Global Marketing Expansion Speech or Presentation

Global Marketing Expansion - Speech or Presentation Example In addition, for a good marketing strategy for the new products being introduced in new markets, it is essential that enterprises engage into a critical analysis of the targeted market or region (Paul 254). This is important because it helps the marketers of the product understand the market dynamics better for enhanced product positioning. As a general rule, a product is likely to sell if the conditions of the external environment are favorable for promotion purposes. The justification behind this is that for the product to be known and accepted in the market, there must be promotion and adoption campaign. This paper identifies the Malaysian market for the purposes of introducing a portable water purifying gadget. The paper will therefore analyze the current situation of the foreign country in terms of the social, political, legal and environmental factors that might affect the introduction and promotion of the new product into the new market. This analysis will be conducted on a ba ckground of the various factors that may hinder the marketing campaign for the new product. To begin, it is important to identify the new product and the justifications for introducing it to Malaysian market. The Portable Water Purifying System The portable water purifier is an innovative product developed for the purposes of ensuring that households and even travelling individuals have access to not only clean but safe water for consumption. Water is an important component of human development. However, although most people have improved access to relatively clean water in the developing and emerging economies today, there is still a problem of making sure that the water is pure and free from disease causing germs. A sure way to eliminate this uncertainty is to have a portable ‘verification’ tool. This is the main reason why this purification gadget has been developed. With the size of a small torch, the purifier uses the ultraviolet ray technology to help purify water especially before drinking. In addition, the gadget is able to recharge using limited solar rays and therefore it is the surest way of creating purification capabilities to households and individuals even in remote areas that do not have access to other purification systems. Another advantage of the product is that it is relatively cheap and durable and hence can be used by many people regardless of their economic status. In addition, the product is user friendly because just like a conventional torch light, the portable purifier works with a slide switch that activates the beam of ultraviolet rays that are able to sterilize water within a couple of minutes before use. With this hand held simple but technologically inventive gadget, the safety of the user is assured. This is because it is able to eliminate the bacteria and other pathogens that may cause illness. This product is therefore suitable in areas that are continually faced with water shortage problems. It is a guarantee of an assisted elimination of illness related to water borne diseases. It is able to purify water in a couple of minutes and therefore ideal for tourists who may not be sure of the water they have for consumption. It can also be used for relief assistance during humanitarian crises like floods to help eliminate water borne disease. Having reviewed the product on offer, it is important to look at the situation in the target country that may make

Business Ethics and dilemma Essay Example for Free

Business Ethics and dilemma Essay 1. Review the assigned readings from the text and article by Carroll (1991). 2. Prepare a 3- to 5-page paper titled, Corporate Social Responsibility. 3. Reflect upon your text readings from Chapters 1 and 9 with a focus on the following core concepts: Organizational Social Responsibility (Chapters 1 and 9) The Ethical Decision-making Process (Chapter 1) Corporate Reputation (Chapter 9) The Corporate Social Responsibility Pyramid (Chapter 9) The Importance of Trust (Chapter 9) The Pyramid of Corporate Social Responsibility (article by Carroll and Chapter 9) 4. Read The Merck and River Blindness Case at the end of Chapter 9 of your text. 5. Compose your paper in Microsoft Word. Include your name, the assignment name and number, the course and section number, and the date on your title page. Follow APA guidelines for formatting and citations.. NOTE: Your paper must meet the minimum requirements as outlined in the section of Weekly Written Assignments of the Assignment Guidelines and the grading criteria of this assignment. You are to provide a minimum of 2-3 references in your work. For this assignment, use of general google.com or Internet search references is not acceptable. Use the university librarys scholarly databases. 6. Respond to each of the following questions and statements: Stakeholders: Produce a list of all key stakeholders that you perceive to have a bona fide interest in the Merck companys dilemma. Corporate Social Responsibility Pyramid: Frame the Merck companys ethical dilemma within the Corporate Social Responsibility Pyramid. E.g. State briefly the key economic, legal, ethical, and philanthropic responsibilities. As a focal point, compare and contrast the economic implications against the ethical and philanthropic considerations. Organizational Values: State briefly and specifically whether the decision to a) proceed with the drug project or b) not to proceed with the drug development best fits with the companys declared organizational values and its principles of profitability. Stakeholder Impact and Trust: If the drug development failed and cost hundreds of millions of dollars, would that harm to the company and its stakeholders be justifiable? If Merck decided not to pursue development of the new drug, what implications do you see this having for stakeholder relations such as the scientists who desire the development. E.g. Is this a trust and leadership consideration? Final Decision: If you were the CEO of Merck and the final decision on this risky new drug development was yours, what would you do and why? Justify your decision. Using Carrolls theory, are you comfortable stating your opinion to the board of trustees, employees, and media? NOTE: Since this is an actual, real-life case, your focus should be on producing creative and new thinking that applies the ethical concepts to the material. Also, include an introduction and conclusion in your paper. You are encouraged to use the headings above in Action Item 7 in your paper for organizational purposes. 7. Submit your paper to Turnitin.com. NOTE: Turnitin.com is used by Franklin University to assist students in detecting plagiarism. Turnitin generates a report within minutes of submitting your paper. Your results will not be e-mailed to you; you must login to review your results. Submitting a paper ahead of an assignment deadline provides you with the opportunity to take action if you need to rewrite any part of the paper. Your professor will provide you with a class ID and password as an e-mail or a Class Communication object. Submission Instructions By Sunday, upload your paper using the Submit tool. Grading Criteria Content and focus: Response addressed the question(s) posed in a logical, cohesive manner: 0 35 points Analysis and critical thinking: Writing illustrates higher order critical thinking, analysis, synthesis, and/or evaluation: 0 35 points Writing style, grammar, sentence structure: Sentences are consistently clear, concise, well written; grammar and punctuation are correct: 0 15 points APA and research: Correct use of APA style in body of paper and appropriately references the text and/or other research sources: 0 15 points

