Foundations for physiotherapy practice The WritePass Journal

Foundations for physiotherapy practice Introduction Foundations for physiotherapy practice IntroductionConclusionReferencingRelated Introduction   This essay will explore the disease COPD and explain the systemic effects that the disease has on the body as a whole. Exercise is investigated in the essay and shows how it may change the quality of life of a patient and decrease certain symptoms of COPD; it will also explain the negative effects that inactivity may cause a patient with COPD. There is varies interventions used to make living with COPD more tolerable for patients. It talks about how exercise benefits the body by decreasing dyspnoea, how increasing the body’s muscle strength will relieve fatigue and decrease the respiratory demand. The affects of exercising on anxiety and depression are examined also. The physiotherapists role will be included detailing all the different techniques that they use for treatment including breathing control, airway clearance, inspiratory muscle training which helps with inspiratory endurance and strength and improving mobility. Finally the important of upper body and strength e xercises will be questioned as to how it helps with improving mobility and promoting rehabilitation. Chronic obstructive pulmonary disease (COPD) is an umbrella term used to describe somebody who suffers from both Chronic bronchitis (Bronchitis is inflammation of the bronchi (the airways of the lungs) and emphysema (Emphysema is damage to the smaller airways and air sacs (alveoli) of the lungs). COPD is the term most preferred but you may also hear it called COLD (chronic obstructive lung disease) or COAD (chronic obstructive airway disease). Pulmonary means affecting the lungs. COPD causes a chronic (ongoing) cough with phlegm, is rare before the age of 35 and there is permanent damage to the airways. The narrowed airways are fixed, and so symptoms are chronic (persistent). Treatment to open up the airways is limited as a result. (patient.co.uk, 2010) As before COPD or chronic obstructive pulmonary disease is two disorders in one emphysema and chronic bronchitis. Bronchitis affects the airways with inflammation narrowing the airway sometimes with phlegm. Chronic bronchitis is a mor e specific condition and it is defined by the amount of phlegm that a person has coughed up over a particular time frame. To be described as chronic bronchitis a person has to be coughing up phlegm every morning for at least 3 consecutive months within a period of at least two years. Chronic bronchitis is mostly caused by cigarette smoking it can also occur form environmental factors. Emphysema is the other disorder you must be diagnosed with to be diagnosed with COPD. Emphysema affects your alveoli which are the little sacs of air at the end of bronchiole in your lungs where gaseous exchange occurs. These are normally made from a very elastic tissue so that they can expand when air fills the lungs. In emphysema, large numbers of the alveoli have been destroyed and there is much less area where gaseous exchange can take place so although people can breathe in it cannot get into the bloodstream. (Miles and Roberts, 2005, PP.1-3) Another systemic effect of COPD is the effect on the musculoskeletal system because of the breathlessness which reduces your exercise capacity which has a knock on effect. When you don’t exercise it has adverse effects on your body muscle wastage and weakening means you may become breathless easier as you will have less muscle and/or strength to perform the same tasks and will require more effort and put more metabolic demand on your body compared to if you had stronger muscles. Muscle weakness whatever the cause has severe consequences, including exercise limitation, reduced quality of life, more of a demand for healthcare assistance and its resources and more severely reduced survival. Physical de-conditioning may lead to a marked decrease in a patient’s ability to cope with activities of daily living, finding even the simplest of tasks to be leaving them breathless, consequently leading to a decrease in quality of life and also decreased survival. It is apparent that systemic manifestations are typical in COPD. Granted, many patients demonstrate a gradual and significant weight loss that exacerbates the course and prognosis of disease. This weight loss is also accompanied by peripheral muscle dysfunction and weakness. (Decramer, M. Et al. 2005, PP. s3-s10) With COPD it is not just the physical effects that play a role in the disease there are neuropsychiatric disorders like depression and anxiety which are more common in people with COPD. Depression in people with COPD rises with an increase in hypoxemia, carbon dioxide levels or dyspnoea. Hypoxemia may be a substantial cause in the development of depression and anxiety in COPD due to brain injury; however oxygen therapy results in little or no improvement in the severity of the depression. Another cause of morbidity of depression and anxiety is negative self-perception and restrictions in behavioural functioning due to reduced physical capacity. (Armstrong 2010 PP. 132) Although the COPD patient population is proven to be more depressed than the general medical population, it is not more anxious, the levels of anxiety observed in the general medical or surgical population on the wards were very similar to those observed in the COPD population. Despite the similarities compared to the other wards the anxiety levels are still high compared to the population without any disease or disorder. (Light, R, W.et al. 1985, PP.35-38) COPD patients with psychiatric conditions spend twice as much time in hospital compared to those without depression and anxiety. It is also found that the quality of life of COPD patients can be impaired in all dimensions compared to those without depression and anxiety, high impact was seen both on walking around, mobility, sleep and rest. (MIKKELSEN, R, L. 2004, PP.65-70) Anxious patients tend to have quite significantly shorter pre-rehabilitation exercise capacity compared with non-anxious patients as do patients with increased depression compared with those who are not depressed. Patients following a pulmonary rehabilitation program for COPD show a statistically significant fall in both anxiety and depression as they progress in their program, with no patients showing