Wednesday, December 4, 2019
In Target Civil Services 2013 If you have the will to win, you have achieved half your success; if you donÃ¢â¬â¢t, you have achieved half your failure. Ã¢â¬â David Ambrose Home History Economy Polity Geography International Relation P. T (SPECIAL) Scien N T ech Tuesday, 16 October 2012 [Essay] Modernization and Westernization are not Identical Concepts Introduction The battle between the east and the west still continues as each try to preserve its culture and assert its powers. Just as the fight to be superpowers continues, the west and east continue to outdo each other in other aspects. The concept of modernization means an evolution from traditional society practices to modern social status. Modernization has brought about transformation of societies which has been experienced since time in history. The term modernization however, has been mistakably been taken to mean the adoption of policies that favor other societies. The changes have been witnessed in the political, economic production and social systems. In addition, it has also been reflected in the way of thinking and behavior of the people. In the twentieth century many transformations continues to change especially the open in browser PRO version Are you a developer? Try out the HTML to PDF API pdfcrowd. com most controversial issue of culture. Societies have remained attached to their practices and beliefs and any attempt to change them. This has remained a contentious issue when the east is approached to adopt policies from the west. They view this as colonization from the west which is blocked in every possible way. This paper tackles the question: Does modernization mean Westernization? It seeks to find out whether there are ways of becoming modern that are informed by different civilization logic. In answering this question it visits the issue of modernization in China in the twentieth century. Civilization brings about modernization; and civilization has historic start in Europe. The different civilizations such as the one rising from Tigris-Euphrates and Nile river valleys contributed a lot to the modern man. The Middle East in the 4000 B. C. E. also experienced civilization revolutions through agrarian revolutions. Technological innovations also characterized this period which contributed to better economic, political and social development. Consequently the changes contributed to the present day modernization. The Chinese Situation In China, modernization came into light during the new culture movement. In this period other terms were associated with modernization; they include westernization, electrification, mechanization, fashionable, and modern. Nevertheless, it was until the 1950s and 60s that the concept of modernization became accepted and used. During this period two western centric ideas were accepted which were; the impact response approach and the tradition modernity approach that contributed to the Chinese transformation. The tradition modernity approach had a direct influence to the modernization which was more known in the American society. Modernization had two practical purposes in the 1950s and 60s; they include to analyse the academic program so as to bring to an end to communism and secondly to give third world nations with a plan to achieve development of a stable, free and content world through the use of science, rationality, enlightenment, capitalist democracy and capitalistic free market. open in browser PRO version Are you a developer? Try out the HTML to PDF API Popular Posts [Essay] Modernization and Westernization are not Identical Concepts Person in News :Pranay Sahay Retd Paramilitary staff gets exservicemen status India Signs Loan Agreement with World Bank for US$ 500 Million for Rashtriya Madhyamik Shiksha Abhiyan Global Hunger Report 2012: India placed 65th Sistema issue: pdfcrowd. com The modernization was characterized in the 1950s and 60s by the split in the development in the modern and tradition period. The traditional period was described as stagnant and static while the modern period was described as rational, fast moving and dynamic. For that reason, modernization was viewed as the elimination of tradition. In those who supported modernization they saw China as incapable of transforming itself to be modern; it required an external shock which should be strong enough to initiate a modern revolution; the west had the chance to provide the enlightenment required for the transformation; and the effects of modernization in China would be to copy the west which was regarded as modern. Modernization Modernization can be traced to the historical development in Europe, since the fourteenth and eighteenth centuries there were major transformational changes. They included renaissance, scientific revolution, the age of great discovery, agrarian and industrial revolution, and enlightenment. In order to be modernized there are two preconditions involved; they are secularization and innovation. In secularization, man is required to have human value that means the satisfaction of practical needs and not accepting idealistic ideas. In adopting secularization man has stronger sense of reality, rationality, and active in social matters. Innovation on the other hand, requires casting away traditional ideologies. In real meaning, modernization moves man from a spiritual or god centered society to a man centered one. It turns out to be rational and scientific. Modernization also brings the issue of enlightenment which brings about a political and social rearrangement that is based on rationality, science and development. For example, the capitalistic system, a liberal democratic system and sovereignty need to be involved. Modernization means industrialization that is built on science and technological revolutions. Science makes man understand the world while technology gives the tools to have a better world. This means that the quality of life is improved contributing to a modern society. Western form of modernization is measured with mechanization regarding to open in browser PRO version Are you a developer? Try out the HTML to PDF API Sistema issue: India hopes agreeable solution Ã¢â¬Å"European Golden BootÃ¢â¬ to Lionel Messi [Essay] Is Gandhian Mode of Protest (Satyagraha) still relevant? Free generic drugs via public hospitals; Three fold increase in the allocation to health sector in the 12th Plan Rehabilitation of Children Under NCLP Scheme Followers Join this site w ith Google Friend Connect Members (1) Already a member? Sign in pdfcrowd. com production modes, urbanization, mass participation in public issues, affirmative action, education popularization, expansion of infrastructure i. e. transport and communication, bureaucracy and international relationships enhancement. In this view modernization is gauged with the amenities and provisions in the country. For modern transformation the country must therefore