Windmere Corp Essays - Marketing, Brand Management, Brand

Windmere Corp WINDMERE CORPORATION What do you recommend that Windmere do over the next two or three years? In my opinion, Windmere must continue to expand its U.S. sales to continue using its factories in China effectively in 2-3 years time. It has focused on a developing a family of brand names in addition to private branding and OEM business , as well as developing additional product lines to push through its distribution channels. These brand names can be easily marketed through these channels which will in return provide reasonable profit to the company. Focusing on brand identities for each of its major product lines is an important issue for this company. Its professional saloon products from the Belson Products Division are marketed under saloon designs, Pro Star and Premier brand names. This enables Windmere to gain large national retain chain clients such as Wal-Mart, Eckerd Drug, Kmart, Target, Caldor, etc. These huge retail clients will be Windmere 's strategic partners. Windmere has to adapt itself incase of huge demand to its product through these retail channels. In the future, Windmere has to provide high-quality goods in case of this unexpected situation of excess demand. Another fact is that, new products of Windmere has to be competitive in the environment. Before presenting these products Windmere has to make some Market Research Appraisals in order to understand product's market position and segmentation. On international scale , three big subsidiaries Hong Kong, Canadian and Dutch provide supply to its international markets, these subsidiaries need to be improved with new subsidiaries in order to provide more integrated distribution networks. Business Reports

Surely You Are Joking Mr. Feynman

Surely You Are Joking Mr. Feynman Question 1 Richard Feynman was a well renowned physician in his era and was known for his works relating to those of Albert Einstein. Richard could have accomplished more had he been more serious. One example is where it is stated that he dwelt more on the past rather than on more innovative ideas. Another one is by the fact that he wasted a lot of time concentrating on family issues. The last one is by knowing that he used very little time in the laboratory. Question 2 Feynman was more relaxed than it was expected of a scientist. For a scientist like him, I expected him to be more articulate in his study of science. Once again this is proved by the minimal hours spent in the lab, the little respect that he gave to the future but rather was content with what was available. Another example is by concentrating more on personal issues rather than scientific ones. Question 3 Feynman’s success in the field of science was attributed to his increased focus towards the climax of his career. This is stated in the book that he increased his focus in due time. There was also the influence of fellow scientists and finally the family members. Question 4 Feynman did not do science as per my expectation. In the book it is stated that he spent very little time researching. We are also told that he focused more on the past rather than on the future. Moreover, his work was expected to yield more as he worked with the concepts of Einstein. Question 5 Feynman was not the way that I expect scientists to be. He was not diligent enough to carry out work alone. Moreover, he could not work without the required push from his peers. Another example that proves this is that he could not work without the role modeling of Einstein. Question 6 Feynman could have succeeded in a non scientific field. This was due to the fact that he spent very little time in the laboratory and enjoyed outdoor activities. Other fields do not require much concentration and Feynman did not offer it hence could have succeeded outside there. Question 7 Feynman could not have been as happy as he was in the non scientific field as he was in the scientific. This was because he did not have role models outside the field of science. He could not have enjoyed as he was just lazy but loved the science environment. Question 8 Feynman did not find science coming easily for him. This can be cited from the fact that he always waited for ideas from the many books that he read about Einstein. It also did not come easy for him as all he did science for was due to the small amount of insight that he had. This was also detrimental in that his ability to think independently was curtailed. Question 9 Science was work of play for Feynman in the prior years to his serious work. This can be cited from the fact that he spent a very small amount of time in the laboratory. Another example is the amount of money that he dedicated in purchasing science material. Also he did not observe all the rules of a scientist such as the procedures of carrying out experiments. Question 10 If I had the ability I could not like a life like that of Feynman. This was due to the fact that he was not serious in his work. He wasted a lot of time that could have been used doing important research for the field of science. If I had the ability I could utilize my intellectual ability more than he did. Question 11 Feynman did science just to earn a living. This can be found in the fact that he spent more time with his family. Also a point in the book states that his family started to face problems as he became lazier and thus he worked harder to maintain it. Another example is where there is little amount of attention that he used to offer to science as compared to other scientists. Question 12 What I found most surprising in his learning of science was his unwillingness to use his talent. This is as it is stated that he had the ability to carry out tests that very few in his era could. His laziness is found where he did not pay a lot of attention to new ways of science. Question 13 Feynman could have definitely achieved an increase in happiness if he had majored in sociology. This is due to the fact that he was a very social person and liked interacting with people. Also an example in the book is due to the fact that he held his family with utmost importance. Question 14 Feynman did not interact well with other scientists and mathematicians in terms of their common field of interest. Rather than this, he interacted with them in the basis of pure friendship. Another example is where it is stated that he spent very little time working with scientists of his era but rather sourced his information from previous scientists. Question 15 Feynman could not have become a good science teacher. This can be attributed to the fact that he did not like socializing with people on the basis of his career. Also, he did not have a full passion for the subject hence could not have offered good coaching. Another example is due to the fact that he was lazy and could have missed many lessons. Question 16 Feynman could have succeeded in Counseling. This was due to the amount of concern that had for the people around him. Moreover, he had very good socializing abilities hence could have succeeded. Another example was from the amount of time that he spent with his family offering them life advice. Question 17 I could not have selected Feynman to help build the atomic bomb. This was due to the fact that he was lazy and hence could have slowed down the process. Moreover, he was negligent and could have ignored some key aspects that could have been dangerous if left. Moreover, he was poor at working with other scientists hence could not have worked well. Question 18 Feynman resembled a normal scientist in that he had a laboratory just like any other scientist. He had the proper attire for science and laboratory as any other physician. Moreover, he had the necessary access to books and material of science. Question 19 I would not have liked Feynman as my teacher. This was due to his laziness hence poor teaching. Also, he did not have a full passion for the subject hence could not have offered good coaching. He was also not very fluent with students. Question 20 I was not surprised at the results of his experiment. The results were poor at first and this was due to his accumulated laziness and negligence. Moreover he did not pay a lot of respect to the lab procedures. For the ones that succeeded. Praise can be offered to his last minute few changes in behavior. Question 21 Feynman was not always as successful as I expected. This was due to the fact that he had various aspects such as laziness pulling him down. The fact that he paid more attention to his family also reduced his working ability. Also, the fact that he did not like the laboratory environment brought him down.

China and Foreign Direct Investment Essay Example | Topics and Well Written Essays - 2500 words

China and Foreign Direct Investment - Essay Example The greater part of FDI in China has originated from other areas of Asia excluding Japan, Hong Kong which is a self governing region of china has the largest record, however the dominance of Hong Kong is illusory in that much of the FDI is from elsewhere, in fact the stock listed as Hong Kong source FDI in China is just Chinese domestic investment round tripped through Hong Kong. Additional FDI in China listed as Hong Kong in origin is in actuality from a variety of western countries and Taiwan that is sited in China via intermediaries. Unfortunately, published records do not exist to point out exactly how much FDI in China that is supposedly from Hong Kong is in fact attributable to other countries. Foreign Direct Investment in its characteristic structure is described as a company from one country making a physical investment in another country for example building a factory (Allen et al 2005). The definition can also encompass investments made to purchase lasting interests in business ventures operating outside the economy of the shareholder. Over the past decade, the direction of foreign direct investment (FDI) in to and from Taiwan has experienced spectacular changes. Whereas the flow of FDI at best languished, the outflow ascended to extraordinary heights, with 20% of annual growth rate. Seeing that the international competitiveness of labour intensive industries in Taiwan reduced, they have shifted from offshore to cheaper labour cost places (Buckley & Mark 2002). Through this process the mainland especially china, has grown to become the preferred destination for Taiwanese FDI nevertheless considerable flows have also gone to the Americans and to Europe, a detail which h as often been disregarded. Meryll Lynch China (ML China) has been the most striking due to its outsized collection of cheap labour, its export advertising strategy which has shared favourably with Taiwan's returns in export-oriented FDI (Allen et al 2005); and the unique customs, language and family association links connecting ML China and Taiwan. Even though Taiwanese FDI in China was formally made acceptable in 1991; ever since 1978 China's policy of drawing flows of FDI had a substantial impact of ML china. In addition some sources report that even before 1991, Taiwanese capital has been moving indirectly to ML china via Hong Kong (Buckley & Mark 2002) An imperative issues concerning Taiwanese FDI in ML China, on the other hand is long term maintainability. Due to the size ( most are small scale) of several of these venture projects and their repeatedly low value added and fundamental technology, they are not in line with ML China's current main concern of increasing the quality of inflows of FDI. This great share of small scale low technology ventures in ML China powerfully contrast to the sizes of Taiwanese FDI projects in other destinations which on average own considerably higher personified technology and possible valued added (Chow 2002). The China Japan Link The current developments in the economic trends have seen Japan and China emerge as the East Asia newly industrialized economies (NIE's) of the region. Other economic powers in the region include Taiwan, Hong Kong, South Korea, and Singapore and are united in an alliance called the Association of Southeast Asian Nations (ASEAN)

