Examining the critical success factors in the adoption of enterprise resource planning. Computers in industry, 59(6), pp.548-564. Nour, M.A. and Mouakket, S., 2013. A classification framework of critical success factors for ERP systems implementation: A multi-stakeholder perspective. In Competition, Strategy, and Modern Enterprise Information Systems (pp. 98-113). IGI Global. Ram, J., Wu, M.L. and Tagg, R., 2014. Competitive advantage from ERP projects: Examining the role of key implementation drivers. International Journal of Project Management, 32(4), pp.663-675. Sarker, S. and Lee, A.S., 2003. Using a case study to test the role of three key social enablers in ERP implementation. Information Management, 40(8), pp.813-829. Schniederjans, D. and Yadav, S., 2013. Successful ERP implementation: an integrative model. Business Process Management Journal, 19(2), pp.364-398. Seo, G., 2013. Challenges in implementing enterprise resource planning (ERP) system in large organizations: similarities and differences between corporate and university environment (Doctoral dissertation, Massachusetts Institute of Technology). Siau, K., 2004. Enterprise resource planning (ERP) implementation methodologies. Umble, E.J., Haft, R.R. and Umble, M.M., 2003. Enterprise resource planning: Implementation procedures and critical success factors. European journal of operational research, 146(2), pp.241-257. Vandaie, R., 2008. The role of organizational knowledge management in successful ERP

Witch Dbq free essay sample

The Witch Witch. A word that, nowadays, carries along with it thoughts of pleasant schools of magic and candy corn for Halloween. But several hundred years ago, from about 1480 to 1700, the term witch was an altogether sinister and grave term, one that was not thrown around lightly, as it often brought upon those tagged with it fates arguably worse than death. It was the era of the Inquisition, in which panels of judges were created for the sole purpose of condemning witches, and executioners prospered like never before. It was a time of religious fanaticism and political unning, of death and wrongful accusations. Witches were persecuted for mainly three reasons, namely for religion, profit, and dislike towards the old, lower-class women. Pope Innocent VIII himself endorsed the trials, claiming that the Devil had taken reign of the weak-willed, while others noted how the executioners prospered from all the executions to the point of their wealth rivaling that of the nobility. We will write a custom essay sample on Witch Dbq or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page And then there are so many statistics showing that a good eighty percent of those executed were female, all of them lower class, and most of them around the age of ixty at a time when people lived not a day beyond seventy. Of course, religion was the base of this paranoia, and the biggest reason for all the persecutions. Religious reasons were the biggest reasons when it came to persecuting witches. People believed that witches were ultimately seduced by the Devil into doing his work for him, which encompassed killing babies and eating them (docA1). Others even considered simple acts such as caring for those with strange diseases as witchcraft (docA4). Others targeted witches for their un-Catholic behavior and difference of religion and faith (docB2). And there were those, such as Calvin, who found reason enough for burning witches in the Bible (docB4). The religious paranoia also had an adverse effect on the youth, who began to believe in devils and demons inhabiting peoples bodies (doc 85). Even scientists gave proof that the Devil was taking over old and embittered souls (docC1). Of course, not all persecutions were carried out for mere religious reasons. Some people had more concrete, materialistic gains to be had from the trials. Many people had much to gain from the trials. Some nobles were promoted for their extraordinary work in ridding the land of the Devil, while xecutioners raked in money with all the new business. Towns and inns in general profited from the great masses of people who would attend the trials and executions of the supposed witches (docA2). And then, of course, any important persons with power that stood in the way of someones advancement could always easily be disposed of by accusations of witchcraft (docA7). The mayor of Bamberg, Germany was one of several cases in which persons were bumped up the political ladder because of executions of those holding high government posts. Of course, not all

