Clubfoot Essay Research Paper CLUBFOOT Clubfoot is free essay sample

Clubfoot Essay, Research Paper Clubfoot Clubfoot is characterized as a natural pes contortion portrayed by a kidney shaped pes that turns internal and focuses down. The forefoot is bended internal, the impact point is never going to budge internal, and the mortise joint is fixed in estate proprietor flexure with the toes showing down. Sawed-off ligaments on the inside of the lower leg, along with strangely molded castanetss that confine movement outwards cause the pes to turn inwards. A fixed Achilless ligament makes the pes demonstrate downwards. The clinical term for talipes will be talipes equinovarus. It is the most widely recognized innate surprise of the lower extremity. There are a few changes, yet talipes equinovarus being the most widely recognized. Clubfeet happens in around 1 in each 800-1000 angels, being twice every piece normal in male childs than misss. One or both pess might be influenced. The historical backdrop of clubfeet started as far back as 400 B.C. Hipocrates was the first to portray it. He utilized patchs to deal with it. As clasp advanced so did the intercession techniques. In around 1743 delicate extending was suggested. During that equivalent century, a mechanical gadget looking like a turnbuckle was utilized to help stretch the ligaments. By this clasp talipes was sensibly acceptable known around the universe, using the run of the mill extending and bracing techniques. In the 1800 s mortar of Paris was premier presented, and in this way that equivalent century, the introduction of sterile method and anasthesia lessened, however non dispensed with contamination. As the 70 s and 80 s moved about, other progressively trustworthy strategies were relied on. These new strategies were less reliant on wrapping and taping. The heft of clubfeet outcomes from unnatural advancement of the musculuss, ligaments, and castanetss while the angel is arranging in the belly. Familial and ecological factors in the advancement of the hatchling appear to other than be a portion of the causes. The bother of the ordinary turning pes likely happens at about the eighth hebdomad of incubation. The reason for the pes turning distorted is obscure, yet accepted to hold something to make with heredity. Numerous cases of talipes do non hold simple recognizable causes. The finish of mediation is to achieve and keep each piece typical as a pes as could reasonably be expected. The degree of the required mediation fluctuates, contingent on the unbending nature of the pes. Treatment may take a while, yet most children figure out how to crawl, stand, and stroll at the ordinary age. There are a couple various approaches to go about dealing with talipes, the two most perfered being use and throwing, and medical procedure. Clubfoot is generally basic in kids who experience the ill effects of spina bifida who have a L4 or L5 engine degree. Numerous orthopedic sawboness then again of successive throwing propose early tape and delicate use followed by a use of a very much cushioned s plint. The ground for this is on the grounds that successive throwing can do skin inconveniences and separation. Another procedure use and throwing is a mediation that starts not long after birth. It includes simple loosening up the fixed musculuss and keeping the pes in an improved spot with a performers. The dramatis personaes are made of mortar and stretch out from the toes to either simply over the articulatio class, or only underneath it. Adduction of the pes is typically adjusted preeminent, trailed by reversal of the hindfoot, all in all the plantar flexure. The dramatis personaes are changed regularly, each clasp moving the pes a little closer to typical. For the initial two-three hebdomads, the dramatis personaes are changed each second to fourth twenty-four hours. Cast modifications are so diminished to one time each one-two hebdomads. This intercession proceeds until the child is three to a half year old. This technique for intercession is perplexing to the child for just a brief time of clasp. For this ground guardians will be shown thrown consideration before go forthing the facility. In the event that the pes is too much hardened to let for equivalent correction, so the tight or abbreviated ligaments may require to be extended or discharged. The kind of medical procedure fluctuates blending to how much delicate tissue is discharged. During a careful amendment of a gentle occurrence of talipes, the sawbones must make up ones brain which verbalizations require no, base, or moderate scratch. In gentle talipes, the mid and back subtalar explanations requires least or no scratch. Every single middle ligament are stretched, the front tooth and midtarsal enunciations are discharged, and the heel harmony is protracted. In taking care of a moderate example of talipes, the sawbones discharges the foremost subtalar enunciation, and every single middle ligament are protracted. Last when taking care of the awful talipes, all distortions are endeavored to be adjusted When a worthy correction has been accomplished by anticipating it will require to be kept up with a brace. The most widely recognized kind of support is the Dennis Brown boot and cantina. At first the brace must be worn 20 four hours a twenty-four hours. As the child figures out how to walk, the clasp in the brace is a tiny bit at a time diminished to evening time utilization only. This could go on until the child is four or five mature ages old. Non-intrusive treatment is other than used to deal with a child with talipes. It incorporates extending, supporting, taping, managing dramatis personaes, and learning the guardians how to help and activate the child to make ordinary life exercises. To keep correction, the child ought to be trailed by the orthopedic sawbones until the castanetss, in the pes have quit turning. This is vital in light of the fact that the turning pes may gradually free correction. In the event that this occurs, medical procedure on the ligaments or unnatural cas tanetss might be required with redundancy anticipating. Most children who have been treated for clubfeet grow normally, and partake in any athletic or recreational movement they pick.

Barriers for Parent Engagement in Childcare Services

Boundaries for Parent Engagement in Childcare Services Basically examine the hindrances that guardians may look in connecting with one territory of the children’s administrations. What job would practitioners be able to play in defeating a portion of these boundaries? Guardians and specialists attempting to get to help for kids with handicaps face numerous boundaries while drawing in with children’s administrations. While changes have occurred in the public eye over the past number of years it can even now be said that there is consistently opportunity to get better in children’s administrations. This TMA will concentrate on kids with a handicap and how guardians and professionals face the obstructions of being heard and getting to the assistance accessible to them. While youngsters with inabilities have been incorporated into standard school or given the open door inside a unique need schools, guardians despite everything face obstructions of the mix of multi-organizations and getting the correct assistance and guidance. In the course of recent years change has come to fruition from kids with exceptional requirements been concealed away to now being incorporated into standard instruction or unique need schools. This has created because of the implantation of new laws and enactment to secure child’s rights for example children’s NI request (1995), Education Act (2011), and furthermore the current Multi year procedure for youngsters and youngsters in Northern Ireland 2006-2016. While this has achieved noteworthy change and better nature of instruction for uncommon requirements youngsters it tends to be basically contended that guardians despite everything face numerous obstructions inside the training framework. Ashley Walter (2014) recognized that kids with handicaps have more neglected wellbeing needs. This was additionally observed more from offspring of rustic zones. Guardians are not just having to adapting to the extra needs of their child’s handicap, yet in addition the boun daries of looking for help and being heard for their youngster to get the correct instruction. As a temporary parents for an impaired kid I can allude to these guardians as I too found the obstructions of referred to what administrations was accessible as data is constrained. Lambing (2009) underpins these guardians when his examinations recognized that guardians face the boundaries of not knowing how the framework functions and the help accessible to access for their child’s needs. It can likewise be similarly contended that guardians themselves set the hindrance to connect with the administrations. This might be a consequence of not grappling with their child’s handicap being willfully ignorant or that they feel embarrassed about not having the option to adapt. I was roused by the examination of Brodhurst (2003) which shows that guardians of crippled kids have a social hindrance in taking part in administrations. Jawline and Philip (2004) bolster this when discussing Cultural capital, on how guardians from various social layers characterize how their kid is raised. It very well may be perceived how parent’s desires can impact hindrances as they can better standards for their kid than they are able to do. This is the point at which the job of the specialist assumes a significant job to defeating these obstructions. Guardians need the help in realizing that there is something incorrectly just as discovering that drawing in with various administrations will defeat obstructions. The combination of children’s administrations has been set up to contact these guardians. Guaralnick J M discusses early mediation and its significance to both the youngster and their family. The improvement of Sure Start is viewed as an essential early year administrations. They give a priceless system of help and direction to help conquer a portion of the reconciliation obstructions parents’ face. Cohan (2005) sees that while administrations change and multi-offices cooperate, so too does the relationship with the youngster change. Guardians are along these lines confronted with the new obstructions of how the youngster will intergraded into this framework. This is bolstered by the examination detailed in the Journal of formative and conduct pediatrics, where guardians and suppliers both viewpoint in obstructions where kids with inabilities can't incorporate into the framework because of their perplexing needs of adapting to change and new offices. It tends to be fundamentally contended that our framework will in general fit the kid into the administrations as opposed to the administration into the youngster. Can arrangements not be completed in the home or school condition? Has the kid condition been contemplated particularly a youngster who can’t adapt to new places or individuals? These are a portion of the numerous inquiries and hindrances that guardians face. As sp ecialist co-ops it can fundamentally be said that we tend to take a gander at what we believe is best for the youngster as opposed to tuning in to kid themselves. As a non-permanent parent I too confronted these hindrances as the kid I thought about discovered troublesome is adapting to change. When going to arrangements it caused pressure and nervousness given the numerous obstructions to survive. Youngster A had the troubles of managing the new encompassing as well as the various countenances and appraisals needs. At that point there are the obstructions of looking out for choices. I can say that I thought that it was difficult to know the results and confronted the boundaries of dissatisfaction in not realizing what is occur and how Child A necessities were being met. It is significant as administrations suppliers to recollect while all regions of improvement are interlinked every kid is a person. Like Young C discussed in video cut three learning guide 17.2 while the contributin g of data is significant we need to consider how we assemble this data as it very well may be seen an advancement when expert visit the setting inside brief period to complete comparative appraisals. This is the equivalent for guardians going to various arrangements as it gets disappointing to getting a similar input and not answers to the administrations their kid needs. Turner (2003) look into I feel is significant as he discussed the significance for the child’s government assistance of having various offices while simultaneously having the help of a co-ordinator known as a Key laborer to deal with their sake to lessen pressure. These techniques would help lessen a few boundaries and offer the help for guardians during troublesome periods. As expressed in the Warnock Report (1978) â€Å"Parents give important on the off chance that not novel data for experts who can, at that point settle on the fitting strategy in the ‘best enthusiasm of the child.† Parentâ₠¬â„¢s investment is vital in the progressing advancement of administrations as they will be there for the kids when expert are definitely not. An intriguing Journal became obvious was the Facilitators and hindrances for co †ordinated multi-organization administrations which featured that while there is little proof on the adequacy of multi-office it has been discovered that obstructions are diminished of gathering data, clear points and timetables. While we talk about organization it is contended that it advances, develops and builds up a style of mentalities and cooperating, it tends to be fundamentally contended that this disposition continually impacts relationship inside the association and the youngsters needs are met. Like Savage J in Video cut 2 Learning guide 17.2 states there is no reason for ‘demonising’ offices who are seen as not contributing; it ought to be perceived that they have their own goals which should be connected to shared targets which should be connected to shared destinations. While this is genuine the obstructions the two guardians and schools face are of experts not having any d esire to over advance their job in settling on formal choices as they don’t feel they have the authority as its past their activity title. The way to heading of interagency work was set out as a procedure of counseling the youngsters, youngsters, and guardians utilizing the administration. It is to empowers the youngsters to remark on their requirements and issues legitimately identified with interagency administration conveyance. While this is the point obstructions are as yet confronted todays guardians and experts. While the interagency is to help mitigate these boundaries as a childcare expert working in the early years I also face the hindrances of been heard. In schools professionals additionally need to conquer hindrances to help the kid just as building parent’s relationship. As a professional we need the guardians support as they are the fundamental wellspring of imperative data for the kid government assistance. This can be testing when a kid is obscure to have an exceptional need and is recognized inside the school. While the UNCRC (1989) administers the ideal for youngsters to be instructed in standar d schools the two specialists and guardians face the obstructions of being heard and having the help expected to permit their kids needs met. In my own setting we face the boundaries of kids not been surveyed before school age particularly youngsters that present with mental imbalance, this consequently drives onto being declined the help required inside the setting. These boundaries have a continuous impact on the kid as well as the pressure guardians face to being heard. Guralnick J M (1991) features the significance of early mediation and the advantages it has on the child’s advancement also Government DFE (2012) recommending that poor arrangement for kids and youngsters with SEND, especially those with requirements, for example, chemical imbalance and dyslexia is probably going to essentially influence their personal satisfaction. Anyway it doesn't generally occur by and by. In my own intentional association we don't have the help of the training framework as we are viewed as a pre-school and not a nursery despite the fact that the thing that matters is the title. This consequently doesn't empower us to have the help of early mediation to get youngsters evaluated for chemical imbalance. These kids are enduring and obstructions are set against the pre-school in offering types of assistance and helping guardians to get the best beginning for their youngster. It very well may be seen that while new laws and enactment has seen upgrades in childr en’s administrations

