Monday, September 30, 2019

Operation Strategy(Dell, Amazon.Com & Ibm) Essay

Question: Discuss operations strategies of three companies. Answer: Operational Strategy: Amazon.com Introduction: Amazon.com has become the largest customer friendly online retailer and provides one click purchase facility to its wide range of products including books, music, toys, gifts, electronics etc. For 2011 Amazon’s net sales documented the value of $48077 million to earn net income of $631 million (Annual Report, 2011). Currently, Amazon is serving more than 137 million of its customers with its 56200 employees all over the world. Moreover, International traffic also ranks Amazon at 16th position. However, Amazon achieved this milestone through deploying its three fold strategy of limitless inventory, customer convenience and low price. The purpose of current study is also to explore that how Amazon achieved its objective by using its digital channel. 1. Mass Customization: Primary difference between a physical retailer and Amazon is its online operations that allow Amazon to adopt mass customization. Amazon.com provides an opportunity to offer huge collection of books, music or other products without keeping them physically on shelf. Millions of books are available at Amazon for purchase while a large brick and mortar store is required to keep such huge inventory. In 1999 Amazon consistently added new product line or capabilities after every six weeks to increase its sale revenue. Currently, its product range can be divided into 34 broad categories. Such product customization differentiates Amazon with its competitors. It is argued that product customization is a critical source of competitive advantage even as compared to price competitiveness as it allows customers to select products according to their needs and wants at one place. So, one can attribute such mass customization to the success of Amazon.com. 1.1 Amazon Operating Models: However, to provide such mass customization Amazon follows its three  operating models. First, it sells its own inventories and manages customer relation and supply chain on its own through Amazon.com. Second, Amazon also act as third person and allow other companies to place their products at Amazon.com for sale. However, Amazon only manages front end customer relations while logistic issues are controlled by sellers. In 1999 Amazon offered Z shop facility that allows small companies to sell their product through Amazon.com. His strategy was to compete with e-bay who was also providing similar services of auction. At last Amazon has also introduced its e-commerce solutions and design web sites and offer hosting services to its customers. In other words these three operating models provide huge collection of products that is consistent to its business strategy limitless inventor y. 2. Integrated Business Operations: Success of Amazon strategies lay within its integrated business operations. Figure 1 illustrates that how Amazon fulfill its customers order through integrating its operations. Amazon.com server uses the supply chain optimization software to predict demand and also optimize its supply chain. In first step customers’ data for credit card is processed to finalize their orders. Amazon warehouse is also information about customer order in this respect for coordination. This is done to find out stock information at Amazon warehouse. However, in case of shortage at Amazon warehouse appropriate suppliers are selected. This information is transferred to publishers, music companies and electronic OEM for further process. After receiving order information publishers, music companies and electronic OEM dispatch required products physically to the nearest Amazon warehouse. At Amazon warehouse these items are packed and also send to customer place through UPS or US postal services. In this way Amazon develop integrated business operations that share information over its network for effectiveness. Figure 1: Amazon Network of Fulfillment Amazon integrated system speeds up the process and customers can receive their product at same or next day. This will positively contribute to customer’s loyalty. Moreover, Amazon also made required changes to its fulfillment system when needed especially for huge order fulfillments. For instance Amazon received record advance order of 275000 for single volume of Harry Porter. This challenged information staff at Amazon. During such event  Amazon mailed to its customers for confirmation of delivery information. Moreover, before shipment data regarding each package was updated. For Shipment purpose Amazon contracted with FedEx for shipping 250000 orders at released date that scheduled 100 flights to fulfill orders. In this way, Amazon successfully met such huge order fulfillment on released date. 2. Low Cost Strategies: Porter (1980) argued that firms can gain sustainable competitive advantages through adopting differentiation, cost leadership or focus strategies. While on the other hand Loudon & Loudon, (2006) argued that firms can gain cost leadership through online operations as it reduces ordering and inventory cost. Mass customization at Amazon also augmented its profitability through high activity with low variable cost. Fixed cost per unit decreases with the increase in activity as compared to variable cost per unit (Drury, 2006). While in case of Amazon fixed cost of system dominates as comp ared to nominal variable cost. Cost of technology, many parts of fulfillment cost and advertisement costs are fixed in nature. On the other hand Amazon is bearing nominal variable cost. This indicates that high activity will lead to low fixed cost per unit cost that Amazon can use to settle for low prices. So, this mass customization will also lead to high productivity that ultimately will optimize profits through decreased fixed cost per unit. Moreover, Amazon also reduces its costs through cross docking shipments. For instance Amazon place its different items like books, toys, electronic etc simultaneously in single order to the closest warehouse located near to customers. To do so, Amazon uses its â€Å"12 technologies† to optimize solutions and to predict demand. 3. Customer Fulfillment Network (CFN) Strategy: On the other hand Amazon has also adopted the customer fulfillment networking (CFN) strategy that emphasize to augment gross profit margins through purchasing books directly from publishers rather than involving distributors who add their profits. CFN strategy was developed to integrate customer relationship management and order fulfills management applications. CFN system compares customers’ demand with their capabilities to recognize that whether Amazon can fulfill their orders with reasonable profits or not. It also allows predicting dynamic demand that ultimately reduces the carrying cost and transportation cost at Amazon warehouse. Moreover, it also allows improving their cash flow as less cash is tired up in inventory and increase inventory turnover that ultimately augments firm’s  profits. 4. Customer Centric Strategies: One can also explain Amazon’s success in respect of its ability to extract and use of customer information. Amazon keeps a complete record of all of its customers. Amazon main a data base that knows that when and what a customer orders. If a customer has not been placing order for some time then Amazon sends him an e-mail coupon containing information regarding entirely different or related product line to stimulate customers for reordering. For instance it is possible that you will receive an e-mail regarding computer equipments products if you last purchased a notebook. 4.1 personalized Options: Similarly, Amazon.com also provides convenience in selecting products over its website through customization. Web pages are customized according to the liking of their customers. One can easily personalize his selection when he login as a customer at Amazon.com. All the Amazon products are divided into 34 broad categories. A person can select and search within these 34 broad categories easily. It is consistent with their strategy of providing convenience to customers. 4.2 Customer Review: It is argued that digital means of information can be used to communication product quality and also creates a bond between buyers and sellers especially within online markets (Chevalier and Mayzlin, 2006). Amazon also stimulates its customers to write editorial and review of book they purchased. This option of book review communicates positive information to other potential customers and increases the like-hood of purchase. It is also consistent with Chevalier and Mayzlin, (2006) who also argued that improvement in scores obtained by a book through book review contributes to purchase intentions and lead to high sales revenue. 4.3 Quick Shipment: Providing hassle-free fulfillment of customers’ order is also viewed as one of the key success areas of Amazon. For most of the product Amazon offers same or next day fulfillment. This is what makes different Amazon with other online retailers. However, Amazon does this through its integrated order fulfillment process as demonstrated in figure 1. Operation Strategy: Dell Introduction Dell is a technological sales company which performs their business in the whole world as is possible to see in the following diagram. With net revenue of $61,133,000,000 is the second largest computer manufacturer company in the word and the number one in United States. Dell focuses on Business to Business (B2B) and Business to Consumer (B2C) commerce to satisfy their business and individual customers. Dell differentiates between classes of customers because the needs of their business customers, who buy large quantities of computers, are different than the individuals who want to configure a single unit. The present document is oriented to analyze Dell just since the point of view of operations management starting with a review of the company, after a look over Product design process, the internal process and the technology associated, how Dell forecast the coming productions rates, how Dell manages their inventory, which is the quality model followed by the company, which is the human resource strategy to finalize with conclusions and reflections. 1. Operations Strategy Identify the operations strategy of Dell is go almost in all the main activities of the company where operations is relevant. Under this perspective, the list of strategies is related to some areas of operations inside of the company: * Be the greenest technology company on the planet and the first computer company to achieve carbon-neutral operations by the end of 2008. * Continue leadership with the climate strategy and global recycling programs. * Partner with customers in energy-efficiency and climate-protection initiatives. * Broaden the Global Citizenship commitment. * Recommit efforts to improve sustainability governance. 2. Product design process For Dell, Globalization has impacted directly in the management of the product life cycle involving more stakeholders during the process of product development; thereby the complexity of this process has become more complex  as well. The most important factor introduced in the product life cycle is the environmental issue. For Dell, the design products have to be energy efficient, to avoid unnecessary materials and to be easy to use, which is supported by rigorous business controls and supplier audits that consider (Dell, 2008): * Energy Efficiency: Dell delivers optimized performance per watt, and help customers deploy systems efficiently. In this way, IT is an important avenue to decreasing cost of ownership and enhancing productivity while reducing a customer’s carbon footprint. * Precautionary Chemicals and Materials Use: Dell design to eliminate the use of unregulated substances if we believe they possess hazard characteristics similar to other, regulated substances. If alternatives are not yet viable, Dell works to develop reliable, environmentally sound and commercially scalable solutions. * Supply Chain Sustainability: We expect suppliers to uphold the same commitment to environmental responsibility as we do, as a condition of doing business with them. Dell design activities are compliant with this internationally recognized standard for environmental management system criteria (ISO 14001 certification program) Other main stream of definition of what Dell is doing in terms of product design rely on the participation of their own customers. The website â€Å"Dell Idea Storm† (http://www.ideastorm.com) where customers participate directly in the conceptualization of products giving their own ideas of develops, voting for another ideas already posted or simply criticizing products from the company. This website is a very comprehensive platform to cover an appropriate SWOT analysis of products design due to the huge variety of post and group discussion on it. 3. Processes and Technology 3.1 Production process The well known operation model of Dell called ‘Dell Direct’ base its value added in just work on demand eliminating intermediaries in procurement, manufacturing and distribution processes. The technology used by the company in the manufacturing process is the base of success and therefore play a very important role in its operations. Dell’s technology allow to the company to combine its resources, its relationship with suppliers and its consumer communication capabilities, developing one big advantage over its