undergo economic, political, and cultural transformation. Economically, the country needs to transform from traditional agriculture practices to modern industrial practices. Politically, the country must move from dictatorial and feudal autocratic practices to free and fair democratic society. Culturally, the society needs to move from uncivilized groups into conscious individualism so as to have independence. The democratic view of modernization is the ability to estrict power by use of law, having multi-party rule, having security forces to protect the state, democratic elections, accountability of the government, decentralizing the functions and having participants of the people. The traditional Chinese culture had entrenched three bonds which were (between ruler and subject, father and son, husband and wife), and five relationships between ruler and subject, father and son, husband and wife, older brother and younger brother, a nd friends. The society had focus on family, male domination, patriarchy, agriculture and household industry. Changing this would need great and strong force of modernization. Does modernization mean Westernization? Separating modernization from westernization is the issue that lies in the mind; whichever side of the debate one is then he or she can give contradicting statements to prove a point. Many will debate on the loss of culture and the imitation of the western culture as modernization while others will base their argument on the adoption of democracy and a free society. The modern societies have a great deal of common aspects however they never merge into homogeneity. Some have the assumption that the modern civilization is the same as the western civilization and consequently western civilizations is the same as modern civilization. This conversely, is not true. This is due to the fact that the western has always been even before open in browser PRO version Are you a developer? Try out the HTML to PDF API Blog Archive ÃÅ½ 2012 (121) November (29) ÃÅ½ October (92) Oct 30 (5) Oct 29 (5) Oct 28 (1) Oct 27 (3) Oct 26 (8) Oct 25 (2) Oct 24 (15) Oct 23 (2) Oct 21 (9) Oct 20 (3) Oct 19 (3) Oct 18 (2) Oct 17 (5) ÃÅ½ Oct 16 (7) [Essay]Imp act of Moderniz ation and Westerniz ation SC green signal to resumptio pdfcrowd. com modernization. The western culture has been seen to be based on philosophy and rationalism of the Greek, the law of the Romans, natural law, the Latin language the rift between Catholics and Protestants and social pluralism. The cultures of the west have not been well accepted in the east in areas like China, Russia, and the Middle East, where centralized bureaucracy and absolutism exists. To the east the adoption of such culture and values would be colonization and modern day slavery. The social and political values depicted as western civilization are therefore rebelled against. The values view as western modernization include liberty, individualism, equality, free markets, capitalism, constitutionalism, separation of the church and state, the rule of law, human rights and democracy. This creates a democracy paradox; where the Islamic world and the east in general oppose westernization. The question at hand (i. e. Does modernization mean Westernization? will help to separate modernization from westernization. Depending on which perspective it is either west or east the argument may last forever but to draw a line and separate the real ideologies can help solve the dilemma of whether the glass is half full or half empty. Can one modernize without being western? As the time passes on the differences between the cultures become less and less; the gap therefore closes. But in the modern society many may resist this change seeing it as colonization. Nevertheless, change is inevitable and as technological and industrial revolutions are adopted the enlightenment period get closer with people demanding their rights. This means that the society will crave for change. However the adoption does not mean a complete merger of the cultures to one global culture. There will always be real and significant differences in the modernization. For example, the democracy, communism, and fascism were modern political systems and since democracy has been adopted by the west does not mean it is westernization. There is therefore need to differentiate the western influence from the modernization in the west. Though modernization may seen by the east as aping the west; the critical part is the difference between the two areas. There are still differences even after modernization since the family values; the social obligations and the meaning of life remain different open in browser PRO version Are you a developer? Try out the HTML to PDF API resumptio n of tourism in Tiger President of Mauritius to be the Chief Guest of 11 Iran denies U. S. llegation of cyber attack Person in News :First woman chief of AU takes char [Essay] Moderniz ation and Westerniz ation are not I National Security Advisor Releases Joint Working G Oct 15 (2) Oct 14 (6) pdfcrowd. com from the west. Their cultures have the various differences which are always unique to the areas and the people practicing them. This brings the cultural identity which is always maintained even after modernization. Modernization and wester nization Societies have defied all odds to modernize despite the negative notion brought by those who oppose change. Westernizing and modernizing have already been differentiated by a clear line. While modernizing is the adoption of technology and industrial revolutions; westernization on the other hand is the adoption of the western culture and ideas. Therefore for those who modernize does not have to adopt the western cultures. They just need to maintain their own culture but retain the ideologies of the modern world. The revolutionizing of people and societies is normally seen as the western culture where governments in the east want to retain the status quo and remain dictatorial. For modernization to take place there must be minimum requirements which include; industrialization, urbanization, occupational social structures that are complex and diverse, rational, effective and efficient economic groups, revolutionary decisions, education of the masses, efficient communication systems, centralization and global economic participation. Above all there must be social and political will; which might incorporate western values such as liberty, human rights, constitutionalism, secularization, democracy, equality and free markets. Citizens from the oppressed nations must therefore be able to distinguish the lies from the truth. Modern day civilization is not just a matter of aping what people want and fighting freedom; it is all about adopting the values that revolutionize society and give them a chance to discover themselves. The East especially the Islamic nations has particularly remained cold in adopting the western values more