Reporting Abuses Essay Example for Free

Reporting aversions EssayEvery child must be protected from harm because it can cause m either negative issuances like trauma, physical and psychological disorders and any other illness that may effect their growth. So, the government makes a law that helps the child from being abused. This law can be found on Penal Code Section 11164 1174.4.3 (California Child Abuse and Neglect Law, 2007).This law aims to protect children and to give the rights of every child. This law also states that failure to report any abuses leave behind consider a crime. In this way, everyone will be aw are that they have the responsibility to protect every child, hitherto if you dont know them (California Child Abuse and Neglect Law, 2007).There are several cases of child abuse in our society but with the help of other people, it has been stopped like the story of Jenny (not her real name). She is a 4 year-old girl that lives with her father. Her mother was in the other country to work. Jenny was a bused by his father and the poor little kid cant do anything. One concerned neighbor report this incident. She reports all the maltreatment Jennys father do. Jennys father was caught and the child was claimed by the societal welfare society until her mother arrives. Now, Jenny is living with her mother and her father was still in jail.This incident is an example of child protection. Jennys neighbor, even though she never knew her, helps Jenny and gives her the right to enjoy childhood. Based on Ethical Standards of Human Service Professionals, we must protect them from any harm. We must guide, educate, and come through them what they need for them to grow physically, psychologically and socially normal (Ethical Standards of Human Service Professionals, 1996).Reporting child abuses doesnt mean that you wont get any protection. The law also states that any reporters will get the protection needed to protect them. In this way, the concerned people wont be afraid(predicate) of report ing anyone who commits this crime. Their identity will remain confidential and they will have immunity for civil and criminal liability. The government also ensures that every report is true up because if it is false, the reporter will suffer the consequences (The Code of Ethics and Good Practice for Childrens Sport in

Hamstring Tightness Is Common Health And Social Care Essay

Hamstring Tightness Is Common Health And Social C are EssayAmong the sinew undergoing adjustive bruskening, dun is the one commonly going for adaptive shortening. The frustrate comprises of three large ponderousnesss namely semimembranosus, semitendinosus, and bicep femoris which arises from the tuberosity of ischium. They are present everywhere the rankerior compartment of the thigh and span the articulatio coxae and articulatio genus joints. because they are the extensors of the hip and flexors of the knee joint.Hamstring tightness is common in typical individual because of immobilization of a wind in a shortened attitude results in adaptive shortening. As the bodybuilder shortens, its elasticity of the normal wind was decreased and a change in the space tension relationship of the heft, spillage of flexibility also occurs. Hamstring tightness could make the musculo unchewable unit more susceptible to injury, increase resistance to various anatomical structures, which whitethorn unravel to employ syndrome.Tightness could also leads to pathological conditions at the joint on which the pass acts, especially on a pass like hamstring which passes over the two joints. vim tightness has a call backing(a) impact on neuromuscular control. muscle tightness affects the normal length tension relationships. When one muscle in a force couple be generates tight or hypertonic, it alters the normal arthrokinematics of the involved joint. This affects the synergistic function of the entire kinetic chain, leading to anomalous emphasise, muted thread dysfunction, neural compromise and vascular/lymphatic stasis. vigour tightness also cause reciprocal prohibition era. Increased muscle spindle activity in a specific muscle will cause decreased neural drive to that muscles functional antagonist. This alters the normal arthrokinematics of the involved segment.Flexibility has been defined as the capacity of a muscle to lengthen and allow one joint (or more than one joint in a series) to move through a ikon of motion.Anderson and Burke defined Flexibility as the range of motion available in a joint or a group of joint that is influenced by muscles, ligaments and bones.Loss of flexibility means decreased strength of a muscle to deform. Loss of flexibility whitethorn lead to decrease in lumbar lordosis, lessening of muscle strength and quadriceps dysfunction during gait, lumbar pelvic rhythm was disturbed, anterior pelvic tilt was restricted, lumbar motion was increased. Excessive mobility of lumbar spikelet leads to over blossom outing of lumbar ligaments and consequently pain and instability. (Levangie and Norkin, 2001)Loss of flexibility can also cause pain arising from muscle, junction tissue or periosteum. (Hardy, 1989 Tillmann and Cummings, 1992)With regard to important use of goods and services of hamstring flexibility restoration of its normal length is necessary. Muscle tissue length is eyeshot to play an important role in efficiency and potency of human try.Benefits of flexibility is to enhance the range of motion, improved body target, potential relief of aches and pain, protection against low back pain and injuries, reduction of order manipulation muscle soreness, and promotes eternal rest.Hamstring tightness can be measured using the (1) energetic unilateral unfeigned leg raise test, (2) Passive unilateral straight leg raise test, (3) Sit and reach test, (4)Active knee extension test. Straight leg raise test are widely used as a neurologic tests, hence they do not give valid measures of hamstring tightness because of pelvic rotation that occurs during the test. Active knee extension test is the legitimate test. unvarying echography therapy increases muscularity length by changing their viscosity and plasticity (Ziskin et al, 1986). Skeletal muscles have a higher(prenominal) rate of absorption of ultrasonography waves when compared to fatty tissue. (Dyson, 1987 Low and Reed, 1990 ).Elevation of collagen tissue temperature affects on mechanical and physical characteristics of tissues and facilitates deformation of the collagen. As pain and discomfort was reduced during protractability and collagen fiber ability to tolerate greater forces was increased. Ultrasound increases soft tissue extensibility and may be an actionive adjunct in the treatment of knee contractures secondary to connective tissue shortening (Folconer et al, 1992). soundless offering allow the muscle spindle to accommodate, reduces their firing rate hence electrostatic open is effective in increasing the length of muscle. (Gordon and Ghez, 1991).Longer asseverate times during reaching of the hamstring muscles resulted in a greater rate of gains in range of motion (Feland et al, 2001).Stretch duration sink than 30 seconds did not increase muscle flexibility (Beaulien, 1981). Static stretch of 30 seconds is sufficient to increases the hamstring muscle length.Combination of echography t herapy with 30 seconds stretch is more effective than ultrasound therapy with 15 seconds stretch in increasing hamstring flexibility (A.Akbari, H.Moodi, A.A.Moein, and R.Nazok 2006).Muscle thrust proficiencys (MET) are manually applied reach techniques that use principles of neurophysiology to relax over alert muscle and stretch chronically shortened muscles.Muscle energy techniques (MET) have the ability to relax overactive muscles or stretch tight muscles and their associated fascial components when connective tissue or viscoelastic changes have occurred.When using Muscle energy techniques (MET), it is important to relax/inhibit the neuromuscular component sooner attempting to stretch the involved musculature. Two fundamental neurophysiologic principles account for the neuromuscular inhibition. The first principle of Muscle energy techniques (MET) is business office contraction inhibition / autogenic inhibition / post isometric relaxation. The second principle is reciprocal in hibition. Muscle energy technique produced an immediate increase in passive knee extension in individuals with hamstring tightness (Ballantyne 2003). Muscle energy technique is importantly improving the hamstring flexibility in collegiate males (Wassim .M et al 2009).1.1 NEED FOR THE fillContinuous ultrasound therapy, static stretching, muscle energy technique (MET) are significant in improving hamstring flexibility in individuals with hamstring tightness. These methods of treatment are well accepted and practised by various researchers according to previous literature, but there was no study to compare the effect of muscle energy technique ( MET) and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.So the purpose of this study is to analyse the efficacy of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.2 A IMSTo find out the effect of muscle energy technique versus ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.3 OBJECTIVESTo study the effect of muscle energy technique in improving the hamstring flexibility in individuals with hamstring tightness.To study the effect of ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.To compare the effect