Startup Hubs Around the World Istanbul

Startup Hubs Around the World Istanbul 1. LOCATIONAt the intersection of Asia and Europe is the country of Turkey. On the shore of the Bosphorus sits the largest city in the country: Instanbul. The rich history of this Turkish city gives an old-world feel to the streets, making it possible to imagine the city as it had been in ages past. Today, however, the streets are filled with a new vibrancy, and the start-up market is starting to take notice. Perched in between two markets that comprise a majority of the world’s population, the city of Istanbul is becoming a hub that is attracting global attention. Within a four hour flight’s reach from some of the world’s largest cities, Istanbul is an attractive to entrepreneurs who need to connect with the outside world, as well as to investors who are looking to have access to their vested interests.2. TAX INCENTIVESThe government of Turkey has established incentive programs to encourage entrepreneurs to begin calling Istanbul home. The development of economic zones has led to technoparks where Research Development (RD) companies can apply to use office space. Low interest, government backed five year loans are available for RD projects that the government approves of, in addition to funding of up to half of engineering costs through grants for government approved projects. For any product developed in the technopark, the company can receive tax exemption for up to ten years of corporate income tax. Payroll tax exemption is also given for engineers who work within the technopark, making it attractive to start-ups looking to maintain a workspace.As enticing as the tax benefits sound, however, there are some strings attached to these governmental gifts. To begin with, the grants and funding provided by the government are based on projects that the government approves of â€" narrowing the field to ideas that are considered worthwhile or important by the Turkish government. In addition, loan money is only granted to start-ups who are able to acquire a ba nk guarantee. The catch-22 here? If a company could get a bank guarantee, they wouldn’t need the loan from the government.Establishing technoparks and offering grants is beneficial to the growing entrepreneurial marketplace in Istanbul. Unfortunately, however, the government assistance seems to end there. While the government asserts that start-ups are vital, there are no real policies in place to support the start-up, nor are there established plans to encourage growth in this area. The government is beginning to slowly focus on assisting the fledgling start-up community, but change is measure in slow increments for this country that boasts of a history almost 2,000 years old. There is an indication that governmental support will grow in the years to come, which should help to further increase interest in the start-up community.3. LEGAL INCENTIVESThe climate of Istanbul towards entrepreneurs is surprisingly welcoming. According to a survey done in 2012, Turkey ranked 13th as a ho spitable destination for foreign businesses. As a foreigner wishing to establish a business within the Turkish city, the simple residence permit allows entrepreneurs to live in Turkey as well as establish a business. Ownership is easily established, with an easy to navigate system of paperwork. In contrast to other nations, Turkish law mandates that a business have at least two owners, but one may have as little as 0.5% ownership. This allows for start-ups to easily create an ownership structure that is functional and financially beneficial. Foreigners are also able to buy property in Istanbul and there are no limitations on ownership based on gender or nationality.The framework for establishing a business within Istanbul is in place, but is not supported by a strong legal or judicial system. While recent developments have begun to change the governmental support of businesses, there is a lack of trust in the government to enforce legal policies. This may lead to a lack of willingne ss to both begin a start-up within Istanbul or to invest in a start-up. Both sides of a start-up are in a position to lose in a battle that comes down to legalities. Without enforcement of intellectual property, the investor can lose their money while the entrepreneur loses their company.4. AVAILABILITY OF INVESTORSIstanbul boasts of a thriving angel investor network. Galata Business Angels has a highly organized platform for investing in early-stage start-ups. These individuals with high net-worth are leading the way for people to discover the available investment opportunities that Turkey has to offer. In addition to the angel investors, there are a growing number of venture capital funds that are branching into the Turkish market. Investment firms from all over the globe are turning their attention, and their money, towards the small city of Istanbul in hopes that they will be on the cusp of the next big start-up.The Istanbul Venture Capital Initiative reported earlier this year that a minimum of 50 active funds are looking for investment opportunities within the city. There are several incubators that attract attention from potential investors, and the growing number of technoparks has helped to establish the area as a viable market.While the interest in Istanbul’s start-up market may be growing, the number of foreign investors in the marketplace is slow to catch up. This may be due to the challenges of getting Turkish companies to the forefront of the global stage and attracting the venture capitalist’s attention. A much needed infusion of Turkish investors who are willing to act as a source of venture capital will help to propel the start-up market place, but they have not been forthcoming in large numbers.In addition to developing a larger pool of early investors, Istanbul must also seek to establish a network of growth investors for secondary stage investments. These investors are rare within the Istanbul tech marketplace, and are essential for the start-up community wishing to move beyond the magic three year time frame that most start-ups need to become successful.The successful hosting of events that draw potential investors from around the globe is serving to not only jumpstart interest in the start-up fields, but also works to provide foreigners and locals the opportunity to preview the developments coming out of Istanbul. A collective organizational group that works to promote such events, as well as provide training and collaboration between existing start-ups would be beneficial.Turkeys Startup Scene 5. AVAILABILITY OF LOCAL RESOURCES AND WORKFORCEThere is a dichotomy between the growing start-up culture and the traditional Turkish way of life. With a vibrant, young workforce, the available employees are more educated than ever before in Turkish history. Overall, 70% of the country’s population is under 35 â€" giving the country a wide market of consumers and workforce potential. With a large rising generation of pe ople who are tech savvy, there are multiple opportunities for start-ups to attract attention. In addition, of the population’s 78 million people, almost half are connected to the internet giving Turkey one of the internet’s fifth largest audiences. Economically, the Turkish way of life is thriving and the average worker is earning double their wages from just a decade ago. The government structure is steady, which lends stability to the country as it struggles to re-invent itself as a modern day hub for the changing world.Within Istanbul, the city has access to some of the brightest minds in Turkey. Well-educated nationals who studied abroad have been returning to their native land and are bringing a renewed interest in entrepreneurial efforts within the country.  Building a potential workforce with the higher skills necessary within the tech market has great potential for the future of Istanbul’s ability to be competitive on the world’s stage.Despite the availability of in vestors, the relatively easy regulations for entrepreneurs and the large available workforce, there are areas of concern within Istanbul that may influence the future start-up market. Governmental policies tend to lean toward Islamic ideologies. Recent protests indicate that there is unrest simmering beneath the surface of the residents of the country. An indication of unrest makes investors uneasy, especially in a market that has not yet proven itself as a successful start-up hub. Current indications of government bribery, coercion and corruption have created an environment that is not conducive to trust â€" a vital element of the start-up market. The Istanbul entrepreneur market is trying to regain some of the advances they had previously made, but only time will tell how successful they will be.In addition to the governmental hurdles, the infrastructure of the country is a huge challenge. Availability of dependable power and water supplies is a problem for companies running high powered computer systems and networks. For a tech-based start-up, power outages can spell disaster, and they happen with regularity. Logistically, foreigners (and even locals) can have a hard time navigating the winding roads of the ancient city. Large amounts of traffic congest the roads, making stop and go traffic the norm â€" not the exception.The negative side of the start-up market in Istanbul can be daunting. One can argue, however, that for any entrepreneur wading into the start-up industry, there will always be a downside. There will always be obstacles that keep people from taking the leap into entrepreneurship; in a way it is a self-selecting process that weeds out the weaker candidates. For the entrepreneur in Istanbul, there needs to be more than a sense of adventure behind the drive for a start-up: the road is long, bumpy and difficult. The payoff, however, can be enormous in a place that is waiting for their first big exit.6. SPECIALIZATION Istanbul has often been seen as the bridge between East and West. A cosmopolitan city with a culture dating back centuries, it is a mix of driven young professionals, and businesses that have been around for generations. More and more entrepreneurs are headed to Istanbul to setup their start-ups. © Shutterstock.com | SeqoyaIn this article about Istanbul, we look at  six essential elements  of a potential start-up location that must be considered: 1)  location, 2)  tax incentives, 3)  legal incentives, 4)  availability of investors, 5)  local resources and workforce, and 6)  specialization.1. LOCATIONAt the intersection of Asia and Europe is the country of Turkey. On the shore of the Bosphorus sits the largest city in the country: Instanbul. The rich history of this Turkish city gives an old-world feel to the streets, making it possible to imagine the city as it had been in ages past. Today, however, the streets are filled with a new vibrancy, and the start-up market is starting to take notice. Perched in between two markets that comprise a majority of the world’s population, the city of Istanbul is becoming a hub that is attracting global attention. Within a four hour flight’s reach from some of the world’s largest cities, Istanbul is an attractive to entrepreneurs who need to connect with the outside world, as well as to investors who are looking to have access to their vested interests.2. TAX INCENTIVESThe government of Turkey has established incentive programs to encourage entrepreneurs to begin calling Istanbul home. The development of economic zones has led to technoparks where Research Development (RD) companies can apply to use office space. Low interest, government backed five year loans are available for RD projects that the government approves of, in addition to funding of up to half of engineering costs through grants for government approved projects. For any product developed in the technopark, the company can receive tax exemption for up to ten years of corporate income tax. Payroll tax exemption is also given for engineers who work within the technopark, making it attractive to start-ups looking to maintain a workspace.As enticing as the tax benefits sound, however, there are some strings attached to these governmental gifts. To be gin with, the grants and funding provided by the government are based on projects that the government approves of â€" narrowing the field to ideas that are considered worthwhile or important by the Turkish government. In addition, loan money is only granted to start-ups who are able to acquire a bank guarantee. The catch-22 here? If a company could get a bank guarantee, they wouldn’t need the loan from the government.Establishing technoparks and offering grants is beneficial to the growing entrepreneurial marketplace in Istanbul. Unfortunately, however, the government assistance seems to end there. While the government asserts that start-ups are vital, there are no real policies in place to support the start-up, nor are there established plans to encourage growth in this area. The government is beginning to slowly focus on assisting the fledgling start-up community, but change is measure in slow increments for this country that boasts of a history almost 2,000 years old. There is an indication that governmental support will grow in the years to come, which should help to further increase interest in the start-up community.3. LEGAL INCENTIVESThe climate of Istanbul towards entrepreneurs is surprisingly welcoming. According to a survey done in 2012, Turkey ranked 13th as a hospitable destination for foreign businesses. As a foreigner wishing to establish a business within the Turkish city, the simple residence permit allows entrepreneurs to live in Turkey as well as establish a business. Ownership is easily established, with an easy to navigate system of paperwork. In contrast to other nations, Turkish law mandates that a business have at least two owners, but one may have as little as 0.5% ownership. This allows for start-ups to easily create an ownership structure that is functional and financially beneficial. Foreigners are also able to buy property in Istanbul and there are no limitations on ownership based on gender or nationality.The framework for establ ishing a business within Istanbul is in place, but is not supported by a strong legal or judicial system. While recent developments have begun to change the governmental support of businesses, there is a lack of trust in the government to enforce legal policies. This may lead to a lack of willingness to both begin a start-up within Istanbul or to invest in a start-up. Both sides of a start-up are in a position to lose in a battle that comes down to legalities. Without enforcement of intellectual property, the investor can lose their money while the entrepreneur loses their company.4. AVAILABILITY OF INVESTORSIstanbul boasts of a thriving angel investor network. Galata Business Angels has a highly organized platform for investing in early-stage start-ups. These individuals with high net-worth are leading the way for people to discover the available investment opportunities that Turkey has to offer. In addition to the angel investors, there are a growing number of venture capital fund s that are branching into the Turkish market. Investment firms from all over the globe are turning their attention, and their money, towards the small city of Istanbul in hopes that they will be on the cusp of the next big start-up.The Istanbul Venture Capital Initiative reported earlier this year that a minimum of 50 active funds are looking for investment opportunities within the city. There are several incubators that attract attention from potential investors, and the growing number of technoparks has helped to establish the area as a viable market.While the interest in Istanbul’s start-up market may be growing, the number of foreign investors in the marketplace is slow to catch up. This may be due to the challenges of getting Turkish companies to the forefront of the global stage and attracting the venture capitalist’s attention. A much needed infusion of Turkish investors who are willing to act as a source of venture capital will help to propel the start-up market place, b ut they have not been forthcoming in large numbers.In addition to developing a larger pool of early investors, Istanbul must also seek to establish a network of growth investors for secondary stage investments. These investors are rare within the Istanbul tech marketplace, and are essential for the start-up community wishing to move beyond the magic three year time frame that most start-ups need to become successful.The successful hosting of events that draw potential investors from around the globe is serving to not only jumpstart interest in the start-up fields, but also works to provide foreigners and locals the opportunity to preview the developments coming out of Istanbul. A collective organizational group that works to promote such events, as well as provide training and collaboration between existing start-ups would be beneficial.Turkeys Startup Scene 5. AVAILABILITY OF LOCAL RESOURCES AND WORKFORCEThere is a dichotomy between the growing start-up culture and the traditional Turkish way of life. With a vibrant, young workforce, the available employees are more educated than ever before in Turkish history. Overall, 70% of the country’s population is under 35 â€" giving the country a wide market of consumers and workforce potential. With a large rising generation of people who are tech savvy, there are multiple opportunities for start-ups to attract attention. In addition, of the population’s 78 million people, almost half are connected to the internet giving Turkey one of the internet’s fifth largest audiences. Economically, the Turkish way of life is thriving and the average worker is earning double their wages from just a decade ago. The government structure is steady, which lends stability to the country as it struggles to re-invent itself as a modern day hub for the changing world.Within Istanbul, the city has access to some of the brightest minds in Turkey. Well-educated nationals who studied abroad have been returning to their native land and are bringing a renewed interest in entrepreneurial efforts within the country.  Building a potential workforce with the higher skills necessary within the tech market has great potential for the future of Istanbul’s ability to be competitive on the world’s stage.Despite the availability of investors, the relatively easy regulations for entrepreneurs and the large available workforce, there are areas of concern within Istanbul that may influence the future start-up market. Governmental policies tend to lean toward Islamic ideologies. Recent protests indicate that there is unrest simmering beneath the surface of the residents of the country. An indication of unrest makes investors uneasy, especially in a market that has not yet proven itself as a successful start-up hub. Current indications of government bribery, coercion and corruption have created an environment that is not conducive to trust â€" a vital element of the start-up market. The Istanbul entrepreneur market is tryin g to regain some of the advances they had previously made, but only time will tell how successful they will be.In addition to the governmental hurdles, the infrastructure of the country is a huge challenge. Availability of dependable power and water supplies is a problem for companies running high powered computer systems and networks. For a tech-based start-up, power outages can spell disaster, and they happen with regularity. Logistically, foreigners (and even locals) can have a hard time navigating the winding roads of the ancient city. Large amounts of traffic congest the roads, making stop and go traffic the norm â€" not the exception.The negative side of the start-up market in Istanbul can be daunting. One can argue, however, that for any entrepreneur wading into the start-up industry, there will always be a downside. There will always be obstacles that keep people from taking the leap into entrepreneurship; in a way it is a self-selecting process that weeds out the weaker can didates. For the entrepreneur in Istanbul, there needs to be more than a sense of adventure behind the drive for a start-up: the road is long, bumpy and difficult. The payoff, however, can be enormous in a place that is waiting for their first big exit.6. SPECIALIZATIONThe trends in Istanbul seem to be leaning towards e-commerce industries, followed by commerce and service industries. While there are a large number of tech industries starting, and the number is growing daily, a majority of the start-ups in Istanbul are focused on localized, e-commerce solutions. The push towards tech industries is being helped by the addition of technically advanced classes at the university level, and the growing interest in the global marketplace. Entrepreneurs need to be cautious that they are developing new and innovative methodologies â€" not simply copying existing platforms. Out of five of the largest start-up investments in a recent year, only one was in the tech industry. While the e-commer ce industry is important, if Istanbul wants to be a global player, they must turn their attention towards global initiatives.Notable start-ups that have come out of Istanbul:Trendyol. Trendyol is an e-commerce site that offers users access to fashion items, home textiles, home electronics and more. Boasting a “new way to shop”, Trendyol has brought some of the world’s fashions to Turkey, and has opened the door for Turkish consumers to experience global outreach.Yemeksepeti. Driving the home based food ordering system in Turkey is Yemeksepeti. The company has a network of restaurants that users can order from, without the addition of extra fees. The listing of participating restaurants includes local and global chains. The company has expanded to include several other Arab countries, but is primarily a locally centered company.Grupanya. A namesake of global Groupon, the cost-saving group offers discounted rates on a variety of items and services.GittiGidiyor. A clone of shoppi ng giant eBay, the GittiGidiyor is another example of how Istanbul’s start-up market is focusing on commerce opportunities. The online auction provider is making in-roads into the Turkish marketplace and is growing in use.CitusDB. The database analytics start-up that is going head to head with Oracle, the open-source tool is one of the tech based start-ups to watch from Istanbul. Developers claim that the CituDB processes will increase database performance with faster queries and more efficient optimizations.The start-up market in Istanbul is filled with complexities. The pieces for a successful launch into the tech market are all in place, but they are surrounded by a tenuous landscape that threatens to overtake any potential success. As the world watches, Istanbul (and Turkey) is wrestling with issues and ideologies that have ramifications for personal freedoms, creative thinking, global perspectives and more. As they establish their position regarding these issues, they will be , in effect, establishing the future for their start-up market. Without entrepreneurship, there is no start-up potential. Finding the balance between the past ideologies and modern ideals is essential to the growth of Istanbul as a start-up hub.

