Think Essays

LAB REPORT ON LACTATE THRESHOLD

Introduction

            The lactate threshold is a field in exercise physiology where several studies have already been conducted. A lactate threshold test is useful as it will lead to the discovery of specific applications for a person’s racing, training, and other exercise activities. The workload corresponding to the lactate threshold and onset of blood lactate accumulation has previously been quantified using lactate tests incorporating stage increments.

            The anaerobic threshold is a submaximal index related to endurance exercise performance, which is usually determined by the measurement of blood lactate concentration during an incremental exercise test (lactate threshold). The lactate threshold, and thus the anaerobic threshold, can also be detected noninvasively in normal subjects by means of the gas exchange threshold (GET).

            The concept that muscle contraction can occur for extended periods of time without sufficient oxygen supply may have been first suggested as early as 1871. As early as 1909, investigators surmised that lactate stimulated respiration during high-intensity exercise., other investigators suggested that lactate was the "signal" that initiated muscle contraction, and the role of oxygen was to remove lactate once it was formed (it is now known, of course, that lactate is the product of, not the cause of, muscle contraction).

Shortly thereafter, several other laboratories in the United States and Europe independently reported that exercise intensity, lactate production, metabolic acidosis, and bicarbonate buffering appeared to be linked. The accumulation of lactate in the blood was thought to reflect a point during exercise in which oxygen supply was inadequate to meet the energy requirements of the working muscle. In the early 1960s, investigators linked lactate production in the blood to endurance performance among German athletes. In 1964, other investigators explicitly developed the concept that a critical threshold exists in which (1) the metabolic needs for oxygen in the muscle exceed the capacity of the cardiopulmonary system to supply them, (2) there is a sudden increase in anaerobic metabolism, and (3) lactate is formed in the muscle.

            There are limited data on the reproducibility of blood lactate variables, heart rates and ratings of perceived exertion (RPE) during sub-maximal exercise. The aim of this study was to determine the lactate threshold, at different blood lactate concentrations, heart rate (beats per minute) and RPE during a continuous, incremental training cycle. The hypothesis of this study is that there is a directly proportional relationship between heart rate and rate of perceived exertion to measures of blood lactate threshold.

 

Methods

 

            The lactate threshold in this experiment was obtained by a progressive exercise test and taking a blood sample at the end of each stage. The lactate content of each blood sample is then analyzed. Lactate profile is a form of testing that is very useful for monitoring changes in fitness and should be performed several times throughout the course of the training cycle.

            Before starting the experiment, the conditions of the testing facility such as the room temperature, barometric pressure, and relative humidity are recorded on data sheets.

            Informed consent is given to every participant of the study and each of them is also asked to complete the health questionnaire given to them. The body mass of the subject is then measured in terms of kgs.

            The heart rate transmitter was attached to the chest of the subject. RPE measurements were recorded every minute throughout the test. The appropriate lab safety and subject care protocol for obtaining a small blood sample were followed.

            As is the same with some other studies that were conducted in the past, the sample blood is taken from the earlobe of the subject at rest and at the end of each stage. The Lactate Pro handheld lactate analyser was used to determine the blood lactate concentrations for the subject. 

            In this study conducted, the test started with 100 watts of power. This is increased steadily until exhaustion is reached by the subject. The duration of each stage is 4 minutes. Every 4 minutes, the resistance of the cycle ergometer is increased by 25 watts.

During the last 30 seconds of each stage, the physiological resistance of each stage is taken and recorded and the resistance is increased by 50 W.

The concentration of blood lactate, the ratings of perceived exertion, and the heart rate are all measured at the end of each 4 minute stage. The blood sample is taken during the last 30 seconds of each stage.

 

            Based on the above table and graph, the following interpretations can be made. At the start of the experiment, when the power is still at 0, the subject’s heart rate is 93 beats per minute, the lactate 1.3 mmol/l, and the RPE is not stated or lacking since this is measured at the start. At 100 watts, when the subject has a maximal heart rate of 121 beats per minute, the lactate is 3 mmol/l and the RPE is 7. At 130 watts, with a heart rate of 132 beats per minute, the lactate is 3.2 mmol/l and the RPE is still 7. At 160 watts, the heart rate is 149 beats per minute, the lactate 3.7 mmol/l and the RPE is 8. At 190 watts, the heart rate is 161 beats per minute, the lactate is 4.8 mmol/l, and the RPE is 10. At 220 watts with a heart rate of 173 beats per minute, the lactate is 7.6 mmol/l, and the RPE is 13. At 250 watts with a heart rate of 184 beats per minute, the lactate is 12.6 mmol/l, and the RPE is 15. Lastly, at 280 watts, the heart rate is 188 beats per minute, the lactate is 16.7 mmol/l, and the RPE is 19.

            There is also a 2-minute post-exercise lactate which is 16.2 mmol/l and a 5-minute post-exercise lactate which is 15.2 mmol/l.

 

Critical Discussion 

 

During exercise, such as sprinting type activities, when the rate of demand for energy is high, lactate is produced faster than the ability of the tissues to remove it and lactate concentration begins to rise. This is a beneficial process since the regeneration of NAD⁺ ensures that energy production is maintained and exercise can continue.

During exercise, the amount of oxygen entering the blood in the lungs is increased because the amount of oxygen to be added to each unit of blood and the pulmonary blood flow per minute are increased. The PO2 of blood flowing into the pulmonary capillaries falls from 40 to 25 mm Hg or less, so that the alveolar-capillary PO2 gradient is increased and more oxygen enters the blood.

Blood flow per minute is increased from 5.5 L/min to as much as 20-35 L/min. The total amount of oxygen entering the blood therefore increases from 250 mL/min at rest to values as high as 4000 mL/min. The amount of carbon dioxide removed from each unit of blood is increased, and carbon dioxide excretion increases from 200 mL/min to as much as 8000 mL/min.

The law of mass action states that as the end products of a chemical reaction build up in a reacting medium, the rate of the reaction approaches zero. The two end products of the glycolytic reactions are (1) pyruvic acid and (2) hydrogen atoms combined with NAD+ to form NADH and H+. the buildup of either or both of these would stop the glycolytic process and prevent further fromation of adenosine triphosphate (ATP).

When their qualities begin to be excessive, these two end products react with each other to form lactic acid. Thus, under anaerobic conditions, by far the major portion of the pyruvic acid is converted into lactic acid, which diffuses readily out of the cells into the extracellular fluids and even into the intracellular fluids of other less active cells.

The increase in oxygen uptake is proportionate to work load up to a maximum. Above this maximum, oxygen consumption levels off and the blood lactate level continues to rise. The lactate comes from muscles in which aerobic resynthesis of energy stores cannot keep pace with their utilization and an oxygen debt is being incurred.

Contrary to popular belief, this increased concentration of lactate does not directly cause acidosis, nor is it responsible for muscle pain or "burning". This is because lactate itself is not capable of releasing a proton, and secondly, the acidic form of lactate (lactic acid) cannot be formed under normal circumstances in human tissues. Analysis of the glycolytic pathway in humans indicates that there are not enough hydrogen ions present in the glycolytic intermediates to produce lactic or any other acid.

            The relationship between the increase in blood lactate and oxygen supply to the muscle has a long history. Studies performed early in this century closely linked exercise intensity, lactate appearance, metabolic acidosis, and bicarbonate buffering. These associations provided a convenient and logical explanation for lactate production during exercise.

Numerous studies have supported the link between oxygen supply and the magnitude of the increase in blood lactate, albeit without direct evidence of cause and effect. For example, the extent to which lactate increases in the blood during exercise is reduced as fitness increases or with training, and is increased in the presence of reduced cardiac output states or disease of the electron transport chain.

When oxygen supply is experimentally altered, blood lactate is profoundly affected. With an increase in inspired oxygen tension, either by increasing the oxygen content of the inspired air or by increasing the barometric pressure, the exercise-induced increase in lactate level is attenuated. Decreasing the fraction of inspired oxygen either experimentally or by exposure to altitude increases blood lactate. In normal subjects, reducing blood volume causes an increase in blood lactate level during exercise. In patients with chronic heart failure, increasing cardiac output with inotropic therapy attenuates the increase in blood lactate during exercise.