of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.4 KEYWORDSHamstring flexibility, Muscle energy technique, Ultrasound therapy with static stretching, Active knee extension test.1.5 venture1.5.1 NULL HYPOTHESIS there is no significant effect of muscle energy technique in improving the hamstring flexibility in individuals with hamstring tightness.There is no significant effect of ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.There is no significant expiration mingled with the effect of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.5.2 ALTERNATE HYPOTHESISThere is a significant effect of muscle energy technique in improving the hamstring flexibility in individuals with hamstring tightness.There is a significant effect of ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.There is a significant difference in the midst of the effect of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.II.REVIEW OF literatureHAMSTRING TIGHTNESSWorrel et al (2003) verbalise that hamstring injuries in athletes is mainly due to the lack of hamstring flexibil ity.Kishner and Colby et al (2002)Stated that adequate mobility of soft tissues and joints is thought to be an important factor in prevention of injury (or) reinjury to soft tissues.Donald E Hartig et al (1999)Stated that increase in hamstring flexibility decreases overuse injuries in lower extremities.Sarhmann.S et al (1997)Stated that muscle tightness and hypertonicity has a significant impact on the neuromuscular control. Muscle tightness affects the normal length tension relationship.Bullock-Saxton.J, Lewit.K et al (1997, 1984)Stated that muscle tightness alters the normal arthrokinematics of the involved joint. This affects the synergistic function leading to abnormal joint stress, soft tissue dysfunction, neural compromise and vascular or lymphatic stasis.Ronald F, Zernickle et al (1996)Stated that extracting flexibility changes related with structural and physiological changes influence the level of physical activity.Zachazewski et al (1989)Stated that loss of flexibility of hamstring may lead to decrease in lumbar lordosis, reduction of muscle strength and quadriceps dysfunction during gait.Cummings, GS, Crutchfeld, CA, Barnes et al (1983)Stated that tightness is referred to mild shortening of a healthy musculo tendinous unit otherwise referred to as a mild transient contracture. A muscle that is tight can be lengthened to all but the outer limits of its range. Normal individual who do not regularly participate in a flexibility program can develop mild myostatic contractures or tightness, particularly in two joint muscles such as hamstrings, rectus femoris or gastronemius. corn dodger E.L et al (1979)Stated that flexibility enhances movement by improving body awareness with greater ease and dexterity.Lawrence Gold et alStated that the hamstrings are the muscles that make a motion from behind and below the knees up to the back of the thigh till the sitbones. Soft tissue injuries, knee pain, torn menisci, chondromalacia patella and poor posture often co me from tight hamstrings. Tight hamstrings can prevent the individual from reaching full extension or from bending over completely.ULTRASOUND THERAPY WITH STATIC STRETCHINGShadmer.A, Astaneh.H.N, et al (2010)Conducted a study to analyse the effect of two different modes (Continuous versus Pulsed) in decreasing the shortening of hamstrings. Thirty non impaired men aged 20 to 30 historic period were included. Ultrasound was applied over short hamstrings. Hamstring flexibility was measured by passive knee extension test. Continuous ultrasound of 2W/Cm, 1MHZ, five minutes and Pulsed ultrasound of 200s burst of 1MHZ, 0.5W/Cm, five minutes was used. They cogitate that the heat energying effect of incessant ultrasound may be more effective than non thermal properties of pulsed ultrasound for increasing the flexibility of shortened hamstrings.Meroni, Roberto, Cerri, Cesare Giuseppe, Lanzarini, Carlo, Barindelli, Guido, Morte, Giancesare Della, Gessaga, Viviana, Cesana, Gian Carlo, DeVi to, Giovanni et al (2010)Stated that the gain in flexibility was maintained for a period of 4 weeks by and by the cessation of training. This improvement was more significantly noticed in active stretching group by using active knee extension test than the passive stretching group.Buker N., Aslan E., Kitis A., Carluk U et al (2008)Stated that the superficial (or) deep heat applications before static stretching exercises shows despotic effects to increasing flexibility of hamstring muscles.Nichole Lee Lounsberry et al (2008)Stated that the ultrasound treatment produced greater immediate gains in hamstring extensibility than moist heat packs treatment.A.Akbari, H.Moodi, A.A.Moein and R.Nazok et al (2006)Stated that the gains in range of passive knee extension obtained in continuous therapeutic ultrasound and 30 seconds stretch group were significantly greater than therapeutic ultrasound and 15 seconds stretch group in subjects with tight hamstrings.Denegar C, Saliba E, et al (2006)S tated that 3 MHZ ultrasound provides superficial heating, 1MHZ ultrasound heats tissue at depth of 3-5 cms and is considered to be a deep heating agent.Odunaiya N.A, Hamzat T.K, Ajayi O et al (2004)Stated that statically stretching tight hamstrings for any duration betwixt 15 and 120 seconds on alternate days for six weeks would significantly increase its flexibility. The effect was also bear on for upto 7 days post intervention.Trae Sakiyo Tashiro et al (2003)Stated that the clinically practical parameters of thermal ultrasound in conjunction with static stretching is an effective way of increasing hamstring extensibility but ultrasound application location didnt showed difference in increasing knee extension range of motion in a healthy population.C.D.Weijer et al (2003)Stated that the static stretching is one of the safest and most commonly performed stretching methods used to measure muscle length.Feland et al (2001)Reported that longer hold times during stretching of the hams tring muscles resulted in a greater rate of gain in range of motion.Prentice WE, McClure M, Becker RO et al (2001)Stated that when slow stretch applied to muscle, golgi sinew electronic organ get stimulated and thereby muscle tension is reduced. This leads is to an increase in length of muscle.Robert and Wilson et al (1999)Stated that static stretching increases muscle length by allowing muscle spindle to adapt overtime and break off fired. It also elicits golgi tendon response and therefore provides an effective flexibility training stimulus.William D Bandy et al (1996)Stated that a static stretch of 30 seconds at a absolute frequency of single session is sufficient to increase the muscle length.Bandy WD, Irion JM et al (1995)Stated that the duration of 30 seconds of stretching is an effective time of enhancing the flexibility of the hamstring muscles.Bandy WD, Irion JM et al , Lentell G, Hetherington T et al, Madding SW et al (1994 )Stated that Static stretching is a method of stretching in which the muscles and connective tissue being stretched are held in a stationary bearing at their great possible length for some period. When using static stretching on a clinical basis, stretches should be held a minimum of 15 to 30 seconds.Chan et al (1993)Stated that tendon reaches greater temperature and heat more quickly than muscle and the tendon was able to maintain vigorous heating for longer period than muscle.Draper D, Sunderland S, Kirkendall et al (1993)Stated that tendon tissue is less vascularized than muscle tissue tendons will retain heat for longer periods of time.Folconer et al (1992)Stated that ultrasound increases soft tissue extensibility and may be an effective adjunct in the treatment of knee contractures secondary to connective tissue shortening.Gordon and Ghez et al (1991)Stated that static stretching may be effective in increasing the length of muscle due to the prolonged stretching which allows the muscle spindle to adapt over time and cea se firing.Low and Reed et al (1990) , Dyson et al (1987)Stated that low absorption of ultrasound waves is seen in tissues that are in water content (eg.,fat), whereas absorption is higher in tissues rich in protein (e.g., skeletal muscle).Warren C, Lehman J, Koblanski J, Strickler T, Malone T, Masock A, Garrett W et al (1990)Stated that ultrasound therapy can be used to target the collagen rich tendinous unit of the hamstring muscle because of its ability to penetrate deeper tissues, and shown that increasing the temperature of collagen to 40 Celsius will increase the elasticity of the tissue. This increased extensibility allows for an even distribution of force and reduces the stress on localized areas of the tissue.Gajdosik RL , Godges JJ et al (1989)Stated that a low intensity maintained stretch that is applied gradually is less likely to facilitate the stretch reflex and increase tension in the muscle being lengthened. This is called static stretch.Ziskin et al (1986)Stated that an increasing in tendon length following continuous ultrasound therapy is due to change of their viscosity and plasticity.Beaulien et al (1981)Stated that stretch duration lower than 30 seconds didnt increase muscle flexibility.Coakley et al (1978)Stated that frequency of 1MHZ ultrasound used for patients with more subcutaneous fat who sustained injuries at deeper level because of its penetration to a depth of 3 to 5 cms.Lehman et al (1968) emphatic on the thermal effects of continuous ultrasound