Evidence-Based Practice Project Research Paper Example | Topics and Well Written Essays - 3750 words

Evidence-Based Practice Project - Research Paper Example The study found that the combination of blood glucose lowering and blood pressure medication slows the progression of microvascular complications. Similarly, the Turnbull (2009) meta-analysis study found that intensive glucose control leads to a reduced risk of major cardiovascular events, showing a reduction of 9% for major cardiovascular events. Advance Collaborative (2008) found that intensive blood glucose lowering with gliclazide and other drugs resulted in a reduced incidence of combined major macrovascular and microvascular events, as well as major microvascular events, because there also was a reduction of nephropathy. Still another study suggests that any kind of benefit attained by intensive lowering of blood glucose is lost after one year. The study conducted by Hollman et al. (2008) found that the patients who were assigned intensive glucose lowering were compared to patients who were assigned the standard treatment of dietary restriction. While the immediate results were that the intensive glucose lowering showed that the patients had a lower risk of microvascular complications then the patients with conventional dietary therapy, after one year, these advantages were lost. Introduction Patients with diabetes suffer from a variety of ailments. Among these ailments are microvascular and macrovascular diseases. Therefore, therapeutic intervention should be investigated to reduce the risks of a diabetic patient suffering from these ailments. One such intervention is aggressively lowering blood glucose levels through drugs such as glicazide. Therefore, this article will examine studies that are focused around the intervention of blood glucose lowering, and will examine whether this is an intervention that is positive for diabetic patients, with regards to lessening the risk of micro and macrovascular ailments. PICO Question In patients with Type II Diabetes Mellitus (P), what is the effect of intensively lowering the blood glucose (I) as compared with s tandard treatment (C) on the incidence of major macro- and microvascular outcomes (O)? Clinical Question Selection Criteria Inclusion Criteria 1. Journals and studies featuring patients who are who are subjected to either intensive glucose lowering or standard treatment. 2. The participants in these studies had either a microvascular or macrovascular cardiac event. 3. The journals were either randomized trials or meta-analyses. 4. Were published in peer reviewed journals. 5. Were reported in English. Exclusion Criteria 1. Journals that reported on either type I diabetes, juvenile diabetes or gestational diabetes. 2. Qualitative studies. 3. Studies that focused upon patients who were under the age of 18. Search Process The process began by looking for studies that had, as their focus, type II diabetes, intensive glucose lowering therapy verses traditional therapy and micro and macrovascular outcomes. These peer-reviewed journals were ones that were written in English. The data bases that were used were Pubmed, Psychosocial Instruments, British Nursing Index, Cumulative Index to Nursing and Allied Health Library, Psychosocial Instruments, Allied and Alternative Medicine and Sociofile. These databases were searched with the initial terms of type II diabetes, intensive glucose lowering therapy and micro and macrovascular cardiac. The articles were then narrowed down to studies that were randomized or studies which were

The spread of diseases on poor countries Research Paper

The spread of diseases on poor countries - Research Paper Example This paper illustrates that in some cases, diseases of poverty are considered to be obstacles to economic development that would curb poverty. In contrast to diseases of poverty are diseases of affluence. Affluence diseases are ailments or disabilities that are more prevalent in developed countries. Activists claim that virtually all diseases of poverty in underdeveloped countries are neglected. Many scholars argue that the pharmaceutical industry has not taken any substantial steps in investing and has failed to devote sufficient efforts in research for these diseases. It is estimated that nearly 14 million people die every year due to diseases of poverty. A large proportion of these diseases are curable with existing medicines with some actually been avoidable. Notably, most of these diseases in underdeveloped countries stems from poverty. These societies are plagued by poor nutrition, lack of access to the quality or proper sanitation, poor health education, and increased air poll ution. The World Health Organization (WHO) estimates that 45% of the diseases in underdeveloped countries are associated with poverty. Alone, Gastroenteritis which is commonly associated with diarrhea is responsible for approximately 1.9 million deaths in young children every year with the majority of these been from low-income countries. Based on research, some of these diseases have been neglected. The Centers for Disease Control and Prevention identifies these diseases as priorities for health actions considering the number of people infected. Tuberculosis is the leading diseases in causing death across the globe.