Alice in Wonderland Artwork by Sigmar Polke: Analysis

Alice in Wonderland Artwork by Sigmar Polke: Analysis Sigmar Polke was creating a wide range of surfaces with various materials, as shown in his 1971 artwork of Alice in Wonderland (Figure 1), which is paint printed on a store bought printed fabric, not a canvas. The artwork is divided into three images. The background shows a soccer game. In the middle and part of the bottom, you notice polka dots covering up some characters. In the front, the audience sees a transparent Alice talking to the smoking caterpillar, who is sitting on the mushroom. As you read Alice in Wonderland, [1] when Alice takes a bite out of the mushroom, she can either grow big or small. This shows that drugs may help the audience for a little bit, but then most of the time, drugs do not help you. Next to the Alice in Wonderland characters in the painting, there is a translucent soccer player. The mixed media art may have been here to tell people, the brain is on drugs when the audience is watching sports. You notice the translucent characters more, since they appear larger than the soccer players. It gives you a depressed and lonely feeling because the translucent characters have no color. It is as though the characters have died and the brain is already dead. The characters being see through indicates they have lost their color; they have lost their soul. Despite having no color, we can still see them; this could indicate they are about to die and be forgotten. The colors of the soccer players are bold because it shows the drugs have sucked up their soul and are going to take over their life. There are splashes of red and yellow on the polka dots. This could mean that not only is your mind confused, it is also messed up. The characters are there, but the audience can barely see them, indicating they could be becoming invisible. Notice how the polka dots only cover up the middle section and a little bit on the bottom because the artist probably wanted to make sure he was covering up Alice, to show her being curious and confused. Alice is watching the caterpillar smoking. The caterpillar faces away from the audience, possibly ashamed of smoking. The artwork has no symmetry. This shows it is not organized because it is supposed to give you confusion. I looked closely at the background and noticed there are many soccer balls, when you only need to play with one. There are also too many players for the soccer game. This is another indication of your brain on drugs with the side effect of having hallucinations and seeing things more than once. [2]Polke used polka dots. This is a pun of the artists name. Using the polka dots is a reference to Sigmar Polkes use of the media and raster dots. The illustrations of the Alice in Wonderland characters are taken from the illustrations by Sir John Tenniel, which were used in Lewis Carrolls 1865 Alice in Wonderland. I feel like there is no true geometric form; even the panels do not look evenly rectangular. The only thing that looks like a perfect shape would be a sphere (the soccer ball). The audience cannot see all of the faces clearly and cannot see their emotion. Since they are hiding their faces, they are probably depressed from taking drugs. The caterpillar is the one taking the drugs. He merely sits, indicating drugs will make everyone lazy. Alice is the bystander, looking up at the caterpillar, wondering if she should try the drugs too. There are no fixed meanings of Sigmar Polke having layers on the image; it shows too many situations. The audience can only interpret what Sigmar Polke is trying to tell us. The picture is showing me if we watch too much television, the mind is going to have a lot of hallucinations between reality and fiction. The Alice in Wonderland characters do not have enough light as the soccer players. The position of the characters are all different. Alice is standing, the caterpillar is sitting and the soccer players are playing. Do the Alice in Wonderland characters have more attention than the soccer players? The pose may be jumpy, yet Sigmar Polke is giving everyone a warning. The use of color in the background and the characters being translucent reveal what happens to the life of a person on drugs; their emotions fade. By not showing the peoples facial expressions, theres an indication they have sold their identity to drugs: they have lost their soul. Alice in Wonderland became quite a humorous visual correspondence using the projection of transparent images onto grounds composed of multiple, contrasting cloths. [3] Thus, the artwork, with its variations from mixed media, suggests the presence, in fabric, of reality versus fantasy with the mind on drugs. 839 words References Carroll, Lewis. Alice in Wonderland. Public Domain, 1898. Davies, Denny, Hofrichter, Jacobs, Roberts, Simon. Jansons History of Art . 8th. Edited by Sarah Touborg. Vol. 2. London: Laurence King Publishing , 2016: 1053. Gintz, Claude. Polkes Slow Dissolve. Art in America, December 1985: 107. Larking, Matthew. artscape Japan.2006. http://www.dnp.co.jp/artscape/eng/focus/0606_02.html.  Ã‚   (Larking n.d.) Figure 1 Sigmar Polke, Alice in Wonderland. 1971. Mixed Media on fabric strips, 106x 86  ¾ ( 3.21.6m). Private Collection, Cologne [4] [1] Carroll Alice in Wonderland Public Domain 1898      [2] Davies, Denny, Hofrichter, Jacobs, Roberts and Simon, Jansons History of Art (Laurence King Publishing, 2016), 1053. [3] Claude Gintz , Polkes Slow Dissolve, Art in America, December 1985, 107. [4] paintersonpaintings. files. wordpress