Foundations of physiotherapy practice The WritePass Journal

Foundations of physiotherapy practice Introduction Foundations of physiotherapy practice IntroductionReferences:Related Introduction The aim of the essay was to explore COPD in both theory and practice in correlation with the three main body systems. The body systems investigated in detail where the respiratory, musculoskeletal, cardiovascular and the neurological systems. Each system was researched for the effects it has on exercise intolerance, quality of life and the limitations that develop for a patient as a result of COPD. The role of pulmonary rehabilitation is inspected throughout the essay and its significance in the management of patients with COPD is expressed immensely within the context of the essay. There is an evidence based background to the exercise program used for the leaflet; it underpins the importance of using both endurance and strength training in order to improve some of the symptoms of COPD. The use of breathing exercises and techniques is also incorporated as it is a substantial part of the rehabilitation program. The role of the physiotherapist is fully established in the essay. The phy siotherapist is recognised for his/her role in each aspect in the management of the condition. Chronic obstructive pulmonary disease (COPD) is a disease defined by airflow limitation that cannot be fully reversed. COPD is a combination of emphysema, and chronic bronchitis. Chronic bronchitis is defined by excessive mucus secretions and a productive cough for a sustained period of time (more than two years). Emphysema is defined by destruction of the alveoli and smallest airways and secondary effects on lung elasticity, and other airways (Gupta and Brooks, 2006, p.180).The airflow obstruction is generally progressive in nature correlated with an abnormal inflammatory response of the lungs to gases. Despite the fact COPD affects the lungs; it also contributes to a substantial systemic reaction (Celli et al., 2004).although evidence shows that no change in lung function (FEV1) occurs, no matter how radical the treatment for the patient may be. Even tough loss of lung function is not regained; affective pulmonary rehabilitation helps slow the rate of decline (Bellamy and Brooker, 2004, p.12). COPD is important common respiratory disorders in primary care. Diagnosis of COPD is often delayed until patients present with severe symptoms. There are a high percentage of individuals that are undiagnosed in the population. Aside from patients being advised to stop smoking, it is important that pulmonary rehabilitation is part of the management of this condition and physiotherapist understand how to prescribe appropriate exercise training for patients with COPD (Gupta and Brooks, 2006, p.180).Patients with COPD are in the largest percentage of individuals referred for pulmonary rehabilitation. There is an increase in the evidence-based support for pulmonary rehabilitation in the management of patients with COPD (Nici et al., 2006). It addresses the numerous needs of the patient. It has many components which are highly effective in caring for the patient. Pulmonary rehabilitation incorporates the following: smoking cessation, education, exercise training, psychology i nterventions, physiotherapy, and nutrition. Exercise training is a vital component of pulmonary rehabilitation and is aimed at improving some of the restricting problems associated with the disease, such as dyspnoea and exercise tolerance despite the irreversible deformities in lung function (Tiep, 1997, p.1652). Management is essential in helping the patient have a better quality of life, as patients with COPD sink into an inactive and dependent state causing them to be at high risk of depression and anxiety. (Maurer et al., 2008). Depression and anxiety are addressed in the psychosocial component of the rehabilitation program (Nici, et al., 2006, p.1399). During the progression of COPD, all body systems in some way become affected (Tiep, 1997, p.1631).patients with COPD tend to stop or reduce their level of physical activity as exertion leads to the patient having unpleasant sensations. A vicious cycle can occur, with reductions in physical activities causing severe deconditioning, and more limitations in each system affected by the condition (Thomas, 2006, p. 62).The changes in each of these systems are coexisting factors that contribute to the exercise intolerance in patients with the disease. The respiratory system is affected greatly by COPD; it contributes to exercise intolerance in a number a ways. Ventilatory limitations