Transformational Leadership and Affective Commitment to...

Transformational Leadership and Affective Commitment to Change There has been extensive interest in transformational leadership behaviours among leaders of organizations (OregBerson, 2011).Transformational leaders tend to have certain skills and competences such as integrity, motivation, drive, emotional intelligence, self-confidence, intelligence and knowledge of the business. These are the necessary skills to get employees involved and committed to the change process (Santhidran, Chandran Borromeo, 2013). The relationship between a transformational leadership style and affective commitment to change is the main effect being studied in this paper. The focus is on the influence of a transformational leader (i.e. the traits that a†¦show more content†¦Commitment to change represents an individual’s degree of support for change events. (Herscovitch Meyer, 2002). This definition is consistent with other research that conceives commitment as the adhesive element between employees and employer objectives during organizational change (Conner, 1992). Commitment to change has implications for important outcomes, such as turnover, performance, attendance, and organizational citizenship behaviours (FugateKinicki, 2008). Herscovitch and Meyer (2002) examined that commitment to change consists of three individual facets; affective, continuance, and normative. Which, respectively, distinguish between the people that ‘want’, ‘need’, and ‘should’ support organizational change events.Thus, if an employee is affectively committed to change the employee has an actual desire to support organizational changes. The term affective is more than mere compliance of the changes. It also embodies authentic attention and effort related to the changes (Fugate Kinicki, 2008 ). A transformational leadership style focusses on getting employees more involved with the organization, the employees automatically feel a stronger link, bond or connection with the organization, this is called affective commitment (Mathieu Zajac, 1990). When an employee is affectively committed to an organization and can identify with its values and goals, they are more likely to engage in a set of behaviours that are advantageous for theShow MoreRelatedAs Pointed Out By Keskes I. (2014), Fundamentally, The1000 Words   |  4 PagesKeskes I. (2014), fundamentally, the empirical and meta-analytic studies suggest that subordinates working with transformational leaders are more committed to their organizations and demonstrate fewer withdrawal behaviours (Bono Judge, 2003). Besides, Bass and Avolio (2004) maintain that transformational leaders perceive the strategic goals of the organization. They argue that transformational leaders are more sensitive to their environment and thus formulate and disseminate strategic goals that captureRead MoreThe Effect of Leadership Style on Organizational Commitment Among Academic Staff in Yemeni Universities10662 Words   |  43 Pagesi The Effect of Leadership Style on Organizational Commitment among Academic Staff in Yemeni Universities Sameh Adel Abdo Saeed UNIVERSITI UTARA MALAYSIA JUNE 2011 ii The Effect of Leadership Style on Organizational Commitment among Academic Staff in Yemeni Universities A Thesis Submitted to the Graduate School in Partial Fulfillment of Master of Business Administration Universiti Utara Malaysia By Sameh Adel Abdo Saeed  © Sameh Adel Abdo Saeed, June 2011. All Rights Reserved iii PERMISSIONRead MoreThe Theory Of Job Satisfaction1097 Words   |  5 Pagescomponents of job satisfaction are promotion and supervisor satisfaction. From the case, it is obvious that the foremen were not satisfied with promotion opportunities. The foremen did not believe there were many opportunities to move to higher leadership roles. In addition, the foreman had low supervisor satisfaction. They felt disconnected from management and secluded from other departments. Furthermore, the foremen believed the supervisors supported the antiquated management practices of upperRead MoreThe Intervention First Begins With The Singtel Sales Representatives1678 Words   |  7 Pagesdissatisfaction with the company which was not stated in the survey results. Secondly, to communicate the changes that the organisation will be undergoing. Studies have indicated that employees play a significant role in the success rate of change and may be resistant to the changes if not forewarned (Shin, Taylor Seo, 2012). Besides reducing resistance, communicating the organisational changes increases employee motivation as it allows employees a personal stake in the process (Gilley, Dixon GilleyRead MoreThe Theory Of Ethical Leadership929 Words   |  4 PagesExplanation of Ethical Leadership The research of Thomas W. H. Ng and Daniel C. Feldman provides quantitative data, which validates the effectiveness of Ethical Leadership through the meta-analysis of 101 ethical leadership related studies conducted over the last 15 years. Somewhat in nascent form, Ethical Leadership (Ng Feldman, 2015) is viewed as conduct predicated on exhibiting positive role mode actions while promoting moral member conduct through collaboration, communication, and reinforcingRead MoreEmployees : Attitudes And Job Satisfaction1463 Words   |  6 Pagespeople, places, or things. It s an expression of like and dislikes based on the values or beliefs that an individual holds. Research suggest that attitude can be structured in terms of three component called the ABC Model: affective, behavioral, and cognitive. The affective component involves a person s feeling and emotion. For example: I hate my job. Behavioral is the action component of the model. It s the way our attitude influence how we beha ve. For example, because I dislike this job, IRead MoreEssay about Starbucks Organizational Commitment1101 Words   |  5 PagesStarbucks Organizational Commitment and Organization How does America’s largest coffee company continue to succeed in a tough market? It devises a strategic plan that focuses on effective leadership and a strong organizational structure. Starbucks continuously adapts to the challenges of its critics and overcomes challenges. Its leadership style greatly influences the organizational communication of the company that allows its employees to feel empowered. Given the organizational structure ofRead MoreWe Start By Defining Executive Coaching Essay1388 Words   |  6 Pagespersonal satisfaction, and effectiveness of the executive coachee’s organization within a formally defined coaching agreement. Executive leadership coaching has a similar definition defined by the Center for Creative Leadership as a relationship â€Å"in which the executive coachee and coach collaborate to assess and understand the executive coachee and his or her leadership developmental tasks, to challenge current constraints while exploring new possibilities, and to ensure accountability and support forRead MoreOrganizational Commitment1344 Words   |  6 PagesOrganizational Commitment and Communication Paper Week 3 COM/530 10/27/2011 Introduction A look at an organization’s communication and leadership styles can say a lot about the organization as a whole. Google has a relaxed atmosphere, where management allows workers to create their own schedules; and fosters creativity by allowing and encouraging their workers to explore side projects (Google Culture, 2011). What would happen if the leadership style were to change? This is one of the elements

Dramatic Technique in Death of a Salesman - 2182 Words

Discuss the dramatic techniques in Death of a Salesman. From a technical point of view, Miller was welcomed by those involved in the practical craft of theatre. In his plays, we find challenge and convention, boldness and caution, daring technical experiment and poetic dialogues. In Death of a Salesman , his new dramatic techniques- unrealistic setting, music, lighting, etc.-all generated a sense of mutation of old forms and conventions. Death of a Salesman concentrates on Willy Loman, an exhausted middle aged salesman, who has failed to realize his dream of economic success and is presented as being on the verge of a nervous breakdown. Failure also engulfs his wife Linda and two sons-Biff and Happy. The play is divided into three main†¦show more content†¦When Charlie finally realizes that Willy is absent-minded, he makes an exit. Here we see Willy’s too much obsession of the past over present. Miller described Willy as literally at that terrible moment when the voice of the past is no longer distant but quite as loud as the voice of the present†. He didn’t see Willy’s internal sequences as flashbacks. Miller says, â€Å"There are no flashbacks in this play but only a mobile concurrency of past and present †¦Ã¢â‚¬ ¦..because in his desperation to justify his life Willy Loman has destroyed the boundaries between now and then.† 3) The action may take place in more than one location simultaneously. In the kitchen when Willy starts talking to young Biff and Happy in the past, Linda enters the room and asks Willy about the car. 4) The Setting must be non-realistic or partly realistic. One part of the stage may be set with realistic scenery, such as the kitchen at Brooklyn in Death of a Salesman ,but this may have an empty open stage area in front of it into which a single piece of furniture or other item may be brought to suggest a location, or the area may be left empty and used for variety of purposes, such as:In the empty space, Howard Wheels on a table with his wire re corder and his office is rapidly set up. To create a restaurant, Happy and the waiter bring on the chair-table the garden at Brooklyn. The play’s setting contributes to the understanding of the theme. In Death of a Salesman, the realistic set is the backyardShow MoreRelatedDeath of a Salesman Directors Vision1128 Words   |  5 Pages14 Pall Mart Belgravia London SW10 Pier 4 Hickson Road Walsh Bay NSW 2000 I write to you to propose the production of Arthur Miller’s classic â€Å"Death of a Salesman.† As the title suggests, the book is about the death of a salesman named Willy Loman. However, through my production, it is not the inevitable ending that will be remembered by the audience. It will be the processes that led to Willy’s conflicted mind that will resonate in the audience’s mind. The underlying values of blindRead MoreComparing Oedipus Rex And Death Of A Salesman By Arthur Miller1255 Words   |  6 Pagesstill use it today in Modern times. b. Today I will be comparing the two works such as Oedipus Rex, which is a playwright written by the great Sophocles and another playwright named Death Of A Salesman written by Arthur Miller. c. Through out the years, there has been a lot of controversy on whether or not Death Of A Salesman is considered to be a tragedy, unlike Oedipus Rex which clearly is. d. I feel these two plays can compare in a multitude of ways despite being written in different historical timesRead MoreDeath Of A Salesman: Illusion In An American Tragedy Essay1738 Words   |  7 PagesWhen the realities of life become too harsh, humankind has a natural tendency to choose the most convenient solution to his problem: illusion. They build dreams and fantasies to conceal the more difficult truths of their lives. In his play Death of a Salesman, Arthur Miller portrays the hold of such illusions on individuals and its horrible consequences. Through the overly average, overly typical Loman family, Miller shows how dreams of a better life become, as Choudhuri put it, â€Å"fantasies to theRead MoreImportance Of Modernism In Modern Theatre1042 Words   |  5 Pagesare a common situation in modern theatre, it can be useful to identify the intentions of dramatists and their dedication to this philosophical idea. For analyzing the modernism in modern drama, it is necessar y to discuss three modern plays (Death of a Salesman by Arthur Miller, A Taste of Honey by Shelagh Delaney, and Top Girls by Caryl Churchill) as the way to enhance the understanding of the topic. Initially, it is important to briefly describe the history of modernism and find out the drivingRead MoreArthur Miller s Psychological And Social Magnitude Of His Characters1657 Words   |  7 Pagesan individual and the relationships that surround him. 2. B. Despite their reduced circumstances, Augusta Miller stressed to her children the importance of learning and high culture, urging all of them to attend college. Like Biff Loman in Death of a Salesman, Miller was more of an athlete than a scholar. He proved a disappointing student at Abraham Lincoln High School, where he had greater success as a football player. He presented himself as a child who didn’t have much interest in school, butRead MoreThe Power of Irony in The Death of a Salesman Essay1778 Words   |  8 Pages102 Professor: Jeff Ousborne 04/05/2013 The Power of Irony on â€Å"The Death of a Salesman† Authors use irony in literature in order to give double meanings and make it more interesting to the reader. In the play â€Å" The Death of a Salesman† Arthur Miller uses irony as a strong writing technique in order to express the characters behavior. In â€Å"The Death of a Salesman† by Arthur Miller moments of situational and dramatic irony helps to illustrate the storys theme in which Willy is a man tryingRead MoreEssay on Death of a Salesman2925 Words   |  12 Pagesâ€Å"Death of a Salesman† written by Arthur Miller in 1948 attempts to give the audience an unusual glimpse into the mind of a Willy Loman, a mercurial 60-year-old salesman, who through his endeavor to be â€Å"worth something†, finds himself struggling to endure the competitive capitalist world in which he is engulfed. Arthur Miller uses various theatrical techniques to gradually strip the protagonist down one layer at a time, each layer revealing another truth about his distorted p ast. By doing this, MillerRead MoreThemes of Modernism859 Words   |  4 Pagescharacter Manley is a bible salesman and he is supposedly good country people, but after he is alone in the barn with Helga his true colors shine through. When Manley pulls alcohol and playing cards with naked pictures on them out of his bible, OConner is showing the grotesqueness of religion. Through these actions OConner is showing that Manley and his religion are sick and twisted and that during the Modernism movement many people lost their faith due to something dramatic that happened to them. Read More Failure in a Success Oriented Society in Death of a Salesman1923 Words   |  8 PagesSuccess Oriented Society in Death of a Salesman    In the play Death of a Salesman by Arthur Miller, the playwright focuses on the theme of failure in a success oriented society. Willy Lowman, a failed salesman, is the central character. Willy’s downfall is caused by his belief in the propaganda of a society that only has room for winners. The significance of this theme, still very relevant today, is heightened by Millers skilful use of a range of key techniques, including setting, characterizationRead MoreEssay on Death of a Salesman and Street Car Named Desire4007 Words   |  17 PagesBiff: â€Å"will you take that phony dream and burn it before something happens† Compare how the authors of Death of a salesman and â€Å"street car named desire explore the conflict between truth and illusion Truth and illusion are utilized in Tennessee Williams â€Å"Streetcar Named Desire† and Arthur Millers â€Å"Death of a salesman† through the use of the character; to lead the reader to a possible conclusion on the beliefs that went into the American dream that prompted people to work hard was that america