Hydrogen: The Best Alternative Energy Source Essay -- Hydrogen, An En

Since the human were created, they have always been depending on an external energy source. Before the use of fossil fuel was discovered, people used the sun as their main external energy source. The sun provides heat, light, and photosynthesis for food that the humans and animals need to make their work energy. And it also affects wind and water motion that the humans also use to make power to do heavy work. When the use of fossil fuels was discovered, it enabled the industrial revolution to begin in the early 19th century. And it also made the growth of human population, technologies, and wealth. Since then, the human use the fossil fuels as their main external energy source. That period could well be renamed as the energy revolution. But if we continuously use the fossil fuels as the energy, it will bring a big problem for the human in the future. It is because the continuously use of the fossil fuel threatens our world energy supply and also makes a lot of negative effects to our environment. The world’s demand for energy is predicted to double by 2050 in response to the population growth and the industrialization of developing countries. The supply of fossil fuels is limited by its finite amount within the earth and it will soon become expire if we continuously use it. The longevity of the fossil fuel energy supply is reduced by the energy consumed through its conversion to a suitable energy form in which human use. While global oil and gas reserves are concentrated in a few regions of the world, demand is growing everywhere. As a result of that, the supply of energy for the world in the future is difficult to assure. Beside that, the use of fossil fuels is not good and risks the human’s health. I t is because t... ...More research, attempt, time, and money are needed to actualize the use of hydrogen as the world’s future energy sources. Works Cited Braun, Harry W. The Phoenix Project: Shifting form Oil to Hydrogen. Phoenix: SPI Publications & Productions, 2000. Crabtree, George W., Mildred S. Dresselhaus, and Michelle V. Buchanan. "The Hydrogen Economy." Dec 2004. 12 Oct 2005 . Gorman, Jessica. "Hydrogen: The Next Generation." 12 Oct 2002. 12 Oct 2005 . "Hydrogen Topics." 04 Oct. 2005. U.S. Department of Energy. 12 Oct. 2005 . Weisz, Paul B. "Basic Choices and Constraints on Long−Term Energy Supplies." July 2004. 12 Oct 2005 .