any increases in either depression or anxiety. Patients with higher star ting anxiety level show a significantly larger increase their exercise capacity than those who start off with lower anxiety levels. Exercise rehabilitation is shown to produce clear improvements in anxiety and depression and to some extent reduces the number of patients with high anxiety and depression compared to no intervention. So exercise benefits COPD suffers with anxiety and depression at least as much as do those with lower levels. (Nicholas, Rudkin, and White, 1999, PP. 362-365) COPD has effects on the cardiovascular system by increasing the risk of cardiovascular disease by up to three-fold. Several different studies have shown that the function of endothelial in COPD is abnormal in both the pulmonary and systemic circulations. The means that underlie these abnormalities are also unclear. It is obvious that tobacco smoking is a shared risk factor for both COPD and cardiovascular disease. Although, it is possible that there are other factors which may quite substantially increase the cardiovascular risk of patients with COPD. With this in mind, many authors agree that the persistent, low-grade, systemic inflammation that occurs in COPD may contribute further to the pathobiology of these cardiovascular abnormalities in COPD. If true, this may have substantial therapeutic implications in the management of these patients because anti-inflammatory therapy would be beneficial not only for the chronic inflammatory process which their lungs are undergoing but also for the prevention of cardiovascular disease. (AgustÄ ±Ã‚ ´, 2005, 367-370.) It is shown that the leading causes of mortality in those with COPD are cardiovascular in nature. Cardiovascular causes are listed as the main cause of death in nearly 50% of the cases, Nevertheless, this data, suggest that a large proportion of patients with COPD die from cardiovascular complications.   (Sin and Man, 2005, p8-11) The impact on cardiovascular function in COPD is mainly due to the increased right ventricular afterload caused by an increase in pulmonary vascular resistance resulting from the structural changes that take place in the pulmonary circulation with the disease One of the most beneficial treatments for COPD and its symptoms is exercise; exercise is proven to have a beneficial effect on your body compared to not exercising. By exercising you significantly increase your muscle strength and endurance. This means muscle dystrophy and atrophy are stopped and even reversed. You see a significant increase in endurance when you walk also as a result of exercising regularly and it also promotes increased efficiency of peripheral muscle oxygen extraction after muscle training, with less contribution from anaerobic (lactic acid) metabolism during exercise. (Clark, Cochrane, and Mackay, 1996, PP. 2590-2596) Aerobic capacity (VO2max) or maximum oxygen uptake is decreased with patients presenting with COPD, due to this the body starts to utilise the anaerobic energy system, this means that for walking the same distance as a normal person you will be utilising the phosphate and the lactic acid system which use less oxygen therefore your muscles fatigue easier. Lactate or metabolic threshold (VO2u) is known as exercise intensity with a sustained increase in blood lactate that cannot be prevented. Lactate threshold may be elevated by as much as 100% of its resting value by successful aerobic training in a normal subject. A de-conditioned individual there for has the potential for a significantly greater improvement in VO2max and VO2u with exercise training. When effective, this modality of physical reconditioning leads to improved functional exercise capacity and reduced breathlessness. Early implementation is desirable to obtain more meaningful responses. (COOPER, 2001, PP. S671-s679) Upper extremity exercise is also important for people who suffer from COPD as they are restricted in the amount of upper body exertion they can achieve even as much as to elevate their arm may cause dyspnoea and increased respiratory demands. It is shown that during unsupported arm exercise the respiratory muscles of the rib cage work actively help to maintain the posture of the upper torso and extended arms; due to this they decrease their roll in respiration in COPD patients. Therefore dyspnoea is worse with arm exercise than it is with leg exercise at the same total body oxygen consumption, suggesting that the load borne by the other inspiratory muscles must increase for the same level of increasing ventilation. (Grazzini, 2005, PP. 1403-1412) The increased demands even during a simple arm elevation may play a role in the development of the patient’s dyspnoea.   The limitation that occurs is a major problem that patients report when performing daily living activities involving the arms. It is important to apply an intervention of exercise training to try help. An upper extremity training regime for patients with COPD results in a reduction of ventilation requirements which will allow patients with COPD to perf orm sustained upper extremity activity with considerably less dyspnoea. A comprehensive pulmonary rehab programme that includes arm exercises, results in reduced metabolic and ventilator requirements for a simple arm lift. The addition of such training has been shown to improve upper extremity exercise endurances. Subjects who are in the early stages or whom are less severe may tolerate these increased loads without difficulty, whereas in severely obstructed patients with minimal reserve, increased ventilatory exertion and the associated recruitment of the diaphragm may contribute to increased dyspnoea. Although has some beneficial effects in this and most other studies to date, ventilatory capacity does not improve in terms of pulmonary function tests nor does fev or fev1. Additionally there is no cross over benefit to arm exercises or lower body exercises so it is important to incorporate both into a pulmonary rehabilitation for a patient with COPD to seek maximum benefit from the program. (Couser, Martinez and Celli, 1993, PP. 37-41) With COPD muscle wastage is quite common and 25% of all patients suffer from it. Muscle weakness and wastage also has adverse effects on fatigue. Leg fatigue for example limits patients with COPD in exercise. Normally the perception for muscle fatigue is higher in people with weak