The Ideal Person Free Essays

Nietzsche’s Ubermensch concept of the â€Å"ideal person† was able to achieve self-actualization, and has developed himself holistically. What Nietzsche meant by achieving self-actualization was to achieve one’s full potential through creativity, independence, spontaneity, and a grasp on the real world. I see an ideal person as someone who surrounds themselves with happiness and love even with no money or fame. We will write a custom essay sample on The Ideal Person or any similar topic only for you Order Now Most people consider the ideal person beautiful and rich. But as many people may say, money doesn’t always bring happiness or love, it could lead to loneliness and emptiness, even with all of the material things. An ideal person, as lived their life without regrets. I do agree with an ideal person is someone who can achieve their full potential through everything they do. They put all their hard work and effort into what they need to accomplish and with the best of their ability. I believe this is the most important similarity with our ideal person as well as Nietzsche’s. A difference between our theories would be that we may see an ideal person as someone who is less fortunate but doing the best of their potential to provide for themselves and their family. And we would see that as with the resources they have and can afford then they are achieving a self-actualization. Nietzsche may be that as not a real ideal person, because someone might not look up to that certain person because they are not so called living the glam life, and having everything around them. He may think that he is not achieving his full self-actualization because of that, when really is he by being happy in life and grasping everything around him that he can and not taking it for granted. Nietzsche believes that the ideal person is high, rare, and far between and mainly mentions them as a â€Å"he†. In my belief the ideal person can be of any gender, by achieving greatness, and many people are ideal and not as rare as he mentions. With the main differences in mind I think that his Ubermensch is not plausible. He see’s the ideal person as a higher power and rare and far between, like the so called superman that is seen in comic books, that was created after his theory. His person is like a fantasy that people wish they were instead of being normal people around us that achieve their potentials and that are plausible. How to cite The Ideal Person, Papers

Argumentative Essay for Transformational Leadership in Early Years

Question: Write about theArgumentative Essay for Transformational Leadership in Early Years. Answer: Introduction Transformational leadership is one of the styles of leadership that is used to motivate the employees and boost them up for better working. The essay here argues the aspect of transformational leadership in the early years. The positive point of early year knowledge is that the staffs learn early with the fresh mind and more curiosity rather than when he actually gets appointed in the organisations. There are multiple benefits that follow the transformational leadership in the early years. Yet there exists the shortcoming of the leadership in early years as well. In the early time period students do not take such an aspect in the serious mode and sometimes the whole influential thing is dependent upon the leader teacher who imparts the knowledge to the students, if the lack of good communication is there the problem is likely to arise. Thus, the essay involves the discussion upon the transformational leadership in early years, its pros and cons and the portion that has been favoured is discussed in detail (Mitigang, 2012). The essay focuses on the premium definition of leadership followed by the importance of transformational leadership in early years. The transformational leadership has been explained in general and then the focus on early years has been drawn. The positive possibilities are discussed followed by the disadvantages that are attached with the early year leadership. The essay concentrates on the positive portion of the transformational leadership in early years and 5 traits of leadership in early years have been focussed. The distributed leadership has been quoted in context of transformational leadership. Thereafter the characteristics of the leader have been discussed in context of early year learning of transformational leadership followed by the conclusion of the essay for better and clear understanding. Transformational Leadership in the Early Years Transformational leadership states that the leader is at the aim to motivate the employees and making them work effectively and efficiently. In transformational leadership style the leader considers the individual strength, weakness, the point of motivation, what inspires the employee and many more factors. The leader measures all the parameters and act accordingly to retain the employee and ensure the growth of an organisation. It is the prime responsibility of the leader to develop the better understanding in context of the organisational activities, policies and procedures (Dunlop, 2008). It is not necessary that the leader is always a manager, leadership qualities has nothing in connection to leadership even the low level employee could be a leader among the peer because of the knowledge, skills and abilities it contains and the manner he/she deals with the things. The transformational leadership is concern about the problem solving and decision making as well. The good leader is one that analyses the problem, studies it and accordingly react upon it with a wise mind. Leadership depicts the quality to solve the issues and deal with the challenges, they are the one that treat dynamism as an opportunity and crack it out into wonders. The decision making quality of the leaders are also appreciated, they evaluate the situation completely and afterwards react to it in a positive manner (Kimberly, 2015). The transformational leader performs these activities to satisfy the employees need and understand the quarrels that are going to happen and take corrective actions accordingly that at last build the trust over the decision making skill of the leader. To be an effective leader no particular degree or qualification is needed. It is the inner zeal and confidence that reflects out when certain situation occurs. Leaders always try to grab the opportunity and take the initiative to make changes, the power resists within the individual only and no particular designatio n is needed to prove the leadership quality. The power is the positive energy that rests under the leader and such a leader reflects and passes on such positivity to other people as well thereby creating a generous environment and encouraging the employees to work in the authentic and smart manner (Antonakis, 2017). The transformational leadership in early years is basically the learning that is given to the students of school. The researcher explains that children are made to learn the values and beliefs in the early age so that the decision making skills starts to develop at the early panel only. The leadership in the early years helps in promoting the confidence within the student and the self-analysis takes place which assists in improving the mindset of the students (Zhao et al, 2016). The leadership should be prevalent in the teachers so that they could make staffs learn the skills and abilities that will help them achieve the goal that they have set or finish up their daily task accordingly. The transformational leadership in early years helps the students to learn more and understand better so that the things start to fall in place from the early age only. This also improves the learning of students and led them toward the success (Hawkins, 2017). The equality is taught to them so that t hey carry the perspective of equal treatment within the organisation and they practice the similar thing when step in the corporate world. Transformational leadership in the early years focuses on the vision that has to be ultimately achieved and in order to attain it the mission is created which is the path to attain the vision (Farmer Tierney, 2017). The practitioners in the early times must be taught the importance of vision in the company and what all efforts should be made to achieve the goal by retaining the quality and not affecting the quantity as well. They are made to learn about how to stay motivated and reflect the similar zeal and positive energy in the environment (Day, Gu Sammons, 2016). From the very beginning they are made to work own their own so that they do not get dependent upon anybody and even they are aware of problem solving tricks and take decisions as per the situation. This thing helps them in the upcoming future and by that time they must have come acr oss a lot of problems and could have effectively dealt with it. When the staffs move forward at the organisational level they are well aware of the environment and things they need to incorporate and quickly they will be able to settle down in the corporate world without much pain or issues in context of problem solving and decision making. When such an approach is chosen at the early times there are chances that person grabs the growth early and seek to the better position (Jaiswal Dhar, 2016). The researches argues over the negative aspect as well and quotes, since in the early time the mind makeup has to be made and practitioners have the free mindset they cannot handle formal behaviour or carry it to the other level (Aw Ayoko, 2017). Since they are not currently working in any particular organisation the practical aspect remains a mystery that might create hurdle in understanding the things thoroughly. Some of the other demerits of transformational leadership in early years could also be investigated. The transformational leadership in early years only motivates and make the student learn about the new things and the ethics that are to be followed; they are not made to practice those things so that practical exposure could be gained. The things end up to be intangible and no sought of tangibility are ever achieved (Travis, 2017). Also it is the time consuming session because the teachers and other leader need to put lot of input and invest their time and energy to make student understand the importance of leadership and how the motivational factor works for the employees and other peers. For conducting the sessions to demonstrate the features of transformational leadership there is the requirement of trust and faith in the leader then only the one could be able to grab the knowledge and learning quickly and stick to it till the time of implementation (Gillet, Fouquereau, Huyghebaert Vandenberghe, 2016). Also another factor that affects the transformational leadership in the early years is that its not always the staffs that have to learn or creates trouble in learning and managing new things for their development at times even the leader could be at the faulty position. The leader delivering the knowledge might be good at handling the people and motivating the staff but do not possesses the quality to impart the lectures in an appropriate manner. The leader might not be good at the part of delivering the knowledge and the theoretical aspect but a t the own concern they might be better in convincing people and dealing with the mangers and suggesting new and innovative ideas. This kind of problem results in the situation that students are not able to clarify the topic and the conceptual portion gets missed out. The base is not well developed therefore the further detailing becomes worthless as the concept is not clear which will always create the problem (Einarsen, Aasland Skogstad, 2016). After analysing both the portion the researcher decided that transformational leadership in context of early years is a beneficial activity. It allows the children to learn more and grow more. It focuses on the succeeding aspect of the child while making good decisions from the early time only. The transformational leadership in the early years involves 5 important traits that need to be known so that the understanding of staff could be developed and monitored so that adequate action could be implemented (Lackey, 2016). First of all in early year leadership it is to be seen that what all are the things that matter to the child and accordingly the analysis could be made and future could be predicted as to which thing could be focussed on to attract the child to learn new thing. The best leader to the child is their parents and they must know the strong point of the child and focus on that point has to be paid so that leadership quality automatically rises up when the person is working in direction