specifically due to the religion factor which is seen as an overtaking of the Muslim religion and culture by the Christian practices and norms. For a global village to be achieved there is need for most nations to adopt modernization and play away all difference. On the other hand, it does not mean open in browser PRO version Are you a developer? Try out the HTML to PDF API Oct 14 (6) Oct 13 (4) Oct 12 (6) Oct 11 (2) Oct 10 (1) Oct 09 (1) Labels ESSAY My Thought Persons in News Total Pageviews 2 3 7 3 pdfcrowd. com forgetting their culture but it means retaining it and preserving what is beneficial to the society. Every person needs to given the right to decide his or her own destiny while the state controls the nation in a democratic way. The people should have the freedom to decide in fair elections and be able to exercise their democratic rights. It also tends to abolish communism and assert democracy in a society that is oppressed. Conclusion Modernization does not mean aping the law, politics, lifestyles, language, religion, and education systems. But, it entails empowering the societies to decide what they need and want at all times. It involves making their lives easier through revolutions such as industrialization which will make them change from the traditional practices to modern concepts. The west has been viewed as very revolutionary and dynamic in the adoption of new ideas; the east on the other hand has been seen to oppose change. In view of the fact that modernization started in the west does not mean that the east should ape them. The clear separation of modernization from westernization is the only factor that will ensure the societies in the east are not lied to by their leaders. The east can experience better economic, political and social benefits if only they embrace modernization. They should use modernization to ensure the cultural and social values are always preserved within the society. This is the unique character of modernization; it does not strive to change the individual but the means of the individual to live. It is also good since it allows individuals to discover themselves, their strengths and weaknesses which will contribute to better control of the system. The east does not have to worry on adopting the western culture rather what the modernization does to the economic, social and political norms. Posted by sonu kumar at Tuesday, October 16, 2012 Recommend this on Google 15 comments: open in browser PRO version Are you a developer? 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Thursday, November 28, 2019
An informational speech on Gatorade. Water will not replace all the ingredients of sweat. Tonight I will inform you about Gatorade and the benefits of drinking it while exercising. You're probably asking yourself "Why should I care about Gatorade while exercising?" and the answer to that is dehydration. Dehydration is defined as the excessive loss of body fluid. First I will give you a history of Gatorade, 2nd I will tell you what Gatorade is, then I will explain how Gatorade works, and finally I will compare Gatorade against other sports drinks on the market.Deep in Florida Gator country dehydration was a major problem. The University started to research on an "alternative to water" and Gatorade was created by Dr. Robert Cade and Dr. Dana Shires in 1966 at the University of Florida and named Gatorade after the University's football team, the gators. A year later after Dr. Cade made an agreement with Stokely-Van Camp to market Gatorade, which he already patented.GatoradeThe Florida Gators used it in 1967 for the first t ime. It was also the first time they won the Orange Bowl title beating Georgia Tech. During an interview with the Georgia Tech head coach a reporter asked why they lost. The head coach replied "Because we did not have Gatorade on our sidelines." In 1969 the Kansas City Chiefs used the sports drink an attribute their Super Bowl victory that year to Gatorade. Only one year after its commercial introduction, Gatorade reformulated its recipe due to the Food and Drug Administration banned Sodium Cyclamate, which is a sweetener, according to Gatorade.com, last accessed on October 9, 2005. The Quaker Oats company bought Stokely Van-Camp in 1983 and licensed marketing rights to Pepsi co. until 2001 when Pepsi Co. bought the Quaker Oats Company, according to wikipedia.com, last accessed on October...
Sunday, November 24, 2019
How to Make a Waterfall Firework A waterfall firework produces a long-lasting shower of glittering sparks, like a fiery waterfall. Here are instructions for making a waterfall firework yourself. This is a bright firework, intended to produce sparks that fall 20-30 feet. The waterfall may be suspended in the air or over a drop, as from a bridge. Waterfall Firework Mixture Potassium perchlorateMixture of 50-100 mesh aluminum and titanium and 300-400 mesh aluminum10% dextrin in water Prepare the Firework Mix together equal parts of potassium perchlorate and the metals with enough dextrin solution that you can pack the mixture.Press the composition into paper tubes approximately 8-1/2 inches x 5/8 inches (internal diameter). You can make the tubes using rolled regular paper, secured on the ends and middle with masking tape. Leave 1/2 inch open at the end of the tube for your ignition mixture.Combine equal amounts of waterfall firework mixture with gunpowder to make an ignition mixture. Pack ignition mixture and a fuse into the last 1/2 inch of the paper tube.Let the firework dry for a day or longer.Suspend a series of the waterfall tubes 20-30 feet in the air, using wire. Link the tubes together using quickmatch.When its time, light the quickmatch and enjoy the show! Waterfall Firework Safety Be sure the wire used to attach the firework to the supporting structure can withstand the heat of the firework. The burning metal produced by the firework will ignite any grass or brush underneath, so be sure to light this firework over a clean, fireproof area. Expect the sparks to be very hot, so let them burn out on their own. Dont attempt to stamp them out. Reference: Kurt Schumacher, pyrocreations.com Disclaimer: Please be advised that the content provided by our website is for EDUCATIONAL PURPOSES ONLY. Fireworks and the chemicals contained within them are dangerous and should always be handled with care and used with common sense. By using this website you acknowledge that ThoughtCo., its parent About, Inc. (a/k/a Dotdash), and IAC/InterActive Corp. shall have no liability for any damages, injuries, or other legal matters caused by your use of fireworks or the knowledge or application of the information on this website. The providers of this content specifically do not condone using fireworks for disruptive, unsafe, illegal, or destructive purposes. You are responsible for following all applicable laws before using or applying the information provided on this website.