competitors. Dell is in â€Å"Mass Production† process category due to mainly the stable demand of products, the assembly work as a main line of production and with a good level of efficiency. To consider Dell as a manufacturing or assembly company is a constant discussion even for the employees of the company. Due to the nature of the products (mainly computers) they build new products that do not exists in the market, in this sense they are manufactures. But in another sense they just assemble component which production is on suppliers, in this sense could be considerate that dell â€Å"buy to sell†. In this document the company will be considered as a manufacturer company. The generation of innovative ideas for the production line is pulled due to the necessity of new kind of products defined basically due to the interaction with suppliers and customers. All the Dell manufacturing centers use the same processes enable by the same systems and are measured in the same way. This insurance consistency award quality across the global network and also allows identifying and implementing best practices. The standardized process of manufacturing is divided as is illustrated in the following diagram. Final Test and labeling Order accumulation area Software Installation and Testing Customer Order Pull Kiting Boxing Build These processes are described as follow: * Customer order pull: receive the electronics orders closer to the ship destination. In this point the order is transferred from Dell order management systems to the Manufacturing scheduling system. The servers of the facility keep the track of order process associating serialized parts with unique codes. * Kitting: the build to order process of Dell generate request for materials which is delivered to the factory. Since there are no warehouses the inventory system is very important and every part is serialized and labeled since this is received from suppliers (which are basically important for Dell quality system). The scanning of these tags associated to the order indicates to the personnel which components should be part of a specific order, and at the end of the kidding line, all the parts of a single unique order are ready for the next step. * Build: the scan of the code associated to the single order gives to the personnel specific instructions to builders based in the customer requirements. In this step, Dell associates every single component using bar codes to the order allowing a better quality control for the company. * Software Installation and Testing: Directed by the main brain, the central gives specific instruction to ensure all the components are presents and operating properly before to install any software in machines. * Boxing: This process ensures all the components required by the user are properly stored and ready for the ship. Once finished the boxing, the order goes straight for shipping or the order accumulation area. * Order accumulation area: When the client creates and order, all the required products start at the same time but not all of them finish at the same time due to process variability. Once all of them are finished the shipping process starts. * Depending form the order, there is an external synchronization with others manufactures as monitors or printers manufacturers for example, which allow to Dell to reduce inventory with extern products to the production line. 3.2 E-business E-business is central to Dell’s entire operations and Dell uses e-business extensively across its entire value chain to deliver high levels of service to its customers and suppliers. Dell basically does trades with two of the four main kind of e-business (B2B, B2C, C2B and C2C) and both of them based in the internet architecture * B2C: the main stream is represented by direct communication between Dell and their customers. Internet allows this direct communication avoiding intermediaries. This guarantees a good quality service for the customers, efficient processes, decision makers in real time, higher customer expectations and globalization. * B2B: this stream of communication connects Dell with their suppliers allowing and efficient process of communication with the same benefits described in B2C. Also, the when big corporations and governments are clients, the definition of relation is established in a very particular way treating them as a special customers that need a special attention. 3.3 Technology In terms of technology, Dell in all its experience in all the manufacturing centers has implemented a large number of solutions in order to accomplish a constant improvement in the value chain. Basically, the main source of constant improvement has been Internet, helping Dell to establish good relations with both their suppliers and their customers. The high level of integration that this technology has allowed is on simple evidence through the corporate website (www.dell.com) where for example suppliers are allowed to follow their material as it used throughout Dell’s operations. They can log-on, drop off invoices, check engineering change orders; review negotiated and forecasted cost reports, and track their overall performances and progress. The â€Å"Dell i2 Supply Chain Management (i2SCM)† is the name of the solution implemented to cover communications necessities with suppliers. This implementation enabled to Dell to reduce costs providing component suppliers and Dell planners with global views of product demand and material requirements. In partnership with IBM, both have managed to maintain high employee productivity. The join in between companies to design the productions lines provide near unlimited availability to their IT infrastructure. Another outcome of this partnership is the use of electronic catalog with appropriate search functionality. As an example time ago, Altiris Recovery Solution was selected by Dell for integrated delivery of backup and disaster recovery. Altiris along with Dell Open Manage Client Administrator (OMCA) will provide â€Å"Direct integration of Altiris backup and recovery technology with Dell OMCA which helps ensure business continuity and helps provide additional cost savings for Dell customers through proactive IT management†. These factors implemented into a concrete disaster recovery plan provide Dell and IBM with the confidence to scale and complex IT network. 3.4 Production Layout Dell is by definition an assembly manufacturer company, where basically the process is only one and the assembly line as well. Dell does not build any part or piece of the computers, lodging basically in their own suppliers which have the necessary expertise and commitment with dell’s production line. If we consider Dell and their suppliers as a unique company it will be represented as typical â€Å"Process Layout†, and Dell will be of course in this exercise the assembly department. The main advantages of the â€Å"Product layout† (or assembly line production layout) are: * The amount of time for a product to be ready is faster in general if it is compared with other kind of process layout. * The set up cost of the product layout is low due to the facilities does not vary in position and functionality. * Due to the tasks of every stage are very specific, the efficiency of this kind of distribution (production layout) is higher than others types of layouts. This very related with the high continuity of the assembly line. * The necessary planning in order to be concern about matters like synchronization is very low if it is compared with other layouts, this because is just one continue line. * The required level of expertise is not so important as well considering that the main task is to assemble. There is no much hard production processes to take care about. * For Dell the level of inventory is very low, maybe too much low considering the average industry in â€Å"Products Layout† companies. This is because the technological advantage of Dell using Internet. As negative point in Dell layout oriented to product, it is possible to say that the required infrastructure is more expensive than other layouts because the high degree of cohesion that should exist in the assembly line which it demands a high technology and dedicated machinery. 4. Supply Chain As is possible to appreciate, Dell Company is in the middle of all the operations since suppliers till the final customer. The simplicity of this model put on evidence the absence of intermediaries in the supply chain, which is synonymous of low cost, fast answer to client’s orders. The communication between Dell and suppliers is by Internet, and in real time which it means that the suppliers are constantly monitoring the status of components in order to prepare new orders and negotiate the prices on demand. Usually suppliers have warehouse building nearby Dell’s Manufacturing Centers in order to reduce the risk of lack of components in the main assembly line of Dell and assuming at the same time the inventory costs that Dell is avoiding. The suppliers usually feed the starting point of the Dell’s assembly line, but as the illustration show, it is possible to have some suppliers after the production line of Dell (even out of Dell facilities). Partnership with screen or printer manufacturers, allow to the final user to order for products that are absolutely out of Dell’s production lines, and it is just necessary to complete the order in their warehouses to finally ship the order to the client. Is important to recognize that the use of Internet is the blood of this system, without this technology would be impossible to coordinate such value system. In order to make the service easier for customers within this supply chain, Dell has divided their home page into a number of major customer groups: * Home & Home Office, * Small Business * Medium and Large Business and * Government, Education & Healthcare 5 Forecasting, Planning and Scheduling 5.1 Forecasting As a forecasting method Dell, as many other big companies, base their analysis on the records stored on the internal Customer Relationship Manager system (CRM). This system stores every registry made by customers in order to analyze the tendency of the actual behavior and predict demand for certain products in the future. Now considering daily operations on Dell, there is a â€Å"Short Range Forecast† process that operates constantly. Dell uses state of the art production planning programs that forecast the quantities of components needed to build  the computers. After those forecasts are made, supply chain systems pass those forecasts to suppliers, who respond with cost estimates and plan their production as a result. As the CRM, the mentioned i2SCM (technology section) is another provider of forecast information as well, providing real-time factory scheduling and inventory management. These methods used by Dell are considerate â€Å"Quantitative Forecast Methods†, leaving for decisions makers, the forecast that comes from â€Å"Qualitative Forecast Methods†. 5.2 Scheduling Dell bases its scheduling process in the system i2SCM system output. One of the basic tasks of i2SCM is to streamlines the supply chain in order to keep a constant flow of component in the starting point of the assembly line, and considering this, as a consequence is in charge of provide a manufacturing schedule the whole plant. This scheduling process is refreshed every 2 hours. 6. Inventory Management Dell has implemented â€Å"Just-In-Time Inventory System† which operates on only 6 days of inventory. This simple number implies a huge benefit for Dell because this enable to the company to reduce the warehousing costs, also is not necessary to hire people to put in charge and maintain the inventories and though technology become obsolete very quickly, for Dell this is not a problem because they don’t hold obsolete technology in its small inventory. The way how Dell controls, in terms of basic definition its inventory and the costs that this means is being a â€Å"Demand Pull Company† (used as well as a Lean system method), whereas one of its top competitors (Compaq HP for example) is strictly a supply-push company and operates in a more traditional manner. 7. Quality model Since several years, Dell has been operating their manufacturer plants using the production standards ISO 9001, ISO 14001 and OHSAS 18001 (Dell). Dell operations in China have been distinguished by Ministry of Information Industry (MII) and China Quality Management Association for Electronics Industry (CQAE) receiving wards such as â€Å"Excellent Quality Management Corporation†, â€Å"Excellent Quality Management Team’s and â€Å"Excellent Quality Management Individual†. It demonstrates Dell’s commitment to providing high-quality products and superior customer experience (Dell). The main support behind this award is the constant focus in the customer-centric strategy, and the will for a constant improving in the quality management system. In Dell, the quality control process starts from engineering design and the early testing stages during which design for reliability is the priority. Been conscious of quality standards in early analysis of failure mode, the product design is based on typical customer profile and operation requirement. It is important to consider that reliability test and improvement are also keys factors to ensuring the best quality. In addition, Dell has extended the â€Å"quality chain† putting great emphasis on suppliers’ quality management, as the company always regards the quality of the components as crucial factors for product quality. According to this, Dell has established a set of scientific and complete management process, which ensures final product quality through rigid selection and process control of industry-leading suppliers. Considering the whole process, the Quality Management during manufacturing process is the strongest guarantee of Dell products’ quality. Engineering pilot and employee training are conducted before any new product launch. Through Statistic Process Control Quality Analysis, Dell is able to detect and improve incoming material and process issues, which guarantee the best manufacturing quality. 