            The concept that a "threshold" exists, in which there is a sudden onset of anaerobic metabolism resulting in the accumulation of lactate in the blood has been challenged. Recently, this issue has generated some rather lively debate. Studies by some investigators raised questions about the subjective intraobserver and interobserver reliability and reproducibility of ventilatory and lactate thresholds. Concerns over the presence or absence of a discrete threshold point led investigators the use of a log-log transformation (ie, plotting oxygen uptake, lactate, or [CO.sub.2] production on logarithmic axes). These investigators reported that lactate exhibited an abrupt transition from a slowly increasing phase to a rapidly accelerating phase, findings consistent with the historic interpretation of the anaerobic threshold .

Despite its wide adoption, however, such an idea was unacceptable to many since among other things, a log transformation could "create" a visually apparent breakpoint where none existed before, by spreading out the early data points over the X-axis relative to the later on.

            The lag in blood lactate concentration observed during the test is possibly related to vasoconstriction of the active muscle mass stemming from isometric contraction of the body during the exercise effort. More specifically, if a measurement of peak blood lactate concentration is required after an ergometry test, it is recommended that a capillary blood sample should be obtained 3-5 min after exercise.

            The fixed blood lactate concentration of 4.0 mmol * [l.sup.-1] has been used extensively to monitor and prescribe endurance exercise training programmes with adults in many studies. It is well recognized that the blood lactate response to exercise is different in young people than in adults. Therefore, a lower fixed blood lactate concentration has been proposed for use with children. The rationale for these single concentrations was that they represent the maximum exercise intensity at which an equilibrium between blood lactate accumulation and elimination occurs. This physiological parameter is believed to represent the highest intensity of exercise that can be supported almost exclusively by oxidative energy metabolism.

 

Conclusion

The lactate threshold provides a clear picture of the subject’s current fitness level. The lactate threshold, along with the power output, can determine a person’s specific heart-rate training zones. Knowing these zones and how to intersperse them enables everyone to ultimately improve performance.

At the start, concentrations of lactate rise slowly, but then suddenly increase sharply at a clearly-defined point, which is termed as the lactate threshold. The lactate threshold corresponds to the shift in metabolism to anaerobic within the muscle cells after exercise has begun in the experiment. At this point, lactate is being produced faster than it can be metabolized and it accumulates, passing into the blood. Obtaining blood samples can determine the amount of lactate present in the blood.

The way to improve Lactate Threshold is to incorporate one or two Lactate Threshold training runs into the weekly plan. These are run at a comfortably hard, near race pace, with a steady, unvarying effort. After about five to 10 minutes of easy running, run for at least 20 minutes at Lactate Threshold pace. An individual should work hard but not have to slow down over the course. If they do, they are going too fast and it won't be as beneficial as maintaining a steady Lactate Threshold effort.

A person can measure their training zone by heart rate, pace, or perceived effort. But it is best if their course can be level and smooth so that they are able to maintain a regular tempo (hence the term tempo runs) rather than having to speed up or slow down to accommodate hills and rough terrain.

 

Hamlet

            This paper would list the different props and materials that will be needed in the production of the play “Hamlet”. It will present a thematic or a symbolic significance of the props that will be used in the play.

            These are some of the list of props that will be needed in the play.

PROPS

Cushioned bench, tapestries, bells, candles, chairs tables, spinning wheel, white wool, war tent, torches, bed, shovels, needlework, buckets, bells, books, sewing bench, musical instruments, drinking goblets, can, tankards, bagpipes, shearing iron, sickle, snaked shape staff, stringed instrument, books, fake dead serpent, flutes, harps, throne, weapons, articles and objects that denote the interior of a castle, various weapons that consist of  fake swords, shields, pikes and body amour and mock skull and bones.

            To make this props blend in to the scene, each props must have the color, dimension and the characteristics that would encompass the time and the scene being portrayed. Props such as books, candles and chairs that will be used in each scene must be appropriately styled so that it would convey the atmosphere necessary for the play. Care should also be taken in using props such as swords, pikes and other weapons displayed throughout the scenes in the play. Although these objects are only props, they must look convincing and real enough to make the audience believe in some scenes that requires the use of these props. They must look genuine and true in order to express the feelings and actions being made by the actors.

            Care should also be taken to avoid anachronisms in using certain props in some scenes. It would be worthy to detail and to routinely inspect props and objects that would be used in a scene so that these objects are in the “proper period”. In a scene, it would be upsetting to the audience if they saw a modern and printed book being carried by a character of the play.

            Props are not only useful in conveying to the audience the sense of motions, feelings and thoughts being made by the actors and actresses. Props also build up the character being played by the actor, it skillfully articulates to the viewers and the audience the position and the stature of the specific character. To illustrate, the king of Denmark can were a large crown over his head to denote kingship and sovereignty without requiring any fine-looking and striking costumes. Each character therefore must have a costume and  a set of props that is suitable  and proper for the characters that  he/she plays. Visual signs must b used by means of props to provide clearer understanding on the part of the audience.

            With regards to thematic and symbolic significance, the swords that were used in the duel can refer to the feeling of anger and rage that is felt by the main character, Hamlet in trying to find and kill the murderers of his father. The swords and other weapons used in the play can also refer to the destructive nature of man. Swords and human nature is vastly similar because they cause harm, injury and even death if used in an evil manner. The poison goblet that was planned to be used against Hamlet during the duel can represent the deceitful and dishonest men of mankind. The poisoned goblet exemplifies men who use guile and duplicity to trick and to swindle their fellow men.

 

Leading Change with the Balanced Scorecard

 What is the problem or issue that necessitates that such an article be written?

            The article was written to discuss the change that was implemented in the measurement of performance. There is a need for measuring the performance of the employees as this creates focus for the future and communicates important messages to all organizational units and employees.

            A Balanced Scorecard program as a change project was introduced. The article discussed the factors that contribute to the successful implementation of such a program as well as its advantages. It describes the new system that evolved out of this new Balanced Scorecard program.

 

 What strategies or techniques are used to solve the problem or address the issue?

            In the Balanced Scorecard program, several strategies or techniques are used in solving and addressing the issues/problems. Organizations that adopt the Balanced Scorecard program for their new strategies understand the need for a new measurement framework and see it as a powerful tool for driving change initiatives.

The executive leadership that creates the Balanced Scorecard becomes the guiding coalition for driving change in the organization. The process of building the scorecard builds both the team and its commitment to the strategy. The scorecard makes the vision and the strategy operational. Words do not sufficiently communicate change initiatives, since the same words mean different things to different people. It's when word statements are translated into measures that everyone in the leadership team understands clearly what the vision and the strategy are about.

            The organizations that adopt the Balanced Scorecard have strategies that include a strong growth component. To increase their profits, they don’t simply do this by cutting costs, downsizing and eliminating unprofitable business units because they believe that cost and productivity improvements typically deliver only the short-term component of the strategy. Instead, what they do to improve profitability long-term is through expanding their revenues.

            Building executive teams are also used as a strategy in the Balanced Scorecard program. Within the team, a shared vision and strategy is created. A tremendous amount of cross-fertilization takes place as each element of the strategy becomes translated into the scorecard format.

 

 Your conclusions and recommendations.

            The Balanced Scorecard program should be used by organizations that are firm in their decision to change for the better. This program introduces the use of meetings report and a discussion of all relevant measures to the strategy and the initiatives designed to improve measured performance along with the usual traditional meetings.

            As presented in the article, it is recommended to have the meetings scheduled in advance. Meetings should be done every month and performance of the employees discussed. The Balance Scorecard program helps drive change in the organization and empower the employees.

 

 Your assessment of how the article contributes to helping practicing managers.

            Practicing managers can gain insight from the article that was presented. They can compare the traditional ways of how performance measurement is done with the new ways like the Balanced Scorecard program. This in a way will help the practicing managers to keep on the right track with their performance and monitoring of employees’ performance.