Thursday, November 21, 2019
How Marketing And the Communications Industry Transformed to the Digital Marketing Era - Research Paper Example Introduction Publicis group is a multinational company based in Paris. The group provides media services, traditional and digital advertising, marketing services and consulting services to the clients. In the era of globalization the medium of advertisement has been changed and the type of advertisement also getting modernized. In the marketing and communications industry there was a transformation seen from the 1990s decade. The agencies change their campaign approaches. They are trying to communicating with the customers instead of communicating at the customers. The Publicis group wants to transform the groupÃ¢â¬â¢s operation as they have bought Digitas. They have begun to identify a new model and for this they have to change the companyÃ¢â¬â¢s agencies. Vivaki is a new strategic initiative designed to improve the advertisersÃ¢â¬â¢ marketing investments and thus boost the growth of the Publicis group. In this modern era of marketing and communications industry needs some inn ovative approaches for retaining the market share. The approach of Publicis group was innovative as four agencies came under one umbrella through which Vivaki can provide good services to the clients. Since launch Vivaki has not performed well but because of the financial crisis. The paper is an attempt to research about the problems with the group using various tools of analysis like TOWS and strategy tripod. The researcher has tried to provide some recommendations that what the company should do in this situation for their long term and short term profit. Analysis The strategy tripod model is the tool a company with respect to three major perspectives of strategy. The three perspectives are industry based view, resource based view and... This paper stresses that marketing and the communications industry has transformed to the digital marketing era from the traditional marketing. Till 2006 there were no digital shops in the top ten spots so the group has acquired Digitas. Digitas is an integrated digital advertising agency. In 2007 Digitas was in the first spot in the ranking of the top digital stores. After that the chairman of the company feels the needs to integrate the agencies that were under the group and then provide products to the clients. So the management has launched a new venture Vivaki which offers the combined scale of operations of four different agencies of the group. The author of the essay declares that At the inception the group has not performed well because of financial crisis. In this report the researcher has analyzed the situation. This report makes a conclusion that the firm should take care of the cultural issues arising as this company is multinational. The company should allocate the responsibility of the agencies who are working in collaboration so that the group can avoid the events like AT & T. They should use the balance scorecard for review the feedback of the clients and employees. As the approach of the company is innovative it can be said from the analysis that the group will be able to increase its market share if they apply the suggestions made by the researcher.
Wednesday, November 20, 2019
Market analysis in Abu Dhabi - Research Paper Example Abu Dhabi is the biggest of all seven emirates in UAE as well as the capital of the country. The population of the city is about 1.3 million out of 3.8 million of UAE and also covers the 87% of the entire area. The city has a booming retail real estate market for residential buildings, offices other tourism places. The real estate market condition in the United Arab Emirates is, as a whole, facing a boom. It has the most secure and profitable market in whole Gulf region. Abu Dhabi is currently enjoying real estate investment from all over the world. The Abu Dhabi market possesses number of opportunities in the real state sector. It has been difficult for the authorities to meet the ever rising demand for real estate projects in the city.This paper presents an overview of economy, demographics and real estate of the retail market growth in the UAE region. It primarily illuminates the major retail real estate markets of Abu Dhabi, reflects on existing and future demand and supply, and provides recommendation for stabilization in the sector.UAE came into being as a result of alliance of seven emirates and Abu Dhabi was made the capital of the state. Abu Dhabi has supremacy in almost all fields i.e. economically and geographically etc. Abu Dhabi covers approximately 87% of total UAE area. According to a census that took place in 2005 the official population of UAE was 3.8 million approximately while the Abu Dhabi population was around 1.3 million. 300,000 people were those non-nationals who did not become a part of the census (Emirates: Abu Dhabi-Country Profile). Economy UAE is one of largest oil and gas producing countries of the World. It has 9% of oil reserves and approximately 5% of gas reserves. Abu Dhabi has the predominant share in these reserves i.e. 95% and 92% of oil and gas reserves. Like almost every Middle East country natural resources are the back bone of economy of UAE. The IMF report says that the GDP group of UAE is around 12% in 2005 and expectedly more in near future (Emirates: Abu Dhabi-Country Profile). The government of UAE, however, does not want to rely completely on oil and gas due to the fluctuation in its prices. It has been focusing on minimizing the country's economic reliance on oil and gas exports. With the government efforts and local and foreign investment in real state retail, tourism and industry the 64% of GDP now consists of non oil and gas sector. The government put huge investment and established Abu Dhabi Tourism Authority (ADTA) and that has been handled by the Tourism and Development Investment Company (TDIC) to promote tourism and real estate sector. Hence, the economy is moving towards the right dimension in the whole UAE and especially Abu Dhabi, which is undergoing rapid economic growth due to huge foreign and local investment in the country from banks and financial