8. Human Resources Strategy Dell’s direct business model influenced an organizational structure that fosters direct communication and open-minded listening. As an strategy to  accomplish this objective is to listen employees, and this is done through â€Å"Tell Dell† program, a voluntary and confidential employee opinion survey. This program is developed to encourage employees to speak frankly and privately about Dell’s principles, values, strategies, policies, managerial effectiveness and employee engagement. In this way the HRM department, after taken the measurement, is able to act in direct response to surveys. Some responses to these kind surveys were for example in the past: * Implementation of an employee purchase program * Greater work-life flexibility * Streamlined decision-making processes * Increased focus on employee development * Improved customer solutions Less formal but equally important strategy to get employees feedback is Employee Storm. A tool that enables every Dell employee to bring experiences and creative solutions to Dell and our customers. With the objective to reduce mistakes and its consequences, Dell has implemented a strategy related to ethic tools. This strategy defines for example policies of communication in order to allow employees approach the company when they feel is necessary according to the defined Dell Code of Conduct. These policies are: * Open door policy * Global Ethics and Compliance Team * Ethic helpline Since Dell is committed to inclusion and diversity, their mission is to succeed in the marketplace by fostering a winning culture in which Dell employees are highly talented, committed, reflective of our global customers, and recognized as our greatest strength. For Dell â€Å"diversity† is the core of their values and winning culture. For this Dell has implemented the following activities: * Employees networking groups. A program that connect employees that share the same nationality, gender, ethnicity, etc. * Diversity Education and Training. Providing quality professional development opportunities to all employees. * Work/Life Effectiveness. Committed to balance the employees contribution to the company with their personal lives. Other areas of strategy where Dell has been working on are: * Global talent management * Employee health and wellness * Employee sustainability engagement Conclusions It is very interesting to remark that Dell, a multinational company with a big size, is successfully capable to repeat basically the same formula of manufacturing process in every manufacturing center that the company has. Dell has been able to repeat the best practices across the borders around the world which by definition represent a big challenge for any company. Never the conditions will go to be the same: restricted markets, cultural shocks for employees, different cost structure are some of the factor that usually affect multinational companies with operations in many countries around the world. Dell strategy found its success in basically the correct and optimums use of technology; Internet is practically the blood of Dell system, or the base of Dell success. Dell’s business model bases its success basically in Information technology. There is not a revolutionary change in the way how to do business, is just a perfect example of how to take advantage of technology to become the most efficient competitor in the computer sales industry. Even though Dell business model is very well know, has been a model very difficult to imitate basically because the huge investment that companies should do together with their suppliers. The supply chain structure in this case is the key of success. Is not a matter of investment coming just from Dell to have success, is a sacrifice coming from Dell, suppliers and partners that in some way are trusting in Dell way of doing business. Trust in the value chain, is definitely a very big competitive advantage for Dell. The product mix from Dell is not as broad as directs competitors are doing it, which in one way has allowed to Dell specialization, focus and expertise in the field. But is a risk at the same time because depending basically on a very limited amount of product and services it does not open many alternatives to explore new markets or develop innovative solutions amount the products and services. Even though Dell is considered a very successful business model, the company has been having problems. These problems are reflected in financial reports which indicate that Dell is not reaching the rate of growing that they were expecting. Although Internet is the base of its success, it has been a big problem for Dell as well, since the point of view that important bloggers has been complaining in the net about the pour quality of services and this has spread quickly between users a non god image of the company. Dell is working on this blog phenomenon taking care of every comment done in the net about their products and services. Another problem faced by Dell is that Dell is becoming victim of its size because they are trying to keep the rate of growing in a market where the value of their products fall significantly every year , this means that to keep the rate of growing is necessary to have a higher rate of sales. As a final weak point in the way how Dell is approaching businesses, Dell is relaying increasingly on new markets which it means that Dell is just applying best practices and knowledge in the field rather than go deep with a study of the new entrance. This could be a risk considering the diversity and cultural matters in between their customers. Operation Strategy: IBM Introduction: IBM or International Business Machines is a well known American computer manufacturer, founded by Thomas J. Watson (born 1874-02-17). IBM is also known as â€Å"Big Blue† after the color of its logo. The company has made  everything from mainframes to personal computers and has been immensely successful selling business computers. Drawing on the strength of the full strategy and change practice: Operations Strategy is one of the four competencies within IBM’s larger Strategy and Change team. The three parallel competencies are Business Strategy, Organization Change Strategy and Technology Strategy. Operations Strategy helps clients resolve a variety of critical issues from strategy and planning to day-today operational improvements. IBM practitioners specialize in identifying the capabilities that are required to execute business strategies and in defining how operational models should be configured, implemented, and continuously improved. With deep experience in operations strategy, IBM provide clients with the support needed to address the operational issues that are crucial to success. Helping clients with critical business issues: Clients look to Operations Strategy for help with these critical business issues: * Cost efficiency and performance improvement * Focus on company’s core business * Increasing shareholder value * Continuous process improvement * Maintaining competitive edge * Improving customer service quality * Migration to new technology * Product innovation management * Merger synergy realization. IBM experience in successfully formulating and implementing operations strategies lies in three main areas: * Helping clients formulate operations strategies that align corporate and business strategy with organization, technology and process strategy. * Providing process expertise for business process change, reengineering and operational improvement, cost reduction, Six Sigma, innovation management, and post-merger integration. * Assisting clients with outsourcing strategies and their execution, including make/buy/partner decision strategies, domestic and global outsourcing, and creating scalable operations. Utilizing a proven, consistent approach: All Operations Strategy engagements incorporate the following key elements: * Mobilization – Utilizes preparation and planning to help increase the odds of successful and timely project completion. * Situation assessment – Establishes a shared assessment of the current and future situation with senior client management. * Strategy development – Defines strategic options and specifies strategic initiatives which are Designed to create significant value for the client. * Implementation planning– Determines critical success factors and establishes change programs to implement the strategic initiatives. * Learning – Measures and adapts the strategic management process in real time utilizing key Performance indicators. Providing a full suite of offerings: Operations Strategy has a diverse range of capabilities, including: Rapid process change: * A solution for rapidly identifying and delivering a step change in process, organizational and systems performance. Rapid process change focuses on achieving tangible operating improvement results in an accelerated time frame. Six Sigma/Lean Sigma: * Strives to create both operational excellence and a strategic change in the culture of a corporation, division or business unit. These engagements  are designed to increase customer satisfaction and drive out costs by helping to improve processes linked to company strategy and key performance indicators. Six Sigma also helps build an enduring capability within the organization that can create and sustain competitive advantage over the long term. Design for Six Sigma: * Extends Six Sigma principles to the development of new products, services, processes, and plants that are designed to precisely meet client current and future needs. Strategic profit improvement: * A framework designed to deliver improved financial performance, including: increasing revenues and margin, reducing costs and assets, strengthening infrastructure, and positioning for future growth. Service after the sale: * Helps clients lower their customer service costs and find new sources of revenue and value-added differentiation. Product innovation management: * Supports the business decision making component of product development. These engagements are designed to reduce time-to market and product development costs and they help increase the pace of innovation. Enterprise focus: * Determines which components of a business are strategic and critical to success of the enterprise and which are not. Then identifies opportunities for improvement and transformation by comparing critical business requirements and operational capabilities. Shared services implementation: * Our team builds a business case for the transition to a shared services operational model, designs a custom shared services solution, and then works with the client to successfully implement the change. Outsourcing governance: * Helps organizations establish a program management office capable of supporting outsourcing Initiatives throughout their lifecycle, from qualification and assessment to development and Operation. Demonstrating success at numerous clients: At one client, a leading consumer electronics manufacturer, benefits of the project included: * Reduction of overhead costs due to redundant / inefficient overhead services and infrastructure in Corporate HQ and five worldwide product divisions. * Annual savings of over $400 million, including: agreements in infrastructure sharing and Governance, shared services and elimination of cost drivers and redundant resources, and establishment of a project management office for active savings tracking and reinforcement. At a large manufacturer of aluminum products, we developed and implemented a new operating model. The scope and results included: * Analyzed operations for 15 business units in 10 countries * Creation of global process models * Over $300 million in annual savings, including improved processes, continued focus on cost Controls, and adoption of best practices across business units. Finally, we developed an outsourcing strategy for a leading manufacturer of semiconductor equipment. The scope Included: * Working with client executive team to develop a vision and operating model * Implemented the model, focusing new investment in core business processes and developing and implementing the roadmap to outsource all non-core processes to save client significant cost and increase competitive advantage. IBM Clients: A small sample of IBM clients includes leaders of every industry and all levels of Government: ABB| Ford Motor Company| Motorola| Aetna| Goodrich Corporation| Novell| Alcoa| Halliburton| Panasonic| America Online| Honda Motor Co.| Raytheon| Ashland| IKON Office Solutions| Royal Philips Electronics| Atkins Nutritionals| International Truck and Engine Corporation| Selectron| Bloomberg| Lam Research| Siemens| BP| Lexmark International| Sony| Chevron Texaco| MCI| Tyco International| Circuit City Stores| McKesson| United States Department of Agriculture| Dupont| Medtronic| Verizon Communications|