leg muscles than to those who are said to have strong legs. Patients with stronger muscles are said to have better exercise capacity this is true for people without COPD. Quadriceps strength has been found to have a significant effect on exercise capacity. So it is said that â€Å"leg fatigue is inversely proportional to leg muscle strength†. (Bourbeau, Nault, and Borycki, 2002, PP.190-191) Strength training is also appealing because it improves muscle strength and mass much better compared to aerobic training. In addition strength training causes less dyspnoea in the exercise period compared to aerobic training. Because of this it may be easier to tolerate for patients with severe cases of COPD. The re are different types of strength training can be used depending on the desired objective or the condition the patient is in. The different types are strength training where you are lifting between (90-100%) of one rep max (RM) this is using low repetitions with high weight which ameliorates strength, whereas when you use a lower weight and higher repetitions you work at a lower intensity for more reps which works on endurance. Moderate intensity work at (10-12) reps performed at 60-80% of one RM is ideal for patients with COPD as it fulfils the objective of building muscle strength and endurance while avoiding the likelihood of muscle injury which is common in high weight low repetition work. It is important to have your medication and a partner. This is important because, effectively, you may become disabled due to your breathlessness. (Bourbeau, Nault, and Borycki, 2002, PP.190-191) Physiotherapists address many of the symptoms of COPD like reducing the work of breathing, promoting clearance of the airways, improving mobility and promoting rehabilitation. Promoting successful management of these complex patients is in two parts: the accurate assessment of the patient to identify clear goals of treatment and team work, which underpins a thorough knowledge of the individual patient. (Mikelsons, 2008, PP. 2-7) There are three main techniques which may improve the efficiency of your breathing, pursed lip breathing, diaphragmatic breathing and paced breathing. These three techniques encourage complete emptying of your lungs and slower, deeper breaths, which will improve the efficiency of your breathing and encourages control of your breathing. Diaphragmatic breathing involves encouraging patients to move the abdominal wall predominantly during inspiration with reduction of rib cage movement and inhale slowly and deeply, in order to improve chest wall movement and the distribution of ventilation, decrease the work of breathing and improve exercise capacity. By utilizing the main muscle of inspiration, the diaphragm, it encourages relaxation of smaller, less efficient respiratory muscles. Using the diaphragm allows more air to move into the lungs with each breath which makes each breath more efficient. Diaphragmatic breathing also decreases the work of breathing by reducing the use smaller, less efficient muscles of the neck and shoulders. (NYU Medical Centre 1997). Diaphragmatic breathing (DB) has been claimed, but not demonstrated, to correct abnormal chest wall motion, in turn decrease the work of breathing (WOB) and dyspnoea and improve ventilation distribution. (Vitacca et al., 1998) Pursed lip breathing is commonly used in COPD patients as it is thought to alleviate dyspnoea. (Spahija, de Marchie, and Grassino, 2005, PP. 640-650) PLB is done by breathing in through the nose and out through the mouth against a resistance created by pursing the lips, this helps to prevent airway collapse. PLB helps you exhale more completely because it slows your respiratory rate and helps to keep your airways open longer. It has been shown that by performing PLB during exertion can lead to a reduction in respiratory rate and increased recovery rate compared with spontaneous breathing PLB can be used just prior to and during activities that have made you short of breath in the past.. PLB during exertion may therefore be a useful addition to the breathless patient’s regime and may be taught as a strategy to reduce respiratory rate of patients with COPD. It is good to use PLB when walking on inclines, up stairs and during any exercise or exertion. Despite the exercises being effective in reducing respiratory rate and decreasing work of breathing it is of note that it has been shown that fatigue of the diaphragm may develop earlier when using slow, deep breathing, but no differences in dyspnoea or exercise tolerance were found.12 R. Garrod, K. Dallimore and J. Cook et al., An evaluation of the acute impact of pursed lips breathing on walking distance in nonspontaneous pursed lips breathing chronic obstructive pulmonary disease patients, Chronic Respir Dis 2 (2) (2005), pp. 67–72. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (12) Paced breathing involves coordinating your breathing pattern with the activity you are doing. For example, when walking on level surfaces breathe in for a count of 2 steps and out for a count of 4 steps. This will help regulate your breathing reducing anxiety and promote good relaxed and controlled breathing allowing you to continue with your activity. Physiotherapists prescribe Breathing exercises l ike Diaphragmatic breathing, breathing control and pursed lip breathing are to relieve breathlessness and promote relaxation. (NYU Medical Centre, 1997) Physiotherapists also teach a techniques called airway clearance techniques the most popular being called active cycle breathing technique (ACBT) which is used for acute exarberations of COPD during exercise. This technique is done by using an alternating depth of breathing to move phlegm from the small airways at the bottom of your lungs to the larger airways near the top where they can be cleared more easily with huffing/coughing in turn making it easier to breath by removing obstructions. ACBT is used by 88% of physiotherapists to treat acute exarberations of COPD. (Connolly and Yohannes 2007 pp. 110-113) Airway clearance techniques have a variety of different techniques such as the ACBT which has been explained, forced expiration technique (FET), and postural drainage (PD). PD is when the physiotherapist puts the patient in positions which make it easier to remove sputum because the cilia are damaged and cannot aid in its clearance of sputum. FET is used instead