compared to other heating modalities in increasing hamstring flexibility.De Vries HA et al (1962)Stated that static stretching offers advantages of using less overall force, decreasing the danger of exceeding the tissue extensibility limits, lower energy requirement, and a lower likelihood of muscle soreness. Static stretching also has less effect on the Ia and II spindle afferent fibres than ballistic stretching, which would tend to increase a muscles resistance to stretch and facilitate golgi tendon organ, thereby reducing the contractile elements resistance to deformation.MUSCLE ENERGY techniqueAhmad Faheem, Ahmad Shamin, Anjani Agarwal, Begum Shabana, Ram C.S, Waseem Mohd et al (2010)Conducted a study in Indian collegiate males on hamstring flexibility by comparing the effectiveness of muscle energy technique and eccentric training. Total of twenty males with hamstring tightness falling amongst age group of 18-25 years were included in the study. Hamstring tightness was measured by popliteal angle/active knee extension test. one group was treated with muscle energy technique and the other with eccentric training. This study stated that hamstring flexibility can be improved with muscle energy technique using post isometric relaxation than eccentric training.Wassim M et al (2009)Reported that muscle energy technique using post isometric relaxation significantly improving the hamstring flexibility (by active knee extension test) in normal Indian collegiate males with hamstring tightness.Azadeh Shadmehr, Mohmmed Reza Hadian, Sedigheh Sadet Naiemi, Shohreh Jalaie et al (2009)Concluded that the hamstring stretches in normal young women using either static stretch or muscle energy technique had similar effects on restoring flexibility to hamstrings.Madeline Smith, Gary Fryer et al (2008)Stated that the muscle energy technique is effective in increasing hamstring extensibility, and there appeared to be sustained improvement one week following the initial treatment.Ross A, Clark et al (2008)Stated that muscle energy technique can produces creep and plastic changes in the connective tissue thereby the length of the muscle can be increased.Lindsey Samilian et al (2007)Stated that muscle energy technique is a method used to establish weak muscles, lengthen the short muscles (or) increase a muscles range of motion. These techniques involve stretch during which a reciprocal force is imposed on the targeted muscle for short period of time, causing the muscle to relax and stretch further.Ballantyne F, Fryer G, MC.Laughlin P et al (2003)Conducted a study to find the effectiveness of muscle energy technique in increasing passive knee extension and to explore the mechanism behind any observed change. Forty asymptomatic subjects between age of 18 to 45 years were randomly allocated to experimental and control group. Experimental group was given with muscle energy technique and Control group with no treatment. They concluded that muscle energy technique produced an immediate increase in passive knee extension. This observed change is due to an increased tolerance to stretch.Chaitlow L, Liebenson C et al (2001)The other name for Muscle energy technique is active muscular relaxation technique.Freyer G et al (2000), Richard L, Gajodsik, Melonie A, Rieck and Debra K et al (1993)Stated that an increase in flexibility after muscle energy technique occurred due to biomechanical or neurophysiologic changes or due to an increase in tolerance t o stretching.Lewit et al (1999)Concluded that post isometric relaxation is directed towards relaxation of hypertonic muscle, especially if this relates to reflex contraction or the involvement of myofascial trigger points.Lewit, Libenson, Murphy et al (1999)Stated that post isometric relaxation is an excellent technique for treating neuromuscular component muscle of a stiff, shortened or tight muscle.Lewit et al (1999), Greenman et al (1989)Suggested that in muscle energy technique, the holding time of 7-10 seconds is more effective than 3-5 seconds.Kuchera et al (1997)Stated that increase in range of motion of a joint after Muscle energy technique is based on neurological mechanism via inhibitory golgi tendon reflex. Muscle energy technique activates this reflex during isometric muscle contraction. Muscle energy technique produces a stretch on golgi tendon organ and a reflex relaxation of muscle.Goodridge and Kuchera et al (1997)Suggested that 3 repetitions of isometric contraction s is optimal in applying muscle energy technique.Lederman et al (1997)Stated that a viscoelastic change in muscle is responsible for the increase in muscle flexibility after muscle energy technique.Chaitlow L et al (1997)Stated that the isometric contraction should be held for 10 seconds. This is the time required to stimulate the excitatory threshold of the golgi tendon organ, which has a neurophysiologic inhibitory effect on the muscle spindle. This provides the opportunity to take the muscle into a new range of motion. Following the isometric contraction, there is a latency period of approximately 25 to 30 seconds, during which the muscle can be stretched.Philip Greenman et al (1996)Stated that manual medicine treatment procedure includes Muscle energy technique which involves the contraction of the subjects muscle by the voluntary effort in a precisely controlled direction, at different levels of intensity, against a counterforce applied by the operator. This procedure can be us ed to lengthen a shortened, contracted or spastic muscle to strengthen a physiologically weakened muscle to reduce localized oedema, to mobilize an articulation with restricted mobility.Ward, Robert C et al (1990)Stated that muscle energy technique is an active, direct technique (engaging the barrier) that promotes muscle relaxation by activating the golgi tendon reflex.Libenson et al (1989)Stated that muscle energy technique is effective in treating the muscle tension disorder and it effectively relaxes stretches, strengthens the muscles and re-educate abnormal sensory motor pathway.Lewit et al (1986)Stated that when a muscle is isometrically contracted its antagonist will be inhibited and reduce tone immediately.Stiles and Greenman et al (1984)Suggested that muscles which requires stretching (agonist) should be the main source of energy for isometric contractions and achieves a more significant degrees of relaxation and so a more useful ability to afterwards stretch the muscle we re the relaxation effect being achieved through use of antagonist (using reciprocal inhibition).ACTIVE KNEE EXTENSION TESTC.M. Norris et al (2005)Stated that active knee extension test when used in conjunction with goniometry, accurate surface making, and manual monitoring of the test leg is a accredited measure of hamstring muscle length.M.Mathews et al (2005)Stated that active knee extension represents maximum length of hamstring muscles.Denise M. Cameron, Richard W. Bohannon et al (1985)Stated that active knee extension test is said to be a useful alternative to the straight leg raise test for providing an indication of hamstring muscle length.Gajdosik R.L et al (1983)Stated that active knee extension test is a more objective measure of hamstring tightness which produces high reliability co-efficient.III. METHODOLOGY3.1 STUDY DESIGNPre test and post test experimental group study design.3.2 STUDY SETTINGStudy will be conducted at Physiotherapy let on Patient Department, KG Colle ge of Physiotherapy, Coimbatore.3.3 STUDY DURATIONTotal duration was one year. Individual received the treatment for the duration of one week.3.4 POPULATION STUDIED30 normal individuals with hamstring tightness who fulfilled the predetermined inclusive and exclusive criteria were selected and divided into two experimental groups by simple random sampling method. from each one group consists of 15 patients. bases are named as group A and group B3.5 CRITERIA FOR SELECTION3.5.1 INCLUSIVE CRITERIAAge between 18 to 25 yearsBoth males and femalesNormal individuals with tight hamstrings (inability to achieve greater than 160 knee extension with hip at 90 flexion.)3.5.2EXCLUSIVE CRITERIALow back pain subtle or chronic.Hamstring injury Acute or chronic.Soft tissue injuries around knee.Pregnancy.Metal implants in lower extremity.Recent fracture and stiffness in lower extremity.3.6 VARIABLES3.6.1 INDEPENDENT VARIABLESMuscle energy technique.Ultrasound therapy with Static stretching.3.6.2 DEPENDENT VARIABLESHamstring flexibility.3.7 PARAMETERSHamstring flexibility3.8 MEASUREMENT TOOLSActive knee extension test.Active knee extension test was used for measurement of hamstring tightness. The subject was instructed to lie on their back with hip and knees bent 90 degrees. Pelvic movement was controlled by the use of straps. By using the lateral condyle of femur as the goniometric axis, the stationary arm positioned along the femur, and the movable arm was positioned parallel to the leg. Keep hip and knee in 90 degrees then instruct the subject to straighten the knee as for as possible till a sensation of stretch being felt. Repeat the same(p) for three times and mean were measured as the final result.3.9 PROCEDURE conclave A MUSCLE ENERGY technique.TECHNIQUE utilise Post isometric relaxation.INDIVIDUALS POSITION Supine lying.PROCEDUREAsk the individuals to assume supine position. Therapist flexes the affected hip fully and then extends the flexed knee with the back of l ower leg resting on the lift of the therapist who stands facing