occur for many reasons. An increase in both airway resistance and expiratory flow limitations causes a severe increase in the work of breathing. The elastic walls of the alveoli provide a certain amount of driving force behind the active process of exhalation (Rochester, 2003, p.61). Airflow obstruction leads t o impaired lung emptying and a higher end expiratory lung volume due to the loss in elasticity of the alveolar walls. This worsens during exercise leading to dynamic hyperinflation. Hyperinflation restricts the tidal volume response to excretion, flattens the diaphragm and the accessory muscles are then used to aid respiration, and   the muscle length-tension relationship of the respiratory muscles is altered forcing the muscles into a shortened position which puts them at a mechanical disadvantage. The degree of hyperinflation a patient is subject to is an important indicator of their exercise tolerance and dyspnea during exercise (Bellamy and Booker, 2004, p 23). Ventilatory   limitations to exercise causes interruption in gas exchange that emerges from the increase dead space to tidal volume ratio, ventilation-perfusion mismatch, and the reduction in diffusing capacity caused by the loss of alveolar/capillary connections. The increased dead space to tidal volume ratio in turn causes an increased ventilatory demand, for the same degree of bodily exertion (Rochester, 2003, p. 61). Other factors also further increase ventilatory demand these include, lactic acidosis and hypoxemia which directly or indirectly limit exercise tolerance (Nici et al., 2006, p. 1391). The musculoskeletal system is affected also, there is evidence showing that muscle dysfunction contributes to exercise intolerance in COPD.   The reduction in physical activities leads to damage in skeletal muscle function which in turn causes more symptoms at a less intensive level of work. Inactivity produces many structural and biomechanical changes in the skeletal muscle. Muscle strength is decreased in patients with COPD; peripheral muscle strength is to a much greater extent affected than upper limb muscles strength. The reduction in peripheral muscle strength may be directly linked with the fact there is a decrease in activity of the lower limbs in patients with COPD (Thomas, 2006, p. 63). There is also a reduction in endurance in both lower and upper limb muscles. Loss of lower limb muscle strength is equivalent to the reduction in muscle mass. With prolonged inactivity type 11a fibres (slow twitch fibres) convert to type 11b (fast twitch fibres), Reduction in fibre type an d decrease in cross-sectional of type 1 and 11a fibres is linked to muscle atrophy. Reduction in oxidative capacity and muscle atrophy is standard in patients with COPD. Deconditioning is an important factor in skeletal muscle dysfunction (Mador and Bozkanat, 2001). Chronic obstructive pulmonary disease has an extensive impact on the cardiovascular system. The increased right ventricular afterload which is caused by the increased pulmonary vascular resistance resulting from the structural abnormalities in pulmonary circulation, and the hypoxic pulmonary vasoconstriction all contribute to the effects of COPD on the cardiovascular system. All of these processes lead to structural changes in the heart which include right ventricular dilatation and hypertrophy, to help conserve right ventricular output (Vonk-Noordegraaf, et al., 2005, p. 1901). The impaired ventricular filling is caused by hyperinflation and or other mechanical impairments. Cardiac output is relatively maintained in patients with COPD compared to normal individuals both at rest and during physical activities. Studies have proven that exercise training has no measurable impact on the changes in the cardiovascular system as the result of COPD. Like the irreversible effects COPD has on lung function, exercise training can slow it down but it can never be reversed back to normal no matter how extensive the treatment (Sietsema, 2001, p. 656-657). The neurological system is affected as a result of COPD. Neuropsychiatric disorders are common in patients with COPD, particularly depression and anxiety. The prevalence of depression is higher than anxiety it is over 20% higher than anxiety. They often go untreated in patients with COPD; the lack of adequate treatment leads to patients having a poor quality of life and is associated with premature death in COPD patients. The overall impact of depression and anxiety on COPD patients, their families, and society is important. Studies show that depression has been found to cause