           

 Provide a list of discussion questions useful for leading a discussion of the article.

            The following discussion questions could be useful in leading a discussion of the article on Balance Scorecard program:

1. Why should a Balanced Scorecard program be a change project and not a metrics project?
2. In what ways can the Balanced Scorecard program be effective?
3.  What is the advantage of organization’s issues being considered as a team problem rather than considered as the domain of a single functional executive?

 

Managing Change

Introduction

Changes in technology, the environment, in the organization, and new strategies impose changes in the entire organizations and needed effective management to be able to cope up with the challenges it can bring and to address the issues accompanied by the changes. This paper discusses the basic roles of management and in implementing change in an organization. It focuses on how the management should lead the organization and the strategies needed to be able for the organization adapt with the changes.

Factors of Changes          

An organization usually experience changes brought about by many factors. One factor is environmental changes, both internally and externally. External changes are those that are can not be control by the management but can be adapted and overcome and at times can be an opportunity for the company. These changes may include consumer behavior such as how consumers buying pattern; changes in society’s attitude; the behavior of the competitors; political and economic changes as well as changes in legislation.

            Changes in technology are a factor that must be capitalize by the organization and maximize the benefits it can bring. Changes in technology may affect and impose new working methods and the development of new products or services produced by the company. Technology also affects communications and information system in a company as well as its interaction with the customers and its marketing strategies.

           

Changes in management are brought about by promotions, changes in upper management or acquisition of new workers as well as mergers with other companies. This changes result to change in corporate culture, values, management style and changes in working relationships. This change is also brought about by changes in the organizational structure or size like a change from a centralized structure to a decentralized one, or by forming new departments, increasing delegation or removing a department due to outsourcing or delayering of the organizational structure.

These changes imply little to great change; can be related with each other and are caused by different factors. Change in management might be caused by a change in strategy and it is needed to have a management more capable of implementing the strategy while change in products being manufactured might be cause by the change in technology and the actions of competitors.

With all these changes encountered by an organization, it is necessary to have a management that has the capability and skills as well as the knowledge needed to lead the entire organization. It is relatively important for the management to know its specific roles to be able to perform them effectively.

The Role of Managers      

Generally, to run a business or an organization, there should be a person in charge that makes decisions, and is responsible for the work performance of other members of the organization. Large and medium companies usually has a hierarchical organizational structure that is composes of managerial levels. The highest-level manager is the top manager. It is the strategic level of management where policies and goals of a company are established. Below the high level managers are the tactical levels or the middle managers who are in charge of different divisions of a company.  Finally, there is the operational level or the lower level managers who are in charge of departments within a certain division and the day to day activities of the company.

 

Generally, all managers’ common function is to manage and interact with people. They coach employees to help them improve their works; they organize job tasks; settle disputes and develop career paths for employees. To make it more specific, activities in business organizations are categorized into six classifications: (1) Technical which deals with production and manufacturing; (2) Commercial which deals with buying, selling and exchanging; (3) Financial which is responsible for obtaining and using capital; (4) Security for protection of property and persons; (5) Accounting which deals with balance sheet, stocktaking, statistics and costing; and (6) Managerial which basic roles are planning, organizing, commanding, coordinating, and controlling.

As stated, managerial work includes planning which involves defining goals, establishing strategy, and developing sub-plans to coordinate activities. It also includes organizing which is determining what needs to be done, how will it be done and who will do it; leading which is directing and motivating all parties and resolving conflicts; controlling which is monitoring activities to ensure  that they are accomplished as plan; and making sure that the organization has achieved its stated purpose.

           

All these roles of managers can be considered as partial for the range of managerial tasks do not lend to a simple classification.  Informational roles and interpersonal roles are the two important dimensions of every manager that must be considered when analyzing their roles. Interpersonal roles as the name suggested involves interaction with the members of the organization such as when making speeches or presentation; welcoming important clients, when acting as a leader when hiring or motivating employees; or when the manager acts as a liaison officer in which the manager builds a up a network of relationship outside the organization to build a private information system (Mintzberg, 1975). Informational roles, on the other hand, involve monitoring wherein the manager keeps tabs on what is going on; dissemination, where the manager passes on some important information to his staff; and representation where the manager acts as the nerve center of the organization, inform and satisfy the influential people who control the organization.

           

Moreover, there are additional dimension which is the decisional roles where a manager acts as entrepreneur, disturbance handler, resource allocator and negotiator. The manager seeks to improve the changing conditions in the environment as an entrepreneur. While all managers assume these roles, to what extent depends on their individual field.

            To be able for a manager to perform all these roles, enough skills and knowledge are required. Managers can be positioned on top management, middle management or supervisory management. Whatever management level he has, he needed all the four dimensions of managerial skills. Managerial skills are conceptual skills, human skills, technical skills and innovational skills. Conceptual skills depend on the manager’s ability to thinking abstract technical skill is the ability to use tools, procedures and techniques in some specific specialization. Human skill is the ability to work with, understand and motivate people as individuals or group. Conceptual skills are important to all levels of management but more important on top management who think and act as the brain of the organization same as how human skill and technical skill become more important to supervisory management who directly interacts with the employees and who teaches the workers how to do their tasks. Different amount of conceptual, human and technical skills are needed depending on the managerial level of managers. However, innovational skills are required about the same amount across the levels of management.

           

Whatever level of management, management skills can be summarized as: leadership – the ability to direct or inspire others; standard setting- definition of roles and responsibilities; delegation- empowering others with the responsibility for tasks; work allocation- sharing out work fairly and appropriately; clear communication- giving information at the right time in the right way; and encouraging good working relations such as teamwork, appraisals and selection.       

 

Leadership means effectively directing the members of the organization towards achievable goals. It demands excellent communication skills and the ability to inspire others through winning their confidence. There is no one set for selecting a manager; it depends on the nature of the job, its roles and responsibilities and the nature and situation of the organization of the business.  In a small business, there may be only one manager. In this case, the person must adapt their management style to suit the business situation.

           

Manager’s responsibilities depend on the level of authority and position he has in the company. A manager may have the authority to hire and fire staff, and to decide on the level of their pay and bonus. A manager has a responsibility for a specific team of people and area of business. For example, an Account manager’s responsibilities are very different with the responsibilities of Human Resource Manager and a Corporate Legal manager and they all handle entirely different set of people. A manager should have the skills and the ability to delegate appropriate staff to a specific task. Delegation of tasks gives employees the opportunity for development and improvement. Even when a manager has delegated tasks to subordinate, accountability remains with the manager. When a manger has delegated and allocated tasks to his subordinates, he can now tackle top level tasks such as strategic planning, generating business, or setting up new production line.

 It is also a manager’s responsibility to set standards. People are better to function efficiently especially in large organizations if they have a framework, a set of rules and standards to provide limits and steer them along.

            Managers should also have the knowledge and skills to encourage good communication and working relationships within the organization. Communication can be encouraged by arranging regular meetings for managers of all sections to update and exchange information directly; by displaying company information on screens, walls, desk aids; by issuing regular reviews on projects and company progress; or by putting important information in writing like memo.

Furthermore, managers should have knowledge on organizational behavior which is the study and application of knowledge about how people, individuals and groups act in organizations. Application of knowledge in organizational behavior helps a manager establish philosophy, values, vision and goals for the organization; motivate employees in order for them to feel job satisfaction; promotes a more stable organizational culture and helps managers become effective leaders.

 

Managers during Change

All the specified roles of managers are very much needed once an organization undergoes changes. As noted above, one role of management is planning. During planning is where goals and strategies are formed and plan on how they will be implemented. It is when the management can identify the changes that the organizations will undergo. During the stage of planning, the management should determine contingencies and back-up solutions once a strategy failed in order for the organization to move quickly and responsively during strategy implementation. It also during planning that changes in the external environment of the organization are discussed with the leadership of the CEO.  