the head of the table. Individual is asked to flex i.e. causing downward pressure against the therapist shoulder with the back of lower leg at the same time therapist resist the individuals voluntary effort so that, slight isometric contraction of hamstrings develops and individuals hold this for 10 seconds.After this effort, the individual is asked to exhale and relax the muscle completely. Then the therapist takes the muscle to its new restriction barrier without stretch. Starting from this new barrier, the same procedure is repeated two or three more times.FREQUENCY OF TREATMENT Once in a day.TREATMENT DURATION One week.GROUP B ULTRASOUND THERAPY WITH STATIC STRETCHINGULTRASOUND THERAPYINDIVIDUALS POSITION Prone lyingPARAMETERSFREQUENCY 1 MHzINTENSITY 2W/cmMODE Continuous. subject OF APPLICATION Hamstring areaDURATION Five Minutes daily (Two minutes for medial hamstrings, Two minutes for lateral hamstrings and One m in for between the two tendon).FREQUENCY OF TREATMENT Once in a dayTREATMENT DURATION One weekSTATIC STRETCHINGTECHNIQUE USED Active static stretching.INDIVIDUALS POSITION Standing position.PROCEDURESubjects performed the hamstring stretch by standing erect with the foot planted on the floor and toes pointed forward. The pawl of the foot to be stretched was placed on a plinth with the toes directed towards the ceiling. The subject then flexed forward at the hip, maintaining the spine in neutral position while reaching the arm forward.The subjects continued to flex the hip until a gentle stretch was felt in the posterior thigh. Then hold this position for 30 seconds and then relax for 10 seconds and repeat the same procedure for three more times a day.FREQUENCY OF TREATMENT Once in a day.TREATMENT DURATION One week3.10 STATISTICAL TOOLSThe following statistical tools used in this study is mated t-test and Unpaired t-testFormula Paired t-test=Where,= difference between the pre test v ersus post test= mean difference= total number of subjects= standard deviationUnpaired t-test was used to compare the mean difference between Group A and Group B.Formula Unpaired t-testWhere,= Mean of Group A= Mean of Group B = sum of the sheltern1 = number of subjects in Group An1 = number of subjects in Group BS = standard deviationLevel of significance 5%IV.DATA synopsis AND INTERPRETATIONTABLE-1PAIRED t TESTPRE TEST AND POST TEST VALUES OF GROUP AGROUP A MUSCLE ENERGY TECHNIQUEHAMSTRING FLEXIBILITY ACTIVE KNEE EXTENSIONThe comparative mean values, mean differences, standard deviation and Paired t test values of Group A , who were treated with Muscle energy Technique.S.NOGROUP AMEANMEAN DEVIATION

Impact of the Acheson Report on Health Policy

Impact of the Acheson Report on health PolicyIn what way did the Acheson Report represent a radical approach to wellness policy? How far did it inform New drudges policy on cut inequalities in wellness?IntroductionA organisation commissioned motif on wellness inequalities led by Sir Donald Acheson has been marked as extremely influential in shaping future UK health policies. The Acheson bill highlights the argona in which health inequalities could be reduced and provides the direction of health policies promoted by the Department of Health. The piece focuses on several areas such as poverty that seems to have disproportionate belief on children. Increased benefit levels have been recommended for women of childbearing age, expectant mothers, young children and older mickle suggesting mothers on income support tend to have inadequate diets. The newspaper publisher in any case calls for more funding support to schools in deprived areas, give nutrition and the concept of he alth-promoting schools. Benefit levels for providing nutritional meals to children should be increased and food should be more affordable for fulfilling nutritional needs of children. The cogitation also focuses on smoking and drinking problems urging for restrictions on smoking in public places, a ban on tobacco advertising and promotion, mass educational initiatives, increases in the price of tobacco and the prescriptions for nicotine replacement therapy. The Acheson report also suggests close links among health and mortality rates.The Acheson report has been instrumental in shaping, directing and implementing several changes in the NHS Health policy. Several studies and research reports have been published on the relate and influence of the Acheson report on changes within health care policy. The Acheson report identified three crucial areas on favorable gradient and health inequalities and suggested thata high priority should be given(p) to the health of families with childr enall policies likely to have an have-to doe with on health should be evaluated in terms of their impact on health inequalitiessteps should be taken to reduce income inequalities and improve the living standards of poor households.The Acheson Report and UK Health PoliciesThe Acheson Report 1998, an Independent Inquiry into Inequalities in Health was similar to the Black Report 1980 and fuel be sum uped as a Department of Health review of the evidence on inequalities in health in England.The Department of Health has responded to the Acheson report by taking an official course of action. The Department of Health mentions that tackling health inequalities is a top priority for the Government, and is means on narrowing the health gap between disadvantaged groups, communities and the rest of the country, and on improving health overall. The strategy for addressing this problems is published in, Tackling Health Inequalities A course for Action that lays the foundations for meeting t he Governments target to reduce the health gap on infant mortality and life expectancy by 2010.A programme for action imply a three-year plan for tackling health inequalities and to help local organisations improve the way renovations are delivered to disadvantaged groups.The programme for action in response to the Acheson report is based onSupporting families, mothers and childrenEngaging Communities and IndividualsPreventing Illness and providing Effective treatment and CareAddressing the underlying determinants of healthThe Acheson report suggests that socioeconomic inequalities in health and scene of life have been found in England for many years and there have been data identifying differences in longevity by ones socioeconomic position. Inequalities of health are measured in terms of mortality, life expectancy or health status and could be categorised by socioeconomic status, ethnic group or gender. The Acheson report suggested that there are differences in the health status of mothers, babies, people of lower socioeconomic status and people who smoke or drink heavily. The report definitely shows that death rates are falling in England and the rates have fallen since 1896. Thus life expectancy seems to have travel in the last few years although bouncing life expectancy has not been rising. In fact the proportion of people with long standing illness has risen from 15 percent to 22 percent (Acheson Report, 1998).The Acheson report thus gave new insights on health policies and identified issues that contribute to an increased rate of mortality and realistic ill health. It identified several socioeconomic determinants including income distribution and household below average income, education, employment, housing, homelessness, public sector, transport and health related behaviour. adjacent the report, the Choosing Health vacuous Paper given by the Department of Health sets out the key principles for supporting the public to make healthier and more in formed choices in regards to their health. done the paper, the Government has provided information and practical support to get people actuate and improve emotional well-being and also provide access to services to get on people to make healthy choices. The government has also drawn up a food and health action plan that focuses on the ways that better health can be achieved through better nutrition at all stages of life and for different groups in society, recognising and addressing different needs, particularly those of disadvantaged groups (Choosing Health, DH, 2004). The government has also set up the Health Improvement Plan and a new NHS plan for tackling health inequalities81% of people in higher socio-economic groups consider themselves to be in entire health now, compared with 61% of people in the lowest groups 76% of people in the higher groups expect to be in good health in 10 years time, compared to 53% of people in the lowest groups (DH, 2004).Putting forward the NHS improvement plan, the Government reiterated the NHS commitment that the NHS is motivated to prevent disease and improve health in general. The Government policies are focused on the fact that inequalities in health cannot be accepted and the rudimentary objective is to create healthier choices for disadvantaged groups.The NHS Improvement plan was laid down in 2004 to not only counter health inequalities but also provide better quality of care to patients and provide safer and more effective treatment.The NHS Improvement Plan set out modernisation and health plansputting patients and service users first through more individualisedised carea focus on the whole of health and well-being, not only illness andfurther decadency of decision-making to local organisations. (DH, 2004)According to the Government report and Action Plan laid out in then Choosing Health White paper the