of coughing to re move sputum, it is found to be more effective than coughing. The main indicator for determining which of the techniques to use of any airway clearance technique is how much sputum they can clear while coughing independently. This will be a key indicator for a patient in the self-management of their disease and patients will be taught modifications of their airway clearance regime during an acute exacerbation by their physiotherapist. (Mikelsons, 2008 pgs 2-7) Physiotherapists may prescribe inspiratory muscle training (IMT) which has been used for co-ordination of respiratory muscles allows maximization of the use of abdominal muscles as inspiratory accessory muscles and has been proven to show benefits in exercise tolerance, Inspiratory muscle endurance and strength, breathlessness and improve quality of life. (Mikelsons, 2008 pgs 2-7) state that by including IMT in an exercise programme it has been shown to increase maximal inspiratory pressure, perception of breathlessness and health-related quality of life.50 R. Magadle, A.K. McConnell, M. Beckerman and P. Weiner, Inspiratory muscle training in pulmonary rehabilitation programme in COPD patients, Respir Med 101 (2007), pp. 1500–1505. Article | PDF (465 K) | View Record in Scopus | Cited By in Scopus (8) High-intensity IMT has also been shown to produce beneficial reductions in dyspnoea and fatigue in COPD patients. Usually a physiotherapist would prescribe training that would ta ke place over 6 to 9 weeks using   from 30 to 60% of maximal inspiratory pressure depending on the patient and how much they can manage, this differs from person to person. Another study by (Lotters et al., 2002 pp. 570-577) also had positive results and stated that IMT alone significantly improves inspiratory muscle strength and endurance, whereas the sensation of dyspnoea significantly decreases in patients with COPD. Although there are no significant additional effects of IMT on exercise performance IMT plus general exercise reconditioning has strong significant training effects on inspiratory muscle strength and endurance, especially in patients with inspiratory muscle weakness. In addition, a clinically significant decrease in dyspnoea sensation at rest and during exercise is also a result of IMT. Conclusion In conclusion there is an array of benefits of exercise training demonstrated in the essay which include, increase in exercise capacity, decrease in breathlessness, substantial changes in health related quality of life, decrease in anxiety, and improvements in depression. It has been shown that the inclusion of strength training is also necessary in the exercise prescription to help reduce fatigue; it has shown benefits in relief of respiratory demand in turn reducing dyspnoea. When evaluating anxiety and depression, there have been studies that show a higher rate of depression and anxiety in COPD patients than the general public. In comparison with the general medical population the rate of anxiety was not proven to be higher but much the same, although the level of depression in patients with COPD tended to be higher due to the disease having a reduced physical capacity and knowing that it will gradually get worse. Although by including a pulmonary rehabilitation program for COPD, patients show a statistically significant fall in both anxiety and depression as they progress in their program, with no patients showing any increases in either depression or anxiety. The inclusion of IMT used by physiotherapists combined with an exercise program has been shown to significantly increase in inspiratory muscle strength and inspiratory muscle endurance leading to the reduction of dyspnoea. Combining all of these techniques help in the management of COPD however it has to be said that although exercise improves certain symptoms of COPD, there still a null outcome when it comes to improvements in lung function (FEV1 or FEV). Referencing AgustÄ ±Ã‚ ´ A. G. N. (2005) Systemic Effects of Chronic Obstructive Pulmonary Disease. American thoracic society, 2 (4), 367-370. Armstrong, C. L. Ed. (2010) Handbook of medical neuropsychology: applications of cognitive neuroscience. New York: Springer. Bourbeau, J. Nault, D. and Borycki, E. (2002) Comprehensive management of chronic obstructive pulmonary disease. Canada:   BC Decker Inc. Clark, C.J. Cochrane, L. and Mackay, E. (1996) Low intensity peripheral muscle conditioning improves exercise tolerance and breathlessness in COPD. European respiratory journal, 9 (12), 2590-2596 Connolly, M. J. and Yohannes A. M. (2007) A national survey: percussion, vibration, shaking and active cycle breathing techniques used in patients with acute exacerbations of chronic obstructive pulmonary disease. Physiotherapy, 93 (2), 110-113. COOPER C. B. (2001) Exercise in chronic pulmonary disease: aerobic exercise prescription. Medicine Science in Sports Exercise.   33 (7), S671-s679. Couser, Jr. J. I. Martinez, F. J. and Celli, B. R. (1993) Pulmonary rehabilitation that includes arm exercise reduces metabolic and ventilatory requirements for simple arm elevation. CHEST, 103 (1), 37-41. Decramer, M. et al. (2005) Systemic effects of COPD. Respiratory medicine, 99 (2), S3-s10. Grazzini, M. (2005) Pathophysiology of exercise dyspnea in healthy subjects and in patients with chronic obstructive pulmonary disease. Respiratory medicine, 99(11), 1403-1412. Light, R. W. et al. (1985) Prevalence of depression and anxiety in patients with COPD. Relationship to functional capacity. Chest, 87 (1), 35-38. Lotters, F. et al (2002), Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis. European respiratory journal, 20 (3), 570-577. Miles, J. And Roberts, J. (2005) Chronic obstructive pulmonary disease 1st ed London: Class publishing. Mikelsons, M. (2008), The role of physiotherapy in the management of COPD, COPD update: Respiratory medicine, 4(1), 2-7. MIKKELSEN, R. L. (2004) Anxiety and depression in patients with chronic obstructive pulmonary disease, A review. European respiratory society, 58 (1)65-70. Nicholas, J. Rudkin, S. T. and White, R. J. (1999) Anxiety and Depression in Severe Chronic Obstructive Pulmonary Disease: The Effects of Pulmonary Rehabilitation. Journal of Cardiopulmonary Rehabilitation, 19 (6), 362-365. NYU Medical Center (1997) COPD AND EXERCISE   [ONLINE]. Available at; http://pfrc.med.nyu.edu/handouts/pdf/proced/copdexer.pdf [Accessed 20 April 2011] Patient.co.uk (2010) Chronic Obstructive Pulmonary Disease [ONLINE]. Available at; patient.co.uk/health/Chronic-Obstructive-Pulmonary-Disease.htm [Accessed 18 August 2011] Sin, D. D. and Paul Man S. F. (2005) Chronic Obstructive Pulmonary Disease as a Risk Factor for Cardiovascular Morbidity and Mortality. The American thoracic society, 2(1) 8-11. Spahija, J. de Marchie, M. and Grassino, A. (2005) Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD. Chest,128 (2), 640-650. Vitacca, et al., (1998) Acute effects of deep diaphragmatic breathing in COPD patients with chronic respiratory insufficiency. European respiratory journal, 11 (2), 408-415.