of interest or heading towards the career goal (Education .gov.nz, 2017). This will help the staff to learn new things by its own and accordingly they would become responsible and accountable to the seniors they have in an organisation. It is the prime responsibility of the leader to focus on each and every member and construct a swot analysis so that appropriate selection takes place. In this way the deserved person get to achieve something and the one who lack certain quality co-op up with it and training is provided to them so that they could overcome the challenges. Also in the early year leadership the learning becomes easy as the fresh and young mind could easily grasp the things rather than the older mind. When better learning has been acquired the success gets assured and personality of the person gets improvised. When one is educated it is the common practice that they will impart the knowledge to the other as well, this practice is more common in context of t he students. The transformational leadership in early years could be turned other way round by connecting it with the distributive leadership. It is the distinctive leadership that promotes and boost up the inner conscious of the person (Lindon, 2012). The zeal to achieve something is developed in the distributed leadership and such a level of motivation increases the job satisfaction thereby the turnover of employee gets reduced as the leader knows the motivational and satisfaction level of the employees. When the adequate and understanding environment has been given to the employees and their problems are heard and solutions are rendered, also they are helped to accomplish the difficult task this lead to the feeling of security and employee feels engaged with the company therefore the organisational commitment is also achieved (Berkovich, 2016). The researcher states that in the distributed technique that better work could be achieved more efficiently if targets are set and work is distributed in the team. This gives the exposure of the team as well. Working in team is equally important as working individually. In teams the work gets distributed and it consumes less time and all the members of the team move ahead in the single direction following the core goal. The leader teacher need to distribute the projects to the staffs in the group so that they could understand each others mindset and accordingly the work could be carried out that involves the collaboration of multiple ideas (Zepke, 2017). If such a task had been completed by an individual the area of knowledge would have been limited. By working in the group the tub of ideas, opinions and suggestions are there and the group need to choose the one best alternative to accomplish the given project. this is what actually happens in the organisations, multiple ideas are collected and one best alternative is selected and this is the criteria of decision making, through this small activity student get to learn about the d ecision making process. Also while working in the teams there are various people from different backgrounds who come together for the achievement of common goal. Through this the members tries to adjust with each other and accept one another the way they are, in doing so the conflicts also take place and mutually these issues also gets resolved which improves and clarify the concept of problem solving as well. The leader should monitor the working of group and while analysing the new leader or student leader could be attained as the qualities of the people reflects out when they work together. There are varieties of things that the person get to know by others by working into the group, the latent talent pops up and this could prove to be the lien of career for certain students (Leithwood Jantzi, 2000). The researcher claims that in the early year leadership, quality could be figured out by looking at certain traits. The transformational leadership consists of certain characteristics that should be focussed on. First of all to be a leader an individual need to have the foresightedness, he/she should be the visionary who studies the external environment and accordingly the actions are taken to crack the opportunity and increase the strength of organisation and the person themselves. These leaders are accountable to the immediate supervisor, to become a leader there is not a need to gain certain position or hold the higher level in an organisation (Kivunja, 2015). The researcher pointed that leadership cannot be learnt; it prevails within the individual from the time they are born, only the efforts need to be made to remove the hesitation and pull out the quality from within the person. Through the better knowledge the mind gets broaden up and this is only the polishing of the person. The leader need to be inspirational, the positive person automatically reflects backs the positivity to the other person and generous environment gets created. The leader should be soft and approachable by the peers and subordinate, he should hold the flexible behaviour so that employees could feel free to contact the concern and seek the valuable advice from the leader (Nayab, 2010). Also, it is highly important for the transformational leader to stay stable and confidential. The disclosure element should be inculcated in the mind of the students from very start so that fellow people do not have the trust issues with their leader. The leader is one who knows about the strengths and weakness of eth members in their team and these should not be disclosed to demotivate the person, instead the efforts and ideas should be given to the individual to overcome the weakness and take it as an opportunity to convert it into strength. For the transformational leader the foremost thing that is highly requires is good communication skills and better interpersonal skills. As discussed earlier the leader might be good at the practical work about the knowledge delivery part lack and this could cause a serious problem to the student as they wont be getting the base clear (Zhu, Avolio Walumbwa, 2009). Thus, for that concern the leader teacher and parents need to focus on the communication part of the child so that they could catch the words easily and is able to interact with the team and clearly publish his/her own ideas confidently. In order to motivate the employee as well the need of communication is there and same applies to the resolution of conflict. It could be argued that being the good speaker and the motivator the leader need to have better listening skills as well. For the leader it is important to listen to the problems of people, analyse them properly to reach to the perfect solution. This structure when adopted by the leader helps in increasing peoples trust as well as the self-improvement is recorded and the student turn out to be the successful leader in the upcoming future (Gorman Gamble, 2016). Therefore, it could be concluded that leadership is the strong portion in the feature of management. It directs the people and influences them to exercise certain things. Now a day most of the company demands for the leaders who are attractive carrying the good personality and confident in their work who has the power to convince the people in the outer world. The transformational leadership should be taught to the practictioner in the early years because at that point of time they are highly creative and curious to learn. While making them learn new things even the leader gets to learn numerous aspects of positive leadership. At the early years the staffs are enthusiastic to learn and they consist of the visionary mind that could be directed in the appropriate direction towards the success and well-being of the students. In the early years leading is distributed in three portions that is leading others, leading learning and leading the innovation (Early year matters, 2017). It is ob vious that in the early year the innovative ideas strike into their mind and zeal to fulfil those goals rises up. For that first of all the transformational leadership has to be understood and thereafter the positive and negative impact of the transformational leadership has been discussed followed by arguing on the positive part of the leadership in early years. Lastly the qualities of the leaders have been explained that need to be monitored and implemented within the person at the early years so that better generation gets ready to achieve the heights. References Antonakis, J., 2017.The nature of leadership. Sage publications. Aw, V.K.J., Aw, V.K.J., Ayoko, O.B. and Ayoko, O.B., 2017. The impact of followers conflict behaviors on teams transformational leadership, team member exchange and engagement.International Journal of Conflict Management,28(4), pp.509-532. Berkovich, I., 2016. School leaders and transformational leadership theory: time to part ways?.Journal of Educational Administration,54(5), pp.609-622. Day, C., Gu, Q. and Sammons, P., 2016. The impact of leadership on student outcomes: How successful school leaders use transformational and instructional strategies to make a difference.Educational Administration Quarterly,52(2), pp.221-258. Dunlop, A., 2008. A literature review on leadership in the early years.URL: https://www. ltscotland. org. uk/publications/a/leadershipreview. aspDownload vom,5, p.2011. Early childhood Australia, 2017, What does leadership look like in early childhood settings?, viewed on 19th November 2017, https://www.earlychildhoodaustralia.org.au/our-publications/every-child-magazine/every-child-index/every-child-vol-18-4-2012/leadership-look-like-early-childhood-settings/. Early year matters, 2017, Leadership, viewed on 19th November 2017, https://www.earlyyearsmatters.co.uk/our-services/school-and-nursery-improvement-partner/leading-learning/. Education .gov.nz, 2017, Leadership in early childhood education for 5 out of 5 children, viewed on 19th November 2017, https://www.education.govt.nz/early-childhood/teaching-and-learning/leadership/5-out-of-5/. Einarsen, S., Aasland, M.S. and Skogstad, A., 2016. the nature and outcomes of destructive leadership behavior in Organizations.Risky Business: Psychological, Physical and Financial Costs of High Risk Behavior in Organizations, p.323. Farmer, S.M. and Tierney, P., 2017. Considering creative self-efficacy: Its current state and ideas for future inquiry.The Creative Self: Effect of Beliefs, Self-Efficacy, Mindset, and Identity, p.23. Gillet, N., Fouquereau, E., Huyghebaert, T. and Vandenberghe, C., 2016. Transformational leadership, work-family conflict and enrichment, and commitment.Le travail humain,79(4), pp.339-362. Gorman, C.A. and Gamble, J., 2016. Leader behavior and follower work behavior: the influence of follower characteristics. Hawkins, P., 2017.Leadership team coaching: Developing collective transformational leadership. Kogan Page Publishers. Jaiswal, N.K. and Dhar, R.L., 2016. Fostering Employee Creativity through Transformational Leadership: Moderating Role of Creative Self-Efficacy.Creativity Research Journal,28(3), pp.367-371. Kimberly, 2015, What is being a leader? Viewed on 19th November 2017, https://www.earlyyearscareers.com/eyc/latest-news/being-an-effective-early-years-leader/. Kivunja. C., 2015, Leadership in early childhood education contexts: looks, roles and functions, Scientific Research Publishing, vol. 6, p.p. 1710-1717. Lackey, N.Q., 2016. The Influence of Training on Guides and Their Environmentally Responsible Behaviors and Transformational Leadership Abilities. Leithwood, K. and Jantzi, D., 2000. The effects of transformational leadership on organizational conditions and student engagement with school.Journal of Educational Administration,38(2), pp.112-129. Lindon, J. and Lindon, L., 2012.Leadership and early years professionalism. Hodder Education. Mitgang, L., 2012. The Making of the Principal: Five Lessons in Leadership Training. Perspective.Wallace Foundation. Nayab, N., 2010. Characteristics of Transformational Leadership, p.2011. Travis, E., 2017, The disadvantages of transformational leadership, viewed on 19th November 2017, https://bizfluent.com/info-7749368-disadvantages-transformational-leadership.html. Zepke, N., 2017. Through Distributive Leadership to Critical Engagement. InStudent Engagement in Neoliberal Times(pp. 187-201). Springer Singapore. Zhao, H.H., Seibert, S.E., Taylor, M.S., Lee, C. and Lam, W., 2016. Not even the past: The joint influence of former leader and new leader during leader succession in the midst of organizational change.Journal of Applied Psychology,101(12), p.1730. Zhu, W., Avolio, B.J. and Walumbwa, F.O., 2009. Moderating role of follower characteristics with transformational leadership and follower work engagement.Group Organization Management,34(5), pp.590-619.