institutions (Emirates: Abu Dhabi-Country Profile). . Real Estate The current boom in the real state market of the United Arab Emirates took place over the last few years and has made a significant difference to the economy. The ratio of real state was 2.5% of the economy which has reached to10.5% (Walters, Kadragic and Walters 78). The real estate is one of those sectors contributing heavily to the overall economy. This huge investment reflects the government interest in the development of real estate market. The whole Gulf region is showing its keen interest in developing its economy while supporting the real estate sector. Abu Dhabi attracts abounding investment from the region in its real estate market. Al-Futtaim is going to launch project of $9.5 billion. That would take approximately 10 years to be done. The project includes residential, commercial, hotel and several office towers (Woods) REAL ESTATE RETAIL MARKET IN ABU DHABI . Abu Dhabi is a different market than any other market in the region for instance Dubai, Sharjah etc. The city is ideal because of its property market and pricing that also
Monday, November 18, 2019
Significance of Belonging in Young Peoples Lives. Belongingness and Identity - Essay Example Belongingness is a phenomenon that is characterized with a central feature called identity - be it a individualized or community based, but identity is the core factor governing the sense of belongingness. Identity attributes the exaggeration of outsider versus insider barriers due to polarization, so is happened with nationalism to the larger extent. Identification with one's own ethnic group occurs at the cost of estrangement from the larger societal framework. Belongingness as a manifested form of identity influences the fundamental structure of personal identification at its basic level, whereas, at its most complex level, it articulates the complex involvement with other individuals within the social network, featuring a range of potentially contradictory identity factors contributing to adherence such as gender factor, attitudinal factors, sexual orientation factor, ethnicity factors, ethnic preference factor and so on. When the development of the sense of belongingness is depr ived, it may result in increased anxiety, stress and emotional distress along with various forms of psychopathology and physiological malfunctioning (Baumeister & Leary, 1995; Anderman, 2002). Need for Belongingness As stated in Sociometer theory proposed by Leary and Baumeister (2000), there is a strong correlation between one's relational value and perceived self-esteem. If an individual perceives that his or her relational value is at risk, it may lower his or her self-esteem to quite a further. This threat is central to the need for belongingness that educes reflection about the problematic condition and potential solutions, as described by rumination theory proposed by Martin and Tesser (1996). Hence, if the perceived threat of relational inadequacy is continuing through the human system, the distorted self-esteem may cause the threat to repetitively turn out to be the individual's focus of awareness by interfering reflection over the barren goal, namely, the satisfaction of the need for belongingness. Aligned to this fact, rumination theory proposes that the perceived threat to the contentment of a basic need is one of the central factors educing and maintaining reflection (Gold & Wegner, 1995). Forms of Belongingness In order to develop an understanding about the relationship of belongingness to a young's life in terms of their living style, historical context of their existing condition, as well as present contextual framework, a thorough approach in considering the forms of belongingness needs to be assessed. There are essentially two forms of belongingness that influence an individual's life especially a young individual's life to quite a greater extent: belonging to place, inclusive of nationality and neighbourhood and a blend of these two aspects and belonging to sexual community. Belonging to Place In several times, various researchers conducted studies in order to find out the implication of belongingness in an individual's life in relation to the social location the individual belong to. It has been found that the sense of belongingness is shaped by the social location in which an individual belonging into (Rutherford, 1990). Hence, the essential contributing factors shaping a young individual's sense of belongingness include locality, gender, ethnicity, religion and social class. In such a study called Inventing Adulthood Study (London South Bank University, 2006) conducted to find out the sense of national identity among young individuals suggests that the national identity seems to be invisible with an
Friday, November 15, 2019
The Disorders Of Homeostasis Health And Social Care Essay This assignment will discuss the changes of normalÃ social,Ã physical, biochemical and physiologicalÃ functions of a disease process of chronic obstructive pulmonary disease (COPD). This is a term used for a number of conditions; including chronic bronchitis and emphysema. COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lungs. The word chronic means that the problem is long-term. COPD is a condition which mainly affects people over the age of 40, and COPD has a higher prevalence occurring among women than men (NHS-Choices, 2008). COPD is also a condition that is long term and incurable that can have a serious affects on health and quality of life, its not fully understood why COPD develops. (Marieb, 2003). The student will also incorporate local and national health and social policies, including frameworks that are in place in relation to the patients illness. The student identified a patient named Mrs J. She was admitted to hospital due to exacerbation of COPD. Her primary diagnosis is Osteoarthritis of the Hip but also had symptoms of emphysema. Mrs J is a 55 year old woman and is married, Mrs J also has an older child of 34 whom she has become quite dependant on and felt like she had impacted on her childs life and had become a hindrances. Mrs J has become more breathless as her condition develops