Scutellosaurus - Facts and Figures

Scutellosaurus - Facts and Figures Name: Scutellosaurus (Greek for little shield lizard); pronounced SKOO-tell-oh-SORE-us Habitat: Woodlands of southern North America Historical Period: Early Jurassic (200-195 million years ago) Size and Weight: About four feet long and 25 pounds Diet: Plants Distinguishing Characteristics: Small size; long tail; bony studs on back About Scutellosaurus One of the persistent themes of evolution is that large, imposing creatures descend from small, mouselike progenitors. Although no one would think of comparing Scutellosaurus to a mouse (it weighed about 25 pounds, for instance, and was covered with bony spikes), this dinosaur was certainly rodent-sized compared to its multi-ton armored descendants of the late Cretaceous period, such as Ankylosaurus and Euoplocephalus. Although its hind limbs were longer than its forelimbs, paleontologists believe Scutellosaurus was ambidextrous, posture-wise: it probably stayed on all fours while eating, but was capable of breaking into a two-legged gait when escaping predators. Like other early dinosaurs, Scutellosaurus was anatomically very similar to the prosauropods and small theropods that roamed the earth during the late Triassic and early Jurassic periods.

Regulatory Theory Essay Example | Topics and Well Written Essays - 1750 words - 1

Regulatory Theory - Essay Example In fact, before these far-reaching reforms, telecommunication service provision remained a monopoly of state corporations or in rare cases, was monopolized by private entities. Due to the fact that the provider of telecommunication services in most cases was the government, the regulation of this sector was never quite independent since, all the policy-making and regulatory powers lay with the government and its agencies (Welfens, 2010). Therefore, the management of telecommunication frequencies and the responsibility of operating networks were a preserve of the government of the day (Davidson et al., 1986). For many developed countries, this classical approach to ICT management was quite profitable for some time, given that the increased international tariffs for telecommunication services covered for the subsidized local tariffs. In addition, with the decreased telecommunication cost that resulted from technological advances, the classical approach to ICT operations did well for mo st developed countries (Welfens, 2010). Unfortunately for the developing and the underdeveloped countries and regions, the classical approach to ICT operation did not work well. The reason for this scenario being that these countries’ networks were somehow restricted to major cities and towns, implying that only the middle and high socioeconomic status citizens could access and utilise ICT services in these countries. While the low socioeconomic status citizen had to make do with poor quality telecommunication services and long waiting lists, the high-income end of the population were advantaged by the cross-subsidisation of ICT prices (Welfens, 2010). Regrettably, the classical approach to ICT regulation did not generate investment income for the developed and the developing countries alike. During the 1980s and the 1990s, the role of telecommunication in the economic growth of countries and the entire world became rather apparent, leading to the development of a number of r egulatory and competition polices, even though to a limited extent, in many countries (Koops et al., 2006). Besides, regulating competition, the regulatory and competition policies were expected to instill dynamism, innovativeness, augment availability, accessibility and increase ICT choices and lower tariffs for customers. The first effect of the wave of ICT reforms that peaked in the 1990s was the privatisation of telecommunication service operators. The second effect of the ICT regulatory policies was the introduction of new varieties of services such as mobile telephony and value-added services (Koops et al., 2006). This paper thus explores the need for the regulation of ICT, whether regulation works in the interests of the public and the implications of convergence and innovation on ICT regulation. The Importance of Regulation That the core role of regulation in any industry is to enable sustainability, growth and development is quite apparent and cannot be overemphasized. Ther efore, the information and communication technology sector, like the other sectors of an economy, requires a strong legal framework and regulatory mechanisms to function for the betterment of the public. A number of reasons have since been identified to underlie the need for the regulation of information communication and technology. Generally, ICT the need for ICT regulation arises from the recently observed structural changes in the communication industry. The transformation of the industry from a monopoly to a competitive one in many a country has particularly necessitated its stronger regulation (Baldwin et al., 2012). Therefore, the regulation of the ICT sector has been particularly important in the creation of an effective environment for fair competition that supports both

Global warming Essay Example | Topics and Well Written Essays - 750 words - 8