Pestle Analysis for Education

Political| * Schools being privatised (like the NHS) * A government initiative creates the risk that the school may fail to deliver the policy or be diverted away from local priorities etc. * Changes to the skills required to be a teacher/ tutor * Changes to curriculum with short lead times * Requirement to be self managing * Requirement to be self financing| Economic| * Central or local government funding decisions may affect school/ establishment finances * Closure of a local industry may affect fund raising plans etc. Ability of parents to raise funds for optional activities * The need to run breakfast/ after schools clubs * Ability to invest ‘savings/ surpluses’ * Cost of providing resources: * Staff – teaching & support * Basics – books/ paper * Technology solutions laptops etc * Interest rates * Shortages of materials on national/ international markets * Over provision of school places in the area resulting in competition from neighbouring schools * T he risk of highly valued, key staff moving on to more ‘up and coming’ schools/ academies| Social| * Decline in birth rate, reflecting national trends * Local population changes (increasing/ decreasing numbers) * Demographic changes may affect likely pupil rolls or the nature of pupils needs e. g. pupils with English as a second language etc. Closure of local firms providing employment * Inability to attract staff * Social networking – blogs, facebook, twitter * Changes to qualifications expected * Integration with local community * Integration of students with special needs * parental preference – an increase in ‘parent power’ has allowed parents more freedom of choice over their child’s school * the risk of highly valued, key staff moving on to more up-and-coming establishments * Information is accessible to staff anywhere in the world via the Internet * Staff were not given enough training or access to effectively change their habits and how they expected information to be made available| Technological| * Changes to standards/ equipment required * Risk of selecting the wrong technology at times of change (i. e. windows -v- open source) * New computer viruses may affect school/ college operations, * Disturbing/ illegal images on the internet may affect ICT security measures etc. * Move from paper based books to e-book readers * Computer hardware being out of date * Computer software being out of date * Time to anage IT systems  | Legislative| * new legislation may create risks of non-compliance with the law, create new administrative burdens etc * Changes to child protection legislation * Raise the age of school leaving age * Raise/ lower the age of starting school. Nursery/ kindergarten * Change to school opening hours * Changes to funding of charity based organisations * Health & safety legislation| Environmental| * A new highway layout near the school may create new dangers for pupils etc * Waste disposal * Reduction of green space available for activities * Changes to local bus routes * Using a significant amounts of paper and photocopier toner to produce printed information. |

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.

Jean Baptiste Moliere essays

Jean Baptiste Moliere essays JEAN-BAPTISTE POQUELIN MOLIÈRE16221673From The Norton Anthology of World Masterpieces Vol. 2, 7th edition, ed. Maynard Mack, et. al. (New York: W.W. Norton, 1999) Son of a prosperous Paris merchant, Jean-Baptiste Molire (originally named Poquelin) devoted his entire adult life to the creation of stage illusion, as playwright and as actor. At about the age of twenty-five, he joined a company of traveling players established by the Bjart family; with them he toured the provinces for about twelve years. In 1658 the company was ordered to perform for Louis XIV in Paris; a year later, Molires first great success, The High-Brow Ladies (Les Prcieuses ridicules), was produced. The theatrical company to which he belonged, patronized by the king, became increasingly successful, developing finally (1680) into the Comdie Franà §aise. In 1662, Molire married Armande Bjart. He died a few hours after performing in the lead role of his own play The Imaginary Invalid. Molire wrote both broad far ce and comedies of character, in which he caricatured some form of vice or folly by embodying it in a single figure. His targets included the miser, the aspiring but vulgar middle class, female would-be intellectuals, the hypochondriac, and in Tartuffe, the religious hypocrite. In Tartuffe (1664), as in his other plays, Molire employs classic comic devices of plot and characterhere, a foolish, stubborn father blocking the course of young love; an impudent servant commenting on her superiors actions; a happy ending involving a marriage facilitated by implausible means. He often uses such devices, however, to comment on his own immediate social scene, imagining how universal patterns play themselves out in a specific historical context. Tartuffe had contemporary relevance so transparent that the Catholic Church forced the king to ban it, although Molire managed to have it publishe...