Drug trade between Mexico and the United states Essay

Drug trade between Mexico and the United states - Essay Example a Frequently asked questions style with a series of questions such as who are the major players, â€Å"What are the risks of using soldiers in the fight instead of police?† and â€Å"What progress has President Calderà ³n made dismantling cartels?† Border scholars have on the whole rejected the claim that the U.S.–Mexico border has been dissolved by late modern crossborder migrations of capital, people, and practices. This article proposes that border policing in the wake of September 11, 2001, surfaces the long-standing relative incoherence of U.S. geopolitical and geoeconomic practice. The author describes the border as a security/economy nexus in U.S. statecraft. This article examines the militarization and transnationalization of the U.S. war on drugs as a liberal technique for identifying populations that must be governed in other ways. It begins by placing its relationship with the rise of the penal state in the context of neoliberalism in the U.S., then examines the geopolitics of its transnationalization in context of neoliberal governance in the Americas, and finishes by examining some of the empirical outcomes of this articulation between neoliberalization and punitive illiberalization in the Americas. It presents political geographical research that links globalization and criminalization and maps out the geographically particular and historically continuous ways in the context of the war on drugs. This is the official website of the Drug Enforcement Agency (DEA). It has accurate information about drug trafficking in each U.S. state. It also provides government press releases and the official view of the U.S. Government on the border situation and the role of drug trafficking and the cartels in its policing. This website traces the history of the drug trafficking between Mexico and the U. S. from 1998-2009. It also identifies the attempts that both countries are making to stop this war. It provides links to hundreds of other articles on the

The spread of diseases on poor countries Research Paper

The spread of diseases on poor countries - Research Paper Example This paper illustrates that in some cases, diseases of poverty are considered to be obstacles to economic development that would curb poverty. In contrast to diseases of poverty are diseases of affluence. Affluence diseases are ailments or disabilities that are more prevalent in developed countries. Activists claim that virtually all diseases of poverty in underdeveloped countries are neglected. Many scholars argue that the pharmaceutical industry has not taken any substantial steps in investing and has failed to devote sufficient efforts in research for these diseases. It is estimated that nearly 14 million people die every year due to diseases of poverty. A large proportion of these diseases are curable with existing medicines with some actually been avoidable. Notably, most of these diseases in underdeveloped countries stems from poverty. These societies are plagued by poor nutrition, lack of access to the quality or proper sanitation, poor health education, and increased air poll ution. The World Health Organization (WHO) estimates that 45% of the diseases in underdeveloped countries are associated with poverty. Alone, Gastroenteritis which is commonly associated with diarrhea is responsible for approximately 1.9 million deaths in young children every year with the majority of these been from low-income countries. Based on research, some of these diseases have been neglected. The Centers for Disease Control and Prevention identifies these diseases as priorities for health actions considering the number of people infected. Tuberculosis is the leading diseases in causing death across the globe.