Global warming - Essay Example (1). The term global warming does not merely connote to an increase in the temperature but also envisages an overall climatic change. Because of this change in temperature and climate, economy, human health, and the ecosystems can encounter drastic consequences. The main pollutant to atmosphere that contributes to global warming is carbon dioxide, which causes warming in atmosphere. Other pollutants such as fossil fuel, methane gas and green house gases also are act as warming agents. Unfortunately, human beings are the ones who cause this imbalance between life and earth and the consequences have already reached disastrous proportions. CO2 emitted from â€Å"power plants and vehicles† play a crucial role in increasing CO2 concentration in the atmosphere (Wang & Chameides 36). Certain other human activities that entail degradation of wild life, â€Å"spread of homes and infrastructure† and sinking of costal land also adds pace to the process of global warming (Wang & Chameides 36). Global warming triggers killer heat waves, drought, forest pests, wildfires and contributes to rising sea level, shrinking snowpack, disappearance of glaciers, disintegrating polar ice, melting permafrost damage to coral reefs, shifting species rang es and yearly cycles and disease outbreaks (36). Besides, it also causes considerable harm to the ecosystem apart fro damaging agriculture and animal habitats. In addition, increase in atmospheric temperature may result in death of life forms, including human beings, due to the unbearable heat and drought. Wild fires can cause loss in â€Å"forestry, agriculture, and electric power sectors† (Wang & Chameides 36). High rates of evaporation may result in an increase in water vapor in air, which can cause heavy rainfall and flooding. Intense evaporation may also entail loss of moisture from soil and consequently droughts can occur (36). Evidence further points to the fact that over the course of 20th century, sea level has

The impact of reverse logistics in retail industry

The impact of reverse logistics in retail industry 1. Background In todays business world, Companies are looking for ways to improve there businesses by reducing costs, and improving labour efficiency. This enables the companies to implement supply chain management into the business. Supply chain management is a process which binds and links the entire process from supplying a product until it gets delivered to the end customer. Reverse logistics is a very essential process which is included in the supply chain management process. Reverse logistics is the process which involves planning, implementing, cost effective flow of stocks and machinery, finished goods, in-process inventory and related information from the point of supplying to the point of final consumption. Remanufacturing and refurbishing are the two vital aspects of reverse logistics which helps in reutilisation and reselling of a product. It also involves recycling of programs, machinery fault or similar asset problems. Few more terms, often used with reverse logistics are: Reconditio ning the machinery when it is not performing up to its mark, repairing it and then using it again. Refurbishing is working on the same product and enhancing and changing it from inside completely. Remanufacturing is similar to refurbishing but may require completely disassembling the product. Reselling is done after one or more of the above three. Recycling happens only when the product is not in condition where it can be worked on like reconditioning, refurbishing, remanufacturing so as to resell it. Reverse logistics is also about keeping the environment healthy by not disposing too much waste, reducing the waste particles or reusing them. 2. Literature Review According to the Reverse Logistics Executive Council, reverse logistics is â€Å"the process of planning, implementing, and controlling the efficient, cost effective flow of raw materials, in-process inventory, finished goods and related information from the point of consumption to the point of origin for the purpose of recapturing value or proper disposal† (Xiaoming Li, Festus Olorunniwo, 2008).   The reverse material movement from end customers to suppliers has received much less attention (Rogers and Tibben-Lembke, 2001).   Most returned products are processed to put back to shelf. Two alternative waste management policies are studied and compared. The first policy deals with the recovery chain, that is, the flow of used products from consumers to recovery facilities. The second policy deals with the disposal chain, in which used products are carried to landfills (Murphy, P R. and Poist, R F.2003).There exists a range of ordered sequencing that different companies adopt depending on which activities are engaged in by the firm. Most of the companies set up their processes based on some knowledge of materials flows: inbound receiving, sorting, testing, storing, and outbound shipping. Different products may go through different routes; same products with different types of damages also may undergo different operations. Companies have operational procedures for machine centres; however, returns flows among machine centres are informal in many cases or many factors are not considered (Trebilcock, 2002).   Using the information, we develop a generic returns process flow by integrating various broad factors: demand, package and product conditions, test and repair, secondary market, vendor, charity giving, recycle, and disposal. Now a days, managers reactions were not quite strong as to whether recycling materials that are un-useable generate considerable revenues or if channel clearing considerably reduces obsolete items inventory, and if repaired item s yield reasonable profits in secondary markets. These set of responses are quite surprising because they are contrary to observations from the experiences reported in the trade literature (Reese, 2005). Murphy and Posit (2000) have reported that recycling of materials, reducing consumption and reusing materials are the three most commonly utilized green logistics strategies. Design for recycling (DFR) has become an important dimension for some manufacturers in the recent times (Masanet, 2002).   The ultimate goal of reverse logistics programs is to produce reverse logistics. Resource reduction refers to the minimisation of materials used in a product and the minimization of waste and energy achieved through the design of more environmentally efficient products (Carterand Ellram, 1998).   The increase of eco-efficiency leads to reverse logistics activities in the firm. The outcomes of the eco-efficiency calculations will help authorities in formulating criteria for collection of disposed products and in monitoring end-of-life performance of take-back systems (Huisman, 2002).   Companies must recognize that reverse logistics has become an important source of opportunity for improving visibility and profitability and lowering costs across the supply chain.   