over time and more so while she was lying in bed unable to carry out her daily activities such as doing the housework, leisure activities, also looking after her appearance as she normally would have done at home . COPD is becoming one of the fastest leading causes of disability (NHS choices, 2008). According to British Lung Foundation, (2010) a recent survey, 83% of COPD patients said their COPD slows them down, 79% said they had to cut down their activities and 56% said their condition has a great affect on their families. COPD is the most common respiratory conditions in adults in the developed world and poses an enormous burden to society both in terms of direct cost to the healthcare services and indirect costs to society through loss of productivity. Recent analysis estimated that National Health Service (NHS) spends Ã £818 million annually in the United Kingdom (UK). (British Thoracic Society, 2006). However 50% of the cost is accounted for by poorly managed exacerbations resulting in frequent re-admissions to hospital (Coakley Ruston, 2001). COPD is a chronic inflammatory condition of the lungs that causes the respiratory passages to be swollen and irritated, increases the mucus production and damaging the lungs. (Marieb, 2003). COPD develops when irritants are breathed into the airway and down the bronchial tubes. Normally, oxygen is passed through the bronchioles into the alveoli, tiny hollow sack-like structures in the lungs where oxygen is absorbed in to the bloodstream. When air is mixed with smoke or irritants, it will damage the lungs and the ability to take enough oxygen in (NHS-Choices, 2008). Mrs J condition would of been triggered by her heavy smoking, the toxins from her cigarettes has made her bronchioles (airway and lungs) become inflamed and narrowing the airway, this will lead to irreversible damage to the respiratory system by obstructing the bronchial airflow and hindering gaseous exchange within the alveoli (Munden, J, 2007). Mrs J suffers from many symptoms due to her smoking these include shortness of breath, a persistent cough, yellowish green sputum, signs of cyanosis to her lips, also Mrs J has continued to smoke as she thinks the damage has already been done so her condition. The vast majority of COPD patients are smokers. By stopping smoking patients can slow the rate of decline in lung function and thus improve the patients prospects in terms of symptoms and survival. The NICE guidance recommends that short-acting bronchodilators should be used for the initial treatment for breathlessness and exercise limitation and goes on to say that, if this isnt having an effect then the treatment should be intensified using either a long-acting bronchodilator or a combined therapy with a short acting beta2-agonist and a short-acting anticholinergic. The respiratory system is the major part for gases exchange to take place, it allows takes the air that enters are bodies when we inhale and travels through the respiratory system, exchanging oxygen for carbon dioxide and expels carbon dioxide when we exhale (munden, J, 2007). Mrs J has been smoking now for 45 years and on an average day having up to 40 cigarettes a day and is not prepared to quit as she feels the damage is already done. Mrs J smokes for comfort and feels that its all for her pleasure, she has become very isolated, her chronic bronchitis makes her breathless when doing actives and is not able to do her daily activities therefore is becoming depressed. Do this having a huge impact on her mental and social parts of her life. Patients like Mrs J with airflow limitation clinically they have become known as pink puffers and blue bloaters (Kleinschmidt, 2008). Patients with COPD have traditionally been divided intoÃ pink puffersÃ andÃ blue bloatersÃ based on their physiological response to abnormal blood gases.Ã The former work hard to maintain a normal pO2Ã which is why they puff away. They tend to have a barrel-shaped, hyper inflated chest and breathe through pursed lips. The latter are blue because of hypoxia and polycythaemia. They are often obese and have water retention. This is why they are bloated. TheÃ blue bloatersÃ are dependent upon hypoxia for their respiratory drive and to give oxygen and deprive them of this will lead to significantÃ hypercapniaÃ and acid base imbalance. (MedicineNet, 1996 2010) Mrs J falls under the term blue bloaters as she linked to chronic bronchitis due to cyanosis which causes a blue tinge to the lips, which occurs from poor gas exchange. Airway Smooth Muscle in Asthma and COPD: Biology and PharmacologyÃ by Prof. Kian Fan Chung pink puffers has been linked to emphysema as the patients may be showing signs of weight loss, using their accessory muscles with pursed lips giving them a reddish complexion, they may also adopt the tripod sitting position (Kleinschmidt, 2008). Although these conditions separate the patient may present with slight variations of them both, however they do differentiate through their underlying process, signs and symptoms (Bellamy Booker, 2004). The respiratory system can be separated into a conducting and a respiratory portion. The conducting portion consists of the air-transmitting passages of the nose, nasopharynx, larynx, trachea, bronchi and bronchioles. This part of the respiratory system serves to filter, warm and humidify air on its way to the lungs. Principles of Anatomy and Physiology by Gerard J. Tortora, and Bryan H. Specialized portions of the conducting system also serve other functions, e.g., the nose in the sense of smell, the pharynx in alimentation, and the larynx in phonation. The actual exchange of gases occurs in the respiratory portion which consists of the respiratory bronchioles, alveolar ducts and sacs and alveoli. Ross and Wilson Anatomy and Physiology in Health and Illness. Principles of Anatomy and Physiology by Gerard J. Tortora, and Bryan H. DerricksonÃ There are two separate arterial systems in the lungs, the pulmonary arteries which carry deoxygenated blood, follow the respiratory passages and end in capillaries in alveolar walls, and the bronchial arteries which carry oxygenated blood. (Ross and Wilson,2009). The lungs are richly