A critical response paper Essay Example | Topics and Well Written Essays - 750 words

A critical response paper - Essay Example Mr. Swift felt deeply for the poor people of Ireland and did not like to see them in the professionally poor conditions that they had come to be in. He wished they would learn better ways to live their lives and this was the main focus of this proposal. Mr. Swift chose a satire to get his point across which according to the age must have been quite a shock to the people. The writer gave a proposal and then supported it by giving a long list of arguments. As we read through the first impression is of disgust, but on and on we realize a write up which hits on the kingdom which is very irresponsible of its poor populations’ fate. A look into Mr. Swift’s life and we see a shining light. Mr. Swift lived in Ireland, which â€Å"was a poor country and was deliberately kept poor by England. It was overpopulated and desperately poor, heavily taxed, with no say in its own affairs. English absentee landlords owned most of the Irish land and crippled its infrastructure deliberately so that there would be no threat from the country† (Cody). Seeing the predicament Mr. Swift was angry and frustrated. His anger at the ‘owners’ of Ireland is evident when he says, â€Å"the remaining hundred thousand may at a year old be offered in sale to the persons of quality and fortune through the kingdom, always advising the mother to let them suck plentifully in the last month, so as to render them plump and fat for a good table. A child will make two dishes at an entertainment for friends; and when the family dines alone, the fore or hind quarter will make a reasonable dish, and seasoned with a little pepper or salt will be very good boiled on the fourth day, especially in winter† (Swift). The writer seemed to make very irrational statements. The very essence of the ‘modesty’ of the article is the irrationality of the prolific use of the positive outcomes of a single event that will cause the poor to prosper. Mr. Swift succeeded

Al Ain Farms Essay Example | Topics and Well Written Essays - 1250 words

Al Ain Farms - Essay Example The company comprises of three Al Ain Dairy Farms, which delivers fresh dairy products, raw milk cow, camel products, and fresh chickens and eggs (â€Å"Al Ain Dairy Farm† 1). The company is in the food production Industry where it employs between 201-500 employees (â€Å"LinkedIn† 1). The company adopts and maintains a commitment to consistent innovation, quality, and freshness (â€Å"Al Ain Dairy Farm† 1). Indeed, Al Ain Farms and Livestock Production Company developed a comprehensive Program of corporate social responsibility and sustainable use of environmental resources. Specifically, the company measures and monitors waste, emissions, and water processing levels in consultation with Al Ain Municipality (â€Å"Al Ain Dairy Farm† 1). Moreover, the company abhors quality and complies with all national and international quality and safety standards such as HACCP and ISO. Indeed, Al Ain Farms and Livestock Production Company received its ISO 22000 certifi cate in 2009 (â€Å"Al Ain Dairy Farm† 1). It also gained the HACCP certification because of attaining the highest international standards of product hygiene and safety (â€Å"LinkedIn† 1). The company focuses on customer satisfaction, quality, safety, and innovation in all its operations. As a result, the company stands out as an award winning company where it continues to receive various consumer and industry awards for its quality and innovation. Specifically, the company received the WCRC "Asia's Most Promising Brand" Award in 2013, UAE Product of the Year award in 2012, BBC Good Food Middle East award in 2011, 2012, and 2013, and the Sheikh Khalifa Excellence Award in 2010 among others (â€Å"Al Ain Dairy Farm† 1). The Al Ain Farms and Livestock Production Company witnessed consistent expansion since its inception in 1981 (â€Å"LinkedIn† 1). Today, the company has three dairy farms with more than 1000 milking cows and 230 camels, which supply UAE wi th a wide range of locally produced safe, hygienic, and high quality dairy products (â€Å"LinkedIn† 1). Moreover, the company invested in technology and machinery, which makes Al Ain Farms and Livestock Production Company the most modern and efficient processing plant with a high volume capacity for production in UAE (â€Å"Al Ain Dairy Farm† 1). Indeed, the company stands out in all aspects as the most successful and prominent dairy company in the UAE. Subsidiaries and Products Al Ain Farms and Livestock Production Company provide a wide range of high quality milk products and juice products in UAE. Specifically, the company offers full fat and low fat dairy products, laban, breakfast drinks and smoothies, and drinking yoghurts (â€Å"Al Ain Dairy Farm† 1). The company is initiating a project to offer a complete range of camel milk products, which includes launched six new camel milk variants under the â€Å"Camelait† brand of fresh camel milk (â€Å"A l Ain Dairy Farm† 1). Al Ain Farms and Livestock Production Company provide long life, nectars, and fresh juices. The company produces a new variety of desserts, which include vanilla and creme caramel & ice cream that come from camel milk (â€Å"Al Ain Dairy Farm† 1). More so, Al Ain Farms and Livestock Production Company provide fresh chickens and eggs. Market Share Through innovation, quality production, corporate social responsibility, compliance, and commitment Al Ain Farms and