Parker Pen Case Study free essay sample

This particular case deals with a number of subsidiary marketing problems of PARKER, a writing instrument company, which ultimately converge into a major marketing problem. The designer of this case also has a specific objective to attain out of this case study. Wrong selection of marketing strategy by the new CEO of PARKER (Mr. Paterson) was the principal problem of this case. There are a number of subsidiary problems associated with this. Long-term The global strategy orientation plans failed in the long run of the company for the past two decades and now the re-establishment of a global strategy with multinational decentralization approach is needed. By which way can the company regain its primary position in the global market with a multinational marketing approach once again and retain the traditional qualities of the brand? In stating the problem(s) be specific, concise, and to the point. The root of all managerial and marketing problems is the ill-defined framework and biases in the decision–making procedure derived from the CEO of the company James R. We will write a custom essay sample on Parker Pen Case Study or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Peterson. Identify and list the â€Å"symptoms† to the problem and Key Facts of the Case The adaptation of a unified global marketing approach can be explained as a self-reference criterion (SRC) mistake of the CEO due to his former experience. Many companies involved in global marketing, do not rigidly centralized all their marketing effort, due to the huge variety in the culture of different region. In some cases companies made little or few adjustments in their standardized global effort to meet the requirements of different environments. But Mr. Peterson and his strategy had the rigidity in following centralized packaging, pricing, and promotional materials. This rigidity was not accepted by the customers of different culture. Pursuing the market and products of lower-end in addition to higher-end products was a devastating re-positioning decision for the company. Over the period of time PARKER established an image, as the seller of high-end products. But the new CEO suddenly started pursuing the lower-end of the market and started producing lower-priced pens. This was counter to PARKER’s tradition and image and many of its loyal customers could not accept this. Ultimately this proved to be an ill – advice for PARKER. There is another reason for the failure of the new strategy. Problems arose on the manufacturing side with the fact that repeated mechanical faults caused disturbance in the productivity of the automated production plant. Mr. Peterson fired a group of his successful managers which consisted of some veteran managers of the company. In some cases, a move was greeted with dismay by the employees within the company, which ultimately affected the productivity of the firm. Under these circumstances, company’s image was affected, which ultimately resulted into the selection of a wrong strategy for PARKER. 3. Strategic Alternatives Analysis, advantages and disadvantages of alternatives Continuing with the Previous Decentralized Strategy via enhancing presence in the local markets like before through investment in local subsidiaries and economic motivation to its past advertising agencies. This strategy may enhance sales gradually but repair the brand image and net equity in the long term. Lower End Market Product may be developed with Different Brand Name. In this strategy PARKER would try focus its efforts again on selling the upper end products in their generic brand name PARKER to keep up the tradition and image of the company at historically targeted market segments. At the same time, the company could pursue the lower end market with different brand name products, in order to achieve risk diversification and better net equity. Initially, this strategy might face some difficulties to penetrate the market but if handled with care it could earn the satisfaction of profitable segment, especially in emerging markets like Brazil, China and Turkey.