After the planning stage, organizing follows. Organizing, as part of the management job, includes the positioning of the right persons for a particular task. For example, if a company wants to adopt e-commerce as a strategy, it needs to have a CIO who has good technical background on e-commerce, the internet and good IT infrastructure or has the capability to determine and maximize the technology needed by the company. Organizing is basically putting people at position where they can be effectively utilized by and contribute more with the company and at the same time where they can grow along with the growth of the company.

 

In organizing due to change, usually the organizational structure is change followed by some significant changes such as change in culture and management style. Like the case of the Ford Motor Company, an established and distinguished manufacturer of automotive. In 1993, Ford was enjoying increased in profits due to its worldwide sales. Also during that time was when the company had elected new president and CEO Alex Trotman. Trotman together with the upper management of Ford decided to globalize the company’s operations with the aim to cover more market, driven by the changing international trade environment and the improvement in communication technology that has made the change seems successful based on the Ford’s condition today.

Case Study: Ford 2000

The strategy that Trotman and his management formulated is called the before the Ford 2000, the company has two major operations, the Ford of North America and The Ford of Europe under an ethnocentric organization controlled by the Ford Family. Each operation was run under a very hierarchical, centralized organization with all operations including the research and development being maintained in Dearborn, Michigan.

With its very hierarchical structure, the organization included multiple layers of management superimposed upon each department. Before a new design or any important matter to be incorporated in a platform, idea had to be channeled first through the hierarchy for approval and then reworked if necessary. This type of process with this type of organizational structure causes delay in implementation and wasteful of human resources, which was a disadvantage on the part of Ford. If the idea was originated in Europe and demanded significant changes involving many platforms, then the idea had to be run through additional channels in Dearborn, Michigan.

Trotman, who once became the head of Ford Europe and having the knowledge on the barriers to global efficiency and flexibility had realized that Ford needed a necessary change in order to eliminate inefficiencies and be successful with its globalization plan, hence the Ford 2000. Ford 2000 is basically a reorganization plot in order for the entire company to adapt to the globalization strategy and remain profitable in the 21^st century. The reorganization involved the consolidation of Ford North America and Ford Europe into a single entity, Ford Automotive Operations. Ford’s hierarchical organization was also changed into a matrix structure consisting of three vehicle centers.

It is the management’s role to coordinate the plan within the company. Trotmam and his management did this through a rigorous internal campaign involving all of Ford’s worldwide management. They had numerous meetings and brainstorming about the plan which was supported by Ford’s management and implemented on January 1995, as initially planned.

The matrix type of organization aims to create synergism through shared responsibility between project and functional management. With matrix organization, information sharing is mandatory. At Ford, design efficiency has improved with the linking of Ford’s multiple global design centers through the use of computer networking and extensive video conferencing. The functional departments have functional responsibility to maintain technical excellence, with the leadership of department manager. Some advantages of matrix are that hierarchical referrals are easily resolved; there is a better balance between time, cost and performance; and authority and responsibility are shared.

With the new Ford management structure, there are plant vehicle teams consisting of quality, design, and production engineers and technicians. They design and implement solutions to problems recognized by dealer and customer feedback. Ford’s organizational structure is focus on teamwork, multiple reporting relationships, and technical expertise.

Another role of the management related to change is leading. To lead an organization, the management has to motivate its subordinates and must be able to resolve conflicts. In contemporary organizations, management act as coach to its members; they inform and educate its members to perform the tasks efficiently and competently especially during the process of implementing a strategy where many changes occur.

Ford came up with worldwide learning, an extensive study of operations and benchmarking to find and implement the best practices currently practiced for a particular operation. The company’s upper level management believes that this kind of learning will be the competitive advantage of Ford on long term basis and is useful to harness the energy of Ford’s employees fro the company’s growth. The upper-level management teaches all Ford’s managers to look at the company from two points of view, that of a shareholder and that of a customer, having a global mindset, a rapid response to custo0mer needs, focus on the activities and operate with the belief that real leaders are teachers. The managers will then teach these perspectives to their subordinates in order for the perspectives to be replicated throughout the company. Ford management used formal programs such as Executive Partnering, Capstone, and the Business Leadership Initiative which are all based on the principle that the best way to learn is to “see one, do one, teach one”.

The ‘see one’ involves observing managers to get their management style and listening to that manager to get his ideas, values, motivational energy and edge. To ‘do one’ consists of a number of projects al designed to result in enhanced shareholder value and the ‘teach one’ comes in formulating one’s own teachable point of view and in turn creating a new set of managers.

Controlling and monitoring are usually the roles of managers to ensure that the plan has been implemented and the objectives and purpose of the company or a certain strategy is achieved. These involve strategy implementation and overcoming hindrances for the company’s success.

Ford has adapted computer networking and video conferencing to have link on the company’s design centers worldwide for easy sharing of ideas and feedbacks. Through technology and the use of computer, major functions of the company such as marketing, purchasing, distribution and other service-oriented processes have been linked to the manufacturing facility making the production and delivery of products faster. Organizational change in Ford has resulted to cost saving, responsiveness to changes quickly and efficient product development. The changes in Ford also have brought significant cultural change by changing the management thinking with the worldwide learning. The management is challenged to become teachers and coaches while employees are challenged to have a shareholder and a customer focus.

The Management Consultant

In changes such as reorganization, management consultants play key roles in change management. They analyze, and propose ways to improve an organization’s structure, efficiency and profits. They also help in organizing the corporate structure and eliminate duplicate or non essential jobs. For example, Ford has implemented computer networking within the company; the company probably hired a network engineer as a consultant in order to come up with a network suitable for the company’s needs and specifications.  A company usually hires a management consultant when the company lacks of internal resources needed to handle a project or to determine what resources will be required and the problems that may be encountered during the strategy or change implementation.

Conclusion

An organization most of the time needs to undergo certain changes in order to grab opportunities, to overcome threats and weaknesses and to capitalize its strengths. To do these, the management plays important roles and these roles must be well-understood and performed by the management to lead an organization to growth and success.

 

 

Has the ideology of Children's Rights affected Parenting Styles?

Introduction:

Modern history has found the birth of Children's rights where the rights the parents may have over their children is put into scrutiny by the state.  There is an attempt to balance out both parties.  This is perhaps brought by the growing awareness of the abuse and violence experienced and witnessed by children.  Their circumstances had been so much ignored and disregarded by the authorities that the children began to be perceived as less a human being, and denied of their rights.  The children inevitably suffer and what people tend to forget is how these children are the future of humankind.  As civilization progresses, more people realize that the children needed to be protected, recognized and acknowledged as important as adults.  This is especially required in Northern Ireland where children are exposed to the cruelties of Corporal Punishment and the dangers of Political Violence.  This is about to change especially in the arrival of the 21st century as governments begin to make moves to acknowledge children's rights and the need towards adjustment of parental styles in order to give way to this. 

 

Children's Rights: An Overview

 

Proposes that the rights are understood in two manners: moral and legal, natural or given by the law. 

 

To allow children to have rights remain to be a controversial topic.  It is generally recognized that they cannot, by their limited level of growth and development, be allowed to hold and decide.  Children are deemed incapable of making a choice or a decision to a certain matter and thus cannot be provided rights.  This is not to say though that children should not be given rights.  It only means that they must have other people deciding for them.  The people responsible for them should exercise a decision as though the children would be making them.  This remains a topic of debate as it may mean control over the children.  Thus the suggestion is that children should still possess a certain kind of right that will be solely their own, and which the adults do not own (as though saying the women have reproductive rights that men cannot essentially have).  This is because children could already possess their own interests.

 

To sort this out, tried to identify children rights through three divisions: A-rights which are solely adults, A-C rights which both Adults and Children share, and C-rights which are solely the children's possessions.  A-rights would be the Liberty and welfare rights would be the Freedom of expression, suffrage and religion while welfare rights means the right to look after oneself and sustain oneself through employment.  This is problematic especially if one would recognize children to have their own interests versus children as incompetent decision-makers.  In this manner, one can define C-rights as possessed during their time as children or through the rest of their lives to adulthood (and thus rights that will be recognized of the future adult).  The latter may be recognized as "A-rights-in-trust" or as "developmental rights". 