Monastic Art Essay Example for Free

Monastic Art Essay Monastic Art is subdivided in two genres the monastic ascetic art form and the aesthetic art form (Sekules 77). The portrayal of saints in the monasteries is a common theme and narrows it down to the whole religious visionaries and deities which produced those visions. The entire monastic sphere was dedicated to placing oneself in a position to receive sacred communication from God; hence it is not surprising that monasteries and convents heavily sought for visual representation of their favorite saints or God. In medieval times, monastic art was commonly etched on ceilings, walls, and frescoes to draw the viewer into a realm of holiness to enrich the artistic and religious experience. As aforementioned monastic life could either be ascetic which falls in line with the austere lives of the monks or it could be highly beautified which displayed all the wealth and glamor of the Medieval Catholic Church. Most monastic art are derived from the Byzantine model were paintings were very embellished, attractive, symbolic, and magnificent in size. At the Abbey of Santa Maria la Real de Las Huelgas, Spain, there are the Berenguela knitted cushion covers and skillfully decorated gloves, overlaid with gold and scarlet (1275). This highly decorated covers are in memoriam of Prince Fernando de la Cerda (Shadis 168). Benedictine Monasteries The Rule of St. Benedict required them to withdraw from the world into a communal life organized around prayer so that their spiritual inclinations were not directed to other areas of conformity† (Sekules 61). Because of this policy art work conforms to the standards of the monastery. Jesus Christ, Catholic saints, monasteries, the virgin Mary, holy mother and child paintings are all regular images of the medieval monastery. Benedictine monasteries boasted a wide array of art such as An Illumination of Stephen Harding (1225) at the Abbey at Citeaux. In this classic, monastic painting there are two models of monasteries, handed by two Benedictine monks, one of which is the Englishman Stephen Harding himself, which are delivered up to the virgin Mary to sanction or reject. Benedictine cloisters featured â€Å"inscriptions in windows, stonework, paintings, and manuscripts† (Luxford 11). This type of veneration is called Cisternian illumination where there is a mystic connection and communication with the divine. Golden auras and golden thrones with elaborate architectured monasteries characterize this work. Another famous Benedictine art form is Benedict of Nursia (1435) displayed at the Abbey at Florence, Italy. This painting done by Frey Angelico exhibits the simple face of St. Benedict with a holy halo encircling his head, in a grave, solemn, pensive mood, similar to what one would expect in a monastic setting. Women in Power-Medieval Feminism: The Empowered Woman Before Mary Wollenstonecraft even crafted the Declaration of Women (1791), the embryonic signs of an emerging feminist movement were already visible. Due to religious, social, and cultural dogmas and restraints, women were confined to the private sphere, unable to take part in the activities and pursuits of men. Nevertheless, a few women have propelled themselves and unwittingly their female counterparts to a whole new dimension in the Middle Ages. The woman is a recurrent depiction in Medieval Art and Architecture, not to mention in an age where in the Marian cult (and even in the Greco-Latin mythology) was venerated as goddess, saint, and intercessor. Personification of places, whether cities or countries especially as regal or armed women, are one of the oldest forms of power symbolism†(Sekules 13). Several countries have depicted women at war as their national icons for example Roma, Germania, Brittanica, Sclavenia, Columbia, Athena, Italia Turrita, Hispania, Polonia, Europa etc. The women are either portrayed as martial, royal, or both. Medieval art demonstrated the empowerment of women, where women sometimes moved out of the home space and actively engaged in business, art, warfare, and politics. Joan of Arc One of the women who stands out is Joan of Arc. Historically, Joan of Arc is lauded as a liberator of France who bravely warred against England to set free her countrymen who labored under the British yoke. â€Å"Quite apart from her saintly character, Joan’s credibility as a military leader may have gained greater currency thanks to the classical tradition that personified the authority of war in female form† (Sekules 165). Art enables social criticism. Martin Le Franc sides with Joan of Arc unique personality both as a feminist and as a woman. Through his medieval portrayal of Joan of Arc both as a heroine, military hero, and spiritual icon, he embraces her as a daring woman. â€Å"Martin Le Franc