Reverse logistics offers an opportunity for improving visibility and profitability while lowering costs across the supply chain. A reverse logistics system will enable us to plan in advance, often as early as the design process, the way to handle returns efficiently and ways this can most effectively feed into the product design plan. Returns provide a revenue generating opportunity via value recapture- return, refurbish, recycle. Sophisticated returns automation systems enable you to leverage a products value by quickly placing it in another product for resale before values depreciate (Anderson, Pat, 2009).   Formerly, firms have been spending significant time and money in improving their forward supply chains while ignoring their potential reverse supply chains. However, in todays competitive business environment, it is important that firms study the profitability and benefits of implementing a reverse supply chain while considering the uncertainties   associated with the supply and composition of used products, disassembly time, recycling or remanufacturing time, and demand for recycled or remanufactured goods(Pochampally, Kishore K. Gupta, Surendra M., Dhakar, Tej S,2009). Few research studies have published specific empirical data regarding the reverse logistics practices of companies.   This multi-stage study employed interviews, site visits, and a mail survey to collect responses from 230 members of the Warehousing Education and Research Council (WERC) regarding their reverse logistics practices.   Results suggest that in spite of the growing importance of reverse logistics, few executives have product return processing as their primary responsibility and often u ndertake this activity along with other job responsibilities.   Most firms handle the product returns process themselves and typically within the same facilities that handle forward logistics. Returning items directly to stock, repackaging and returning to stock, and selling as scrap, were the three top disposition options employed by firms.   Results indicate that, contrary to general understanding, the majority of retailers and wholesalers reported a recovery rate of over 75% of product cost (James R. Stock and Jay P. Mulki, 2009).   If a firm is not able to resell the items, they often end up in land fills, or perhaps recycled. Also, the profit margins could be lower for the manufacturer because in addition to the refurbishing cost, the product often must be sold at a lower price. In view of this, manufacturers desire to maximize profits often dictates the proportion of product that gets refurbished (Vorasayan and Ryan 2006).   Retailer emphasis on training customers in t he proper use of their products which can help in improving customer relations as well as decreasing costs of product returns. Retailers can help a great deal by initial sorting and by making decisions on processing versus returning to manufacturer. This could reduce the uncertainty in the timing and quality of returns that has been blamed for the unpredictability of reconditioning and refurbishing returned products (Guide and Van Wassenhove, 2002).   A reverse logistics flow is much more active, with much less visibility. Retail stores like primark do not initiate reverse logistics activity as a result of planning and decision making on the part of the firm but in response to actions by consumers or downstream channel members.   When a customer returns an item to a retail store, the store collects the items to be sent to a centralized sorting facility.   At the time of return, information about the item and its condition may be entered into the retail stores information syste m, and forwarded to the returns processing centre (Ronald S. Tibben-Lembke and Dale S. Rogers, 2002).   3. Research questions Do you typically return a whole system, or rather just a subset of components, and where should the items go next?   What is the importance of reverse logistics in cost reduction? How reverse logistics influence environmental and social retail environment? How to improve supply chain management with the help of reverse logistics? How to encourage customer loyalty using reverse logistics? 4. Expected Contributions Primark, is a well known retail stores were people do a purchase in bulk due to its low prices.   Demand is changing with a high pace; customer may like something today and something else tomorrow and to keep up with this pace organizations need to adopt returns management. For a clothes store like Primark, which go as per the market demand, they need to update themselves with time as customers these days are all looking for style, current trends and so on. This isnt easy to predict, no one can really forecast what is in today and out tomorrow, this is where returns management comes in picture. A company should know how to reuse or resell by doing some refurbishment. Retail stores and even other suppliers have exchange policies or payback policies which provides customer with an ease of exchanging goods and supplies, once these items are returned, it then goes to production houses for refurbishment or to see what can be done with them in order to reuse or resell them. Organizations in order to survive the competition and to maintain a good customer relationship have to be good at exchange policies and need to shorten the time from accepting the returns to the actual supplier so that they can reduce the operational costs and increase profitability. The important task of management is to mind the gap between returning of products till the time it reaches the supplier; this plays an important role in reducing the costs and increasing the profitability. Keeping the customers happy is the only source of income, so satisfying all they need is really very important. A recent case study implies that Primark is looking for a solution which would facilitate an increase in its volumes which were projected to grow by 30% per annum- from 45,000 cartons daily to levels of 100,000 by 2010. 