fatigue, dyspnoea, and disability (Maurer, et al., 2008, p. 43). Depression increases with hypoxemia, carbon dioxide levels, and dyspnea. Hypoxia in patients with COPD may be a major factor in the development of depression and anxiety due to lack of sufficient oxygen to the brain. However reduced physical capacity and negative self image may also be a causing factor in the development of the disease (Armstrong, 2010, p. 132). Pulmonary rehabilitation is the main intervention used to try and improve the systematic effects of COPD; its main concern is to control the symptoms and disease by including essential components such as the multidisciplinary team for support and guidance and the exercise training program for improvements in the patient’s physical limitations (Burton, et al., 1997, p. 879). The exercise training program of pulmonary rehabilitation must address the individual patient’s limitation to physical activity; these limitations may include ventilation limitations, gas exchange irregularities, and skeletal or respiratory muscle dysfunction. Exercise training aims to improve motivation for exercise, neuropsychiatric well being, decrease symptoms and improve quality of life. Moreover, the substantial improvement in oxidative capacity and efficiency of skeletal muscles has caused a decrease in alveolar ventilation for same degree of exertion. This can reduce dynamic hyperventilation, thus decreasing exertional dyspnoea (Aliverti and Macklem, 2001, p. 229). Pulmonary rehabilitation normally focuses on lower limb training, as loss of peripheral muscle strength in patients is high as loss of quadriceps muscle is reduced by up to 20-30% with patients in the moderate to severe phase of COPD. This is why exercise training is used to improve muscle strength. The dist ribution of muscle strength in patients with COPD is not equal between the lower and upper limb, there is evidence to prove the better preservation of the upper limb muscle strength (Thomas, 2006, p. 63). However upper limb exercises should be incorporated into the training program. Upper limb training results in an improvement in a patient’s ability to perform daily activities involving the upper body. Upper limb exercises also reduce dyspnoea and ventilatory requirements for arm elevation.   Evidence based guidelines recommend the use of upper limb exercise as part of the exercise program as it is safe and requires little equipment (Rochester, 2003, p. 70) There are two types of exercise training used in the rehabilitation program aerobic endurance and strength training. Aerobic endurance exercise training is the main component of pulmonary rehabilitation. Evidence from a number of randomized controlled trails supports the use of lower extremity exercise training, it has been found to significantly improve exercise tolerance, timed walking distance, sub maximal endurance time, and health related quality of life. Exercise training includes ground walking training, treadmill walking, cycle ergometery, and inspiratory muscle training (Gupta and Brooks, (2006), p. 182). Cycle ergometery training supervised by the physiotherapist to make sure the patient is performing the exercise at the right intensity, has been proven to improve exercise capacity in patients with COPD. Studies have shown that the combination of both inspiratory muscle training and cycle ergometery training has greater benefits for patients than just cycle ergometery alone. The addition of inspiratory muscle training enhances both inspiratory muscle endurance and strength, improves exerc ise capacity significantly more than just cycle ergometery training on its own (Wanke, et al., 1994, p. 2205-2211). Walking is an exercise prescribed to patients for endurance training, as it is a regular exercise that patients find easy and a large percentage of patients continue walking at home or after the rehabilitation programme. Patients are encouraged to walk to the point of breathlessness; this technique improves exercise tolerance in patients as they push themselves to get physically fit. The Physiotherapist gives support to patients, by reassuring them that breathlessness during walking doesn’t cause any damage to the lungs or heart it is beneficial in improving their quality of life (Bellamy and Booker, 2006, p. 115). Strength training is used in pulmonary rehabilitation for both the upper and lower body. In many studies patients rated their dyspnoea and fatigue the lowest after strength training. The strengthening exercises may include knee flexion and extension w hich works the quadriceps and