in Le Champion des Dames, a work directly inspired by the quarrel about Le Roman de la Rose, takes Joan’s part against her detractors. Their arguments focus on her belligerence, her transvestism, and her condemnation by the Church† (Warner 220). In the late-Medieval painting â€Å"Le Champion des Dames† (1450), one observes Joan of Arc holding two white flags and flanked by them in a biblical setting. Although critics say that this portrayal is anachronistic, it voices volumes in asserting the sanctity of a patriot and prophetess who received visions and supernatural messages. â€Å"Christine was an admirer of Joan (of Arc’s) achievements and a defender when she needed it† (Sekules 165). Joan of Arc, a powerful woman, inspired another medieval woman in power, Christine de Pisan, who highly esteemed Joan as a valiant, holy, and still feminine woman. Christine De Pisan Another medieval woman which broke from the social norms and launched out into the space of art, literature, and religion is Christine de Pisan (1365-1434). One could argue that because of her aristocratic status she enjoyed many more liberties than the average woman of the Middle Ages; however open prejudice and misogynist ideologies against the woman existed and was encouraged against both the lower and upper classed woman. Christine de Pisan was literate, cultivated her artistic talent, and was mistress of her household (Christine de Pisan). Although today these characteristics seem ordinary, back in the medieval times, it was a rarity for a woman, even an aristocratic one to be qualified with all these talents. Christine de Pizan was born in Italy but married to a Frenchman. De Pisan was a prolific author as she produced several essays, poems, books, ballads, and epistles. The art piece of â€Å"Christine de Pisan Writing† is not as common as it seems for women were often relegated non-scholastic tasks for the general public deemed them inferior. In the depiction of De Pisan writing, the setting is clearly at an abbey or monastery. De Pizan was also the breadwinner of her family following her husband’s passing; therefore she emerged as one of the few women who made a livelihood from writing. Numerous medieval portraits of Christine de Pisan exist where she is either consulting with people in power such as Joan of Arc (Christine de Pisan Livres des Faits des Armes et de Chevalerie, 1409), diligently writing at an abbey (Christine de Pisan Writing), or educating her others (Christine de Pisan Instructing Her Son and Christine de Pisan Lecturing a Group of Men). Convents or nunneries in the medieval period. It can be argued that nunneries and convents â€Å"offered women an element of freedom† (Medieval Convent or Nunnery). At the convents, the nuns had most commodities at their disposal and were not bound to family responsibilities, for here they concentrated on God and pursued holiness in the secluded religious life. Nuns were also enfranchised to vote in an abbess or mother superior, who in turn would govern the affairs of the female community. Since medieval times, the nunnery also was fitted with hospitals, gardens, chapels, dormitories, libraries, and a school. As a result, nuns had the unique opportunity to be holistically educated and independent. This peculiar branch of female liberation fosters artistic exploration. Art work often has appeared at convents where nuns have drawn or invented masterpieces such as †¦ Second to Nun Paintings Medieval paintings also tended to focus on holy women: whether they be goddesses or cloistered nuns and mothers. One major medieval masterpiece shows Hildegard von Bingen (1098-1179), a nun of St. Benedict of wrote books, plays, sermons, and poetry; practiced medicine, and functioned as advisor to monarchs and popes. Hildegard is indeed a medieval and modern-day feminist who was not afraid to hold and wield power even among men folk. A celebrated illustration of her is represented in Illumination from the Liber Scivias, 1151 where she receives a vision and transcribes it as a deity reveals it to her. This dynamic woman dictates the divine messages in a book called The Scivias. This portrait conveys the reality of the enlightened woman in all spheres. She too can be an instrument not only for familial purposes but in multifaceted way, contributing to society, religion, and culture. References: Christine de Pizan http://www. kirjasto. sci. fi/pizan. htm. Retrieved 06 May 2010 Les Enluminures Presents Women in Medieval Art http://www. lesenluminures. com/womencatalogue. pdf. Retrieved 06 May 2010 Luxford, Julian M. The Art and Architecture of English Benedictine Monasteries 1300-1540 A Patronage History. Boyell Press, United Kingdom, 2008. Medieval Convent or Nunnery http://www. middle-ages. org. uk/medieval-convent. nunnery. htm. Retrieved 06 May