Sunday, September 29, 2019

Diet analysis Essay

At a young age, I had always had an aggressive appetite, never caring about what I put into my body because I was young, and it was of no concern to me. Over the last 5 years, I have been more aware of my eating habits, but still not making a conscious effort to change what my body intakes. Throughout, My Diet Analysis research, I was able to identify eating habits that I was unaware of specifically during the weekdays. I decided to record two of my busiest days during the week, Monday and Tuesday and one lacks day, being Sunday. My findings were somewhat surprising, showing me on paper just exactly how unhealthy my eating habits are. My diet analysis gave me just the motivation I needed to fully make a change within my everyday diet. Overall, it is very clear that I need to make some changes within my diet on a daily basis in order become fit and healthy. My results from my 3 day recall shocked me slightly, because I didn’t realize how little I ate, but how unhealthy many of my food choices were. I wasn’t in range with my calorie intake for the 3 days. My calorie intake was over 1500, and my recommended calorie intake was a little over 1200. The foods I ate that consisted of the most calories were foods from fast food restaurants, mainly being McDonalds, and foods that were full of carbs. I generally eat a lot of fast food during the week because my schedule is so hectic and nonstop, I don’t have time to indulge in anything else. My calorie intake was higher on Sunday and Tuesday than it was on Monday. My overall calorie intake on Monday was 100.1, Tuesday it was 2312.7 and on Sunday 1258.7. I was a little surprised to see that my calorie intake on Monday was lower than on Sunday, but after reviewing the foods I consumed, it made sense. Out of the 3 days, Monday was the day I consumed the most vegetables, green tea, and water. I typically drink a lot of water and green tea every day, so that wasn’t a surprise, but according to my di et analysis my vegetable intake for Monday was excellent. My vegetable intake is usually higher on Sundays because my mother usually cooks, and makes at least two green vegetables for that particular meal. As I continued to review my diet analysis I noticed I barely ate any fruits, which was very clear to see considering over the 3 days I had only eaten chunked pineapples, and the fruit that was in a smoothie. According to the USDA dietary guidelines my fruit intake should be at least 33% a day. It’s obvious that I need to substitute snacks, such as cookies, and chips for an apple or a fruit cup every day to meet my fruit  requirement. I wasn’t too surprised to find that my fruit intake was low because I don’t tend to eat fruit on a daily basis. I would defiantly say I indulge more vegetables than I do fruits, and that probably won’t change too much when it comes to my diet. Even though I’m aware that I have a slight addiction to salt and salty foods I was still disgusted at my sodium intake. My average sodium intake came out to be 12263.4 over the 3days. I am now more than ever motivated to stop adding salt to everything I eat because not only is it a bad habit, but it can do much damage to my body in the long run . Along with having a high sodium intake, my Trans and saturated fat intake was high. Trans fat is something I never want in my system, but consuming fast food doesn’t necessarily help me met this goal. My average intake of saturated fat over the 3 days was 13.7 and my overall trans-fat intake was 1.5. Although my trans-fat intake wasn’t exceeding, it’s not something I want to ingest/digest even in small amounts. I typically drink a lot of water, but according to my diet analysis, I need to be drinking twice as much as I consume. I don’t drink sodas or juice at all, so my beverage intake only consists of wate r and green tea; so seeing that I still need to consume more water was shocking. My average intake over the 3 days was 1,607.19 and I need my recommended number is 2,700.00. This will probably be one of the easier changes to make because I don’t mind drinking water, and prefer to drink water over any other beverage. I believe if I become more active this will help me consume more water throughout the day. Drinking the recommended amount of water every day is important to me because water helps your body work to its greatest potential, and helps with skin, hair and nails. I usually find myself exhausted and extremely tired throughout the day, and never really knowing why or exactly how to change that aspect of my life. When reviewing my Vitamin intake, it all began to make sense. My Vitamin levels are very low, especially my Vitamin D level, which goes hand in hand with my energy; explaining why I’m always tired. My Vitamin D intake was 1.13 which is extremely low compared to my recommended amount, which was 15.00. In order to help increase my vitamin D level, I have to first research which foods have a high level of vitamin D. I do recall when I was 18 my doctor explaining to me that my Vitamin D level was low, but seeing it makes it much more real. The weather has an effect on my Vitamin D level being low as well. The sun is a great source of Vitamin D, but because it’s  winter my exposure to sun is limited. Milk also has a great amount of Vitamin D, but unfortunately I am lactose and tolerant, which probably has a great effect on my Vitamin D level. It would be in my best interest to consume Vitamin D supplements to help increase my Vitamin D levels efficiently. I currently do no t exercise as often as I should considering the foods that I eat on a daily basis. I do however; have a job that consists of being active with children three time out of the week, which is a nice benefit. Once the spring is here it would be in my best interest to go running every day for at least 30 minutes. This will help with my physical activity and sun exposure, helping with my Vitamin D levels. I would like to continue to monitor my eating habits using my diet analysis because I do believe it is hard to determine my eating habits with only analyzing 3 days. But it is still very evident that I need to make some changes. The Diet Analysis project has taught me a lot about my own eating habits and has inspired me to modify them for a healthier lifestyle. Probably the biggest change I will make after having done this project is to increase my intake of vegetables, fruits and Vitamin D. Fruits and vegetables will provide more fiber in my diet (something I am lacking) as well as cert ain other vitamins and minerals that I am deficient in. I will also try to limit my fat intake, especially saturated fats, trans-fats, and fats from animal sources. I may even start packing my own lunches since most of the flaws in my diet are from of convenient and fast foods.