nutritional priorities were given as followsincrease in the average consumption of a variety of fruit and vege tablesincrease in the average intake of dietary fibre to 18 grams per dayreducing average intake of salt to 6 grams per dayreduce average intake of saturated fatmaintaining the current trends in reducing average intake of total fatreducing the average intake of added sugar(Choosing Health White paper, 2004)The Government took several steps to ensure that the recommendations of the Acheson report is considered for any further changes within the NHS. Accordingly major steps have been taken to ensure consumer awareness on the consumption of healthy foods and phylogenesis of good food habits. Reducing the proportion of fat, salt in the diet has been recommended and retailers and caterers have been asked introduce healthier range of foods and offer such foods in convenient stores, centre locations and in remote areas of the city.In a plan to tackle health inequalities, the Government has focused on many plans including Offer people personal health plans with support from the NHS.Recruit NHS health trainers to provide advice and support for people to develop their personal health plans.Provide services in the areas of highest need.Offer disabled people the option of taking up a health check. (DH, 2004)Considering the Acheson report on the exaggerated problems of health care among enceinte women and children, the government has also provided eligible pregnant women with vouchers that can be exchanged for fresh fruit and vegetables, milk and infant formula through a new scheme called Healthy Start. A original Start scheme is also in place for providing training, guidance and support for early years to children. Practitioners encourage changes in parental behaviour and improve the social and emotional development and physical health of children in the early years. Community Parental Support Projects are also in place that involves training of channel workers in 500 communities. Healthy Schools programmes are encouraged to target deprived schools including Pupil Ref erral Units. The Government has promoted the concept of healthy schools by 2006, working towards a healthy school status by 2009.The concept of Healthy schools, Sure Start and the Concept for providing Parental Support as well as providing people with personal health plans are some of the steps that the government has taken to ensure the promotion of health. Some of the objectives of the Action Plan have been given as follows. Following the Acheson report, the government focus has shifted from the one aimed to meet national targets to a different approach that could be given as followsstandards are the main driver for unceasing improvements in qualitythere are fewer national targetsthere is greater scope for addressing local prioritiesincentives are in place to support the formation andall organisations locally play their part in service modernisation. (Care Standards Planning Framework, 2004).Research StudiesWe discuss several studies which deal with the Acheson report. Oliver an d Nutbeam (2003) point out that health inequalities has been considered staidly for an approach to improve health care and government policies have been developed to explicitly address existing health inequalities that has become an important issue since Labour has returned to power in 1997. The development of health inequalities policies, have been critically examined to assess how such policies could or should be developed. The authors point out that progress in the development of health inequality policies has been made although the progress is less than expected or ideal.Kisely and Jones (1997) have written on the issues of public health ten years subsequently the Acheson report. They point out that the issue of communicable disease control and the role of public health medicine is of considerable concern in the light of outbreaks and NHS reorganisations. The Acheson report seems to have highlighted several issues in this regard. Yet as Kisely and Jones the Reports findings ha ve yet to be fully implemented. The paper calls for a further review of public health function and should hold the removal of the specialty from management costs, and the clarification standardisation of the roles of the Director of Public Health (DPH), CPHM and other members of the multi-disciplinary public health team (Kisely and Jones, 1997). realistic organisational implications for a public health approach have also been suggested.Tarlov (1999) has delineated four conceptual frameworks providing the bases for constructing public policy strategies for improving commonwealth health and this include (1) Determinants of population health. (2) Complex systems (3) An intervention framework for population health improvement. (4) Public policy development process with two phases of public consensus and policy action.The Acheson report can be judged in this context and has provided both a consensus and a policy framework.ConclusionThe research studies and analysis of the Acheson rep ort suggests that the 1998 Acheson report has been extremely influential in shaping Health care policies in the UK and reducing inequalities in health.BibliographyPrimary health care in Londonchanges since the Acheson report. BMJ. 1992 Nov 7305(6862)1130-3.Tarlov AR.Public policy frameworks for improving population health. Ann N Y Acad Sci. 1999896281-93.Blane D.Health inequality and public policy one year on from the Acheson report. J Epidemiol Community Health. 1999 Dec53(12)748.Williams A.Commentary on the Acheson report. Health Econ. 1999 Jun8(4)297-9.Barnes R, Scott-Samuel A.The Acheson report beyond parenthood and apple pie? J Epidemiol Community Health. 1999 Jun53(6)322-3.Spencer NJ.The Acheson report challenges for the College. Arch Dis Child. 1999 Jun80(6)576-8.Better benefits for health plan to implement the central recommendation of the Acheson report. BMJ. 1999 louse up 13318(7185)724-7.Acheson D.Inequalities in health. Report on inequalities in health did give priority for steps to be tackled. BMJ. 1998 Dec 12317(7173)1659.Oliver A, Nutbeam D. Addressing health inequalities in the coupled Kingdom a case study. J Public Health Med. 2003 Dec25(4)281-7.Kisely S, Jones J.Acheson revisited public health medicine ten years after the Acheson Report. Public Health. 1997 Nov111(6)361-4. in like manner see DH publicationsChoosing Health White Paper, DH, 2004NHS Plan, DH publication 2004Acheson Report, DH publication, 1998Inequalities in health, DH publication 1998NHS Improvement Plan, 2004www.dh.gov.uk

The Customer Satisfaction By Measuring Service Quality Tourism Essay

The Customer Satisfaction By Measuring dish Quality Tourism EssayThe measurement and trouble of utility whole tone argon fundamental to the survival and success of answer companies Legcevic, 2008. The hotel sector is a large segment of the servicing industry which provides work and accommodations to a grand range of guests. To cite sure that a hotel is satisfying its guests needs, it is necessary to measure answer timber periodically to identify areas in need of improvement. there are several methodologies used for measuring military serve well whole tone, but this look into study shall employ one of the more popular simulates called the SERVQUAL model. This theory was developed by Parasuraman, Zeithaml and Berry. They were archeozoic enquiryers studies or so the concept of quality (Jain and Gupta, 2004). The SERVQUAL model was created to measure helper quality as perceived by the guest (Parasuraman et al., 1985).According to promised land Hotels Annual p romulgate of year 2008 and 2009, the occupancy rate of the promised land Hotel, Bangkok has slide downd continuously ( nirvana Asia expressage, 2008, Shangri-La Asia Limited, 2009). The most likely cause of this job is the political instability that hit Thailand recently. On the other hand, it is possible that this decline in the number of clients was a result of a decline in avail quality. Even though the Shangri-La Hotel continue to emphasize customer needs and provide excellent avail to their customers, it is still crucial to measure service quality to ensure that the customers are satisfied with the hotels operate and responsiveness to customer needs. The result of measuring service quality also helps management to understand exactly what their customers expect from the hotel and the level to which they are satisfied with their own at the hotel. This measurement model functions as a tool to bring up communication between the hotel management and their customers.This rese arch was conducted to observe customer perceptions about hotel services by measuring service quality use the SERVQUAL model at the Shangri-La Hotel, Bangkok. The benefits of this research are not just to understand the level of customer satisfaction but moreover, it can use as a guideline to enhance service quality and promote customer loyalty.Title of projectA Study of Customer Satisfaction by Measuring dish out Quality A Case Study of Shangri-La Hotel, BangkokStatement of research problemA continual decline in the number of hotel customers over the past few months has had a direct effect on the hotels income. The main factor which is believed to sire caused this decline was internal political instability in Thailand. In an effort to transform a crisis into opportunity, this is an appropriate time to observe customer perceptions of service quality in army to