hamstring muscles, also chest press which involves both pectoralis major and latissimus dorsi. Weights are used during each exercise and are altered increase or decrease the intensity. Strength training increases strength in all muscles that undergo the training this is due to muscle hypertrophy and improvements in neural recruitment patterns. Strength training has been proven by many studies to improve exercise performance and quality of life (Mador, et al., 2004, p. 2039-2041). Studies have supported evidence that endurance training has little effect on muscle weakness and muscle atrophy, two problems in patients with COPD and contributes to their exercise intolerance and poor quality of life. As a result most pulmonary rehabilitation programs combine strength and endurance training together as it is more beneficial to the patients. Studies have proven that the addition of strength training to endurance training produced a greater improvement in muscle mass and strength than endurance training alone (Ortega, et al., 2002, p. 670). Another study investigated the combination of both strength and endurance combined and found it was effective in reducing depression and anxiety. Moreover, there is evidence to confirm the beneficial effects of the three methods of exercise training (strength, endurance, and or combined) on the quality of life and level of dyspnoea in patients with COPD (Mador, et al., 2004, p. 2043). There is a debate as to whether high or low intensity training   in endurance and strength exercises should be used and to what beneficial effects either intensity will sustain in improving the symptoms of COPD. Low intensity training does result in improvements in symptoms, activities of daily living and health related quality of life, there is evidence to support the use of high intensity training producing greater physiologic training effects (Maltais, et al., 1997, p. 555-561). Training intensity that exceeds 60% of the peak exercise capacity is enough to cause some physiologic effects, even though higher percentages have been tolerated and are more beneficial. The effects of cycle ergometery training at high intensity work load were compared to low intensity work load in 19 patients with moderate to severe COPD. The group following the cycle ergometery at the high intensity work rate had a greater reduction in lactate production and ventilation requirements, although the low i ntensity group had a similar result but not as much significant gains in aerobic fitness (Rochester, 2003, p. 67-68). Therefore using high or low intensity training has beneficial effects, high intensity exercise training is more advantageous producing physiologic changes in patients that are capable to reach that level, low intensity exercise training is more tailored to the health benefits of the general population and for patients who are in a more fragile state (Calverley, et al., 2003, p. 468-470). Aside from endurance and strength training the pulmonary rehabilitation program has breathing exercises and techniques that are incorporated into the program. The role of the physiotherapist in the management of COPD is established especially in breathing exercises and techniques. Physiotherapists play a crucial role in the exercise, assessment and education aspects of the pulmonary rehabilitation program they are a valuable part of the multidisciplinary team. They are there to provide specialist advice and support for the patient, especially during an exacerbation, when patients have trouble clearing their chest secretions, and to help control any anxiety or panic attacks they may lead to hyperventilation. When physiotherapist helps patients clear chest secretions it often involves teaching the patient about the active cycle of breathing technique (ACBT) using forced expiration to enhance chest clearance. Physiotherapists also use techniques to reduce the work of breathing, which involves the use of breathing retraining or relaxed breathing control. Diaphragmatic breathing and pursed lip breathing are two examples of breathing retraining; these are of benefit to manage panic attacks and breathlessness. Physiotherapists also teach a patient varies positioning techniques to help with dyspnoea. They have a major role in pulmonary rehabilitation programmes, along with respiratory management they provide advice and support for patients with mobility problems (Barnett, (2006), p. 174). Physiotherapists are involved in educating and supporting patients in breathing retraining. The main goals of using diaphragmatic breathing and pursed lip