Saturday, September 28, 2019

Climates and Climate Related Factors Essay

Tropical wet climates or wet equatorial climates are usually found in areas near the equator as the name states. These areas include the Amazon, Congo, Southeast Asia and are sometimes found in the trade wind belts. The Koppen symbol for this type of climate is Af. This climate has the smallest temperature range in the world being between 2 and 3.6 degrees. These areas don’t have a dry season because of the close proximity to the equator which covers 5-10 degrees. The weather remains constant being warm and wet year around. Tropical wet climates see 60-100 inches of rain annually and experience convective thunderstorms. This climate is known for being seasonless due to the consistency in day to day weather. The reason for thse constant weather patterns is mainly location. The latitude position allows sun coverage directly above creating uniform insolation. Also, the ITCZ creates the year around humid, unstable air. These weather conditions create oxisol and latosol soils which are the least fertile; however, are an ideal location for tropical rainforests to emerge. Tropical rainforests and selva are home to animals such as birds, reptiles and insects. Those who live in these types of climates may use the weather to their advantage with agriculture, forestry, and with slash and burn cultivation. Tropical savanna climates are found further from the equator extending to 25Â °N and S latitude. The Koppen symbol for this type of climate is Aw. Characteristics that make this climate distinctive is the alternation of a wet and dry season. Locations that experience the Aw climate are Africa, S. America, and N. Australia. Winters in this climate are dry with clear skies and are associated with subtropical highs. The summers are wet with many thunderstorms anf convectional rain of the ITCZ. The tropical savanna sees an average of 35 to 70 inches of rain annually which mostly comes from the summer season. The average annual tempeteature range is 5 to 15Â °. A surplus of the water supply comes during the summer. These weather conditions create a laterite soil type making it an ideal location for grasslands and tall grasses to thrive. These grasslands are home to lions, gazelles and zebras. Those who live in these locations can create ranches with animals or use the wildlife to their advantage for ecotourism. The tropical monsoon climate is similar to the tropical savanna climate in the way they both have wet summers and dry winters. The Koppen symbol for this climate is Aw. This type of climate is found in areas such as southeast Asia, western Africa, northeastern South America, the Phillipines, northeastern Australia, and some islands of the East Indies. It isn’t uncommon to see 30 inches of rain within two or three months in the summer. The annual total rain in inches falls within 100 and 200. There is a surplus of rainfall in the summer and a deficit in the winter. The tropical monsoon climates are dominated by offshore winds and seasonal reversal of winds. Latosol soils, red or yellow in color, are found in the Aw climate allowing deciduous forests with some grasses to grow. Birds, reptiles and insects call this climate home. Those who live in tropical monsoon climate can build plantations, grow rice or sugarcane. The tropical desert climate, or Bwh, is found in North Africa and southwestern Eurasia. Moist winds are kept out of this area by the Andes mountains. These locations are found 25-30 degrees N and S latitude. The tropical desert climate experiences very hot summers and mild winters. The annual temperature ranges 15 to 25Â °F with scarce rainfall typically less than 12 inches. Climatic controls that cause these weather patterns are cool ocean currents that cool any air that comes across it and subsidence from subtropical highs. The desert has aridosol soil which is fertile, but requires irrigation. Snakes, birds, reptiles and rabbits call the tropical desert climate home. Those who call the tropical desert home can create jobs by salt mining. The steppe climate, or Bsh, is very similar to the tropical desert climate and surround the Bwh climates except on the western side. They are found mostly on the edges of the desert. Rainfall is somewhat greater than the tropical desert climate and temperatures are slightly moderated with hot summers and mild winters. The weather system is controlled by cool ocean currents and is affected by the rain shadow of mountains. The steppe climate has short grasslands making it an ideal home to many reptiles, snakes, birds, and rabbits. Chestnut/brown soils allow these grasses to grow. Those who call the steppe climate home may take up cattle ranching to earn an income. The humid subtropical climate, represented as Cfa Cwa and Cwb, is located at 30 degrees latitude on eastern sides of the continents. Some locations that experience this type of climate include North America, South America, and Eurasia. The summers at this latitude are warm and hot, while the winters are mild to cold. During the summer, the average temperature ranges between 75 and 80 degrees. These climates receive convectional rain during the summer and cyclonic rain during the winter. Annual precipitation is abundant between 40 and 65 inches. The location of the humid subtropical climate plays a huge role on the climate. It is located in between and on up tilted side of subtropical high pressure cells. There is gray/brown or yellow podsol soil in this climate allowing forest growth. Forests also bring along the forest animals such as deer, raccoons, and black bears. This also makes it an ideal farming area. The Mediterranean or sometimes referred to as the Dry- summer sub-tropial climate, is known as Csa or Csb. These C climates are located 35 degrees North and South latitude. Some locations that experience this type of climate include Southern Europe, Central Chile, and the South tip of Africa. Summers in these locations are hot and dry with wet, mild winters. Average annual precipitation ranges from 15 to 25 inches. Rainfall in the Mediterranean is cyclonic. A large amount of the precipitation falls in the winter and summers are mostly rainless. These weather patterns are controlled by the subtropical high pressure cells. There is a deficit of rain in the summer and a surplus in the winter. The soils in these C climates can be very fertile if irrigated. The soil is a chestnut/brown pedical which is very dry with an abundance of calcium. Chaparrals thrive in this type of climate. They take on a brown/yellow color in the summer and become green in the winter. Mountain lions, bears, deer, coyotes, gofers and birds call this climate home. These areas are used for agriculture with irrigation in the winter. Moving further from the equator at 40-60 degrees North and South latitude is the West Coast Marine climate. The koppen symbols for this type of climate are Cfc and Cfb. Some major locations within this climate are Western and Central Europe, the Western side of North America, and New Zealand. For this latitude, these areas experience very mild winters as well as mild summers. Westerly winds adjacent to the ocean are the reason for the mild summer and winters. It is wet year around due to oceanic influence with an annual rainfall between 30 and 50 inches received mostly in the winter. Podsol or spotosol is the soil type this climate allowing needle leaf forests with some deciduous trees to grow. Deer, bears, birds and other forest animals call this climate home. These forests may be used people for lumbering to gain a profit on the lands. The mid-latitude desert and steppe climates are also very similar. First, the mid-latitude desert climate, or Bwk, can be found distant from the ocean and surrounded by mountains. Some of these locations include central Eurasia, North American and southern South America. The Bwk region receives most of its precipitation during the summer when warming is occurring. This warming also causes the ice to melt and create more of a water supply. The winter is dominated by severely low temperatures and anticyclonic conditions. These low temperatures create a much lower annual temperature range than the subtropical desert climate. The most fertile soil in the world is found in the mid-latitude climate allowing grasslands to grow. These grasslands are home to grass eating animals and the lands are used for animals to graze. The mid-latitude steppe climate, or Bsk, isn’t much different from the desert climate. It’s mainly used as a transition between desert and humid climates. Some areas that experience these climates are in found in the interior southwest of the United States such as Colorado. The temperatures in the Bsk climate are similar to the desert climate; however, have more precipitation and lesser temperature extremes. These climates are similar in the way that they are both grassland oriented, home to grass eating animals, and the land is used for animals to graze. Moving even farther from the equator, between 35 and 55 degrees North and South latitude, is the Humid Continental climate, or Dfa, Dfb, Dwa, and Dwb. Eurasia and North America are a couple locations that have this type of climate. They experience long, very cold winters and hot summers. Precipitation is not high ranging only between 20-40 inches. Westerly winds and storms, especially in the winter play a key role in the weather conditions. The average winter month temperature is usually between 10 and 25 degrees F. Gray-brown podsols are found in the humid continental climate as well as prairie grasses and mixed forest, deciduous and evergreen. There is a large variety or mammals and birds. The humid continental climate is ideal for farming. 50 to 70 degrees North and South latitude is the Continental Subarctic climate, or Dfc, Dwd, Dfd, and Dwc. Locations that experience this climate are Western Alaska across Canada, Eurasia, and Scandanavia. There are extremely cold winter conditions in these D climates with a light amount of snow that falls during the winter; however, little melting takes place until the summer. Cyclonic storms alternate with prominent anticylonic conditions. The annual precipitation is 5-20 inches. Also, continentality is also a key factor in the reason for the cold winters and hot summers. The absolute annual temperature variation has sometimes been as dramatic as -90 degrees F to 98 degrees F. Podsolization occurs here making the soil cold and wet. This is an area where evergreen trees will thrive and be a home to animals such as deer, birds, bears and elk. Many people use these locations for forestry. The last two climates are Tundra and the Icecap which are both cold climates. The Tundra, or ET climate, is located pole ward of the margins and occupies small coastal areas in the Antarctic. The warmest month will only reach up to 32 degrees F making it extremely difficult for plant life other than small bushes and grasses to grow. The ET climate experiences long, cold winters and cool summers. Most of the precipitation falls during the summer, but is less than 10 inches annually that falls mostly in the form of snow. There is a low evaporation level due to the low temperatures. Tundra soil is found in these climates. Polar bears and some birds can tolerate the coldness of the ET climate and many people use these animals for fur trapping. The last climate is the Icecap or EF climate. Antarctica and Greenland are two locations that experience these freezing weather conditions. 50 degrees F is the average temperature of the warmest month found on the very edge of the Tundra. More towards the center of the tundra, temperatures don’t exceed 32 degrees F. There is a sparse amount of precipitation in this climate with only less than 5 inches all in the form of snow. The cause for these freezing temperatures is mostly the latitude location. Also, the distance from sources of heat cause cold temperatures. There is no soil type here, with no vegetation and no economic activity.

Friday, September 27, 2019

Authentically Human Essay Example | Topics and Well Written Essays - 750 words

Authentically Human - Essay Example He suffers from a looped life in which he repeats incomplete actions anxiously. DBS (Deep Brain Stimulation) surgery improves a patients brain and helps their lives. After a patient is diagnosed with OCD, doctors can request a DBS surgery. However, after surgery, patients minds are under the control of doctors. In effect, patients do not have the ability to control their feelings and behaviors. However, patients can be able to control themselves and behaviors, as a basic human being. In the essay "Alone Together" by Sherry Turkle, she explores how robots could engage in intimate relationships with persons, as well as become a better life. People consider the ethical aspects of technological controls. Technology controls people’s feelings and constructs the virtual world, which damages social lives that separate the people from the reality. In essence, overreliance on the technologies cannot do anything on its own. Technologies become intimating with the virtual world rather than an authentic world, which is they drift people away from the real life through controlling their feelings. One of the problems associated with the use of DBS is that people change their emotions very rapidly and unreasonably. Slater expresses that along with the development of medical technology, the use of advanced medical technology brings improvement in the fight against diseases such as OCD. This technique was established on DBS treatment, which can lock off a part of humans feelings in order to treat OCD. Mario, who becomes one of the first American psychiatric patients, explains his experiences. He feels that the diagnosis and treatment process that he received from Dr. Greenberg and Rasmussen benefited him a great deal and saved his life. She says, "When Mario talks about that time now, tears come to his eyes. â€Å"It was like a miracle, I still have some OCD symptoms but way, way less. Dr. Greenberg and Rasm ussen saved my life† (241). However, DBS works to bring

Thursday, September 26, 2019

Developing Strategic Management and Leadership Skills Essay

Developing Strategic Management and Leadership Skills - Essay Example This project stresses that a leader will verify that the salaries are being paid in time; will pursue a system of rewards and bonuses; and, will listen to the employees’ troubles and will try to remove them. This will keep them working at high competence. The leader will make agreements with business partners while respecting their decisions. This confidence between the partners makes the organization grow and maintains its integrity. A leader will know how to schedule his projects keeping in mind the time frame and instructs the team to manage their work schedules accordingly.  From the report it is clear that the goal of leadership is to make the new comers follow the way the leaders work and behave in the organization. The leaders should show such an attitude at the workplace that would inspire others to follow their directions. The ultimate goal of the leadership is to create such teams that work effectively to produce greater results. The most important thing is conside ration about internal and external communication. If leaders want that employees participate in a vigorous collaborative environment where they interrelate with each other in a better way to share their ideas and information, they would have to take steps to improve their communication with their workers, listen to their problems, talk to them and work out their issues. Workers will automatically start following them and the overall organizational culture will improve. This is the transformational leadership. (Brown & Travino, 2006) actually in which the leaders produce such an effect on their subordinates that they inflict a â€Å"transforming effect† on them thus producing â€Å"sweeping changes in organizations and societies† (Priyabhasini & Krishnan, 2005, p.1). Strategic Management Strategic management is the process of determining goals and objectives while recognizing roles and responsibilities and meeting deadlines. It involves the