5. Methodology 5.1 The research method This piece of study or investigation emphasizes more on the utilisation of the reverse logistics approach in retail business like that of renowned store primark. The investigation consists of field as well as desk study. The field study will be done on evaluating companys annual turnover, sales and collection of relevant data via companys website, conducting interviews with various decision makers of concerned departments. Desk study or research will consider examining literature collected via the website of the retail store, retail industries journals, press, statistics and magazines and other media sources. 5.2The concept of interview An analytical study via interview will be conducted for the collection of primary data. The concept is to evaluate the validity and implementation of current reverse logistical operations in the retail business of primark.   Interviews are particularly useful for getting the story behind a participants experiences. The interviewer can pursue in-depth information around the topic. Interviews may be useful as follow-up to certain respondents to questionnaires, e.g., to further investigate their responses (McNamara,1999). The qualitative research interview seeks to describe and the meanings of central themes in the life world of the subjects. The main task in interviewing is to understand the meaning of what the interviewees say(Kvale,1996). 5.3 Interviews The store manager of primark. The manager of marketing department. The manager of finance department. 6. Proposed study timetable Period Aim Task Duration (days) February, 2010 -March, 2010 Collect key principles and research strategic data Finding relevant literatures and evaluating it, online survey methods, interpreting research questions. 15 March, 2010 April, 2010 First meeting with supervisor Finalizing the benchmark of the research area. Discuss the coursework and the research subject of the dissertation. 15 April, 2010 May, 2010 Utilisation of resources Strategic and Statistical analysis of the data and writing the output. 25 May, 2010 July, 2010 Analysing and justifying key findings Interpreting and formulating the relevancy of the collected data for making the supreme structure. 55 July, 2010 Second meeting with supervisor Following the guidelines of the supervisor step by step and implementing the necessary changes to be made. 25 August, 2010 Third meeting with supervisor Fully utilising the resources in-order to follow the concept and application. Completing   the initial draft and heading towards next step. 25 September, 2010 Final meeting with supervisor Finishing the remaining part and Submitting the two copies with a CD of softcopy on 24th September, 2010. 10 7. Resource Implications It would be more helpful to make the use of newsletters, online forum, regular meetings through events, telephonic calls. All this is done to analyze the data and to know how often does primark change its outstanding stocks on the shelves, check the unsold stock to avoid wastage in-order to make improvements in the reverse logistics processes. The presence of application system is important now-a-days in order to maintain and analyze the huge amount of data collected through staff meetings. 8. Evaluation It is quite clear that in the future, more firms will lavish considerable attention on reverse logistics. Many firms have only become aware of the importance of reverse logistics relatively, and have yet to realize the strategic importance of reverse logistics.

Integration of faith no name

The Merriam Webster cautionary defines character as, â€Å"the good qualities of a person that usually include moral or emotional strength, honesty, and fairness†. From the beginning of time, people have had the example of negative and positive character. The lesson comes from the Bible in Hebrews 13:18 Pray for us: for we trust we have a good conscience, in all things willing to live honestly. These qualities, as stated in Hebrews make a successful leader. A successful leader has a victorious team which will produce quality products and attract loyal customers.Kettle and Keller state the vital role for any COM is to instill a customer viewpoint and create a loyal clientele (Kettle & Keller 2012). This is done through marketing and includes everyone in the company to reach to consumers. Within the marketing management the holistic marketing approach of 4 elements carries the workload that all employees should know the needs, wants, and interests of their market. This leads to value and satisfaction. If corners are cut to make a cheaper product the customer will not be happy with the quality.Building or providing high quality goods and services are a sign of character, being honest with good conscience. What would the employee or company do when no one is looking? Would they do the right thing and be honest? Or would they lie, cheat, and steal to close a deal with a customer or client? The best companies will be the ones that give back to the community and help those in need that may be down on their luck. A well known restaurant chain of having a good honest character is Chick-fill-a.As of last year 2014, Chick-fill-a has given over $68 million to education and various charities, working closely with the community. They have successfully built a loyal market. They also value family time and allow their employees a day off, Sunday. By being an example of giving to the community and creating a firm foundation in character, people are attracted to the value s and passion of this restaurant. A mission statement, ‘this is where you breathe real life into the lungs of your organization† (Ramsey 201 1).

The Building And Construction Industry - 6387 Words

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Eg high-rise buildings, bridges, medium to large commercial buildings, and smaller structures where the soil conditions do not allow code-based design. Material taken from: http://www.cruxsurveying.com.au/ Land Surveyors: Surveying is the science of the accurate determination of the relative positions of points above, on, or below the earth’s surface for the planning and efficient administration of the land, the sea and any structures on the land. Land (or cadastral) surveying, deals with theShow MoreRelatedThe Building And Construction Industry Improvement894 Words   |  4 Pages20 March 2012, the Building and Construction Industry Improvement (BCII) Act of the Australian Government was replaced by the Fair Work Bill (FWBI) 2012 which was implemented on 1 June 2012 (FWBC, 2012a). It was regarded as bill for ‘Transition to Fair Work Australia for the Building and Construction Industry’. 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