How to Tell Your Parents You Want to Transfer Colleges

How to Tell Your Parents You Want to Transfer Colleges Chances are, you and your parents spent a lot of time looking at, preparing for, applying to, and finally deciding on which college you wanted to attend. Which means, of course, that if you decide you  really  dont like where you are and you want to transfer to another institution, bringing the topic up to your folks presents quite a few challenges. So just where should you begin? Be Honest Its okay to admit that you dont like where you are; approximately 1 in 3 college students ends up transferring at some point, which means that your desire to head somewhere else certainly isnt unusual (or even unexpected). And even if you feel like youre letting your parents down or are otherwise creating problems, being honest about how your current experience is going is still really important. Its much easier to transfer before things become overwhelming, after all, and your parents need you to be honest if theyre going to be able to fully help and support you. Talk About What You Dont Like at Your Institution Is it the students? The classes? The professors? The overall culture? Talking through whats causing your stress and unhappiness can not just help you find a solution, it can help transform what feels like an overwhelming issue into smaller, conquerable problems. Additionally, if youre looking to transfer, youll be better able to identify what you  dont  want at your next college or university. Talk About What You Do Like Its unlikely that you dislike every single thing at your current school. It can be hard but also helpful to think about the things you really do like. What attracted you to your institution in the first place? What appealed to you? What do you still like? What did you learn to like? What would you like to see at any new place you transfer to? What do you find appealing about your classes, your campus, your living arrangement? Focus on the Fact that You Want to Continue Calling your parents to say you want to leave your school can be heard two ways: you want to transfer colleges or you want to drop out of college altogether. And for most parents, the former is a lot easier to handle than the latter. Focus on your desire to stay in school and to continue your education just at another college or university. That way, your parents can focus on making sure you find someplace with a better fit instead of worrying that youre throwing your future away. Be Specific Try to be very detailed about why you dont like where you are. While I just dont like it here and I want to come home/go somewhere else might adequately convey how youre feeling, broad statements like these make it difficult for your parents to know how to support you. Talk about what you like, what you dont like, when youd like to transfer, where (if you know) youd like to transfer, what you want to study, what your goals still are for your college education and career. That way, your parents can help you focus on the things that are most important in ways that are specific and actionable. Talk Through the Specifics If you really do want to transfer (and end up doing so), there are a lot of logistics to work out. Before you fully commit to leaving your current institution, make sure youre fully aware of how the process will work. Will your credits transfer? Will you have to pay back any scholarships? When will you have to start paying back your loans? What financial obligations do you have in your living environment? Will you lose any efforts youve made in the current semester and, consequently, would it be wiser to just stay a little while longer and finish up your current course load? Even if you want to transfer as soon as possible, you likely dont want to spend longer than needed cleaning up what you left behind. Make a plan of action, knowing deadlines for all of your to-dos, and then talk with your parents about how they can best support you during the transition.

Apple vs samsung Essay Example | Topics and Well Written Essays - 3250 words

Apple vs samsung - Essay Example The content of this report concentrates determining the main reasons behind the increasing competitiveness of both the companies and the reasons behind the recent success of Samsung in comparison to Apple in the smartphone segment. From the findings, it is determined that Samsung has significantly focused on availability, after-sales service and use of media to lure the consumers as compared to Apple. The presented findings of this report also discuss about the pertinent views of the general managers of both companies who highlight their opinions regarding the changing competitiveness in the industry and their future endeavors with the offered smartphones . It concludes with the assessment that despite possessing impeccable brand image Apple has slightly remained behind Samsung in the smartphone segment due to the lack of availability, after-sales service and a reduced focus on ensuring utmost consumer satisfaction of ease of purchase. Thus, certain recommendations including focusing of untapped consumer segment and reducing price of the smartphones have been offered to Apple. Conversely, Samsung has been recommended to increase its market share in the segment of smartphone through sustained focus on augmentation of brand awareness and product promotion. I hope this report will prove to be satisfactory. If you should have any questions concerning my project and report, please feel free to contact me â€Å"Sumaya Ali â€Å" at Samyaa0202@hotmail.com. Sincerely, Fatima Ali Attachment : My report on Smartphone Comparison Table of Contents NU SUBJECT PAGES 1 Summary of the Report 4 2 Introduction 5 3 Procedure 6 4 Overview About Apple And Samsung 6 5 SWOT Analysis 9 6 Findings 14 6.1 Questionnaire Findings 14 6.2 Interview Findings 21 7 Conclusion 24 8 Recommendations 25 9 Appendix 26 9.1 Survey Questionnaire 26 9.2 Interview Questionnaire 28 10 References 29 1- Summary of the Report The report intends to provide a comparative study of the smartphones of two of t he world’s leading manufacturer’s i.e. Apple and Samsung. From the perspective of technology and innovation, both the companies are superior in this field. However, there are a number of pertinent parameters based which Samsung can be stated to be noticeably ahead of Apple in terms of sales as well as market share. Therefore, as a part of this report a consumer feedback questionnaire has been designed and feedbacks from the smartphone users have been accumulated accordingly. In addition, a set of interview questionnaire is also designed for taking the interview of the Chairman/CEO/General Manager of Apple as well as Samsung. Based on the feedbacks obtained as a part of this report, a set of relevant recommendations has been offered to both the companies. 2- Introduction Over the past decade in the field of technology segment, Apple Inc and Samsung Electronics have been two of the major players as well as rivals. Apple Inc is an American based multinational organisation (MNC), founded in 1976 by Steve Jobs (Apple, 2013). Samsung Electronics is a South Korean based MNC founded in 1938 by Lee Kun-hee (Samsung, 2013). Although Apple came into the market later but in the course of focusing on sustained technological innovation it has turned into one of the preferred and respect brands in the world, thus in turn creating an immense challenge for the competitors to match up to the offerings of Apple. In

American Revolution Research Paper Example | Topics and Well Written Essays - 1250 words

American Revolution - Research Paper Example The protests to these laws were initiated by a group calling itself the sons of liberty, who in their bid to show their concerns against the law, infiltrated a ship in the Boston harbor, destroying 342 chests of tea in the year 1773 (McCullough, 27). In response to these protests, the British Empire imposed a series of punitive laws, referred to as the intolerable acts in 1774. In 1774, the American patriots suppressed all loyalists, and took control of each colony, establishing new government. The British Empire responded by sending troops for purposes of establishing royal control in the year 1775 (McCullough, 26).   The war ended in 1783 with the surrender of Britain, making the colonists establish the federal government of United States, with each of the 13 regions having a governor, and a parliament.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     During, and after the war, one of the most important and notable figures was Benjamin Franklin. Benjamin Franklin is regarded as on e of the founders of America, having played a great role convincing the 13 colonies of America to stay united (Prelinger, 5).   Benjamin Franklin is also credited as being the only person amongst the founders of America to sign the three documents that freed the American colonies from the colonial rule. These documents are the Treaty of Paris, the American Constitution, and the Declaration of Independence (Prelinger, 9). It is important to understand that the role of Benjamin Franklin in assisting Thomas Jefferson to come up with a formal document.