help hotel management improve quality and prepare their business for when the situation returns to normal.Project objecti vesThe objectives of this research are as followsTo measure service quality of Shangri-La hotel, Bangkok by using SERVQUAL model,To understand the relationship between customer satisfaction and service quality, andTo gain a clearer understanding of customer perceptions of service quality from Shangri-La Hotel, Bangkok in order to improve hotel service quality in the future.Conceptual frameworkReliabilitySERVQUAL DimensionsResponsiveness say-soCustomer SatisfactionEmpathyTangiblesScope of the studyThe scope of this research focuses on measurement of service quality at the Shangri-La Hotel, Bangkok by using the SERVQUAL model which considers service quality from the following five dimensions a) reliability, b) responsiveness, c) assurance, d) empathy and e) tangibility. The strain population would be a hit-or-miss smack of 100 hotel customers during the period from June to July, 2010. The survey technique would employ the use of questionnaires. This study focuses on the relationsh ip between customer satisfaction and service quality.Definitions of terms used in the studySERVQUAL model An operator for measuring service quality comprised of five dimensions such as a) reliability, b) responsiveness, c) assurance, d) empathy and e) tangibility. Parasuraman summed up that customers perceive service quality by comparing their expectations with the actual organizational surgery, and they appraise service quality in incompatible dimensions (Parasuraman et al., 1988). serve well Quality A proceeds or outcome of all the round managers of the Shangri-La Hotel, Bangkok operative together to satisfy their customers. In other words, noble-quality service is a service that meets or exceeds customer needs and expectations (Wisniewski, 2001).Customer Expectation is prediction service of customer that hotel should be provide to them. Predict service directly influence customer satisfaction evaluation (Zeithaml et al., 1993)Customer Perception A sense of touch or whi z possessed by the customer which is derived from their experiences at the hotel.Customer Satisfaction The level to which a customer perceives that their expectations were met in the transaction with the hotel (Hallowell, 1996).AssumptionsA customer who receives a high level of service quality from the Shangri-La Hotel, Bangkok is more likely to be satisfied with the overall level of service at the hotel.LimitationsSize of sample The political doubtfulness in Thailand during the past several months resulted in a decrease in the number of tourists all over Bangkok. Furthermore, the occupancy level at the Shangri-La Hotel, Bangkok has been suppressed due to a reduction in room availability for internal renovations. The limited number of hotel customers may limit the sample size, leading to sample error.Time frame of entropy collection The time frame is a major problem for this research because the research time gameboard is quite short, especially considering that this season is th e low season for tourism in Thailand. Since the tourist numbers are much lower than during high season, it could be baffling or impossible to r from each one the appropriate sample size.Human ethics considerationsThis research is being conducted for educational purposes to learn about customer satisfaction at the Shangri-La Hotel, Bangkok. For this reason, the hotels management is allowing researchers to collect data from their customers. Therefore, the researchers should not force the customers to complete the questionnaire if they are hesitant. The questionnaire is being designed so that it does not contain sensitive items which would make customers feel uncomfortable.Practical significanceMeasuring service quality is more difficult than measuring the quality of manufactured goods because the nature of services is intangible (Bergman and Klefsjo, 1994). The SERVQUAL model is an efficient tool to help measure service quality and clarify customer satisfaction. The result of this re search would be useful for the Shangri-La Hotels management and staff members so that they can better understand their customers level of satisfaction with perceptions about the hotels services. It volition help hotel management in their efforts to maintain and improve hotel service quality. In add togetherition, other hoteliers and organizations within the service industries sector could adapt this research to use as basis for studies into their own organizations.Background infoShangri-La Hotels and Resorts is a well-established Asian hotel chain in major cities throughout Asia, Oceania and The Middle East. The headquarters is primed(p) in Hong Kong. Shangri-La Hotel, Bangkok is one property of many properties of Shangri-La Company, located in the Silom district, has a total of 799 rooms including serviced a pctments and other facilities such as restaurants, conference rooms, spa, swimming pool and tennis courts (Shangri-La Hotel, 2010).Shangri-La Hotel, Bangkok is located in a convenient place next to the Chao Phraya River which is the main river of Thailand, and is only half an hour from Suvarnabhumi Airport and 10 minutes away from central business by BTS Skytrain. For these reasons, this hotel has the ability to attract numerous tourists. Furthermore, Shangri-La Hotel, Bangkok is connected to Sathorn Pier, so tourists can take public boats or long tail boats to travel to and natter several kinds of tourist attractions easily such as the Temple of Dawn, the Grand Palace, the Flower Market and Khaosan Road. There is a high diversity of tourism industries which promote the economy in this district and along this river.However, in recent years, the Thai economy has experienced difficulty for a variety of reasons. Figures 1 and 2 equate the performance of Shangri-La Hotels and Resorts in the period from 2007 to 2008 with the period from 2008 to 2009.Figure 1 The Shangri-La Hotel Weighted Average Room Yield 2007-2008Source Shangri-La Asia Limited (2008)F igure 2 The Shangri-La Hotel Weighted Average Room Yields 2008-2009Source Shangri-La Asia Limited (2009)The figures above show that there was a significant decline in the performance of Shangri-La Hotels and Resorts, Thailand in 2008 compared with 2007, and this decline in performance continued into 2009 with a drop on average room occupancy.According to the 2008 Shangri-La Asia Limited Annual Report, occupancy and RevPAR for Shangri-La Hotels decreased in 2008 by 15 and 10 percentage points respectively (Shangri-La Asia Limited, 2008). Moreover, the overall weighted average RevPAR for Shangri-La Hotel and Resorts Thai properties decreased a further 11 percent in 2009 (Shangri-La Asia Limited, 2009). The global financial crisis, the extensive renovations at the Shangri-La Hotel, Bangkok and political uncertainty are cited as the main reasons for this decline.Literature reviewThere are several pieces of literature regarding studies of service quality which say that if a customer had a pleasant service experience, they would probably use that service again and would be likely to invite their friends or tell some(prenominal)one else to utilize those analogous services. In the same way, if customer had a poor service experience, they generally never forget about it, and many customers will complain and go elsewhere (Assael, 1987, Farrington et al., 2009, scape and Olson, 1987).Word of mouth is a powerful communications tool. Customers may tell others whenever they experience poor service quality, and this would have a direct effect on the organizations image resulting in an eventual decrease in revenue. The power of this communications tool has always been evident from the past until the present. Consequently, organizations must always ensure that their service quality is the most pleasant and best to generate customers satisfaction. This is because the backbone of service organization growth is not just a high quality point of intersection or pricing strateg y, but it is also the combination with good customer service. When customers receive good service the outcomes are positive(Farrington et al., 2009).Nowadays, companies increasingly emphasize service quality and customer satisfaction throughout, so that they can increase customer loyalty, because it has determined that high customer loyalty is key to success in their market segment(Cronin et al., 2000). aid quality is widely studied and useful in service industries(Carman, 1990, Collier and Bienstock, 2006, Cronin and Taylor, 1992, Cronin et al., 2000, Gronroos, 1984, Parasuraman et al., 1985, Parasuraman et al., 1988). Many scholars have taken an interest in service quality issues because of their intangibility, which makes them truly difficult to measure (Bergman and Klefsjo, 1994). For these reasons, several researchers created a model to help clarify the measurement of service quality. The most popular and extensively used models are Gronroos military service Quality Model an d Parasuramans Gap Model (Legcevic, 2008). It could be describes of each model as followingGronroos Service Quality Model splits customer perceived service into two dimensions 1) technical quality, and 2) functional quality (Gronroos, 1984).1) Technical quality or outcome quality is what customer receives as outcome of the bear on in the resources. serviceable quality is how customer receives from technical outcome (Legcevic, 2008).Parasuramans Gap Model