 

The United Nations Convention of the Rights of Children

All of those are merely moral rights.  There are still the cases of legal rights which is provided by the law.  One obstacle there is that children do not virtually become children forever.  They grow up too and will have a change on rights (the A-rights.)  sees the need towards the inclusion of children rights in laws because their very exclusion exposes and endangers them to accountability and lack of coverage and protection that adults have.  This is especially true in juvenile crimes.  The United Nations Convention of the Rights of the Children in particular recognizes the need to include children as among the liberal rights

Thanks to the United Nations, the children are recognized as rights holders and thus are, by mandatory, involved in major organizations especially as among subjects of human rights (who are once solely adults).  The CRC has given children an opportunity to be among and involved in actions which goes to suggest how important Children's Rights are.  It involves Children in moral and legal discussions, and to put it more simply, they are acknowledged to exist in this world as citizens and recognized as subjects.  Children are given a voice and an organization they could air their side to.   This will flat out illegalize the child labour, prostitution, recruiting to armies, and among other abuses through-out the world because children are perceived as less than adults.  Some parents see it perfectly fine to abandon their children, as some adults would pay no heed to orphans and refugees.  Children are clearly powerless as they are denied rights.  It is so easy to victimize them in the absence of rights and the permissive ignorance going about.  There is no effort to monitor or intervene to enforce their rights.  Because of the CRC, it is clear that the children cannot be treated so untowardly, without utter or significant regard or through inequality with respect to adults.  Legal punishments and penalties now await those who attempt violence and abuse against children.  However the CRC remains insufficient to combat and minimize the millions of children abused at this writing.  Another point of the CRC is not only that they recognize children as human beings, but also the fact that they are younger human beings and thus they would require special attention towards care and protection even prior to after their birth.  

 

Protection then becomes an important C-right as children are provided a special kind of coverage that adults do not have especially in terms of exploitation, abuse, or neglect.  This acknowledges the incapability of children to protect or care for themselves due to an inherent defenceless-ness, vulnerability, weakness and dependence.  To describe children as such, becomes another issue as children are now perceived to be unable to hold individual rights. 

 

The existence of Children's Rights would surely determine parental treatment of children.  Children's rights will be enacted and balanced by their parents.  Critics would contest that parents, as possessing steward roles, should enforce their own rights.  After all, it was the parents who executed to right to rear children and establish a family.  There is the question of safety and the teaching of values and beliefs that will equip the child.  By being in a family, the children and parents share each other due to the intimacy suggested in being a family.  What Children's Rights encourage above all is diversity and versatility of modes in parenting styles.  For as long as the parent recognizes that the child has an open future and does not ignore his or her nature which will be the prerogative of the parents rather than the state.

Generally, parents are given two choices: protection versus participation.  It is question of whether or not parents are going to allow freedom (democracy or participation) or if they are going to limit freedom and take over their welfare (control or protection).  Freedom also means the Laissez Faire style or the democratic permissiveness.   In such a style, the parent is not too judgmental and in fact tolerant and accepting of the child's actions, wants and spontaneity.  The child is expected to exercise thought and reason in order to reach one's desired ends.  The ideal set-up, is to allow more freedom by allowing children to have a voice in the family and the right to choose in its activities.  To do this overly though is to possibly make aggressive, delinquency, cruel and resistance.  They would demand attention to their needs and wants as well as immediate satisfaction.  Because their emotions are uninhibited, they may tend to be extreme and poorly maintained.  On the other hand, if parents would be domineering, children will be seen as obedient and fearful, but at the same time, the lack of individualism will also lead to a lack of creativity and curiosity.  Purdy would cite another study that would say otherwise, and would suggest in fact that submissive children will tend to be more rebellious, unruly and lazy.  (p. 101). 

 

The Irish Context

Ireland is plagued with warring factions that would bring a history of migration.  Children have been victims of poverty and violence brought by conflict and famine.  Irish children in the past have been deprived of educational opportunities while becoming orphans due to the circumstances.  Irish children's choice of religion and values were ruled by an iron hand.    

Needless to say Irish children had been the brunt of political violence and abuses.  Children who reside in homes that have been ran by religious orders have been reportedly abused sexually and had been neglected of their education and even, sustenance.  Clearly there is a lack of protection and coverage on these children and they are well exposed to harm from parents and teachers.  There is a certain view that proceeds as: "a good beating never hurt anyone" in order to instil a fear on authorities, to instil discipline and to mold the children as ideal moral citizens.  Ireland still allows Corporal Punishment in its children following this philosophy.  Parents were not confronted as to why they harm their children.  Despite the fact that Corporal Punishment has been limited in homes and schools, Ireland continues to receive cases and complaints of punishment taking place.  The government is not taking a wary eye on the proceedings.  Teachers are not held accountable to their actions or are they reprimanded for blatantly violating the law.  Ireland generally does not talk or discuss about the corporal punishment taking place at home and at school.  To them it is a way of life.  Nobody complains or speaks about being punished at home even during the 20th century when the world has been establishing children's rights.  It was still an ideal method to teach a lesson among children despite the establishment of a law that would protect them from abuse and assaults.  The rule states that:

            Once a person is convicted, the penalty ranges from a fine or imprisonment.  The problem is that parents are also by law, mandated of a legal protection over their children that permit such abusive actions in the name of discipline.  The law fails and is insufficient to protect the children of incurring physical harm.  The law will even recommend or encourage beating in order to discipline the child and in fact, the lack of a punishment was frowned upon.  Judges are satisfied if parents do beat their children in the name of correcting a crime and they would advise it.  Punishment, in the form of a stick or a rod, was hereby authorized so the children may realize the error that they have done.  In fact the child may be legally whipped by a constable with the inspecting or a high ranking police watching by, until the year 1997 when the 1997 Criminal Law finally eradicated the law which had apparently only taken effect because a child had died of a father's severe beating.  In the particular trial, the father, who beat a girl several times, defended himself saying that the girl was lying to him although it had been clear that it was not the first time for the girl to be beat up.  This suggests how severe beating can still be justified.  The verdict of 1 year imprisonment was already seen as severe and too much for a father's attempt to legally punish the child in the name of discipline.  Corporal punishment has also been occurring without supervision, intervention or care by others.  It is apparently a private affair.  It was so much private that nobody wanted to attempt to question its legalities or extents.  Schools are ambivalent are would refuse to abolish corporal punishment thus contributing to the permission of such act in Ireland.  The Irish student is clearly deprived of rights to protect him/herself as s/he is exposed to the danger of corporal punishment in his/her daily school affairs.  Education then is not about the interest or passion in a subject, but through the fear of Corporal Punishment if s/he is to break a rule or a law or at the very least, if s/he is unable to do the assigned task for the day.  This had become so common in the life of an Irish student that it has been accepted and normalized.                

As mentioned above, another aspect of Ireland's children violence is brought by the casualties of war that affect women and children the most.  Children have been inflicted violence, social disorders especially through orphaning.  This too has become so normal to see an unaccompanied child and trying to help him/her adjust with the trauma.  If Children do not experience the violence, they would most likely witness it, especially in the case of rape.  There is an estimate of 150 children younger than age 14, between the years 1969-1983 who have been killed due to the political violence in Northern Ireland.  Last 1998, the number has soared to 257.  Children who have experienced or witnessed such violence had exhibited poor antisocial or even psychotic behaviour.  Needless to say, the children will be scarred forever due to the fact that they are not sufficiently protected by rights in Ireland.      

            Novelist Frank McCourt in his book Angela's Ashes would liken a miserable childhood to an Irish childhood, and even worse, is the Irish Catholic childhood.  An Irish childhood has the mixture of poverty, the alcoholic father, the religious but submissive mother who cannot do anything but weep, the arrogant priests and the oppressive schoolmasters.   With the Corporal Punishment in mind, it is unimaginable how an Irish child would withstand childhood without becoming criminals or insane.

 

            But today, the government is starting to move on.  The 21st century brought about hopes in Northern Ireland as the Human Rights Commission Bill has taken effect last June 2001.  The Human Rights Commission was established last March 1999, tasked to promote Children's rights.  In the year 2000, the government introduced the statutory Children's Rights Commissioner.    