breathing are to relieve breathlessness and encourage relaxation (Mikelsons, 2008, p. 3). Pursed lip breathing is a technique used where exhalation is accomplished through resistance created by narrowing (pursing) of the lips; it is often naturally taken up by COPD patients. Studies have shown that pursed lip breathing can have a positive effect on dyspnoea when performed by patients during exercise. Patients who experience reduction in dyspnoea due to pursed lip breathing also had reductions in end expiratory lung volume and increase supply in inspiratory muscle pressure-generating capacity. During breathing at rest and exercise pursed lip breathing contributed to a slower deeper breathing pattern in patients, and is a useful technique to apply when an onset of breathlessness comes upon a patient (Spahija, et al., 2005, p. 640-648 ). Diaphragmatic breathing is used as another technique to help with dyspnoea and dynamic hyperinflation. In diaphragmatic breathing physiotherapists teach patients to synchronize inspiration with abdominal expansion as they breathe slowly and deeply. On the exhalation the diaphragm is pushed up by the abdominal muscles which create a better length tension relationship and a better curved posture. This technique increases the capable force of the diaphragm as an inspiratory muscle. Diaphragmatic breathing has a significant increase in tidal volume and a major reduction in respiratory frequency which caused an increase in minute ventilation. In hypercapnic patients with COPD, diaphragmatic breathing helps with hyperinflation in these patients. However studies have shown that severely hyperinflated  Ã‚   patients are incapable of performing this breathing technique (Gigliotti, et al., 2003, p. 198). Secretion clearance is an important technique used for acute exacerbation management . Acute exacerbations are common in patients with COPD; they are associated with a poor quality of life and are a burden to both family and caregivers. Symptoms include dyspnea, purulent sputum, and an increase in sputum volume. Patient’s awareness of the symptoms of exacerbations and early intervention reduces the risk of hospitalization and leads to a better quality. Physiotherapists are important in providing such interventions to help patients with sputum clearance. Physiotherapeutic techniques used to help with sputum clearance include active cycle of breathing techniques (ACBT), percussions, vibrations, and shaking. ACBT consists of breathing control, lower thoracic expansion exercises and forced expiratory technique. ACBT aids bronchial clearance by improving mucociliary clearance while also decreasing adverse effects such as hypoxia and increased airflow obstruction. Compared to percussion, vibrations, and shaking ACBT has been proven to be the most effective techniqu e in chest clearance with over 80% of physiotherapists the UK using it always or often when treating patients with COPD. Studies have shown that ACBT helps improve oxygenation, assists in sputum clearance, reduces anxiety, and enhances health related quality of life (Yohannes and Connolly, 2007, p 110-113). Many patients with COPD adopt a forward leaning position to help with the feeling of breathlessness, this is a useful technique which physiotherapist teach patients to self manage dyspnoea, during the stable phase of COPD and when they get an acute exacerbation. There is evidence to reinforce the use of the forward leaning position to improve breathlessness and decrease work of breathing. This position promotes diaphragmatic function by allowing the shortened diaphragm to be lengthened by the movement of the abdominal content away from the diaphragm thus enhancing the length tension relationship. This position can be altered to suit individual, it can be used in everyday life such as standing leaning against a wall, window sill or shopping trolley. These functional positions enable patients to get out and improve both their breathlessness and quality of life (Mikelsons, 2008, p. 3). Studies support the use of breathing retraining, chest physiotherapy and exercise training as it contr ibutes to improvements in dyspnoea, functional exercise capacity, and quality of life in COPD patients (Guell, et al., 2000, p. 978). In conclusion, the importance of COPD as a disease is relatively high as it has been stated to be in the top four leading cause of death and disability in the world (Gupta and Brooks, 2006, p. 187). The considerable effects COPD has on the respiratory system are discussed showing the limiting effects it has on both ventilation and gas