Comparing The Yellow Wallpaper Story English Literature Essay

Comparing The Yellow Wallpaper Story English Literature Essay The work by Charlotte Perkins Gilman The Yellow Wallpaper and the work by Tillie Olsen both represent the genre of a short story. These stories are very much alike. Apart from the similarities they share, they have a lot of differences. Both works belong to the genre of a short story. However, they were written with an interval of sixty nine years. Charlotte Perkins Gilman wrote her The Yellow Wallpaper in 1892. The work I Stand Here Ironing by Tillie Olsen was printed in 1961. Still, if to analyze the content of these stories it would be rather difficult to imagine this interval of almost seventy years. Both works deal with the same problem a females right for her personal happiness and self-realization regardless of her social duties of a wife and a mother. Both stories are told by women whose life went wrong because of their responsibilities towards their families. The narrator of the story by Charlotte Perkins Gilman The Yellow Wallpaper is an insane woman who has a husband and a child. Having suffered from a serious depression she takes a course of treatment. Though, it does not seem at all to have much effect on her. Doctors characterize her as a woman with slight hysterical tendency (Gilman). However her insanity aggravates. First she feels that there is something queer (Gilman) about her illness. She wants to relieve her mind (Gilman). She is tired of rings and things in her bedroom (Gilman). I Stand Here Ironing is a story about a womans sacrifice that she made after becoming a wife and a mother. She is not insane, but her feelings are of the same nature. The difference from The Yellow Wallpaper is that the narrator feels guilty. The narrator feels that she is responsible for her failings as a wife and a mother. She realizes that her best efforts were frustrated by such circumstances as lack of social services and inadequate pay. As opposed to the character from The Yellow Paper not only does she blame other people and life circumstances for her hard life and lack of her daughters confidence. It is hard to admit but the narrator is aware of her fault. But the main character of The Yellow Wallpaper does not seem to demonstrate any sign of such awareness. She considers that her family murdered a person inside her, but does not think about the fact that her husband needs her as a wife and her child needs her as a mother. She is an egoist. Both stories The Yellow Wallpaper and I Stand Here Ironing contain a lot of autobiographical elements. The story by Tillie Olsen includes such narrators recollection as being a young mother whose opportunities are rather limited, or being a wife who was abandoned. This story is autobiographical. Like the main character of the story I Stand Here Ironing Olsen also met some challenges in life. She struggled to balance her family life with her political ambitions and activism. The story by Charlotte Perkins Gilman tells about the authors own severe depression and mental disorder. She confessed that the presence of her husband and child even worsened her terrible state. Both the character of The Yellow Wallpaper and the character in I Stand Here Ironing are unfortunate miserable women. However, the narrator of I Stand Here Ironing is not the only unhappy woman in the story. This is the other distinction from the story by Charlotte Perkins Gilman. The narrator confesses in a phone conversation that her daughter Emilys childhood was rather rocky. Though she was a beautiful baby (Olsen), she was a very unhappy child, that cannot be helped (Olsen). However, these unhappy characters are united by one common problem: they do not see themselves as valuable creations. The narrator of I Stand Here Ironing is oppressed by environmental and her personal circumstances. She feels sad that she did not succeed as a wife; she laments her unwise and desperate choices that she made as a mother. Emilys fractured portrait comes from her mothers memories from the past. When her mother tell about her poor life, it becomes clear, that Emilys life was not better than her m others. She was a forgotten child. She suffered a lot; her development was slow, her nature was silky and gloomy; her self-esteem was very low; and her life was not a joy, but a survival in the brutal world. The narrator of The Yellow Wall Paper also feels sorry about her unrealized dreams and wishes. In contrast to the main character of The Yellow Wallpaper who has a serious mental disorder and blames her husband for unhappy life, the narrator in I Stand Here Ironing has the ability to analyze her life and her mistakes and determine the best way to solve her problems. However, she did not have this luxury long ago when she was a young and inexperienced mother. The woman is literary weighed down with constant demands of her family and domestic duties. Of course, being a mother she understands her responsibility for not very successive role in her daughter Emilys unhappy life, her development. However, this responsibility is not full. The narrator also blames environment, social conditions that can make the life of a single mother terrible. Thus, she cannot estimate in full how unhappy her daughter is. Both stories contain very bright symbols that reflect the inner state of both characters. These symbols are named in the titles of the stories. The main character of I Stand Here Ironing tells about her life while ironing clothes. Ironing is a backdrop for her thoughts, her considerations as a mother. The narrator in the story by Ch. Gilman is totally obsessed with the yellow wallpapers that cover the walls of her bedroom. The narrator believes that there is woman trapped inside. Her intention is to help the woman, though the narrator is afraid to reveal her intentions as she realizes that no one would ever understand her. By the end of the story a reader comprehends that the character is completely insane as she believes that she herself is a woman from the wallpaper. These symbols mean that both women have found something to distract from their grief. One of them hides in ironing and another one hides in wallpapers. Written in different periods of time both short stories have much in common. They are both told by women who are not satisfied with their family life. The work by Charlotte Perkins Gilman The Yellow Wallpaper and the work by Tillie Olsen I Stand Here Ironing are both masterpieces that raise serious questions of duty, self-esteem, personal self-realization and female happiness. Still, they also bear a lot of differences. Once one woman blames people who surround her, another one comprehends that her own fault is also great.

The Battle of Crecy :: Essays Papers

The Battle of Crecy The Battle of Crecy is one of several battles fought during the Hundred Years War between England and France. William I was the first to intertwine England and France. He did this by separating his French and English holdings between his two oldest sons, Robert and William II. This led to intermarriage of French and English, which eventually created land disputes, dramatic affairs and inadvertently led to the Hundred Years war and the Battle of Crecy. The Battle of Crecy took place on August 26, 1346. The battle was waged by two kings, the English king, Edward III, the French king Philp VI and their respective armies. The French forces are thought to have consisted of around thirty-six thousand men, including thousands of Geonese from Italy. On the other side the English are suspected of only having around twelve thousand soldiers. Although the English were outnumbered by thousands of French knights they proceeded to savagely defeat the French that day. On the day of the battle the English were in a defensive position awaiting the attack of the French forces at a place known as Crecy Ridge. The English armies were "trained, disciplined, well-armed and confident" meanwhile the Frenchmen and Geonese were "largely untrained, hastily collected and lacking cohesion" (Burne 186). The English were also thought to have had a crude form of a cannon, the first ever used in a battle. They also had excellent archers who easily defeated many of the French cross bowmen and knights from a distance with a longbow. The English win was enormous, and it is said that "Phillip VI fled the battlefield" (Allmand 15). Jean Froissart helped to to sensationalize and romanticize the battle in his "Chronicles of the Hundred Years War". With this work he helped to create legends about the "Black Prince", Edward III's son who first gained honor through the Battle of Crecy. The work idolizes the warriors who fought in the battles and exaggerates the cowardice of the French.

Dave Chappelle Satire

Dave Chappelle's comedy has made numerous aspects of American race relations and racial stereotypes subject to ridicule in a manner that has both united and divided. On one hand, his name became synonymous with comedy for the younger generations; on the other, his values caused him to question his own comedy, leading him to effectively terminate his career. In the Wake of ‘The Nigger Pixie': Dave Chappelle and the Politics of Crossover Comedy† by Bambi Haggins demonstrates that Chappelle's comedic style is the result of numerous elements of comedy in the African American community coming together and that it came about as a result of his experiences. It gives and expands upon the reasons that Chappelle left Chappelle's Show and presents them in an optimal setting.Chappelle's roots are established as guiding him through his comedic career, his desire to share his comedy with the masses without accommodating the tastes of the networks or what they would think would be †Å"palatable† to their audiences. Haggins' analysis of Chappelle's comedic style for the duration of Chappelle's Show explains how Chappelle was able to blend older styles of African American comedy into his unique comedic style by using his sketches to support her claims.Haggins knows how to blend this mixture artfully into an essay piquing the interest of others on the topic of Chappelle's career and comedic style. Haggins begins the chapter with a quick explanation of why Chappelle eventually left the show. Chappelle explains that the â€Å"loud and long laughter† (233), emanating from one of the white crew members was â€Å"the beginning of the end† (233) for him. This depicts the time in his life when he started to think that rather then diluting them, his skits sometimes reinforce these stereotypes.Something he never intended to do. The biggest thing that separated Chappelle’s show from the rest is his seamless ability to achieve the de facto crossove r consistently in his show. His gift at portraying stereotypes and social conflicts while appealing to a wider audience is what led him to the top of sketch comedy. But this soon becomes problematic for him as he struggled with himself to decide what was crossing the line. As his success gave him the ability the push the line even farther, it also reminded him how important it was to not cross the line.Another big factor that provided Chappelle with the chance he needed to really show everyone what he could do is by taking a risk with Comedy central. The Chappelle’s Show co-creator Neal Brennan explains, â€Å"We went to a place, Comedy Central, that sort of needs us and gave us a lot of freedom†¦. We didn’t get much money, but that was the trade-off-you get control† (236). This gave Chappelle the ability to reach a wide audience while still having the control of the material that goes into each show, thus promoting his real comedic self and rocketing him t o success and fame.While staying at the top Chappelle constantly was balancing on a delicate line, â€Å"Chappelle’s show walked the razor edge of provocative comedic sociopolitical discourse† (237). Haggin’s in depth analysis of both his argument and Chappelle’s descent into racial stereotyping is prevalent through his specific examples of the comedian’s sketches and then providing commentary about the concept as a whole. In his article, the author uses Chappelle’s â€Å"Racial Draft†, â€Å"Black Bush†, and â€Å"Nigger Pixie† as clear cases where racial satire went too far. The author begins with Chappelle’s background and his emergence into the television world.This is an effective rhetoric strategy because it allows the audience to see Dave Chappelle before the Chappelle’s Show. However, if one reads closely, they can clearly tell that Chappelle had never changed throughout his years of comedy and kept the â€Å"openness and fluidity†(236) in his comic persona. Haggins also points out the element that the comedian always had an ability to attract viewers from all areas and speak â€Å"for and to Gen X and Gen Y subcultures in both black and white communities† (234). This was especially evident in Chappelle’s Show and added greatly to its popularity.Finally, the method in which the author used examples by including specific skits in the â€Å"Lost Episode† where Dave Chappelle went beyond boundaries to point out the racial stereotypes that are present in everyday life is very effective. Through his fluid diction and terrific explanation of each skit, Haggins is able to â€Å"paint a picture† in words for the reader. When reading the article and each sketch that Chappelle acted out, the audience can clearly see that the comedian’s racial satire was humorous, yet lie awfully close to the reinforcement of racial stereotyping.This is the reaso n the â€Å"Nigger Pixie† sketch example is so significant. By playing a black-faced minstrel, Chappelle only emphasized the idea of harsh racism and the stereotypical black want for fried chicken. The author analyzes how numerous comedic styles from the African American community coalesced on Chappelle's Show by using specific sketches as supporting evidence. One example, Haggins' analysis of the â€Å"Reparations† sketch (Haggins 240-241), demonstrates that numerous styles blended quite clearly.Her use of the sketch, which describes the ludicrous amount of economic prosperity that would occur if reparations for slavery were given to the descendents of formerly enslaved African Americans (Haggins 240), outlines how â€Å"the ‘white' media† (Haggins 240) would report such an occurrence, and that while the sketch â€Å"[offers] a cringe-worthy embodiment of stereotypes, [it] (somewhat) congenially calls the audience out while also acting as a reminder of t he issue of reparations for the legacy of slavery that still informs aspects of the African American experience† (Haggins 241).Her demonstration of the older styles of African American comedy coming together one one television program was effective. After all of this occurred and Comedy Central aired the shows despite the wished of Chappelle, he found it impossible to continue his relationship with Comedy Central and he left the show.The argument made throughout the chapter is further solidified in the end when Haggins states, â€Å"As long as the assumptions implied by the race-baiting little demons (the Nigger Pixie and his brethren) resonate in the hidden recesses of popular consciousness-not as critique but as confirmation-the road for social satire, regardless of media outlet-will be arduous† (248). To revisit what was discussed earlier, as long as racism exists, â€Å"doing racial satire will be problematic† (248).