Cost Accounting and the objectives Essay Example | Topics and Well Written Essays - 500 words

Cost Accounting and the objectives - Essay Example Relevant revenues/costs show future costs/revenues that will change by the decision taken while irrelevant costs/revenues are not affected by the decision. Inclusion of both quantitative and qualitative data ensures that an informed decision is made. This is because it ensures that all factors are taken into consideration. Short run pricing decisions has a less than one year time horizon while long-run pricing decisions have a year or longer time horizon. Example of short-run pricing decision is pricing a one-time only special order or adjusting output volume and product mix. A long run pricing decision includes pricing of a product in a major market where there is some leeway in price setting. Target pricing refers to an estimated price for a good or a service that prospective buyers will be willing to pay. The balanced scorecard is a strategic planning as well as management technique used by organizations in aligning the performance of an organization to its objectives and vision. It has four perspectives namely, financial perspective, customer perspective, learning and growth perspective and business process perspective. Financial perspective learning and growth perspective measures employee retention, knowledge management and employee satisfaction. Business process perspective measures costs and quality of business processes. Customer perspective requires that customers be satisfied, retained to increase the company market share. Financial perspective advocates timely and accurate financial data. A cost pool refers to a grouping of individual expenses or costs, regularly by division or a service center. It is from such cost pool that allocation of costs is made. For instance, the maintenance department cost is accumulated in a cost pool before allocated to the departments that use its services. Cost pools are normally utilized for the production

Wednesday, September 25, 2019

Interactive and Digital Marketing Research Paper

Interactive and Digital Marketing - Research Paper Example 636-645). Furthermore, in this age, both interactive as well as digital marketing is highly used in order to enhance the bonding within the customers and the organization. It is the bonding or relationship that acts as a catalyst for the organization of today’s age to improve its presence and sustainability in the market. However, in order to retain such type of relationship with the customers, it’s extremely essential to offer all sort of essential information or details regarding the products and services of the organization in an effective way. This report mainly deals with the information available within the web-sites of two retailers named Primark and marks and spender (M&S). It also describes the difference present within the websites of the two mentioned retailers along with the traditional bricks and mortar shops. According to Kotler (2008), marketing acts as a tool that may be used to identify, anticipate, and gratify the requirements and demands of the customers in an effective way. Moreover, in today’s age, marketing is essential to identify the target customers of the products or services of an organization. However, in this age of digitalisation, it might be possible only if an organization becomes successful in developing an online presence. Online or digital sites helps an organization to present its products or services to a wide range of customers of varying income profiles, age-groups and standards in a very short period of time as stated by market segmentation theory. Along with this, with the help of online or digital websites, an organization may immediately fulfil the queries of its target customers and develop the customised products that might prove effective in increasing its profitability and loyalty in the market among other rival brands (Keegan. 2002, pp. 456-467). Due to these underlining reasons, the level of preference of digital or online websites is quite high as

Tuesday, September 24, 2019

Can and should the arts be used for emancipatory or progressive Essay

Can and should the arts be used for emancipatory or progressive purposes Answer this question drawing on relevant cultural theories on the relationship between the arts and politics - Essay Example In this regard, the arts are usually associated with recreation, distractions and amusements (Wolff & Geahigan, 1997, p. 1). Proponents of the arts argue however that the arts are embodied knowledge and quite often interprets, constructs and criticizes life. In this regard, the arts like the sciences, also transfers knowledge. The arts aids in shaping an â€Å"understanding of the world† as it is or as it should be and as such can and often does, guide progress and emancipation (Metallinos, 2009, p. 146). Therefore, the arts can be powerful communication sources and may transfer knowledge relative to social, political and cultural realities and in doing so can raise consciousness and lead to progress and emancipation. The purpose of this research paper is to explore and analyse the assumption that the arts are powerful social, political and cultural communications and whether or not the arts should be used for progressive and emancipatory purposes. This is a particularly complex issue as arts are not all expressive and some are wholly aimed at creating pleasure and economic investment. Even so, given the communication associated with the arts, this research paper explores whether or not it is fair to impose emancipation and progressive responsibilities on artists. In order to determine whether or not the arts can and should be used for emancipatory and progressive purposes, cultural and political theories of the arts will be analysed. The arts are often defined as representations and expressions of life, nature, objects and human feelings and activities. Art as a representation and/or an expression is immediately defined as a communication between the artists and the audience to which it is directed or exposed. In this regard, art is said to be reflective in that it often invokes human emotions and thoughts. At the same time, some arts such as instrumental classical or any

Monday, September 23, 2019

Discuss how RAID can be implimented Essay Example | Topics and Well Written Essays - 250 words

Discuss how RAID can be implimented - Essay Example back is its high cost due to use of a separate processor and software which gives the RAID system greater strength to handle recovery and disk rebuilding. Another approach to implementing hardware RAID is IOC. The advantage of controller-based RAID is that it is cheaper because it simply uses processors on the disk controllers. However, controller based RAID is restricted by the power of the processor and the memory bandwidth of the controller, which makes it slower than IOP RAID. On the other hand, software RAID can be implemented using a disk controller driver or an operating system. Software RAID is cheaper than hardware RAID but is not as reliable. Software RAID may be useful in small applications where quality performance is not really expected. It is used in the drivers of the hard disk controllers and is independent of the operating system. Operating System based RAID uses a RAID engine in the operating system. Both disk controller driver and operating system driver RAID are dependent on system processor which can be specifically used in low performance and lightly loaded

Sunday, September 22, 2019

Did Charles I Succeed in Implementing Royal Absolutism Essay Example for Free

Did Charles I Succeed in Implementing Royal Absolutism Essay I succeed in implementing royal absolutism during the period of Personal Rule? Royal absolutism is a state of government whereby the monarch rules supreme, with virtually no legislative power placed in other organisations such as Parliament. For the people of England in the 1630s, it was a very real threat. After the dissolving of Parliament in 1629, Charles I embarked on his Personal Rule. Without analysing whose fault the breakdown in relations was, it was probably the only thing Charles could do in the circumstances. Certainly, no dialogue with Parliament was possible. After 1629, the country became particularly distrustful of the King. Charles problem was he was an inept ruler whose belief in such ideas as the Divine Right of Kings and Royal Prerogative meant that he did not moderate his beliefs publicly. England needed stability, the Continent was a very real threat at the time, and England needed a monarch to represent England and its peoples principles. Unfortunately, Charles was not the right person. There is much debate over the legitimacy of the image Charles attempted to portray during Personal Rule. Evidence suggests Charles was simply a ‘collector of fine arts’, and simply wished to add lustre to his monarchy. The counter-argument is that paintings of Charles, the most famous of which were created by European artist Van Dyke, were presenting Charles as a ‘divine king’, implementing absolutism with images of the King atop large horses, looking out over his kingdom. Did Charles use these artworks to transform his public images, lend majesty to his physical attributes and glorify Monarchy? His clothes were often flamboyant, portraying wealth and royalty. His face, calm and relaxed, implying that the King is laid back and in control. This lack of emotion can also portray Charles a s a cool, calm and collected person, who has no trouble maintaining his vast Kingdom. The Court was the central point for Charles’ rule, a model for a reformed government and state. It was a microcosm of the Kingdom Charles intended to create and maintain. An example of uniformity and conformity at its finest. In his Court, Charles had made significant changes; the Court was now a completely different place to that of his father’s, James. James allowed his court to be free, letting people goes wherever and whenever they wanted. Charles kept a suppressive rule over his using strict discipline. The court was disorganised under James. Charles replaced it with a formal regime, a model for moral restraint. Following a predominantly Revisionist view, Charles’ Court was simply a reflection of his strongly developed aesthetic sense. It portrayed an insistence on virtues of peace, despite the war. Possibly more than anything else, Charles’ government during the Personal Rule revealed his absolutist intentions more than anything else, starting with the privy Council, a group of the Kings selected advisors, who’s key job was to shape the Monarch’s wishes into policy. Despite Revisionists (such as D. L Smith) believing that Charles â€Å"wished to use the council to implement a far reaching reformation of government†, it was used for a much greater purpose. It was used to remove the need for Parliament, leaving him in full control. He ruled this council with an authoritarian temperament, implying that he even strived for complete control in his own Council. The more powerful courts (also known as the Prerogative courts) were made up of the Star Chamber and the Chamber of High Commission were more powerful than the local or royal courts that would deal with the day to day matters of the Kingdom. These courts would allow Charles to bypass regular laws and decisions made by lower down courts, in order for him to get his own way. Charles had complete control over the Government during his personal rule, and was blatantly portraying the characteristics of an Absolutist monarch. Charles’ financial innovations during his personal rule were an attempt to gain independence, No longer needing money from Parliament would be one step closer to becoming absolute. People may argue that Charles simply needed the money to pay off large debts, also an attempt to neutralise the on-going feud with Parliament. His policies during this time were extremely absolutist. A good example of this is ship money, making it mandatory for all citizens to pay a tax that goes towards funding ships to protect the coasts. The problem was that as well as the people living on the coasts paying this tax, people living in central England were also forced to pay it. This was surely an unfair venture, and caused mass resentment throughout the country. Religion was a key issue during the personal rule, with some believing Charles’ decisions regarding Catholicism and the newly discovered ‘Armenianism’ to be somewhat controversial. Right from the start of his reign, Charles had displayed Catholic sympathies as expressed in Arminianism, which some people called Catholicism under another name. But now with Parliament gone, there was seemingly no-one to keep the Kings beliefs in check and to remind him that England was a Protestant country. The Kings religious beliefs were of special concern thanks to the rapid promotion of William Laud, eventually to Archbishop of Canterbury. Laud was an unpopular figure even by the Kings own supporters. Those opposing the King detested Laud for his Arminian reforms in the Church of England. Unfortunately for Charles, this did tend to unite people against him. The problem was that Puritans and Calvinists who opposed the Arminian innovations had good reason to be concerned. Lauds changes were very Catholic in nature, including repositioning the altar so that staunch Puritans would say that the minister is blocking the route to God. Laud tried to raise the status of the clergy so that they were equal to any gentleman in England. He ordered that the private pews of the gentry that set them apart from the rest of the congregation be removed. This humiliated them. Arminianism was such an ambiguous idea that, while it was clear that it had many similarities with Catholicism, it was not clear whether it could be compatible with the Church of England. This question was raised directly in 1634 when the Pope offered Laud the position of Cardinal. Of course Laud refused (if he had accepted, there is no doubt that England would have been thrown into turmoil), but his refusal was not strongly enough worded; he said that he could not accept Rome as it is. This seemed to suggest too many Puritans that Laud was intent on moving towards Catholicism, or at least Catholicism independent of Rome. It is important to realise that Laud was a key supporter of Charles and that any criticism levelled at Laud was also at Charles. Laud was the Kings instigator of his religious beliefs. If the King did not believe completely in the principles of the Church of England, this was not a problem that would threaten to bring down the Kings rule. The trouble was the nature of Charles religious eccentricity. As already mentioned, it was very Catholic. And Catholicism was widely feared and hated in England. Charles’ rule was not confined to England. It could be argued that Charles’ rule of Ireland and Scotland were even more problematic than the tensions created in his other kingdoms would, ultimately have dramatic damaging consequences on his rule in England. Through Wentworth, Charles intended to rule in the manner in which he hoped to eventually govern England, absolutely, efficiently and without regard to any interest but that of the crown; in how own word ‘thoroughly’ (Clarke. A). Charles also attempted to extend religious reform to Scotland, which was, in conclusion, rather unsuccessful. After implementing his changes, it was clear to see that Charles was a threat to Scotland’s power, and Scotland knew this too. In an extremely absolutist manner, Charles had attempted to revoke many titles to Scottish crown and church lands that Scottish nobles had acquired since 1540. To conclude, Charles was most definitely an Absolutist leader. He strived for financial independence during his rule, following countless feuds with the English Parliament. His councils and chambers were able to bypass common law, therefore rendering him all powerful in that aspect. A second aspect was his court, which was a direct microcosm of what he believed his kingdom should be, a place of conformity and uniformity. Had Charles been successful in his reforms in Ireland and Scotland, he may have pursued to become more powerful, though the revolution soon ended his reign of mediocrity. Most monarchs labelled as absolutist had no greater power to those who were non absolutist. Was absolutism simple a label used to emphasise difference between the rhetoric of monarchs and the realities of the effective use of power by these monarchs? Perhaps. The on-going question of Charles’ absolutist intentions will be never have a definitive answer.