 

Conclusion

            Parental style would inevitably change brought by such developments.  As the government and the school are now realizing the dangers of Corporal violence by establishing a Human Rights Commission that will protect the children, and above all discourage such abuses and violence to be enacted without a grave punishment waiting the adults who attempt so.  As the provision is just early enacted, it is too early to say whether or not parenting styles have truly been changed.  What remains certain is that change is about to take place, and the situation in Ireland is looking optimistic as far as children rights go. 
 

The Young Child and Environment

Currently, there are numerous arguments regarding curriculum and teaching methods, but it discovered more than the socio-cultural and political experiments of teaching physical education. Children may learn as much from the methods or mode of transmitting knowledge based on the contents of the curriculum. Teaching PE has recommended that girls are more likely, and have more opportunity, to learn independence and problem solving skills in PE than boys because of the frequent maintenance of the pattern of female teachers teaching girls while male teachers teach boys, and then the tendency for female teachers to use child-centered teaching techniques more often than their male counterparts, who routinely subject their students mainly to didactic teaching modes. Students learn from the pedagogical mode as well as or even instead of the content that teachers intend or want them to receive. In essence, there is no such thing as a content-only curriculum. In the act of teaching, teachers socialize students as they skill them. Indeed, there would hardly be the heated debates surrounding the nature of teaching methods in schools. Pedagogic discourse is a ‘rule which embeds two discourses’; a ‘discourse of skills of various kinds and their relation to each other’, which he refers to as ‘instructional discourse’, and a discourse of social order, which he calls ‘regulative discourse’.  The Instructional discourse is always embedded in regulative discourse, and the regulative discourse is the dominant discourse. Thus there can be no transmission of skills without the transmission of values.

      Physical and psychological health and safety are very important to children’s educations.  The young child sensible knowledge and skills to enhance positive attitudes in children and early childhood professionals by stressing the role of family and culture in child development and their learning environment should help them expands on the underpinning of developmentally suitable physical activity, movement development, physical fitness, nutrition, safety in the early childhood learning environment, and the responsibility of parents and communities in developing healthy attitudes and lifestyles for the young. They also believed that early childhood educators should investigate the range of factors that affect the progress of a physically and psychologically healthy and safe lifestyle for infants, toddlers, and young children."

     The school organizational level should define three major aspects of framing the curriculum . The first is the curriculum which defines for teachers and students the organization and the content of what is to be taught. The necessities in developing curriculum in physical education have increasingly been set for teachers and students by interest groups and political agendas operating outside schools. The second is the timetable which puts groups of students together with teaching and staff and resources within designated curriculum for specific periods of time. It is this which generates planned diversity in the context of order. It decides the social and physical space of students, subjects and teachers. Time is not evenly distributed amongst subject disciplines or to areas of activity within the curriculum. This necessarily acts as a limit upon the actions of teachers and has implications for how they and their subject are perceived. PE tends to receive significantly less time than other ‘core’ subjects. The third factor, schooling, and reaches out to what we have recently referred to as the discursive frames of schooling and is a more complex phenomenon. It is not synonymous with all that goes on inside schools. Curriculum in PE normally entails having the cognitive, emotional, socio-cultural attributes/ resources and discursive resources that are prerequisite to learning in large classes and the different modes of transmission such as methods of making knowledge available to children and young people within them. Whether there are discursive processes, affective and cognitive skills and attitudes which are constantly required by students to facilitate access to curriculum content whatever their measured ‘ability’ or ‘skill’ should be of primary interest to any study of  teaching and learning in contexts of PE. In essence, educators need to make much more complex our ideas of what it is to be ‘skilled’ and ‘able’, or otherwise, in school and contexts of PE. Decisions taken in policy contexts outside school or in the broader school context concerning the timetable, curriculum and ‘schooling’ can thus be seen as frames forming limits or possibilities for the actions of teachers and students.

 

The Parricide Punished

Gothic fiction almost entirely proceeds in a formula of impending tragedy and doom.  A mood of frustration overwhelms not only the part of the protagonist, but also the reader, who must anticipate a disaster.  This is foreboded by recurring images usually found within a household to enhance the fear, suspense and terror that will be accomplished in the climax.  The household (besides the likes of blood, a clap of thunder, or skeletons) is a Gothic convention, it is not strange to come upon a creaking door, a sudden bang, crash or shattering noise that is supposed to inspire shock and a heightened sense of horror.  The house (usually worn down or decadent) is an important ingredient and symbol of Gothic fiction.  It is part of the burden that stimulates heavy emotions and it most often than not overwhelms the protagonist perhaps due to its size and structure as large and unmovable (thus, hopelessly uncontrollable).  Indeed, there's a wide disarray of domestic disorder abounded by symbolisms and connotations on the household and the family.

 

One of the most apt gothic fictions that best emphasizes the doomed household is The Parricide Punished, written by an Anonymous author.  This is a story that was written in Medieval Europe which immediately inspires the Castle, a massive towering structure that becomes a symbol of authority and power.  "The Parricide Punished" is told by a guest who observes the marriage of M. de Vildac (in a letter being written to his father).  The guest was to stay inside the Castle until that night he was interrupted by noises only to come from an old man who claims to be Vildac's father.  The old man, apparently imprisoned, is amazed to come upon a resident of the lodge and begins elaborating his woe on his cruel and heartless son.  His son had seen the enormous wealth brought by a father's death and willed that it be done to him.  Thus Vildac imprisons him and declares him dead until 20 years, the guest arrives in the lodge.  The speaker of the story shows a brave front, eager to protect the old man, horrified by what Vildac has done.  The old man has been changed drastically especially of his countenance and attitude on life.  Pessimistic, depressed, the old man can only go back to his prison, warning the speaker of the dangers that lurk if the speaker should intervene.  Thus the speaker departs the castle and leaves his neighbourhood so to avoid Vildac and he ends the letter to his friend.           

 

Immediately, the narrative is given hints of danger and evil through M. de Vildac's "wild and suspicious glare, something which has given me disagreeable sensations for which I could no way account" (1) Further, Vildac does not know how to show joy, instead there only seemed to be a "secret torment."

 

The speaker of the story is made to stay in Vildac's "ancient castle" which is immediately pointed out as being decaying "Old Tower" (1).  The speaker would sleep, only to be wakened by "a heavy kind of noise", a clear ingredient to the gothic narrative.  This immediately suggests the Castle as a venue that contains peril.  The Castle in this regard becomes a prison of horror, especially when further sounds would add to by the "footsteps of some one slowly descending, and dragging chains that clanked upon the stairs" (1).  The presence of chains heightens the danger especially at their ominous clinks and the association of chains as a binding and restricting material.  The material is used in the likes of prison and dungeons (this also contributing to the overall effect of the Castle as a prison).  Finally, it was determined that they come from a "withered old man, half naked, with a bald head, and a white beard" (1) a truly horrendous sight as an old man would express fragility and would suggest the dehumanized treatment. Plus, the very presence of the man evokes the fear that the Castle certainly has dark secrets that it has the capability to put people in such an ill condition.  Thus it heightens the terror the Castle encases.  In this household disorder, it is this old man, Vildac's father, who is challenged.  Vildac has caused disorganization to the family by imprisoning his father and declaring him dead so he can have his patrimony wealth.  The Ancient Castle stands for all such disorder. 

 

The gothic fiction presents man in an evil and corrupted light, as someone who may be enticed to commit evil in the name of self-gratification.  Never mind if the people involved is part of the family.  Man is a suspicious being who is capable of horrible actions to satisfy his own desires and welfare at the expense of the household and the family. 

 

John Brown: Mad?

            Madness is usually defined as “the quality or condition of being insane”. The term madness is often referred to as a serious mental illness or disorder which impairs an individual’s capacity to function normally and safely. Sometimes, madness is also termed to a foolish behavior (i.e. insanity, folly, idiocy, nonsense, preposterous, etc.).