Exploring Literature Review and it Significance to Present Health and Social Care The WritePass Journal

Exploring Literature Review and it Significance to Present Health and Social Care Chapter One Exploring Literature Review and it Significance to Present Health and Social Care Chapter OneIntroductionPURPOSE OF CHAPTERBACKGROUNDAIMS AND OBJECTIVESRESEARCH QUESTIONRATIONALE FOR CHOSEN TOPICCHAPTER TWOMETHODS2.1 PURPOSE OF CHAPTER 2.2 METHODLiterature SearchCHAPTER THREEANALYSIS3.1 PURPOSE OF CHAPTER FINDINGSChapter 4Discussion4.1 Purpose   of chapter4.2 DISCUSSION   4.3. LIMITATIONS 4.4 IMPLICATIONS FOR PRACTICE, EDUCATION, MANAGMENT AND FUTURE RSEARCHConclusionRelated Chapter One Introduction The aim of this assignment is to undertake a secondary research in exploring literature review and it significance to present health and social care. Clinical question will be formulated with rationale given for choice of topic by undertaking an extensive review of the literature. Following the systematic search, the student will critically evaluate literatures and other evidenced based information in order to discuss and answer the question. The design methods and data analysis will be discussed. It will also consider evidence based practice and the applications of research studies on nursing practice. Producing a dissertation that draws conclusion and makes recommendations for nursing practice will be deliberated. PURPOSE OF CHAPTER This chapter will introduce the background of the review, its rationale, research question, aims and objectives. BACKGROUND The World Health Organisation (WHO, 20010) defines obesity as a complex condition, one with serious social and psychological manifestations that affects virtually any age and socioeconomic groups and threatens to overtake developed and developing countries. Obesity is the commonest form of malnutrition and is reacting epidemic proportions in developed and undeveloped countries around the world (Wadden et al. 2002). Arterburn et al. (2008) also defines obesity as a chronic condition characterised by an excess of body fat. It is often diagnosed in adults by using the Body Mass Index (BMI), which is calculated by measuring weight in kilograms and dividing this figure by height in metres squared (kg/ m ²) ( Shepherd, 2009). Individuals with BMI ranging from 25Kg/m ² indicate overweight whiles 30+ kgm ² indicates obesity in adults. Overweight occurs when energy intake exceeds energy needs. Weight gain occurs when individuals for whatever reasons overeat or under exercise (Ahearne â €“ Smith, 2008). Obesity is a complex, costly and debilitating condition. The health implications of obesity are vast and the cost of treating this condition is a burden on the NHS, in terms of finance and resources. (Department of Health (DH) 2009a). Estimates put the cost of treating obesity and its associated complications at over one billion pounds per year in the UK, this   figure is predicted to rise to  £45 billion by the year 2050 (Wintour, 2007). Research has estimated that in England, 6.8% of all deaths attributes to obesity (NHS, 2010).   A recent study looking at data for 27 year period concluded that about one quarter of deaths in England was directly or indirectly related to obesity (Duncan et al. 2010). Predicted trends in obesity amongst men and women in England extrapolated to 2010 indicates that 26% of men and 28% of women will be clinically obese, imposing huge burden on the healthcare (National Audit Office, 2001). Evidence indicates that there is a complex interrelationship between genetics, environment, childhood, family and non genetic factors (Kipping et al. 2008). There is also growing body of evidence that describes obesity as a polygenic disorder, with many genes being linked to or associated with a predisposition to adiposity (Batch and Baur, 2005). One of the latest genes to be associated with an increased risk of obesity is the fat, mass and obesity gene (Loos and Bouchard, 2008), which is thought to confer a predisposition to the disease through the control of food intake (Cecile et al 2008). Cairns and Stead (2009) discusses the increase in weight as a reflection of the trend in the western world generally and has been attributed to an abundance of food combined with disposition towards less physical activity of our daily lives. It further explains the diminished physical activity stems not only from changing employment patterns, but also from the many aids available to the average house holder, the ubiquitous motor car, and trends in the design of buildings and cities. Obesity is a chronic metabolic disease, considered to be one of the main risk factors for cardiovascular disease and correlating with increased morbidity and mortality (NHS, 2010). Research shows that there is a link between excess body fat and the risk of developing a number of serious disease including diabetes, hypertension, cerebrovascular disease, arthritis and some cancers (Swain and Sacher, 2009). It has been confirmed that overweight individuals decreases their risk of premature death by doing physical activity even if their weight doesn’t change. People who are overweight can be limited in their ability to carry out physical activity because of reduced oxygen uptake capacity and painful muscles and joints. This limitations in locomotive power influences movement behaviour and lead to problems in activities of daily living. Weight loss reduces blood pressure and improves metabolic profile. It also reduces the symptoms and improves several obesity related chronic conditions such as diabetes, obstructive sleep apnoea and osteoarthritis (SIGN, 2010). Weight loss is also associated with improvement of vascular morphology and function. Research by Pierce et al. (2008) demonstrated that short term, energy intake restricted weight loss alone is an effective intervention for improving endothelial function in obese subjects. The impact of being overweight and obese has been studied from the perspective of health related quality of life (HRQL). Although, there is no standard definition of HRQL, It is generally accepted that it is subjective, multi dimensional assessment of the physical health, emotional wellbeing and psychosocial functioning (Hassan et al. 2003). There is also a growing body of cross – sectional data that support strong relationship between obesity and quality of life, in that quality of life tends to decrease as function of weight increase. Literature also supports that even small weight reduction leads to significant improvement in HRQL (Fontaine and Brofsky et al. 2001). Results of meta-analysis on the effects of randomised controlled trials of weight loss on HRQL using variety of intervention methods (behavioural, surgical, pharmacologic) suggest that the most consistent effects are found only when using obesity specific measures of HRQL (Masiejewski et al. 2005). In addition, the majority of the studies in HRQL changes in obese and overweight individuals have focused on major medical techniques such as gastric bypass surgery and pharmacotherapy. Although these may be important strategies and options for obese individuals, the majority of populations are more likely to attempt behavioural programme focused on changing their dietary and exercise behaviours (Fontaine and Bartlett, 2001). There have been relatively few studies that have examined the effects of lifestyle modification programs on changes in quality life among overweight and obese individuals. Physical activity in combination with can be effective in improving health related quality of life in social functioning, mood and self esteem. Many literatures exist on the effects of diet and exercise with no clear agreement on their long or short term efficacy. However, it is unclear if weight loss improves risk factors in all obese persons or only in high risk groups. Finally, it is important to determine if weight loss studies are applicable to everyday clinical management for these patients. AIMS AND OBJECTIVES The aim of the literature is to ascertain the long and short term effects of weight loss management programme (dietary, exercise and behavioural modification) on health related quality of life for patients with obesity problems. To assess the clinical effectiveness and cost effectiveness of weight loss management. To explore the long term effects of obesity treatment on body weight, risk factors for disease and quality of health and its benefits to the individual. RESEARCH QUESTION The salient research question for the review is: ‘’Does structured weight reducing programme improve the quality of health for patients with obesity?. The weight reduction programme will focus on the non-pharmacological aspects of weight reduction programme which are diet, exercise and behavioural changes. RATIONALE FOR CHOSEN TOPIC The rationale for the choice of topic has been influenced by dominance in the media recently with regards to cost to the society in treating patients with obesity and co – morbidities associated with the condition. The role of the nurse involves educating and promoting the health of individual clients or patients in terms of weight management. The writer has also developed an interest in gaining knowledge and understanding of the conditions and interventions for promoting weight loss as some form of management in enhancing patient’s quality of life. Undertaking this research would add to the students knowledge and, hopefully to provide some answers to the research question. CHAPTER TWO METHODS 2.1 PURPOSE OF CHAPTER This chapter will document the methods used to identify literature relating to the aims of the review. Also, how the literature search was conducted as well as the inclusion and exclusion criteria used in identifying relevant articles will be presented.   Outcomes of the literature search and a presentation of the data will be included (Appendix 1). 2.2 METHOD Partaking in evidence-based practice require the ability of nurses to evaluate and gather best available evidence, and integrate them into clinical practice and individual expertise (Burns and Grove, 2011). The fundamental purpose of literature review is to identify a broad spectrum of relevant information on a specific topic and develop a robust appraisal of its methodology and research designs to highlight any inconsistencies of the literature (Hewitt-Taylor, 2002).   Many authors including Aveyard (2007) defines it as a systematic search and interpretation of a particular research area which adds to the implementation of evidence based protocols. Similarly, Hek et al (2002) explains it as a process of literature search and guiding of a topic to reveal ‘gaps’ in the current knowledge. Aveyard’s definition will be utilised for the purposes of this review as through systematic searches, relevant articles will be scrutinized for current knowledge and development of how healthcare professionals can effectively use evidence based in promoting the health of patients (Aveyard, 2007). Some research studies may however have misleading findings due to their destitute research design, thus a critical appraisal tool would be used to critically appraise and disregard such evidence and provide findings from robust studies (Katrak, 2002).   