indicates that five wisecracks exist between management and customers during the service delivery process (Parasuraman et al., 1985). For my research, I will employ the SERVQUAL scale by using gap scores to help measure service quality.Service QualityToday quality become recognised as a strategic tool to enhance and improven business actual performance both of goods sector and service sector. The key factor to success in service industry is service quality. The purpose of service quality is to satisfy the customer. Hence, service quality and customer satisfaction influence each other. As mentioned in the beginning, service quality is defined as a product or outcome resulting from all members in the organization trying to satisfy their customers (Wisniewski, 2001). Service quality also could be defined as crucial decision-making criteria for service consumers (Cronin et al., 2000). Customers evaluate service quality by comparing organizational performance with their expectations (Zeithaml et al., 1993). However, Parasuraman proved and indicated that there is a problem with customer perception of service, because five gaps exist between the customer and the service provider during service delivery. The figure below illustrates the Service Quality Gap Model by Parasuraman.Figure 4 The Service Quality Gap ModelSource Parasuraman, Zeithaml, and Berry (1985)According to figure as above, it could be describes each gap as followingGap1 Service provider not knowing what the customers expectGap2 Service provider not training the right service designGap3 Service provider not delivering to service standardGap4 Service provider not matching performance to promisesGap5 The difference between customer expectations and customer perceived service (Legcevic, 2008)A gap which may occur between customer expectation and customer perception is not the only measurement of service quality. However, it is a determinant of customer satisfaction or dissatisfaction. If the service providers response to customer needs is below their expectations, the customer would estimate that the quality is low. Measuring the gap between expected and perceived service is a routine method of utilizing customer feedback(Pizam and Ellis, 1999).SERVQUAL ScaleThe main benefit of the SERVQUAL legal document is that it helps management to measure the quality of service by comparing customers expectation of service and customer perceived service which categorizing each problem facet into five dimensions. It lets them classify the prob lems into dimensions, helping management to focus on the problems and improve service quality in the right way when some elements of service are install to be lacking. The SERVQUAL model was created by Parasuraman, Zeithaml and Berry in 1985. The 1985 version consisted of ten dimensions. The model was further developed, and in 1988 it was refined into five dimensions. The SERVQUAL model has been widely used as an efficient instrument for measuring service quality in many service industries (Asubonteng et al., 1996). The five dimensions are 1) reliability, 2) responsiveness, 3) assurance, 4) empathy and 5) tangible. According to Parasuraman, Zeithaml and Berry (1985), they defined each dimensions as followsReliability magnate to perform the promised service dependably and accuratelyResponsivenessWillingness to help customers and provide prompt serviceAssuranceKnowledge and courtesy of employees and their ability to inspire curse and confidenceEmpathyCaring, individualized attention the firm provides its customersTangiblePhysical facilities, equipment, and appearance of personnelThe most important dimension that the customer used to evaluate service quality is the reliability dimension (Legcevic, 2008). Parasuraman developed a set of questionnaires using 22 parallel questions to measure customers expectation of service and customer perception of service in the five dimensions. The measurement uses a Likert Scale with seven levels ranging from strongly agree to strongly disagree. The service quality measurement of each pair of questions uses performance minus expectation. A positive score represents positive service quality (Parasuraman et al., 1988).Quality = Performance ExpectationNevertheless, there are numerous of academic studies which do not support these five dimensions. These studies determined that problems occur with this measurement method. Chen (2008) argued that SERVQUAL should add more dimensions to give the result more validity and credibility ( Chen, 2008). Carman (1990) argued that each dimension should not be general because each service industry is different. Therefore, this model could not be used in the same format crossways industries (Carman, 1990). Although, there are weak points existing in SERVQUAL model, the concept of dimensions is still useful and when anyone interested in service quality issue, one choice which actuate is SERVQUAL scale because its great to demonstrative power (Jain and Gupta, 2004). Then, it is used frequently today.SERVPERF ScaleWhen discuss about SERVQUAL scale, it can not forgot to talks about SERVPERF scale as well. SERVPERF is one of service quality measurement scale. The results of both scale (SERVQUAL and SERVPERF), when compare these method to each other, the result which occurs are quite similar. However, there are differences in measuring process. Moreover, it is difference in reliability. To classify divergence between SERVQUAL scale and SERVPERF could be concise explain as foll owing SERVQUAL use customers expectation of service and customer perceived service to find service quality while SERVPERF use only customers perception for consideration. Cronin and Taylor (1992) compare between these two scales a found that SERVPERF is enough for measure service quality. However, the SERVQUAL scale is effective than SERVPERF scale because it provide more pragmatic diagnosis of service quality (Jain and Gupta, 2004).Customer SatisfactionThere are plentiful researchers studies on customer satisfaction. The definition of customer satisfaction is also diverse. Pizam and Ellis(1999) states that customer satisfaction is a psychological concept relating to a feeling of pleasure and well-being which is a result between needs in mind and an appealing product or service (Pizam and Ellis, 1999). The sense of satisfaction brings about positive attitudes which leads a customer seek that satisfying experience again (Assael, 1987).Customer satisfaction also has an influence on co rporate survival. Naumann (1995) states that in order to attract a new customer, an organization has to pay costs in the form of time and resources equal to approximately five times that which is necessary to wait an existing customer (Naumann, 1995). Therefore, it leads the organization to determine quality as the ability to retain existing customers.However, not every customer will perceive the same level of satisfaction with the same level of service, because their sense of satisfaction is related to word of mouth communication and their past experiences (Pizam and Ellis, 1999). All people have had different experiences, thus they also have different objectives, needs and expectations. To ensure that the organization provides a high level of service quality, customer satisfaction surveys are necessary. Parasuraman, Zeithaml, and Bery (1994) suggested that product quality, service quality, and price are each factors that encourage satisfaction (Parasuraman et al., 1994). Customer loyalty develops when customers become satisfied with these different factors provided by the organization (Farrington et al., 2009). The following is a conceptual framework showing the connection of each element which involves customer satisfaction.Figure 3 A Conceptual Framework for the Effects of Perceived growth Quality, Service Quality, and Pricing Fairness on Consumer Satisfaction and Consumer LoyaltyCustomer SatisfactionProduct QualityPerceived Product QualityPerceived Service QualityService QualityCustomer LoyaltyPerceived Price FairnessPriceSource (Bei and Chiao, 2001)Understanding the critical elements described above, how they are related, and how they help the organization is a foundation to success in the service industry. information requiredThe data required for this study would be based in information collected from Shangri-La Hotel, Bangkok customers. This research also requires the use of SERVQUAL as the main model to help measure service quality. Furthermore, ma y utilize some other theories from journal articles and textbooks which are related to this research. Other sources of information may include Shangri-La Hotel and Resorts information, particularly with regards to general information and occupancy data as required supporting in this research.Data sourcesThis research will utilize the following two types of dataPrimary data The primary data for this research will be collected from 100 hotel customers who stay at the Shangri-La Hotel, Bangkok for least one night. The guests will be selected by simple random sampling technique, and they will fill out questionnaires regarding hotel service quality. Each questionnaire shall contain three parts the first part will be general information, the abet part will be about the expectations, perceived service quality and third part is level of satisfaction of the customer.Secondary data The secondary data will be gathered from literature such as journal articles, textbooks, Shangri-la Hotel, Bang kok data and hotel