            John Brown has been considered by many to be a madman. He was a man of extremes, one that is capable of leading the murder of proslavery men. Brown calls himself as an instrument in the hand of God. He was a driven man – a man of action. He was someone who would not be put off from his mission of abolishing slavery. On October 16, 1859, he led an army of 21 men on a raid of the federal arsenal at Harpers Ferry, Virginia, planning to arm slaves with weapons that he and his men seized from the arsenal. However, he did not succeed as he was cornered by local farmers, militiamen and Marines led by Robert E. Lee. Within 36 hours of his attack, most of Brown’s men were killed and captured.

            John Brown was a zealot; he saw a great wrong being committed and was determined to right the wrong and no law nor state was going to stop him. However, his method of proving that slavery is wrong and that it has to be abolished is completely wrong. Killing, no matter what the cause may be, will always be wrong. No rational human being is allowed to kill despite his overwhelming feelings over an issue. Morally speaking, bloodshed is never an option.

            Overall, John Brown was mad; however, it really does not matter anyway whether he was or not. If it had occurred at this time, it would have mattered because it would have saved him from getting hanged. Those were the days before modern psychiatry where there were many people, some of them even quite prominent and famous, can now be recognized as suffering from various mental illnesses or psychosis as defined today. Brown was one of them.

 

UK Government

            The National Health Service, NHS, is a government agency in UK under the management of the Department of Health whose primary responsibility is to provide healthcare to UK citizens. NHS has three parts: hospital services; family doctors, dentists, opticians, and pharmacists; and local authority health services, including community nursing and health visiting.

           

In 1999, the UK government initiated the modernization strategy on institutions across UK including government agencies such as the NHS. The aim of this modernization scheme is to exploit technology for the advantage of the people all over UK. Part of this modernization scheme is the implementation of e-commerce strategy within government agencies. E-business within government agencies is electronic transactions or public service between a government agency and the public; electronic transactions between government agencies and between departments of an agency; and electronic transactions between the government and the industry.

           

As a health agency, NHS has a great involvement in the e-business since it handles many transactions with the public such as medical services, and the industry where it gets supply for the medicine, equipments and other facilities needed by a health agency. The focus of this paper is the complex supply chain of NHS and how e-commerce can be capitalized for the benefits of NHS, the public and the suppliers which are all part of the chain. The paper discusses on the elements of the e-commerce strategy for the NHS supply and the barriers that may hinder the effectiveness of the strategy as well as the approach needed to overcome the barriers.

           

As stated above, NHS has a complex supply chain. What made it complex are the many independent organizations such as hospitals, primary care trusts and health authorities. Health authorities all over UK include the Bromley Health Authority, the Dorset Health Authority, North West Lancashire, South Humber, and the South Staffordshire Health Authorities. NHS Trusts includes the many hospitals and infirmaries such as Airedale NHS Trust, Glasgow Royal Infirmary University NHS Trusts, Ipswich Hospital NHS Trust and many others. Each trust and health authorities has different needs and demands, making the supply chain complex.

           

In addition, NHS needs to manage its £11 billion annual procurement budget. It needed a system that will help manage the transaction in NHS and make transactions transparent. A centralized purchasing using e-commerce is then needed to

To address this issue, NHS has formed the NHS Supplies Authority, an organization formed in 1991 which aims to integrate the variable supply operations across UK by creating agreements with suppliers with fixed prices. The agreements between the NHS supplies Authority and the suppliers allowed all health authorities and NHS trusts to have contract with the suppliers at pre-agreed prices for particular goods and services. The NHS Supplies Authority is involved in the purchasing arrangements between the customers and the suppliers. The organization also has direct customers which buy products directly to them so NHS Supplies Authority also buys goods from the suppliers which they sell through their warehousing and distribution service.

            However, the role of the NHS Supplies Authority is limited to providing framework agreements which serve as a basis of supply contracts. NHS Supplies Authority does not cover other aspects of purchasing such as how much a certain health institution will spend, which brand and which suppliers will provide certain goods or services. In other words, NHS Supplies Authority is not sufficient to make efficient procurement across the NHS supply chain, thus the NHS Purchasing and Supply Agency, PASA, was formed. NHS PASA is basically a government agency that develops policy on supplies and formulates strategies including the incorporation of e-commerce strategy in the NHS supply chain. It is responsible of modernizing and improving supply management across UK to ensure that the money allocated for NHS is spent wisely and effectively.

            The functions of NHS PASA includes improving purchasing and supply performance across the NHS; leading the modernization of the supply chain; improving efficiency and reducing cost in the supply chain; raising the profile of the purchasing and supply function; ensuring that all non-pay expenditure is subjected to professional purchasing and value for money practices; and encouraging new and innovative suppliers.

            As noted above, there are differences in purchasing performance across the NHS that make the supply chain complex. This complexity makes the supply chain response slower. To address this, NHS PASA recommended the formation of a middle tier of purchasing between the national and local level purchasing. This is the formation of Supply Management Confederations, a group of trusts who work together to negotiate contracts on a geographical basis. They group together for mutual benefit to achieve a joint approach in areas of purchasing such as strategic outsourcing, product and supplier rationalization, stock management, contracting and supply chain management.

            Through the Confederations, trusts need to commit to NHS PASA contracts and procurement strategies and plans; agree the configuration and terms of reference of their Confederation; develop project implementation plans for collaboration; harmonize corporate governance arrangements; agree and commit to the sharing of risks and benefits; develop strategies within the confederations; monitor and feedback performance using national performance indicator; and share information with regard to best practices.

            NHS Logistics Authority was also formed with the aim to improve the supply chain of NHS. NHS Logistics Authority is structured into four directories which are Finance and Performance; Human Resources; Customer Services; and Information Technology. The NHS Logistics serves as the distribution centers within NHS and its role is to deliver a range of essential modern supply chain services, to manage and develop the NHS-specific supply channel for consumable goods required by the NHS. NHS Logistics also implement the range of e-commerce supply chain solutions it has developed; implement a supplier performance regime; and assists the Supply Management Confederations with the necessary supply chain arrangements and skills.

            In developing a supply chain using e-commerce strategy, it is necessary to identify the members of the supply chain who will operate within the network. In NHS, the members of the supply chain are already mentioned above. These are the customers which may be the patients and the doctors; the NHS PASA, the NHS Trusts and Health Authorities; the Confederations; and the suppliers.

            Before the modernization plot, NHS supply chain network was very complex due to hundreds of NHS trusts involve in the chain. With the modernization ply and implementation of e-commerce strategy, the NHS supply chain network has been simplified as shown in the figure below:

            The network was simplified by classifying the members into two categories: the primary members and the support group members. The primary members are those who carry out value adding activities in an independent environment while the support members are those that simply provide resources, knowledge, utilities, or assets for the primary members of the supply chain. In the diagram above, the primary members are the customers, the NHS trusts and Health Authorities, and the suppliers. The support members include the NHS PASA which leads the modernization in NHS, the NHS Logistics and the Supply Management Confederations.

           

The customers are the end users of products and services being given by the trusts, hospitals and health authorities under the supervision and standards set by the NHS. Therefore, the trusts are responsible in forecasting and demand planning. They are the ones who can determine the products and services needed by the end-users. The Supply Management Confederations as noted above are groups of trusts in a certain location. They are group together to share best practices and skills necessary for product inventories and supply management. The Confederation shares with its members the knowledge and e-commerce supply chain solutions the NHS Logistics Authority has developed. NHS PASA assists trusts in negotiating contracts with the supplier. NHS PASA also established common standards such as the catalogue system where products are categorized and classified and given product codes.

            In any organizations today, they want to incorporate e-commerce strategy in their supply chain management. This has been the primary role of NHS PASA, how to incorporate e-commerce strategy in the NHS supply chain management that will help in reduce expenses in the supply chain and at the same time makes the supply chain more responsive and the flow of products or services faster for the benefits of each member of the chain.

           

Defining supply chain management, SCM, it is the integration of key business processes, from suppliers through end-users that provide products, services, and information that add value for customers and stakeholders. It is also a network of facilities and distribution options that integrate the functions of demand planning and forecasting, procurement of materials, manufacturing, distribution, and return. The goal of SCM is to reduce inventory cost and to improve the coordination and collaboration with suppliers and distributors.