Coca Cola Bonite Bottlers Moshi

Coca Cola Bonite Bottlers Moshi Bonite Bottling Limited (BBL) is Franchise Company operates under lances of Coca Cola Company in USA it deals with bottles and distributes twelve (12) Coca Cola brands of drinks. A subsidiary of the IPP Group of companies, Bonites main plant is located in Moshi in the Kilimanjaro region of northern Tanzania. BBL also bottles its own brand of bottled water: Kilimanjaro Drinking Water. The company operates in 4 major regions of Northern Tanzania Kilimanjaro, Arusha, Manyara and Singida. BBL has over 450 permanent employees, most of them men with only 18 women. Over 300 of the employees are based at the main plant. BBL also employs casual employees, some of whom are employed for periods of up to 6 months. In the peak season (August to Jan/February), there are approximately 400 casual employees and in the low season the number declines to about 200. COCA COLA BRANDS Varieties of Coca Cola brands produced by BBL company such as Fanta Orange, Fanta Passion, Spaleta Pinute, Spaleta Citrus, Stoney Tangawizi, Coca cola, Light Coke, Sprite, Bitter Lemon, Seven Up, Fanta Black Currant, Kilimanjaro Drinking Water, Crystal, Club soda, Ginger ale, Tonic. BBL REQUIREMENT Strategy Global partners but supplying locally, including local content market Considering BBL as a preferred customers when giving access to innovation. Transparency in terms of cost and strategy Develop Complete system supplier where it adds value. Technical skills / innovation skills. Residential chemist when required Referenced definitions of supplier development (or customer development or SC development) A supplier development should function at establishing suppliers network performance, not browbeating them into charging less or simply auditing and rewarding them. Instead, supplier development is all about on condition that suppliers with what they need to be successful in the supply chain. There some of the most important functions of a supplier development program should be aimed at achieving as following: Lower supply chain total cost A firm might be able to reduce total cost to serve a customer as a result of spending more for faster, dependable transportation because the overall cost of inventory associated with the process may be reduced by an amount greater than that being spent for premium transportation Increased profitability for all supply chain participants Increase the profit is the main objective of supply chain management the firm should focus on how can earn much profit by supply their product in the location / place where there is advantage competition. This will come out when the management will consider distributing the product in the place where it seems that demand are always increase regards to the influenced factors of that area/ place. Therefore when demand of that product having a tendency of grow up, the firm should distribute the products at a large amount to ensure the supply are always mach with demand this will lead to generate and increase profit when the supplier will sell their product at surplus cost compare general cost of the product Increased product quality Increase production quality are normally considered as strong point can support supply development because supply develop it may happen depend on the responsiveness of the consumer behavior, any consumer make consideration on the quality of the product when he/she thinking on buying product. The consumer will always motivated to buy product seems having desirable quality without fear how much expensive cost it is. Therefore for the case of firm to develop supply of their product should consider increasing quality in product or services compare to other competitors in the market. Near-perfect on-time-delivery at each point in the supply chain The presence of the product or services once its needed on time within a market it always make consumer having confidence of utilize that product and after being common to them it became very hard for another product to replace the uses of this product among consumers. The supply development also influenced with the behavior of delivery product/services into the market, Providing information about products, expected sales growth, etc. Presence of communication about product/ services is one of the biggest factor influenced developed of the supply chain network. Lack of information translates into additional costs (usually in the form of just-in-case inventory). Suppliers need to become extensions of their customers. Training in the application of lean and quality tools. Asking suppliers to drop their price without giving them the know-how to lower their costs through lean implementation is not sustainable long-term. In other words, this will drive suppliers out of business, which goes against the purpose of supplier development SUPPLY CHAIN According to John, J.J et al (2009) Efficient and Effective supply chain can free up valuable resources and improve customer fulfillment system so as to increase return on investment or assets and improve shareholder value. The performance of supply chain must be measured in team of overall corporate goal for success. Supply chain need to focus on the customer at the end of the supply chain and be flexible and responsive. Supply chain can be determined with capital consumption since they impact working capital, Inventory level, and other assets such as warehouse The foundations needed for successful development Dignified process for selecting items for supplier integration Supply management should focus on determine the kinds of the services and material used for the implementation and successful of the new product. Supply management should make estimation of the total costs of the materials and services which will help on making right decision either to implement and authorized in the new product develop process. Supply management should also control and monitor all actions that will be involved in the supply market to prepare and fixed cost of the product in the market. Also supply management has responsibility of examine and invite new technology innovation that could help to increase supply development. Use of cross-function team for supplier evaluation and selection Evaluation and selection by using cross-function