The appraisal tool chosen for the review was the Critical Appraisal Skills Programme Tool (CASP, Public Health Resource Unit, 2006). The CASP tool comprises a list of questions which enables the findings, study design and sample of research studies to be critically assessed and evaluated (Katrak et al, 2004).   The CASP tool was chosen due to its simple guidance in critically appraising research studies while assessing its applicability and validity. Also both quantitative and qualitative research may be influenced by confounding variables, thus the CASP Tool helps to highlight variables that may reduce the validity of the results (Burns and Grove, 2011; Hurley et al, 2011). Literature Search Healthcare literature forms the basis of a great deal of work that nurses do, therefore searching and reviewing literature is a key skill as it helps to locate   new initiative in its context and to examine new ideas (Steward, 2004). Literature search was used to device an evidence based question. Literature search is a structured approach to search information, producing the best available evidence for informing and guiding practice (Parahoo, 2006). Computers and electronic databases were used to undertake the literature search. This offered access to vast quantities of information, which could be retrieved more easily and quickly as compared to the manual search (Younger, 2004). Data were gathered from literature search using the following databases, MEDLINE, COCHRANE, CINHAL, EMBASE, SYNERGY, OVID etc. Using specific electronic databases with the help of the librarian enabled the student to identify which databases were relevant to the topic or subject area. The selected database contained indexes of journal in the medical sciences, in addition to nursing, midwifery and related disciplines in retrieving a wider range of quality and relevant research to demonstrate wider reading and awareness of available databases. Some of the databases such as MEDLINE and COCHRANE library had some restrictions in accessing full text articles. An initial search of the literature was used in narrowing down the process of topic selection. The following words were used for the search: obesity, overweight, training, exercise, physical activity, behaviour, adult, weight loss. This type of search highlighted many areas that could be exploited and conducted. Timmins and McCabe (2005) explains that using the initial search to identify a topic may gain an advantage over others because it gives certainty that there are recent and accessible published researched on a topic. Once the area of interest had been decided, a more focused and detailed search was used in incorporating many different sources. Burnard and Newell (2006) suggest that comprehensiveness and relevance are what reviewers needs to consider and adds that more specific the topic or question been search is, the more focused the results will be. Alternate key words with similar meanings such as bariatric patients, weight management were gleaned from databases and thesaur us to help elicit further information. Hek et al. (2002) states that the key principles for guiding literature search are being systematic, explicit, thorough and rigorous. Boolean and truncating operators was also incorporated in searching for the literature by expanding, excluding or joining key words using ‘AND’ or ‘NOT’. These operators instruct the search engine to combine specific and necessary element within the last ten years (2001 – 2011) were utilised to enable the student to narrow and obtain the most recent articles relevant to the formulated question. The search was also extended to other countries because of limited articles in the UK and its applicability to the subject area. The inclusion criteria for the literature review are as follows: the study had to be researched articles, the subjects had to be adults, diet, exercise and behaviour modification had to be part of the treatment, the subjects would be overweight or obese. The inclusion and exclusion criteria also involved the first read of the articles that have been collected to get a sense of what they are about. Most of the published articles contai ned a summary or abstract at the beginning of the paper, which assisted with the process and enabling the decision as to whether it is worthy of further reading. Cohen (1990) framework for undertaking systematic review was adapted to aid with the process of narrowing and choosing the articles relevant for the research question proposed.   This method involves the preview, question, read, summarise (PQRS) system kept the student focused and consistent but ultimately facilitated me with easy identification and retrieval of materials, leaving me with articles that were deemed relevant to the purpose of the review. A total of 12 relevant articles were obtained after the literature search and with the application of the inclusion and exclusion criteria, only two articles were from the United Kingdom. The rest were from Australia, Holland, Netherlands, Canada and America. They all addressed the aims as well as the research question. All the articles were selected on the basis of its abstract, title, year and its relevance to research question. A summary of search history   and findings of reviewed articles are presented in Appendix 1. Timmins and McCabe (2005) summary of grid table would be used to put the data extracted into chronological order and also into different classification can be seen in appendix 2. In order to be able to compare treatment outcomes from the different groups in the studies, the effect size will be used to analyse the studies intervention effect with reference to weight loss. In evaluating the literature, the systematic approach literature will be divided into classifi cation and themes and presented chronologically. CHAPTER THREE ANALYSIS 3.1 PURPOSE OF CHAPTER This chapter explores the key findings of the selected research articles and provides a critical analysis of the research methodologies and findings. They will be presented as themes and will be compared and contrasted to reveal any ‘gaps’ or inconsistencies in the literature. FINDINGS The aim of Jehn et al study was to examine the long-term effects on weight maintenance and dietary habits of participants in a clinical trial weight loss. Forty – four hypertensive overweight men and women were randomised in a comprehensive ‘lifestyle intervention’ group or monitoring group for 9 weeks. Participants in the ‘lifestyle intervention were fed hypo caloric version of the Dietary Attempts to stop Hypertension Diet (DASH) and also participated in a supervised moderate intensity exercise programme three times a week. The dash diet is rich in fruits, vegetables and low fats dairy products, and reduced in saturated fat, total fat and cholesterol. It has also been shown to substantially lower blood pressure in normotensive and hypertensive individuals (Appel et al 1997). Participants were provided all their meals. The monitoring group received no active intervention during the study but did receive up to three sessions of nutrition and lifestyle counse lling following completion of data collection. One year following the completion of the DEW-IT trial, 44 participants were contacted for a single follow up visit. Participants were weighed on a certified balanced bean scale, and completed two brief dietary questionnaires in assessing reason for participating in the trial, changes in diet and exercise following participation and perceived barriers to maintaining weight loss. Wilcon test and t- test were used to compare groups for differences in continuous variables and chi square test were used to compare categorical variables. 42 of the original 44 participant returned for the 1 year follow up visit (n=23 for monitoring group and n=19 for the lifestyle group). The results showed weight loss at the completion of the study averaged 5.3kg in the lifestyle group and 0kg for the monitoring group. The intervention group in comparison to the monitoring group achieved significant improvements in their blood pressure and lipid profiles. Inte restingly, 95% of the lifestyle intervention group and 52% of the monitoring group gained weight at the end of the study although, they both reported similar intakes of fruits and vegetables. Leslee et al (2009) however conducted randomised clinical trial, using diet and exercise programme to reduce incontinence and to determine whether behavioural weight reduction intervention for overweight and obese women with incontinence would result in greater reductions in the frequency of incontinence episodes at 6 months as compared with control groups. 338 women were recruited between July 2004 and April 2006 in Alabama and Rhode Island. Women were eligible for the study if they were at least 30years of age, had body mass index of 25 – 50kgm ² and at baseline reported 10 or more urinary incontinent episodes in a 7 day diary of voiding. The participants were required to monitor their food intake and physical activity for a week, to be able to walk unassisted for two blocks without stopping, and to agree not to initiate new treatment for incontinence and weight reduction for the duration of the study. Eligible participants were randomly assigned at a 2:1 ratio to an inten sive 6 month behavioural weight loss programme or to a structured four session education programme (control group). Random assignments were concealed in tamper proof envelopes, the participants were aware of their treatment but the staff members who collected data were not. This helps to reduce the possibility of selection and study bias, thereby increasing the reliability and validity of the results (Polit and Beck, 2008). However, the cost and time pressures of undertaking RCTs compared with other research methodology may limit their feasibility or restrict recruitment. The participants completed questionnaires concerning their demographic characteristics, medical and behavioural history and history of incontinence. The subjects were weighed and height recorded. They were also trained to complete a 7day dairy of voiding. All participants were given a self-help behavioural treatment book with instructions for improving bladder control such as information about incontinence and pelv ic floor exercises. Women assigned to the control group were scheduled to participate in four education sessions at months 1, 2, 3, 4. The participants in the weight loss group were provided with meal plans, encouraged to gradually increase physical activity. The results showed that the women in the intervention group had a mean weight loss of 8.0% (7.8kg) as compared with 1.6%(1.5kg) in the control group. After 6 months, the