           

According to the UK government, e-commerce is the exchange of information across electronic networks at any stage in the supply chain, whether within an organization, between businesses, between businesses and consumer, or between the public and private sectors. Electronic commerce and Supply Chain Management focuses on systems and processes to support the flow of information within and between organizations which occurs in the context of procurement, manufacturing, sales, distribution of goods, information and services. Both e-commerce and SCM is focus on the integration of information and products or services thus by incorporating e-commerce within the supply chain, the goal of SCM will be achieved.

            With e-commerce, NHS expects to have exploited and consolidated transparency of information across all networks within NHS; obtain greater leverage through appropriate aggregation of demand across the NHS, the government and the wider public sector; and improve efficiency of transactional processes of NHS and its suppliers, ensuring high quality of service.

           

To be able to achieve theses benefits, e-commerce strategy needed to have key elements necessary before and during its implementation. One key element is a good IT infrastructure within NHS and other members of the supply chain including the trusts, health authorities, the Confederations and the suppliers. IT infrastructure composes of computers and laptops, servers, according to the needs of the organization. The software used for SCM should communication networks and software and must be combined together matching the operating system used and should be capable of storing data needed in the supply chain such as product information and supplier information. On the part of the trusts, they should have system capable of storing and retrieving the medical data to plan and forecast demands.

           

Another key element of e-commerce is resources. These resources include human resources and financial resources. Financial resources are needed for the purchase of equipments needed to develop a good IT infrastructure. If the UK government has no enough allocated budget for e-commerce, then the strategy could be a failure. Human resource is very much needed with e-commerce strategy.

 

NHS should have a CIO that has the capability and technical knowledge handling e-commerce. E-commerce involves having a standardized information system within NHS and a CIO and other technical people are needed to implement e-commerce. Employees of NHS especially those involve in the supply chain such as the finance and procurement department should be educated on how to maximize the use of such systems. The people involved in the supply chain are the ones who will implement e-commerce so the success of the strategy is dependent on its implementation. Effective leadership is also a key component of e-commerce. Employees should be motivated and organizational learning should be implemented in order for everyone in NHS become aware of e-commerce.

           

With all the necessary information about the supply chain members as well as the key elements of e-commerce known, e-commerce has been implemented. With e-commerce, all the transactions within the chain are done fast and efficient. Customers can order online with the use of e-mail or via the established website of NHS that publishes information and online catalogues. Via the internet, NHS PASA can assists trusts with contract negotiating. Trusts and suppliers can have interaction for order placement and transaction can be completed online by electronic payment. Suppliers will then deliver the products to distribution centers of the NHS Logistics Authority and distributed to the trusts and to the end-users.

            E-commerce programme in NHS with the leadership and initiatives of NHS PASA includes undertaking electronically traditional and discrete procurement-based activities such as electronic tendering, catalogues and ordering; overlapping financial and probity processes such as invoice receipt and matching, payment of suppliers and audit trail/authorization procedures; generation of management and strategic supply information such as budget planning, reporting and control, demand forecasting, supply chain performance management, and strategic sourcing and supply decisions.

            Undoubtedly, the primary benefit of e-commerce is cost reduction by automating the purchase requisition, approval and process; reducing errors and reworks; ‘maverick’, off-contract purchasing; providing online access to multiple suppliers, thereby facilitating price comparisons; and saving administrative time and providing more developed data which enable purchasing professionals to negotiate better terms with suppliers.

            However, there are some barriers that may hinder the effectiveness of e-commerce. These may include an uncompromised member of the chain. Traditionally, all departments such as management, system, administration, inventory, distribution and the purchasing of an organization such as a health-providing organization like NHS operate independently and are often conflicting. Health Trusts also have different departments responsible for the procurement of health products and facilities. With e-commerce incorporation in the supply chain management, all the different functions of these departments should be aligned and integrated. In order for e-commerce solutions to supplant the healthcare industry’s current methods of transacting business, seamless integration with buyers’ information systems and effective coordination of buyers’ and suppliers’ actions is required.

            E-commerce in NHS will also lead to cultural change due to the substantial change brought about by e-commerce and modernization and it is common that there are some members of the NHS organizations who will resist to changes. It is the responsibility of NHS management to inform and educate its members and defined to them their functions as e-commerce take effect in order for them to appreciate the benefits e-commerce will bring to the entire organization.

            Another barrier is lack of financial and technical expertise. As noted above, with e-commerce in the supply chain management, good understanding of the internet, the web, online marketplaces, and information systems and management require good technical facilities that will support reliable systems. Not all trusts in NHS are in the position of making necessary investment in purchasing and supply. Resources for financial support for facilities as well as human resources for technical and senior procurement positions lack in some trusts.

            Like in any industry implementing e-commerce, security of the system is always an issue. In the supply chain of NHS, important data and transactions are involved therefore it needed security to avoid system failure or interference of hackers in the system.

            To overcome these barriers, the UK government who initiated modernization in government agencies should allocate resources to financially support e-commerce in the supply chain of NHS. NHS PASA addressed the issue of lack of human resources through inter-trust supply management, where a group of trusts in the same geographical area and with similar needs collaborate to pool expertise, avoid duplication of effort, and maximize value for money and the potential for savings. This collaboration of trusts is also the Supply Management Confederations mentioned above. In addition, NHS PASA provides strategy and assists trusts in communicating with the suppliers. Inter-trust supply management has potential benefits for individual trusts and for NHS as a whole. These benefits include economies of scale and lower total costs through volume aggregation, reduced duplication and sharing of costs; increasing purchasing leverage and reduced cost of ownership; purchasing savings; shared risk; shared purchasing resource and expertise and improved career prospects for purchasing and supply professionals; development of centers for procurement excellence; opportunity to standardize products, systems and processes more widely and collective support and raising standards of weaker trusts.

            It is also important for NHS and individual trusts to reorganize in some level to able to have an organizational structure integrated with e-commerce. Sound organizational structure usually means a certain mix and interaction of talented individuals, working in relevant functions and areas of responsibility, sharing knowledge and related assets, behaving responsively and constructively. When a structure’s elements are properly aligned with one another, the structure facilitates effective implementation of the organization’s strategies. Some internal departments must be set up like Strategic Sourcing, Procurement and Systems and Operational Procurement departments set up in Addenbrooke’s NHS Trust which led to a cash releasing savings of £1.35.

            E-commerce and supply chain management can be at their full potential if integrated together effectively. With this kind of project that involves a lot of changes but will results to huge benefits not only for NHS but especially to the public sector who are befitted by the services provided by NHS, the initiative should be reorganization. Putting people at the right position and defining to them clearly their tasks will help the project become effective and will help eliminate problems during its implementation. Reorganization also helps in effective collaboration and coordination among the members of the supply chain. With the advent of technology, e-commerce in health care agencies is important for the speed and flexibility of health care services given to the public.

 

Nursing Profession and Research Opportunity

            For the past years, I have been courageously living through a small business.  Seeing businessmen succeed had originally encouraged me in pursuing a field in the business world.  In the dream of helping other people through my business, I realized that it wasn’t even satisfying having a business of my own.  It was the time when I was about to wonder what would it be and what I would do to make me contented and happy.  An answer came from a solemn advice of my sister who is a doctor recommending me in taking up nursing.  It was like a light bulb popping up out of my head, “that’s it!” that’s what I wanted to do and it perfectly fit me in attaining a valuable life helping others. 

            Sigma Theta Tau International is an organization for nursing professional providing education and research to enhance the health of all people and to improve the delivery of care to the patients.  It is a great opportunity having to be a part of this prestigious organization.  With the organization’s mission to serve, support, and improve, members were supported in their learning and professional development in improving nursing care globally. 

            There were actually a lot of research opportunities for nursing students and professionals.  This nursing education would help a lot in accomplishing my responsibility as a nurse to provide high quality and safe nursing care to the community that needs it in line with my undying love of helping and taking care of others who need it.