Saturday, September 21, 2019

The Neurobiological Basis of Major Depressive Disorder (MDD)

The Neurobiological Basis of Major Depressive Disorder (MDD) Family name:  Batty Personal Name:  Therese Major depressive disorder (MDD) which is also known as either unipolar depression or major depression is a common yet disabling mental disorder affecting over 400 million people worldwide with a higher incidence in women than men (World Health Organisation, 2012). Depression may be endogenous where there is no discernible cause or reactive whereby the depression is a result of an incidence such as the loss of a parent, loved one or stress. Some of the emotions that individuals may experience with depression are, feelings of sadness, anger, bitterness and resentment, emotions which can last a few days or in some cases, months and have a huge impact on the individuals life. Some individuals suffering from MDD are also more likely to have a substance abuse problem, other mental and physical problems, and are likely to have a greater suicide risk. MDD is a widely researched topic with a sense of urgency to find the exact aetiology and pathophysiology behind the disease so that a more tho rough understanding can be reached and treatment can be uniquely designed for each individual. Researches surmise that various factors are involved such as the chemical changes in the brain, genetic predispositions and environmental factors. The aim of this essay, although not comprehensive enough, is to try and bring together research material from various sources and highlight some key areas around MDD such as a synopsis of the aetiology, pathophysiology, risk factors, treatments and test available today. Aetiology The underlying aetiology (causes) of MDD is so complex with many gaps that it appears that no-one is quite sure what causes depression, however much research done to date into this condition suggests that a combination of factors are involved, such as genetics, an individual’s biochemical environment, personal experiences and psychological factors. According to Dr Michael Miller, a Professor of Psychiatry at Harvard University (2013), several forces interact to bring on depression including faulty mood regulation by the brain, medications, medical problems, genetic vulnerability and stress. In as much as age related brain changes, disease related changes , for example, cerebrovascular disease, Parkinson’s disease, and epilepsy, lead to disruptions in the circuitry of emotion regulation and can cause the onset of depression (Wryobeck, Haines, Wynkoop and Swanson, 2013). Areas of the brain underpinned by major depressive disorders such as the thalamus, the hippocampus and the amygdala (Limbic circuitry) (Figure 1. Miller, 2013 ) include several groups of neurons and white matter. Cell connections, nerve cell growth, and the functioning of nerve circuits in the brain have a major impact on how the brain functions, particularly in the way they communicate with each other. Several different chemicals and hormones working within and outside these nerve cells play a key role, with reduced levels of serotonin and noradrenaline posit to be a huge factor associated with the disease (Miller, 2013). Similarly, Villanueva (2013) through the construct of a survey used to assess the neurobiology of MDD, found that brain-derived neurotrophic factor (BDFN) along with expressions of miRNA’s (involved in neural plasticity), abnormal gastrointestinal signalling peptides and proinflammatory cytokines are all causative factors of major depressive disorder. What proinflammatory cytokines do, is stimulate the hypothalamic-pituitary-adrenal axis, activate secretion of growth hormone and inhibits the thyroid stimulating hormone secretion, all of which are associated with depression. Whereas gut microbiota (flora), specifically leptin, ghrelin and cholecystokinin (signalling peptides), influence the central nervous system including modulation of neurogenesis which can influence brain chemistry and consequently an individual’s behaviour. According to Lopresti, Hood and Drummond (2013), as seen in figure 2 below, a bi-directional relationship is likely to exist between depression and lifestyle factors with key symptoms including changes in appetite, general energy levels, motivation levels and sleep, which in turn affect diet, exercise and sleep thereby creating a cycle of influence. A vicious cycle, all of which point to the necessity of promoting lifestyle changes Figure 2. Potential mechanism of diet, sleep and exercise on major depression. In Lopresti et al. (2013). Another avenue suggested by Dr Miller (2013), is that research has identified that genetics play a role, in that not only do certain genes make individuals more vulnerable to low moods, but it can influence how individuals respond to drug therapy. Likewise, Stanford school of medicine surmise that through its research on the study of identical (100% genetically identical) and non-identical twins (50% genetically identical) and major depression as a heritability factor, heritability shows to be a huge contributor in the development of this disease. Each individual inheriting a unique combination of genes, with a predisposition to certain illnesses (Levinson and Nichols, n.d.). Genes controlling either the production or utilization of serotonin plays and important role in the pathogenesis of depression and in particular with serotonin reuptake due to the fact that depressed individuals have a lower rate of serotonin uptake. In depression of the elderly or late onset depression, genetic s is less common or does not appear to play a role as genetic markers are not present (Halverson, Bhalla, Bhalla and Andrew (2014). In so saying then, non-genetic factors, many of which are not known, also need to be taken into account, as Levinson and Nichols (n.d) suggest, these factors also increase the risk and progression of depression. Pathophysiology Progression of the illness as indicated by Treadway et al.(2014), is linked to biological changes. Due to over-stimulation of steroidal and inflammatory signalling molecules by stress, structural abnormalities within the prefrontal cortex and hippocampus, known for regulating behaviour and endocrine responses to stress, can be damaged. Moreover diet, sleep and exercise not only play a significant role in the development and progression of the illness, it also impacts on the treatment. One research analysis undertaken by Maletic, Robinson, Oakes, Lyengar, Ball and Russell (2001), summarised that MDD involved structural, functional and molecular alterations within the brain. Similarly research conducted by Halverson et al. (2014), speculates that although the underlying pathophysiology of MDD has not been clearly defined, studies show a strong interaction between the neurotransmitter availability and receptor regulation, with emphasis again on serotonin activity disturbances in the cen tral nervous system. Other neurotransmitters such as epinephrine, dopamine, glutamate and brain derived neurotrophic factor (BDNF) are also implicated in depression. Cells within the hypothalamus are responsible for an individual’s emotional state which in turn link to the stress responses. Several studies , in particular Lopresti et al. (2013), show that during stressful times, the hypothalamic – pituitary-adrenal axis (HPA), the neuroendocrine circuit that manages stress in the body, becomes activated. This then leads to the release of epinephrine and glucocorticoids (cortisol) to assist the body in its adaptive response to stress. However, if the body remains under a constant state of stress, excitotoxicity of neurons, particularly in the hippocampus can occur leading to dendrite atrophy and apoptosis of neurons (Wryobeck et al. 2013). Research shows that while cortisol helps the brain to cope with stressful situations, it also damages and kills cells in the hippoca mpus. So it can almost be said that stress excites brain cells to death. Furthermore research shows that individuals experiencing depressive disorders have a smaller hippocampal volume than individuals who do not from depression and that positron emission tomographic (PET) showed a diminished activity in the area of the prefrontal cortex in individuals with depressive disorders. Thereby underlying the functional and structural abnormalities in the brain regions of individuals suffering from depression (Halverson et al. 2014). Most individuals with MDD present with normal appearance however, individuals with more severe symptoms may present with more significant signs such as, poor hygiene, poor grooming and changes in weight. Individuals with MDD have a distorted view of their life whereby negative attitudes make it more difficult to see a positive outcome from a difficult situation. Other symptoms such as psychomotor retardation, agitation or restlessness, suicidal thoughts or atte mpts, social withdrawal and in the elderly somatic complaints may also be evident. These however are only some of the underlying signs and symptoms as individuals vary from one to the next. Risk factors / causal agents It is a widely held view that there is an unambiguous relationship between physical, psychological, environmental, genetic and social factors as well as a dysregulated response to chronic stress as risk factors for depression. Halverson et al. (2014) infer that stress plays a dominant role in depression due to the chemicals involved throughout the body such as adrenaline and cortisol which in abundance, leads to other