mean weakly number of incontinence episodes decreased by 47% in the intervention group, as compared with 28% in the control group. As compared with the control group, the intervention group had a greater decrease in the frequency of stress incontinence episodes (p=0.01), but not of urge incontinence episodes (p=0.14). Obesity is associated with increased arterial stiffness, an early marker of vascular wall damage. However, data on the long-term vascular impact of intentional weight loss are limited. Goldberg et al (2008) aimed to evaluate the effect of weight loss induced by nutrition and exercise intervention on arterial compliance, metabolic and inflammatory parameters in obese patients who participated in a weight reduction programme. An open, prospective study, 37 obese subjects attended a 24weeks nutritional and exercise interventional programme. During the course, participants received diet instruction and participated in physical training once a week. Arterial elasticity was evaluated using pulse wave – contour analysis at baseline and end of study. Fasting glucose, HbA1C, insulin, lipid profile, hs-CRP, fibrinogen were measured. BMI Decreased from 36.1 ±7.4kgm ² at baseline to 32.8 ±7.4kgm ² after 6months. Large artery elasticity index increased from 12.1 ±4.1 to 15.8 ± 4.7ml/mmhgÃâ€"10 during the study. Small artery elasticity index also showed an increase. There was significant improvement in fasting hyperglycaemia, HbA1C and significant decrease in LDL cholesterol, fibrinogen and C-reactive protein. Goldberg et al concluded that moderate weight loss induced by nutritional and exercise intervention improved small and large artery elasticity. The increase in arterial elasticity was associated with improvement in glucose and lipids homeostasis as well as markers of inflammation. Obesity may affect lung function and so cause worsening of asthma. The mechanism by which weight loss can alleviate asthma may include alleviation of the airway collapse, stimulation of adrenal activity, and reduction in possible allergens, bronchoconstrictors or salt content in the diet (REF). Aarniala et al (2000) investigated the influence of weight reduction on obese patients with asthma. The design is an open study, two randomised parallel group in a private outpatient centre in Helsinki, Finland. Two groups of 19 obese patients with asthma (BMI=30-42kg ²) recruited through newspaper advertisements. Base line measurements were taken and randomised to treatment group (19) or control group (19) by shuffling cards with the help of someone not involved in the study. The treatment group took part in a weight reduction programme included 12 group sessions, which lasted for 14wks, including 8weeks dieting period. The control group had sessions at the same intervals as the treatment g roup. All participants used normal medical care throughout the year. A peak flow metre and spirometer was used to measure their daily morning and evening pre bronchodilator and post bronchodilator peak expiratory flow, FVC, FEV as baseline,   during the dieting period, at the end of dieting period, at 6months and 1yr. Data were analysed by means of start view 512+TM (brainpower) for apple Macintosh and SPSS. Mean weight reduction in the treatment group was 14.2kg of their pre-treatment, the control 0.3%. The corresponding figures after one year were 11.3% and weight gain of 2.2% for the treatment group. For the treatment group, health status improved with respect to all three subscales when compared with controls. By the end of weight reduction programme, reduction in dyspnoea in the treatment group was 13mm and 1mmin the control group. There were minimal exacerbations reported in the treatment group than in the control group. Aarniala et al concluded that weight reduction in obes e patients with asthma improves lung function, symptoms, morbidity, and health status. Similarly, Shawn et al (2004) prospectively studied 58 obese women with a body mass index of 30kgm ², 24 of whom had asthma, were enrolled in an intensive 6month weight loss programme to, whether loss of body mas would be correlated with improvements in bronchial reactivity, lung function, and disease specific health status. Patients were placed on a regime of three liquid meal replacement supplements per day, which delivered 300 kilocalories per meal. Those with severe obesity were enrolled into a long programme consisting of a diet of 900kcal per day that continued for twelve weeks. Patients were assessed in series of three paired study visits. Symptoms and disease specific quality of life were assessed using the St. George respiratory questionnaire (SGRQ) at baseline and every three months for duration of the study. The results showed that patients lost an average of 20kg over the 6 month period. For every 10% relative loss of weight the FVC improved by 92ml, and FEV1 improved b y 73ml. However, bronchial reactivity did not significantly change with weight loss (p=0.23). Patients who lost 13% of their pre-treatment weight experienced improvements in FEV, FVC and total lung capacity as compared to   patients in the lower quartile   who failed to loose significant amount of weight. Patient who completed the programme experienced improvements in respiratory health status. Syed et al (2008) sought to identify the effect of weight reduction program on right and left ventricular structure and function. 62 patients presenting to the eating disorder clinic at a single academic institution for weight loss programs were prospectively enrolled. Subjects BMI were greater than 30mg/m ² and attempting to lose weight by diet and exercise. Baseline and follow up transthoracic echocardiograms were obtained after at least 10% weight reduction or 6 months after baseline echocardiogram. Patient lost an average of 28 ±3kg over a period of 266 ±36days. Left ventricular mass index decreased significantly from 255.87 ±12 to 228 ±11gm. There were no statistically significant changes in contractility or diastolic indices. The ratios of early to late diastolic mitral inflow and annular velocities also increased. The results of the study concluded that weight reduction is associated with decreased in the ventricular diastolic size and left ventricular mass. However, the weight reduction did not associate statistically significant improvement in systolic or diastolic function. Contrastingly, Kaukua et al (2003) studied health related quality of life in a clinically selected sample of obese patients. The study was carried at two obesity clinics at Helsinki University Central hospital. General occupational practitioners or hospital specialist referred all patients for weight loss treatment. Referral criteria included a body mass index ≠¥35kgm ², failure of previous weight loss attempts, presence of obesity related comorbidity requiring weight loss and motivation to take part in a structured weight loss programme.   An endocrinologist examined the patients and evaluated suitability for treatment. Patients were excluded if they had obesity due to secondary aetiology, had significant psychiatric disorders, severe eating disorders, and were eligible for bariatric surgery. The treatment comprised 10weeks on very low energy diets (VLED) and 17 weekly group visits with behavioural modification. The eight groups in this study were carried out during 1999 â €“ 20000. The behaviour modification programme was on LEARN programme for weight control. The core elements of behaviour modification were goal setting, nutrition etc. Anthropometry assessments were used to measure the patient’s height, weight with calibrated electronic scale and calculated the BMI whiles the obesity specific questionnaires measured the obesity related psychosocial problems in everyday life. SPSS 10.0 was used to analyse all data. The Helsinki University central hospital and Peijas hospital ethical committies approved the study protocol and the informed consent form, which subjects sign after having received written and oral information. The results of the 126 patients who received treatment showed that the mean BMI did not differ from sexes. But the mean waist circumference was significantly larger in men. There was also decrease in obesity related psychosocial problems at the end of therapy and this improvement was maintained up to 2yrs despite weight r egain. There was also large increase in physical functioning, improvement in body pain and general health, but not all the scale showed statistical significance relative to base line. The study selection process outlined identified 8 studies. There was fair or good agreement for study inclusion suitability and data extraction. To summarise, all the eight research articles received ethical approval from the ethics committee to protect the rights, dignity and safety of the study participants. Consent was also gained from the subjects before participating in the research. They also had clear aims, methods, findings and conclusions. Chapter 4 Discussion 4.1 Purpose   of chapter This chapter will give a detailed discussion of the prime findings highlighted whilst comparing and contrasting evidence. An interpretation of the themes will be made as well as evidence-based recommendations for future management, practice and education. The focal research question was: ‘’Does structured weight reducing programme improve the quality of health for patients with obesity 4.2 DISCUSSION   This review has provided an alternative lens in understanding the importance of weight management and weight loss in improving the health of these patients as well as reducing it cost to the health service in managing this condition. Weight reduction requires energy expenditure to exceed dietary energy intake. Despite a considerably   amount of   research dedicated to understanding  Ã‚   the role of diet in mediating weight control, there still remains disagreement regarding basic issues including the appropriate energy content, and perhaps   more controversial, the ideal macronutrient distribution. Manipulation of the energy content will impact the rate of weight loss. Very low calorie diets will result in larger, more rapid reductions in weight loss, whereas a small to moderate reduction in energy intake will result in a small, steady rate of weight loss. The pertinent question becomes: does the rate of weight loss affect long term weight maintenance or other health related outcomes? In most of the studies the subjects had lost significant amount of weight by the end of the intervention period. Some of the studies also indicated weight gain. There was significant weight loss in all groups. In Jehn et al (2006) study of weight loss intervention demonstrated the effectiveness of short term intensive programme of diet and exercise in blood pressure control. However, significant amount of weight gain occurred also in treatment group and consequently, weight at the 1 year follow visit did not differ between the treatment and control groups. Similar