supplied with lymphatic vessels, which are organized into two sets a deep set that accompanies the pulmonary vessels and airways and a superficial set that lies beneath the visceral and parietal pleura. Little or no anatomises occurs between the two plexus except in the region of the hilum. (SUNY Downstate Medical Center, 2008) The lung is the organ for gas exchange; it transfers oxygen from the air into the blood and carbon dioxide from the blood into the air. To accomplish gas exchange the lung has two components, airways and alveoli. The airways are branching, tubular passages like the branches of a tree that allow air to move in and out of the lungs. The wider segments of the airways are the trachea and the two bronchi. The smaller segments are called bronchioles. At the ends of the bronchioles are the alveoli, thin-walled sacs. Small blood vessels (capillaries) run in the walls of the alveoli, and it is across the thin walls of the alveoli where gas exchange between air and blood takes place. 1996-2010 MedicineNet, http://www.medicinenet.com/chronic_obstructive_pulmonary_disease_copd/article.htm Airways and air sacs within the lungs are elasticised, with the air we breathe the lungs will change shape with inhalation they expand and return to the normal shape after they have been stretched with full of air. With in the Lining the of the nasal cavity is a mucous membrane full of blood vessels, with the many blood vessels this enable the nose to warm and humidify the incoming air quickly. Cells in the mucous membrane produce mucus and have tiny hair like projections (cilia). Usually, the mucus traps incoming dirt particles, which are then moved by the cilia toward the front of the nose or down the throat to be removed from the airway. This action helps clean the air before it goes to the lungs. Ciliated Columnar Epithelium which contains goblet cells and cilia, the goblet cells are responsible for secreting mucus which is able to trap the finer particles from inspired air and the cilia which are fine hairs to trap particles from going into the respiratory track. The cilia carrys the particles by a sweeping the mouth or nose where it can then be swallowed, coughed or sneezed out of the body (Munden, 2007). The two major sources of mucus secretion in the respiratory tract are the surface epithelial goblet cells and mucous cells. In lungs, goblet cells are present in the large bronchi, becoming increasingly thin toward the bronchioles. The sub mucosal glands are in the airways with the thickness decreasing with airway quality. With COPD, sub mucosal glands increase in size (hypertrophy), and the number of goblet cells will increased (hyperplasia) (Rogers, Jackson, 2001). The increased of goblet cells to ciliated cells will cause thickness in the bronchioles, this then impairs clearance of mucus. Patients affected by COPD also show the presence of edema, which can further reduce airway size and compromise the lung function. (Postma and Kerstjens, 1998). In clinical studies, these inflammatory parameters have been shown to correlate with a reduction lung function and an exaggerated bronchoconstriction (Postma and Kerstjens, 1998). The goblet cells are replaced within the small airways (bronchi) with Clara cells they are another form of secreting cell that are form ciliated cells and to help renew the bronchiolar epithelium, they produce hypophase component and a protease inhibitor these help protect the lungs by clearing foreign bodys from the airway (Stokley et al, 2006) Gasses exchange in the lung takes places in the airway with in the alveoli, The largest airway is the windpipe (trachea), this then branches into two smaller airways; the left and right bronchi, At the end of each bronchiole are thousands of small air sacs (alveoli) the walls are a thick network of tiny blood vessels called capillaries. The thin barrier between air and capillaries allows oxygen to move from the alveoli to the blood and allows carbon dioxide to move from the blood to the capillaries into the alveoli (Matterporth Matfin, 2009). Mr J has a poor respiratory drive due to having poor ventilation on the lungs. Hypoxemia and hypercapnia can take place due to the poor ventilation, hypoxia in Patients with COPD like Mrs J have raised CO2Ã levels andÃ dependÃ on a deficiency of oxygen (hypoxia) to encourage respiration. They will develop increased CO2Ã retention,Ã respiratory acidosisÃ and subsequently will require mechanical ventilation (oxygen). It also causes the kidneys to produce erthpoietin which stimulates excessive red blood cell production as Mrs J has poor ventilation intake the blood cells are not fully oxygenated there for cyanosis can occurs (Munden, J, 2007).This has lead to hypercapnia due to raised carbon dioxide levels resulting from suppression of hypoxic ventilation drive. However, this understanding does not account for the many factors that contribute to the control of breathing in patients, and has resulted in oxygen being withheld inappropriately from some patients with acute respi ratory failure.Ã (Brooker Nicol, 2004). Mrs J has lent to live in hypoxic drive as she has made adjustments in her life and has lived like this for 4 years now and has become normal to her. Mrs J has sensitivity to falling oxygen levels rather than raised carbon dioxide (Brooker Nicol, 2004). A higher level of oxygen within Mrs Js system reduces the stimulus to breath therefore inducing carbon dioxide maintenance (Walsh Crumbie, 2007). Emphysema occurs when the air sacs at the ends of your bronchioles gradually gets destroyed, smoking is the leading cause of emphysema. Resulting in the air sacs (alveoli), in the lungs becoming over stretched making their thin walls tear, there for losing the lung tissue and elasticity. The lungs cannot expand or contract fully, and so become less efficient when breathing. (McCance Huether, 2006)Ã As the condition worsens, emphysema turns the air sacs which are like a bunch of grapes to become enlarged, irregular pockets with gaping holes in their inner walls; this reduces the number of air sacs and keeps some oxygen entering the lungs from reaching the bloodstream (Munden, J, 2007). This makes you try