exchange all contribute to the exercise intolerance in patients. The musculoskeletal system is greatly hindered by the effects COPD has on the structural and biomechanical aspects causing limitations in the ability to exercise. COPD leads to cardiovascular problems which progressively get worse if patients aren’t introduced to the exercise training program to help slow down the deterioration. Anxiety and depression goes undiagnosed in a lot of patients with COPD but has been shown to contribute to both exercise intolerance and poor quality of life in patients. The intervention of the pulmonary rehabilitation program has been proven to help increa se exercise capacity, decrease dyspnoea and improve health related quality of life. The support and advice from the physiotherapist in the exercise training program, breathing exercises and techniques is a key element to the success of the pulmonary rehabilitation program. In light of all the advantages of the rehabilitation program there is still the unsubstantial effect it has on lung function in patients with COPD. References: Aliverti, A. and Macklem, P. (2001) How and Why Exercise Is Impaired in COPD. Respiration, 68 (3), pp. 229-239. Armstrong, C. (2010) Handbook of Medical Neuropsychology: Application of Cognitive Neuroscience. United States of America: Springer Science and Business Media. Barnett, M. (2006) Chronic Obstructive Pulmonary Disease in Primary Care. United Kingdom: Whurr Publishers Limited. Bellamy, D. and Booker, R. (2006) Chronic Obstructive Pulmonary Disease in Primary Care. 3rd ed. United Kingdom: Class Publishing Ltd. Burton, G. et al., (1997) Respiratory Care A Guide to Clinical Practice. 4th ed. United States of America: Lippincott-Raven Publishers. Calverley, P. M. A. et al., (2003) Chronic Obstructive Pulmonary Disease, 2nd ed. United Kingdom: Arnold. Giggliotti, F. et al., (2003) Breathing retraining and exercise conditioning in patients with chronic obstructive pulmonary disease (COPD): a physiological approach. Respiratory Medicine, 97 (3), pp. 197-204. Guell, R. et al., (2000) Long-term Effects of Outpatient Rehabilitation of COPD. Chest journals, 117 (4), pp. 976-983. Gupta, R. and Brooks, D. (2008) Aerobic Exercise for Individuals with Chronic Obstructive Pulmonary Disease. Physiotherapy Canada, 58 (3), pp. 179-186. Mador, J. and Bozkanat, E. (2001) Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Respiratory research, 2 (4), pp.216-224. Mador, J. et al., (2004) Endurance and Strength Training in Patients with COPD. Chest journals, 125 (6), pp. 2036-2045. Maltais, F. et al., (1997) Intensity of training and physiological adaptation in patients chronic obstructive pulmonary disease. America journal of critical care medicine, 155, pp. 555-561. Mikelsons, C. (2008) The role of physiotherapy in the management of COPD. Respiratory Medicine, 4 (1), pp. 2-7. Nici, L. et al., (2006) American Thoracic Society/European Respiratory Society Statement on Pulmonary Rehabilitation. American journal of respiratory and critical care medicine, 173 (12), pp. 1390-1413. Ortega, F. et al., (2002) Comparison of Effects of Strength and Endurance Training in Patients with Chronic Obstructive Pulmonary Disease. American journal of respiratory and critical care medicine, 166 (5), pp. 669-674. Rochester, C. (2003) Exercise training in chronic obstructive pulmonary disease. Journal of Rehabilitation Research and Development, 40 (5), pp. 59-80. Sietsema, K. (2001) Cardiovascular limitations in chronic pulmonary disease. Medicine science in sports exercise, 33 (7), pp. 656-661. Spahija, J. et al., (2005) Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD. Chest journals, 128 (2), pp. 640-650. Thomas, A. J. (2006) Chronic Obstructive Pulmonary Disease: The contribution of skeletal muscle dysfunction to exercise intolerance. Physical therapy reviews, 11 (1), pp. 62-66. Tiep, B. (1997) Disease Management of COPD with Pulmonary Rehabilitation. Chest journals, 112 (6), pp. 1630-1656. Vonk-Noordegraaf, A. et al., (2005) Early Changes of Cardiac Structure and function in COPD Patients with Mild Hypoxemia. Chest journals, 127 (6), pp. 1898-1903. Wanke, T. et al., (1994) Effects of combined inspiratory muscle and cycle ergometer training on exercise performance in patients with COPD. European Respiratory Journal, 7 (12), pp. 2205-2211. Yohannes, A. Connolly, M. (2007) A national survey: percussion, vibration, shaking and active cycle of breathing techniques used in patients with acute exacerbations of chronic obstructive pulmonary disease. Physiotherapy, 93 (2), pp. 110-113.