finding was also found in Kaukua et al single stranded 2 year follow up study of diet, exercise and behaviour modification for weight loss management. The patients in their study produced marked weight loss (12.5%) and wide range of improvements in health related quality of life in the short term. However, with longer follow after treatment, weight loss maintenance on average was only modest with mean regain of two thirds w eight lost in 2yrs.Interestingly to weight loss, the improvements in health related quality of life started to diminish after 2 year. On average, only obesity related psychosocial problems and physical function showed improvements. Not only weight loss, but other factors such as therapeutic effects of taking part in a weight loss programme or increase in exercise   and physical activity promoted by behavioural modification, might have been the cause of improved the quality of live as in the studies reviewed(reference). Among overweight and obese women with urinary incontinence, the comprehensive weight loss programme in Leslee et al (2009) resulted in a significantly greater reduction in the frequency of self-reported urinary incontinence episodes as compared with the structured education programme. Higher proportion of women in the weight loss group than in the control group reported clinically meaningful reduction of at least 70% in the total weekly number of episodes of any incontinence, stress continence and urge incontinence. In addition the women in the weight loss group perceived greater improvements in their incontinence and were more satisfied with their improvements. These results suggest that overweight or obese women with stress, urge or mixed incontinence may benefit from weight loss. It has been hypothesized that obesity may contribute to urinary incontinence because of the increase in intraabdominal pressure due to central adiposity, which in turn increases bladder pressure and ureth ral mobility, exacerbating stress incontinence and possibly urge incontinence (Stewart, 2010). Weight reduction may reduce forces on the bladder and pelvic floor, thus reducing incontinence as a result from changes in dietary intake and physical activity (Subak et al. 20005). Obesity is not only disproportionate gain of weight, rather it is a complex metabolic process associated with hypervolumic state, elevated pressures and dyslipidaemia. It is also associated with elevated cardiac output mainly produced by high stroke volume. Elevated stroke volume along with an expanded total blood volume presents an elevated preload to the left ventricle (reference). In Syed et al (2008) study, significant weight loss of 28.29 ±3kg was associated with decreased left ventricular mass, wall thickness, and diastolic dimensions. The beneficial changes were accompanied by preserved left ventricular systolic function. Contrary to the expectation, the observed decline in left ventricular wall thickness, and left ventricular mass did not translate into improved diastolic function or significant reduction in left atrial size. Instead, they observed increased early transmitral inflow velocities and decreased diastolic myocardial relaxation velocities. Left atrial dimensions decreased, but this does not reach statistical significance which represents that there is no decline in the size of left atrium.   In Syed at al study, none of the findings are associated with improved diastolic function. This may represent that ventricular stiffening that leads to diastolic dysfunction associated with obesity may be less reversible than the other parameters. An explanation given to the lack of improvement in diastolic function is perhaps due to the short duration of the study or inadequate number of patients in the study. A larger study of longer duration will be needed  Ã‚   to verify the myocardial mechanical abnormalities suggested by their study. In contrast to Syed et al study, Goldberg et al (2008) study moderate weight loss induced by nutritional and exercise intervention was associated with improved small and large artery elasticity. The increase in elasticity was associated with improved glucose homeostasis and lipid profiles together with a reduction in the markers of inflammation. In response to a mean weight loss of 8% observed during 6month follow up, both small and large arterial elasticity increased significantly. Moreover, subjects who lost 10% of baseline body weight had significantly greater large arterial elasticity values and lower insulin resistance  Ã‚   compared to patients who did not lose or lost 5% of baseline body weight. In obesity, arterial stiffening is consistently observed in across all age groups and may contribute in part to excess cardiovascular morbidity and mortality. These harmful vascular effects may be mediated by comorbidities linked to obesity such as hypertension, dyslipidaemia, insuli n resistance and diabetes. Recently, it has been demonstrated that excess body fat, abdominal visceral fat, and larger waist circumference have been associated with accelerated stiffening independent of blood pressure levels, ethnicity and age (Sutton-Tyrrell et al 2001). These results emphasize the adverse effects of obesity on the arterial wall and suggest that this effect is reversible with weight reduction. Aarniala et al (2000) trial showed that in obese people with asthma, losing weight can improve asthma in terms of lung function, symptoms and health status. Several possible explanations exist for this improvement in asthma during and after weight reduction. In asthma airway obstruction causes early airway closure during expiration. This feature is accentuated by overweight. Weight reduction reduces closing capacity and exercise load which may alleviate asthma symptoms during exercise (reference). Although, general symptoms and lung function improved in the treatment group, use of rescued medication remained unchanged. This may reflect the fact that, whereas overall clinical picture of the asthma was improved by weight reduction, airway hyperactivity persisted. Some strengths of the review were the use of randomised trials which can increase the reliability of the results, allowing the researchers to compare changes in weight between the intervention group and the control group that did not receive an intervention.   Additionally, the researchers used actual weight rather than self-reported weight which has been shown to be unreliable for reporting long-term weight maintenance. Furthermore, participation for the follow up was good. This minimises the potential bias that those who volunteered to participate were more likely to have been successful at weight maintenance (Jehn,2006). The studies also indicate that without on-going contact, structural support and reinforcement of health goals, individuals are unable to maintain weight loss one year after intervention. Further research is needed to determine whether adding more intensive nutrition, education components and or cognitive behavioural therapy to dietary feeding trials can produce successful long-term weight maintenance. In this review we included those three components that have been shown to be most important factors in weight loss; exercise, diet and behaviour modification. In view of the foregoing, the aims and research question of the review has been successfully answered and a wider understanding of the importance of weight management in helping to prevent morbidity and mortality of obesity. In addition to the findings, it also appears from the above that diet, exercise and behavioural modification has significant effects in managing weight loss and reducing obesity. Clinicians have to be skilled in eliciting and promoting the health of these individuals to prevent morbidity and mortality (ref) 4.3. LIMITATIONS The main limitations of the studies are the small sample size, impeding the ability to examine predictors of weight change in multi variant analyses. A major limitation of this review was the use of researched articles from   America, European countries as well as other Non European countries such as Australia where the delivery of care differs from that of the United Kingdom and what may appear as important to American patients may not be important to that of the United Kingdom. Furthermore, the use of only published articles, poses the risk of publication bias as most journal articles do not deliberate on the ‘negative or no effect’ thus hidden evidence that is vital in synthesising the findings application of research question may be missed (Aveyard, 2007). Limiting the exclusion and inclusion criteria from studies published from 2000 to 2011 meant that any valid research before that had to be excluded, thus any significant findings relevant to the review may have been overlooked (Jokinen et al, 2002). Although an attempt was made to retrieve recent data, literature into obesity and weight loss management commenced around the 1960’s thus it is a broad topic and not all relevant research studies could be included in the review (Verhallen et al, 2004). Lastly, financial restrictions were also a limitation of the review as most journals required membership or a fee to retrieve articles thus useful articles for the review may not have been attained. 4.4 IMPLICATIONS FOR PRACTICE, EDUCATION, MANAGMENT AND FUTURE RSEARCH Adequate research has now been gathered to demonstrate diet, exercise and behaviour modification is important in the effective management of weight loss for patient with overweight or obesity problems. Eliciting the health concerns of these patients and the cost to both family and society in this review has demonstrated the urgent need to address the quality and effectiveness of the weight induced programme in improving the health of these patients in order to reduce the comorbidities associated with the condition. The level of motivation in overweight individuals probably plays a very important role in the success or failure of weight treatment. Factors that influence motivation include the degree to which overweight individuals receive support from their families, advice and information from healthcare professional that can also set up realistic goals through continuous contact. Conclusion According to the present review, the treatment of overweight and obesity that promises the best results consist of diet, behaviour modification and exercise. Treatment with exercise alone cannot be expected to any significant weight loss, regardless of the type exercise. On the other hand, exercise can be important factor when it comes to preventing continued weight gain or maintaining lower weight even in the long-term. Thus this review reached an important conclusion that the treatment of overweight individuals requires a multidisciplinary approach. This approach means that representatives from all professions, dieticians, behavioural scientist, psychologist, psychotherapist, nurses, physical therapist and doctors must collaborate with each other