and breathe harder as insufficient oxygen is not getting into our airways. Our bodies compensates by lowering cardiac output and we then begin to hyperventilate, which then results in limited blood flow through fairly well oxygenated lungs this is in contrast to chronic bronchitis (Brooker Nicol, 2004). Due to low cardiac output in Mrs Js body it will tend to suffer from tissue hypoxia leading to weight loss or muscle wasting (McClance Huether, 2006). Mrs Js chronic bronchitis is a Type 2 respiratory failure; this refers to hypercapnoea, which is a presence of an abnormally high level of carbon dioxide in the blood steam, which can occur with or without hypoxia. This type of respiratory failure is caused by a decline the amount of gas inhaled and exhaled (Higgins,D., Guest,J, 2008). Respiratory failure occurs when alveolar ventilation is ineffective to expel carbon dioxide in the body. Poor ventilation is due to reduced ventilation effort, it affects the lung as a whole, there for carbon dioxide accumulates in the lungs this could deadly if it is not treated (Partridge, 2006). This process is seen in patients such as Mrs J with COPD and can be made more aggressive by an illness (Higgins,D., Guest,J, 2008). Mrs J views her quality of life as poor and hates getting up in the mornings, this is because Mrs J becoming breathless and not being able to fulfil her daily activities. COPD can leave patients feeling anxious and suffering from panic attacks (Christen Antoni, 2000). Mrs J feels frightened becoming breathless as she has had frequent admissions of exacerbation with long stays in hospital, exacerbations is a increased case of breathlessness and sputum experience and very distressing for patients and disruptive to their lives (Alaxander,Fawcett Runciman, 2006). Because of Mrs J being short of breath she feels very lonely and isolated, Mrs J has now got a low self esteem and self confidence this has been induced by her affects of the disease, any activities such as washing, dressing and shopping has become quite dependant on her family in these tasks and feels helpless and a burden to them. The psychological affects of living with COPD can be overwhelming the anxiety and panic levels are very high as Mrs J is living in constant fear and frustration each day of the affects of the illness. COPD patients tend to have a high prevalence rate of clinical depression (N, Haynes, 2000). Depression is very common in COPD patients, around 40% are affected by severe depressive symptoms or clinical depression (Henriksen,A, 2008). Since Mrs J has been diagnosed she has had to make some psychological adjustments, she has some challenges ahead of her such as maintaining her ADLs i.e. self image and personal hygiene. Mrs J feels weak and drained on any activities she does due to breathlessness, most of the time she has to rely on her husband and family to meet these needs and has become dependant upon them; this can lead to activation of negative self image which has lasting changes to the patient (Christen Antoni, 2000). Mrs J feels that dealing with her chronic illness she has had to challenge her own self worth, her own sense of vulnerability and to think of what the future has in hold for her (N, Haynes, 2000). COPD may also adversely affect Mrs J self image which is negatively stigmatised her self inflicted this illness on her self due to smoking (Gore et al, 2000). Stigma has had a huge impact on Mrs Js low self esteem as she has smoked most of her life and has caused her condition to progress, so she only has herself to blame. Having low self esteem can be very difficult for some patients to handle as is plays a role in their lives (Christen Antoni, 2000). The more inactive Mrs J will becomes it will decrease her self esteem and can have an impact on her well being (Haynes, 2000). Mrs J also thinks that she has become depressed due to her condition which has had a huge impact on her quality of life with has lead to isolation and dependant on family and friends (Barnett, 2008). COPD patients are being stigmatized in todays society, this disabling condition has been linked to poor lifestyle changes and people that have smoked (Bartolame, Berger, 2009). Patients with COPD feel stigmatised due to medical profession as they have been labelled under pink puffers and blue bloaters this can have a negative impact on their image (Johnson et al, 2007). Mrs J feels that the main reason that she has become isolated is that she is embarrassed by her visible side affect due to poor mobility and breathlessness. COPD research has mainly focused on the medical side rather than the social impact of the disease. This neglect is seen as patients are not prepared for wider social attitudes of smoking related to their illness and has been looked at as self infliction and avoidable conditions creating stigma which is attached to the disease (Johnson et al, 2007). The National Clinical Strategy for COPD is currently being developed by the Department of Health. This was previously known as the National Service Framework (NSF). Following the Darzi report which stated that high quality for all this was based upon ways to reshape and improve the NHS. The National Clinical Strategy will address the lack of awareness of COPD and also focus on the undiagnosed or inaccurately and also making clear pathways for those diagnosed. (NICE, 2004). NICE guidelines on COPD Cover a full range of care that should be available from the NHS to adults like Mrs J who has this illness and to have the appropriate support and treatments this includes smoking cessation, pulmonary rehabilitation and management of exacerbations and to have easy access to these services (NICE, 2008). COPD has had a huge negative impact on Mrs Js life she has had to overcome challenges due to her COPD such as her basic day to day activities, by making some adjustments to meet these tasks. With Mrs J disabling disease this has lead to loss of function, low self confidence and has become socially isolated in her own home due to her clinical depression (Brooker, 2005). Alexander, M. F., Fawcett, J., Runciman, P. J., (Eds.). (2006). 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