Role of the nurse in management of COPD

Role of the nurse in management of COPD Chronic Obstructive Pulmonary Disease (COPD) is a treatable condition that is defined as being a disease characterised by airflow limitation that is not fully reversible. This airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases (Fabbri, 2003). One in every four acute admissions to hospital is due to respiratory difficulties, and 50 per-cent of these are caused by the complications of COPD (Roberts, et al., 2001). In the United Kingdom, it is the third most common cause of overall adult morbidity and mortality, especially among smokers, (Barnes, 1999), and it is a significant burden to the NHS. In recent years, nurse-led primary care interventions have become more widespread. Although there has so far been insufficient evidence to support their implementation, there appears to be no difference in quality of care between doctor-led and nurse-led COPD programmes (Pye, 2008), and they may offer a cost effective and holistic solution to both the NHS and patients respectively. This essay will use a case based discussion to illustrate the role of the Nurse Practitioner (NP), and nurse prescribing issues for a patient with COPD. Case study The patient is a 62-year-old married Caucasian female who attended for a routine primary care nurse-led COPD evaluation during 2010. The patient had no other past medical history, apart from moderate COPD. This was diagnosed three years ago, following recurrent respiratory infections, two of which had necessitated hospitalisation. The NP had not seen this patient before and after familiarising herself with the notes and establishing a rapport with the patient took a medical history asking important questions about the history of the presenting complaint, the COPD, the patients past medical and surgical history, medication lists, allergies to medications, social history and smoking habits. The NP used a template questionnaire that was part of the COPD care pathway to identify how the COPD impacted on the patients quality of life. She herself had introduced this questionnaire herself as a result of her own reflective learning and had based it on one from a paper by Vandevoorde, et al., (2007) that included aspects about patient symptoms that patients do not always volunteer to medical professionals, such as side effects from medication and qualitative measures of fatigue and mental well-being (Vandevoorde, et al., 2007). Three months earlier, the patient had one exacerbation, which resulted in admission to the local hospitals medical assessment unit, and she recovered well. She occasionally had moments of shortness of breath, but these were typically on exertion and doing other strenuous activities. During this visit, she reported that her condition was stable. Her sputum production was approximately  ¼  ½ a cup/ day, and she needed to use 2.5l of oxygen at night. The patient continued to smoke six cigarettes/ day, and being a much heavier smoker previously she had a history of 60 pack years. She was compliant with her regular inhalers and had no problems with side effects, apart from a bad almost metallic taste in her mouth that she had occasionally recently started if she had forgotten to wash her mouth after using her inhalers. She had also been started on a Corticosteroid inhaler by the hospital respiratory team following her last exacerbation, but she mentioned that she had not noticed any difference in her COPD symptoms in using this. On direct questioning, she remembered that she also did have an unpleasantly sore mouth and voice was becoming hoarser since she had commenced using this steroid inhaler, but she didnt know if this was the effect of the steroid inhaler, the drying effects on mucous membranes of using oxygen therapy, or something else. She had noticed these symptoms for at least three weeks, and two weeks ago she had noticed white patches on her tongue. Apart from oxygen, and the newly introduced Corticosteroid inhaler that she was using; in terms of her other medication, she was taking the long acting beta 2-agonist Salmeterol twice a day, and the anti-cholinergic bronchodilator, Ipratropium Bromide. She had been using both Salmeterol and Ipratropium Bromide for several years, and she had no side effects with either of these medications. Antibiotics had been stopped for some time since her last exacerbation, and she had finished her Prednisolone some time ago. Overall, from a medical perspective she felt well in herself apart from the mouth problem. On examination, the patient spoke in short sentences, and occasionally her wording was stifled by shortness of breathe, but she did not appear to be in distress, and she was alert. Her skin was pink in colour and she appeared to be breathing with pursed lips, which is a characteristic feature of being a pink puffer and having the diagnosis of emphysema (Flenley, 1990). The NP then examined the patients vital signs, checking her pulse, which was 96 beats/ min and regular. Blood pressure, was 140/ 78 mmHg, and she was apyrexial. The NP then looked for signs of peripheral and central cyanosis by checking the colour of the patients hands and asking the patient to show the underside of her tongue. There were none, but the patient appeared to have oral candidiasis. The patients hands had a fine tremor, a side effect of her taking the long acting beta 2-agonists (Rossi, et al., 2008), but when questioned, she reported that it was not a problem as she was still able to write housework instructions to her husband. The patients respiratory rate was slightly higher than normal at 18/ min, but this was satisfactory. The NP listened to the patients chest and bilateral breath sounds were equal, but with a few polyphonic wheezes. There were no crackles and no crepitations were present. Heart sounds were normal. Spirometry was done, after explaination to the patient how to do the test in detail beforehand, giving the opportunity to ask questions. The patient had done the test many times beforehand, but expressed appreciation. The results showed airway obstruction and ventilatory impairment, consistent with the diagnosis of moderate COPD. A blood gas analysis was not taken, but the oxygen saturation on air was 96%. Inhaler technique was checked and this w as satisfactory. She lived with her husband, although she mentioned he had recently had to stop work due to him having ill health, and this was causing her a lot of anxiety from both the worry over his health and also the potential impact of the loss of income to their household. He had previously worked in a factory that stored and distributed flour products, and he had over several years started to develop breathing problems himself, despite him being a lifetime non-smoker. He was under investigation by the respiratory physicians, and this was causing a significant amount of tension to both of them. She reported that when she had her last exacerbation, he had become ill at that time, and she had to help him with personal care at home for a period of time, and the increased workload caused her shortness of breath to increase. She felt that her energy levels had been depleted for several weeks in the run up to her last admission to hospital, and that she did not even have time to smoke. Despite her COPD being relatively stable on this visit, the patient appeared depressed. When asked if she was depressed, she answered that she was and she was also having difficulty sleeping at night with financial issues caused by the ill-health retirement of her husband being the biggest stressor. The NP explained to the patient that she had identified several areas that needed action and further discussion with the GP. One was on the appropriate use of the steroid inhaler, the second was the oral thrush perhaps caused by the use of steroid inhaler (Ellepola, et al., 2001), the NP explained that there are treatments available for this that might be appropriate for her. Furthermore, she told the patient that the issue of depression needed further assessment by the GP. The patients medical records were updated with the findings of the assessment, as per good note keeping practice (NMC, 2009), and the patient was left in the room while the GP was consulted. The NP presented the case to the patients GP and mentioned her concerns about both the depression, and also the appropriateness of using the Corticosteroid inhaler and the oral candida. The NP recalled a lecture she had received during her course on nurse prescribing for COPD and discussed this with the GP. The GP took the opportunity to do an informal teaching session and agreed with the NP reminding her about the findings from a paper in 2000, by Barnes, which suggested that inhaled corticosteroids are not indicated for the treatment of COPD anymore. Unlike in asthma, where inhaled Corticosteroids are the mainstay of treatment, they have been found to have a limited role in the maintenance of function in patients with COPD. It was observed that only 1 in 10 patients with COPD will show a significant improvement in lung function following treatment with inhaled corticosteroids (Barnes, 2000) and the reason is thought to be that different inflammatory mediators are accountable for th e airway hyper reactivity that is present in asthma and COPD, and those that are responsible for COPD are less responsive to inhaled steroids (Barnes, 2000). Respiratory physicians will still use them, but usually only in cases where symptoms are not optimally controlled with bronchodilators alone (Fabbri, 2004), hence explaining why they were introduced when this patient had her last exacerbation. It was thought very likely that the oral candida as well as the metallic taste and hoarse voice could be due to her use of the steroid inhaler. The NP showed to the GP that the patients pulmonary function, as demonstrated by the Spirometry taken that day, was no worse than on her previous visit, prior to the Corticosteroid inhaler being started. Since a significant clinical response had not been objectively observed, both the GP and the NP decided together that the steroids should be discontinued from the point of view of risk v benefit and also evidence-based best practice. Both the GP and the NP then explained to the patient about the likelihood of the steroid inhaler not offering her that much benefit, instead causing her new symptoms. Her mouth was examined and it was confirmed that the patient had oral thrush, which is a known side effect of using steroid inhalers (Ellepola, et al., 2001). It was decided to wean off the Corticosteroid inhaler over a couple of weeks before stopping completely, and see how things go. She was also advised by the GP to rinse her mouth thoroughly after using the steroid inhaler, as well as the others. If the situation became worse, with regards her breathing she was advised to call the surgery for an urgent appointment to review her medication. The NP then suggested that the patient was started on an antifungal medication for the Candida albicans infection, such as Fluconazole, a decision that had been made following consideration and reflection, in line with the steps of the prescribing pyramid (National Prescribing Centre, 1999). The NP had already consulted the British National Formulary online (BNF, 2010a) to check for contraindications. The patient had none and also there were no history of liver problems or cardiac arrhythmia where caution should be exercised. The decision was made to commence treatment using a course of oral Fluconaz ole. The patient was advised about this, and also she was told of the possible side effects such as headache, dizziness, nausea, vomiting, abdominal pain, diarrhoea and the small possibility of liver problems (BNF, 2010a). She understood the information given and found the decision acceptable and so agreed to commence treatment, and to report any side effects that she noticed. With regards the patients depression this was assessed by the GP, after taking a psychiatric history and risk assessment. Both the patient and GP together decided to try a short course of antidepressant medication, which would be kept under close review. She was also encouraged to pursue social service channels with regards to disability living allowance if she was finding it difficult to care for her husband, especially because she was also infirm. The NP provided her with relevant paperwork for local social services and offered to make some enquiries on her behalf to arrange a home assessment. Before the patient left the room, both the GP and the nurse reinforced the importance of smoking cessation on her COPD and the possibility of nicotine replacement. The patient smiled and said she will give it some thought. Influenza vaccination was also mentioned as a reminder for later in the year. A follow up telephone consultation had been arranged for two-weeks time with the NP. The notes were then completed by both the GP and nurse with regards this part of the consultation. Two weeks the telephone consultation took place and the patient reported that she felt much better about her quality of life, her oral symptoms were almost back to normal and since taking the antidepressants, she had noticed a higher ability to perform day to day activities, and overall she seemed to have a more positive and bright outlook on life. The patient mentioned that she had also finally decided to stop smoking and wanted assistance with this in the form of nicotine patches that the nurse had previously mentioned. The NP arranged for the patient to attend a smoking cessation clinic, during which she made a mental note to apply the prescribing pyramid to this particular issue of nicotine replacement, and offered her congratulations on the patients progress. A further review appointment was also made with the GP to monitor the antidepressant treatment. Discussion This case illustrates the role of the COPD NP in primary care, and discusses prescribing issues. The nurse had taken a complete history and identified several medical, psychosocial issues and prescribing issues and taken appropriate action. From a medical and functional viewpoint, the examination and spirometry showed the patient had stable, moderate COPD, however holistic assessment revealed that she was taking steroid inhalers that were ineffective in her condition and were also causing her to develop an oral thrush infection. The NP also identified that the patient was depressed and there were social problems at home, caused by the patients husband being unwell. The COPD NP correctly identified several issues that needed referral to her GP colleague, and she had worked through a prescribing pyramid to identify that both the steroid inhaler may not be needed anymore, and that the patient would benefit from using an antifungal medication for her thrush. The prescribing pyramid The prescribing pyramid (National Prescribing Centre, 1999) is a stepwise approach that has involves seven stages (1-7), and each stage should be considered carefully before climbing to the next: Consider the patient. Which strategy should be used? Consider a choice of product Negotiate a contract Review the patient Record keeping Reflection With regard the oral thrush infection, the patient had a full history taken and clinical examination. A holistic viewpoint that took into account the fact that the patient was experiencing unpleasant side effects led the nurse to conclude that GP referral was necessary to confirm the diagnosis and also to tackle the concurrent issue of the steroid inhalers and depression. When considering step four, the NP had reviewed the British National Formulary online (BNF, 2010a) and had decided that Fluconazole was the most effective product for this patient as the patient also had a dry mouth because of her oxygen therapy. Nystatin, another antifungal can be used for oral thrush, but it is less suitable for patients who have dry mouths (BNF, 2010b). The patient also had no contra-indications to Fluconazole, and she was not taking and other drugs that had known drug-drug interactions with this new agent. The patient was informed of all the possible side effects in a form that she could underst and. This patient had a central role in the decision making process in this consultation in line with stage four of the prescribing pyramid (National Prescribing Centre, 1999). Effective communication skills are an important part of good nursing practice, as originally outlined by the UKCC in 1996 (UKCC, 1996). In the context of nurse prescribing, this includes explaining what the prescription in for; how to take the medication; how long it takes to work and what the possible side effects may be. The nurse also referred to the BNF as reference when making this decision, which is an example of good, evidence-based reflective practice. In accordance with step five, a review of the patient was organised to establish whether the treatment was effective, safe and acceptable. The patient was also advised to make contact if there were any problems, which is in line with guidance (National Prescribing Centre, 1999). For step six, the nurse practitioner made detailed notes in the medical records immediately after the consultation as per recommendations by the NMC (2009). The NP reflected on her own practice in this situation and asked the GP to give her constructive feedback, which was useful for improving her own learning and practice. Her need for continuing professional development was acknowledged in the original planning of the service within that practice and as a specialist member of the team, having a good working relationship with all the GPs she had the clinical support to hand and was able to obtain medical advice, supervision and guidance when required. The department also had regular visits from pharmaceutical companies and teaching on local formulary practices. The NPs own educational programme included critical appraisal training to enable her to be aware of the influences on prescribing. Conclusion Nurse-led COPD primary care assessment services where specialist NPs are responsible for performing assessment, investigation and are able to act as liaison officers for patients are becoming more widely implemented in the UK as an integrated medical-social and holistic approach to COPD management. Such nurses prescribe full treatment packages for patients and provide them with a point of contact for specialist advice should the patients have an exacerbation at home, as well as forming the link to the tertiary respiratory units should the need arise. Keeping the majority of COPD care in the community should offer better patient centred care as well as cost savings for the NHS. NPs have a crucial role in the management of COPD, and must be aware of prescribing issues reflective learning to give their patients the best possible care.