Free Essays on Celebrity Vs. Religion

Has Celebrity Replaced Religion in Society? Religion has been around forever. It was formed to explain the unexplainable, and lasted through countless revolutions and discoveries, giving the people who followed the support needed to go about each day. Recently, people who attain celebrity status can gain quite a big following. These groups of people will often look up to, and possibly idolize or worship the celebrities, seeing them as above the regular human being. This has, in turn, prompted the debate of whether celebrity has replaced religion in society. To this, I feel it has not. The first thing that comes to my mind when I think of this question is the amount of people that follow a specific religion. I usually think of Christianity because of its widespread belief and popularity. The number of people who worship celebrities is far less than the people who attend church on Sunday’s, and when other religions are considered, the ratio is practically laughable. Granted, the ratio is becoming less and less desirable, but the fact is that religion is still alive and strong. Another reason I feel that religion hasn’t been replaced by celebrity is the reasoning that people looking up to celebrities or other people in any sort of spotlight can not only be good, but help aid in there everyday lives. Plenty of famous people live good, quality lives following good morals, and looking up to them can offer guidelines to help live a good life. On the flip side, looking at celebrities can offer a way not to live your life. For example, because they are in the spotlight all the time, you can analyze their mistakes, and see that if you were to avoid similar mistakes, then you could avoid many potential problems. The last reason I feel that celebrity has not replaced religion is that many celebrities are very religious. The fact that people would worship celebrities who have a strong faith in a religion make it so eventual... Free Essays on Celebrity Vs. Religion Free Essays on Celebrity Vs. Religion Has Celebrity Replaced Religion in Society? Religion has been around forever. It was formed to explain the unexplainable, and lasted through countless revolutions and discoveries, giving the people who followed the support needed to go about each day. Recently, people who attain celebrity status can gain quite a big following. These groups of people will often look up to, and possibly idolize or worship the celebrities, seeing them as above the regular human being. This has, in turn, prompted the debate of whether celebrity has replaced religion in society. To this, I feel it has not. The first thing that comes to my mind when I think of this question is the amount of people that follow a specific religion. I usually think of Christianity because of its widespread belief and popularity. The number of people who worship celebrities is far less than the people who attend church on Sunday’s, and when other religions are considered, the ratio is practically laughable. Granted, the ratio is becoming less and less desirable, but the fact is that religion is still alive and strong. Another reason I feel that religion hasn’t been replaced by celebrity is the reasoning that people looking up to celebrities or other people in any sort of spotlight can not only be good, but help aid in there everyday lives. Plenty of famous people live good, quality lives following good morals, and looking up to them can offer guidelines to help live a good life. On the flip side, looking at celebrities can offer a way not to live your life. For example, because they are in the spotlight all the time, you can analyze their mistakes, and see that if you were to avoid similar mistakes, then you could avoid many potential problems. The last reason I feel that celebrity has not replaced religion is that many celebrities are very religious. The fact that people would worship celebrities who have a strong faith in a religion make it so eventual...

Macro economic Essay Example | Topics and Well Written Essays - 1500 words

Macro economic - Essay Example Any central bank which achieves its inflation objective but damages output in a way unacceptable to the community will not keep its mandate for long. It is the recognition of this point which has produced a voluminous discussion and academic literature, which basically asks the question - central and basic prices (principally wages) will rise faster than this .There is, of course, also the very substantial danger that a rise in non-tradeable prices faster than the target inflation rate will trigger an asset boom, particularly in the classic non-traded asset of real estate property. There is also the issue that, compared with the situation before the capital inflow and appreciation of the exchange rate, interest rates will have to fall: we know that the extra capital inflows are putting on the exchange rate. Following the reasoning I have outlined so far, the proper response to this is to allow the exchange rate to appreciate. To the extent that this is a long-term or structural change, the inflation targeting framework would allow the appreciation to be reflected in inflation, to the extent that it meant that non-traded (domestic) prices would rise faster than the target. On most counts, this is o.k. - it is proper that relative price between tradeables and non-tradeables changes (in order to encourage the current account deficit that is the counterpart of the financial capital inflows). a) i ) The introduction of a lagged output gap in this equation is important for comparing inflation and price-level targeting. Conceptually, the lag will be introduced any time friction prevents instantaneous and complete adjustment of output to unexpected changes in the price level. The second equation explains monetary growth. In other words, what the central bank does. Here, they react to offset the output gap (but with a lag), but they do so imperfectly, John F. Muth (1961)

How Companies Use Their Structure, Culture and Team Resources to Essay

How Companies Use Their Structure, Culture and Team Resources to Develop Competitive Advantage - Essay Example According to the research findings, it can, therefore, be said that the culture of the organization should be designed in such a manner that supports continuous improvement, seeks to improve their employee’s style of job performance and in the long run developing quality awareness. Culture is one of the most important building blocks of an organization and for this reason, it is imperative that the organization work very hard to uphold it. Various studies indicate that most of the successful companies have strong cultures embedded in them. However, for them to be this successful, a number of conditions have to be affected. The effect of organizational culture relies partly on how strong the organization is and can be measured by how extensively and profoundly employees hold the company’s governing values and assumptions. In organizations with strong cultures, these values are institutionalized through well-established artifact and this renders them very difficult to alt er. Some of these cultures may be traced to the foundation of the company through its founding father’s values and assumptions. Organizations that seek to obtain the commitment of their employees require them to identify with the values, beliefs, attitudes, norms, and artifact of the organization, hence the need for organizational culture. There are seven elements in the cultural web that are interlinked while the commonly held beliefs, attitudes, and values are also known as ‘the paradigm’ are at the center. The seven elements include routine, symbols, power structures, rituals, stories, control systems, and organizational structure. Titiev asserts that learning and sharing culture is central to culture definition. The culture of an organization can be defined as: â€Å"A pattern of shared basic assumptions that the group learned as it solved its problems of external adaptation and internal integration, that has worked well enough to be considered valid and the refore, to be taught to new members as the correct way to perceive, think, and feel in relation to those problems.