health complications. With the various types of onset of stress being for example, the loss of a parent prior to the age of 10 years, parent-child relationships, due to poor interaction between the two and child stressors, which can contribute to depression or thought to be associated with both early and late abuse and neglect. In addition, stressful changes in life patterns such as a serious loss, difficult relationships, trauma or financial problems can trigger a depressive episode. Women with a previous history of depression are at higher risk of menopausal depressio n while low testosterone levels in older men also aid in onset of depression (Halverson et al. 2014). Likewise Martin (2014) highlights that women may experience more episodes of depression than men due to hormonal changes such as during premenstrual phases, pregnancy, postpartum and menopause. Coupled with this is the additional stress of work-life balance where women take on the added responsibility of tending to children and or aging parents whilst still trying to forge a career for themselves. Individuals with a family history of depression tend to be at higher risk of developing depressive disorders. Psychosocial risk factors according to Halverson et al. (2014) can include impaired social supports, caregiver burden, loneliness, bereavement and negative life events. Abused substances and pharmacological agents can increase depression risks due to altering brain chemicals. These include pain relievers, sedatives, sleeping pills, cortisone drugs and seizure drugs, to name but a few. Whilst in the elderly, neurodegenerative diseases particularly Alzheimer’s and Parkinson’s, stroke, macular degeneration (vision) and chronic pain can all contribute to higher rates of depression (Martin, 2014). Treatment strategies First and foremost, education plays an important role in the treatment of MDD as individuals may become aware of the signs of relapse thereby allowing them to seek early treatment. Family and support members also need to be educated about the nature of depression and the treatment involved so as to be able to give the support needed, ensure medication compliance and encourage a change in lifestyle such as keeping active (Halverson et al. 2014). Wryobeck et al. (2013), posit that with depression being a multi-factored illness, treatment should encompass a combination of therapies such as psychotherapy, electroconvulsive therapy, lifestyle management, psychosocial therapy and pharmacotherapy. Pharmacotherapy such as anti-depressants being one method affects the neurotransmitters. Selective serotonin re-uptake inhibitors (SSRIs), a new class of antidepressants, which allow for the increase of serotonin by blocking the re-uptake of serotonin into the presynaptic neuron, is according to Clarke and Gordon (2011), used as the first line of treatment. SSRIs allow for autoreceptors to be desensitised or down-regulated, nerve transmission and serotonin levels are normalised and mood is elevated. Figure 3 below, illustrates how the amount of neurotransmitters in individuals with depression are reduced and postsynaptic receptors are increased as a response to these lower levels. The re-uptake of serotonin adding to the decreased amount of neurotransmitters. When treatment of SSRIs take place, serotonin levels increase due to the blocking of the re-uptake and down-regulation of postsynaptic receptors occur (Clarke Gordon, 2011). Figure 3 Action of selective serotonin re-uptake inhibitor drug. In neurobiology of mental illness Clarke Gordon (2011). Psychotherapy can include behaviour therapy, cognitive-behaviour therapy, family therapy, interpersonal therapy, psychodynamic psychotherapy and supportive psychotherapy. Psychosocial therapies according to Halverson et al. (2014) and supported by The American Psychiatric Association (APA) is often a first-line of treatment for mild cases of depression however, in more severe cases this should be combined with antidepressant medication. Other approaches according to Wryobeck et al. (2014) and Halverson et al. (2014), can include electroconvulsive therapy (ECT) which is thought to increase neurogenesis, reversing degeneration and decreased proliferation of nerve cells, regulate neurotransmitters and correct dysregulation of neuropeptides. Stimulation techniques such as vagus nerve stimulation which involves the nerve to be stimulated with electrodes resulting in the assumption that it may alter norepinephrine release and elevating levels of inhibitory GABA. Transcranial magnetic stimulation concentrates magnetic energy over parts of the brain allowing for either an increase or decrease in cortical excitability depending on the frequency. Stimulation over the right frontal lobe apparently reduces the symptoms of depression. Talk therapy as well as exercise are more non-invasive forms for dealing with MDD allowing the individual to develop problem solving skills, coping mechanisms and in some instances to form a suppor t group. Relevant tests To date there are no physical findings that are specific to MDD, instead diagnosis is dependent on the individual’s history and mental state exam. As depression may be linked to an underlying physical problem, both a physical exam as well as thyroid function blood tests can be done. A psychological evaluation is also of benefit to gather information around an individual’s feelings and behaviour pattern. In New Zealand a wide range of tools are available such as the Kessler 10 (K10) for assessing depression, anxiety and general mental health, the patient health questionnaire (PHQ-9) for depression and the GAD-7 for anxiety assessment. According to the Best Practice Advocacy of New Zealand [bpac z](2009) these tools also allow for monitoring the response to an individual’s treatment regime to ensure that optimal health is being met. In conclusion, to date the specific causes of major depressive disorders (MDD) is still unknown, however a substantial amount of research has gone into and still continues in this area with a consensus that depression appears to be a multifactorial and diverse group of disorders involving the chemical reactions and nerve communication in the limbic circuitry of the brain and both genetic and environmental factors. Progression of MDD is linked to biological changes, diet, sleep and exercise. Treatment strategies appear to be multi-factored with underlying assumptions based on individual research results. Education is still an important element focusing on the individual and support structures while more up to date pharmacopeia such as serotonin re-uptake inhibitors, lead the market as the go to drug for antidepressants. Most literature to date however, underlines the need for more research to take place, in particular, within the area of the aetiology / pathophysiology of the disease and likewise specifically structured individual treatment strategies. References Clarke, G. Gordon, C. (2011). Neurobiology of mental illness. In J. Craft, C. Gordon A. Tiziani (Eds.), Understanding pathophysiology (pp. 1177-1180). Chatswood, NSW: Elsevier. Halverson, J. L., Bhalla, R. N., Bhalla, P. M. Andrew, L. B. (2014). Depression. Retrieved from http://emedicine.medscape.com/article/286759. Levinson, D.F. Nichols, W.E. (n.d.). Major depression and genetics. Retrieved from http://depressiongenetics.stanford.edu/mddandgenes.html. Lopresti, A. L., Hood, S. D. Drummond, P. D. (2013). A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise. Journal of Affective Disorders 148 (2013), 12-27. Maletic, V., Robinson, M., Oakes, T., Lyengar, S., Ball, S. G. Russell, J. (2007). Neurobiology of depression: an integrated view of key findings. International journal of Clinical practice, 61 (12), 2030 – 2040. doi: 10.1111/j.1742-1241 Martin, B. (2014). What are the risk factors for depression? Retrieved from http://psychcentral.com/lib/what-are-the-risk-factors-for-depression. Miller, C. M. (2013). What causes depression. Retrieved from http://www.health.harvard.edu/newsweek/what-causes-depression.htm. The Best Practice Advocacy centre of New Zealand. Assessment of depression in adults in primary care. (2009). Retrieved from www.bpac.org.nz/BPJ/2009/adultdep/assessment.aspx. The world health organisation. (2012). Depression fact sheet. Retrieved from www.who.int/mediacentre/factsheets. Treadway, T. M., Waskom, M. L., Dillon, D. G., Holmes, A. J., Park, M. M., Charavarty, M. M., ‘†¦Ã¢â‚¬â„¢, Pizzagalli, D. A. (2014). Illness progression, recent stress and morphometry of hippocampal subfields and medial prefrontal cortex in major depression. Society of Biological Psychiatry. Retrieved from http://dx.doi.org/10.1016/j.biospych.2014.06.018 Villanueva, R. (2013). Neurobiology of major depressive disorder. Neural Plasticity, volume 2013. doi: 10.1155/2013/873278 Wryobeck, J. M., Haines, M. E., Wynkoop, T. F. Swanson, M. M. (2013). Depressive disorders. In C. Noggle S. Dean (Eds.). The Neuropsychology of psychopathology (pp 201-220). New York, NY: Springer Publishing. List of illustrations Figure 1. Miller, C. M. (2013). What causes depression. Retrieved from http://www.health.harvard.edu/newsweek/what-causes-depression.htm. Figure 2. Lopresti, A. L., Hood, S. D. Drummond, P. D. (2013). A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise. Journal of Affective Disorders 148 (2013), 12-27. Figure 3. Clarke, G. Gordon, C. (2011). Neurobiology of mental illness. In J. Craft, C. Gordon A. Tiziani (Eds.), Understanding pathophysiology (pp. 1177-1180). Chatswood, NSW: Elsevier.