Prescription Health Care Costs and its Effects on the Elderly Essay

Prescription Health Care Costs and its Effects on the Elderly - Essay Example ribed in case of the elderly and the price are these drugs are more compared to the older drugs thus adding additional burden on the elderly (Berndt et al, 1998). However, those who rely on a fixed income are vulnerable towards price inflation of prescription drugs due to which they either skip doses or at times even forgo the prescriptions which can have an adverse affect o their health (Berndt et al, 1998; Safran et al, 2005). According to a national survey report on prescription drug adherence by the elderly more than one-quarter of elderly did not adhere to the prescription due to the associated high costs. The non adherence was more prominent among those without drug coverage, low-income groups and those with complex chronic illnesses (Safran et al, 2005). The introduction of public health insurance programs such as Medicare and Medicaid and private-employer insurance programs has not seen a significant reduction in prescription drug adherence by the elderly. These programs cove r only partial medical services for the elderly and do not cover the costs of outpatient prescription drugs (Safran et al, 2005; U. S. Healthcare, 2010; The cost of Prescription Drugs, 2001; Shang & Goldman, 2007). This coupled with the rising inflation and global economic recession in the recent years has only laid excess strain on healthcare expenditure due to which the costs have outweighed the benefits (U. S. Healthcare, 2010). The increase in the costs of prescription drugs has been mainly associated with the emergence of expensive state-of-the-art technology in drug production and for the development of such high-end drugs the costs will have to be shared with the consumer. Factors such as larger prevalence of chronic and long-term illness coupled with longer life spans have increased the demand for such drugs. Additionally population ageing and administrative costs also add up to the health care costs (U. S. Healthcare, 2010). Public health insurance programs such as Medicare

Culture, Behaviour and Management in field of Construction Project Essay

Culture, Behaviour and Management in field of Construction Project Management - Essay Example The potential effectiveness of these ideologies is tested through the London Olympics 2012 construction projects. It is proved that such ideologies can be effective in the construction industry but only the terms that they are appropriately supported in all their aspects. 1. Introduction In the last decade, the rapid expansion of globalisation in countries worldwide has caused a series of changes in traditional organizational practices and frameworks. It is in the context of this trend that the recent credit crisis appeared. The specific crisis has been related to a series of mind-sets and ideologies. In this way, the management of the effects of the credit crisis is not an issue of organizational practices but rather of ideologies and behaviour. The role of mind-sets and ideologies in the development of the recent credit crisis is examined in this paper; emphasis is given on the potential use of these mind-sets for handling the effects of the crisis on the UK construction industry. The construction projects of the London Olympics 2012 are used as indicative examples for highlighting the potential value of mind-sets in handling problems related to the financial crisis – especially cultural and behavioural problems. ... It is recommended that project managers involved in the particular construction projects – those related to London Olympics 2012 – emphasize more on the use of mind-sets for resolving the cultural and behavioural problems of these projects. At the next level, these practices could benefit the construction projects developed in markets with different characteristics, such as the Thai market. 2. An explanation of the recent ‘credit crisis’ taking the perspective of ‘ideologies and mindsets’ to account for the phenomenon. The recent credit crisis proved the inability of leaders in organizations of all industries to take the necessary measures for increasing the strength of their firm towards the market pressures. As noted in the study of Dotlich et al. (2009) in order to be able to face the developments in the global market, modern leaders should ‘develop four mind-sets: a) a global mind-set, b) an innovation mind-set, c) a virtual mind-set and d) a collaborative mind-set’ (Dotlich et al. 2009, p.36). The above mind-sets could be further explained as follows: a) the first (global) mind-set would help leaders to understand the conditions in the global market and set the appropriate strategic priorities, aiming to help their firm improve its position in the international market, b) the innovation mind-set would refer to leaders who are able to identify and promote creative ideas; these ideas could help organizations to increase their competitiveness or, at least, to avoid major losses in periods of severe crises, like the recent one, c) the virtual mind-set refers to leaders who are able to communicate effectively with external providers established in other countries worldwide (Dotlich et al. 2009, p.36), d) the collaborative mind-set reflects the leader