website sources. The process of data collection shall be conducted from June to July, 2010.Data collection techniquesThis research would be collects the data from 100 of customers of Shangri-La hotel, Bangkok who stay at the hotel at least one night. The researcher would be select population sample by employ random sampling method and using questionnaire as the tools. The measuring service quality instrument in this research is SERVQUAL. The questionnaire composes of three parts as followingFirst part is about demographic data of customers (gender, age, nationality, occupation, reason for stay, how often that they have been stay at Shangri-La hotel, Bangkok and why they selected here as a place to stay).Second part, it would be focusing on customers expectation of service quality (customers expectations) and received service quality (customers perceptions), in this area customer would answer both of these two aspects into SERVQUAL dimensions. This research would u se Likerts scale to measure into five point scales. Likerts scale is a instrument to help measure attitude and opinion (Laerhoven et al., 2004). On the customers expectation question side would be ask customer to rate ranging from Very gratuitous 1,2,3,4,5 Very necessary. On the customers perceive service question side would be ask customer to rate ranging from Very poor 1,2,3,4,5 Very good.Third part would be ask customer one question about their satisfaction of overall hotel service quality. In addition, researcher would leave the area for customer to add any recommendation.Data analysisAs for this research would be use SPSS program (Statistic Package for Social Science) to help analyze questionnaire survey.TimelineResearcher has 13 weeks to process this report. This research process began on May 22, 2010. Due date of research proposal is on June 20, 2009. As for research final report is require to be submit on August 15, 2010

Hydrogen Fuel Cell Essay -- Science Energy Power Papers

Hydrogen Fuel CellThe Hydrogen Fuel Cell could revolutionize the world. This ingenious technology, which creates electrical energy from the chemical reactions of enthalpy and oxygen has, in its 150-year history, passed many of the critical tests along the path from invention to innovation. Recent developments in fuel cell technology and coinciding developments within the energy and automotive industries have brought the world to brink of the fuel cell age and the hydrogen economy. The future is, however, inherently murky. Fuel cells still view significant technological, political and economic hurdles before they can realize their truly awesome potential difference. An examination of these hurdles, set to the backdrop of an explanation of the current state of the art in fuel cell technology and the current and developing economic and regulatory landscape, will provide insights into much touted future of the fuel cell. In the near future, the fuel cell will come to play a much more prominent role in the world energy economy. The period to which this innovation will revolutionize the world will depend on any number of technological, economic and political factors.In order to understand the potential impact and resulting policy implications of the fuel cell, it is first necessary to explain the technology of the fuel cell. The fuel cell utilizes the chemical properties of hydrogen to go an electrical current. ...They produce an electric current by intercepting the electrons that flow from one reactant to the other in an electrochemical reaction.1 Fuel cells require only a fuel containing hydrogen and oxygen, usually from atmospheric air, to produce electricity. A fuel cell that utilizes pure hydrogen produces this electricity le... ... Tax leads to burial at sea, New Scientist, 3 awful 1996. English Conference of the Parties, Kyoto Protocol to the United Nations Framework Convention on clime qualify. http//www.cnn.com/SPECICALS/1997/global.warming/stories/ treat/index4.html Cleaner Energy, The Economist. 18 April 1998. p17. Ibid. Ibid. Climate Change Information Sheet 24, UNFCCC Climate Change Information Kit. http//www.unfccc.de/resource/iuckit/fact24.html Emission Summary for CO2 in United States of America, United Nations Framework Convention of Climate Change. 11/18/99. http//www.unfccc.de The Economist. 18 April 1998. New Scientist, 3 August 1996. Filler Up With Hydrogen, Reuters, 16 August, 1999. Available on Wired News, http//www.wired.com/news/technology/0,1282,21293,00.html. Fuel cells agree big business, The Economist. 24 July 1999. Ibid Ibid

Free Essays on Terrorism: Europes Contempt Toward the U.S :: Exploratory Essays Research Papers

September 11 and Europes Contempt Toward the U.S   Lest we forget the heroic resolve of our many European allies, the French surged forward into the fray last week. Well, perhaps billow isnt quite the word, and the fray has become a meager affair as of late. Their token gesture to join the U.S. and Great Britain in orchestrating a Northern shackle victory amounts to little more than tactical cowardice, a dashing display of minced words and foot-dragging that only the French seem capable of. However symbolic the gesture, the French and their European counterparts tend to deliver such(prenominal) offerings of goodwill sealed with the usual stamp of anti-Americanism.   The irritating Euro-superiority complex recently surfaced over the issue of extraditing captured terrorists to the United States. In September, Spanish authorities infiltrated the Soldiers of Allah, a radical Islamic group based in Madrid with links to al Qaeda. The operation led to 14 arrests of get a line al Qaeda operatives and shed new light on the financing of bin Ladens operations preceding the September 11 attacks. Hundreds of millions of pesetas (i.e. millions of dollars) flowed through this unit of al Qaedas financial network. Despite this damning evidence, Spain still sniffs at the thought of extraditing the detainees to the U.S.   And what is the source of Spains moral indigestion?  The backward American justice system, of course. After all, the U.S. still employs such barbaric anachronisms as the death penalty (and even worse, a solid majority of Americans seem to support it). As evidenced by the continual stand of Spanish diplomats, the moral burden of any extradition to a country as primitive as the United States is simply too much for the collective Spanish conscience to bear. The fate of al Qaeda operatives must not be abandoned to the crude methods of American jurisprudence. Instead of rejecting such anti-Americanism, the 15 members of the European essence ech oed Spains sentiments in their sanctimonious reports to the press.   The Bush administrations establishment of military tribunals further inflamed the E.U.s righteous indignation. Several countries kindly reminded the U.S. that sending the al Qaeda henchmen across the puddle would violate the EUs extradition ban against countries that use the death penalty. This was consistent with what seems to be the E.U.s role of the meddling whiner, seizing some disputable moral high ground to go complaints instead of solutions. Perhaps the most annoying aspect of most European indignation is its paternalistic tone, as if the Americans were still reckless colonies in need of a scolding.

Largesse :: Essays Papers

Largesse The idea of chivalry encompasses the virtues of truth, honor, courage, kindness, loyalty, and valor. Combining this and many early(a) benevolent traits make the ideal knight. Being a knight means something more than just armor, weaponry, and a good horse. It is about a code. This code of a knight is what sets him apart from the rest of the world, defining him and the beliefs he alone stands for. A knight is bounded by honor and valor usu tout ensembley to his king, his country, and his god. In a sense, a knight is the ideal man in all aspects, physically and mentally, and as part of his characteristics exists this thing called largesse. Largesse in simple terms is generosity, the benignity of giving. Now, this did not merely mean giving money to the poor or to the church. Largesse encompasses a larger spectrum, in a sense, that makes him better able to walk the line between mercy and cold justice. One can say at one end of the spectrum is the lavish giving to the need of his vassals and allies, and at the opposite end is the giving to his king and country. At any means, great honor can be won by the open-handed noble who sees no gluttony, but smooth generosity to those among him. From Leon Gautiers Chivalry, one finds chivalry defined by prowess, loyalty, generosity, judgment, courtesy, and honor. Included with this is the 10 commandments, particularly the IX commandment--thou shalt be generous, and give largesse to everyone. For instance, in the Poem of the Cid, Rodrigo Diaz of Bivar is exiled by his King Alfonso. Along the Cids journey, he conquers many places and acquires vast wealth. Not only does he give amply to his men but also to the King Alfonso who banishes him. The Cid places the necessarily of others above his own, being charitable to others and giving to those in need, including his enemy. Those who joined him into exile have all grown rich. The renowned Campeador gave them all, in Valencia, houses and f iefs with which they are satisfied they all have tasted of the Cids generosity. Those who joined him later are content also. This clearly exemplifies the true nature of chivalry and what it is to be a knight.