team to formulate supplier team contribute much on the how supply chain could be developed, supply management has responsibility on evaluate and select a team which could uses to achieving the target objectives. These teams must building by selecting those suppliers who are creative and innovator who can be able to survive on the market. Early supplier selection for both design work and full volume production The early supplier selection helping on formulating team which will be used to eliminate obstacles could being faced supply management by putting effort and consideration in the following: Targets, This will involved in ensure that the supply can achieve on target regarding quality of the product, cost and other performance criteria. Timing, the supplier should be able to deliver their products/ services on time and before deadline. Innovation Technical: The supplier should acquire expertise and physical factor to develop an adequate output and solve the problem when they occur. Supplier membership and participation on the buying companys project team. The membership and association of the supplier members with the buying product companys team should increase availability of efficient of the services agreement between them. Direct cross-function intercompany communication during the project Co-location of buyer and supplier company personnel. Formal business unit trust development efforts Sharing of technology between buyer and supplier companies. The ability of sharing technology between buyer and supplier increase assurance of supply development when the buyer explain to the suppliers how could they being satisfied when the new technology will be involved on making and increase quality on the products. Joint education/training effort between buyer and supplier companies. The training and education about product supplied should be implemented between buyer and suppliers, this well helping on increase supply development when the buyer will be aware of about product quality and improvement which could What it seeks to achieve (its objectives): The Objectives for BBL Company The target of BBL objectives of supply chain is about to maximize the overall value generated. The value a supply chain generates is the difference between what the final product is worth to the customers and the cost of supply chain incurs in fillings the customers request. Supply chain value: difference between what the final products is worth to the customer and the effort the supply chain expends in filling the customers request Value is correlated to supply chain profitability (difference between revenue generated from the customer and the overall cost across the supply chain) To improve technology is the among of the objective for supply chain management of the BBL that should always examined to ensure the goal of attaining profit has implemented To control and promote total quality supply management, this is also objective of the Suppliers chain strategic of BBL, they are focus on arrange and prepare guides which will be suitable for the whole process of controlling supply and ensure the acquire profit. Logistics (just time practice) this is another objective of the BBL supply development to ensure that the material and all items needed for the making product to be available prepare on time. The assurance of availability of material once it needed it will help on making products at on time there therefore it reduce tendency of delay in the market. Another objective is to determined and establishing pricing policy of the products, this will be done after the market researcher make analysis and survey in the all place where targeted for supply process for product, The pricing will involved the general cost for product include the cost for supply and targeted profit which will also totalized and forming product price for the last consumer Sources of supply chain revenue: Source of supply chain revenue is also considered by BBL as objective for supply development. This objective are conducted by the supplier team to ensure they achieved on generate revenue at resulted on implementation of the Sources of supply chain cost: flows of information, products, or funds between stages of the supply chain The reason and driving forces for suppliers (or customer or SC) development actually to take place According to Chopra, S. and Meindl, (2007) The strategic fit requires that a company supply chain achieves the balance between responsiveness and efficiency that best meets the needs of the companys competitive strategy, this involves drivers of supply chain performance. Facilities: physical location in the supply chain network where products is stored, assembly or fabricated. Facilities are categorized into two parts which is production sites and storage sites. Inventory: raw materials, work in process and finished goods within a supply chain Transportation: is the means of moving inventory from point to point in supply chain.. Information: is potentially the biggest driver of supply chain performance because it directly affects each of the other drives. Data and analysis concerning facilities, inventory, transportation, costs, price, and customer throughout the supply chain responsive and more efficient. Pricing: This determines how much a firm will charge for goods and services that it makes available in the supply chain. It affects the behavior of the buyer of the goods or services, thus affects supply chain performance. Sourcing: Is the choice of who will perfume a particular supply chain activity such as production, storage, transportation or the management of information. What supplier (or customer or SC) development actually is in real life. Supply development has been examined by the real life example of the company which used her has case study. The survey has been taken which could help to develop suppliers together with the problems to successes of the suppliers development strategic of the company. The benchmarking survey has been focused on the critical strategic of the supply chain management and procurement. The results of the response rate for the supplier development from BBL include the following indication: Industry product (78%), Service (7%), Consumer non-durable products (13%), capital goods (2%), Consumer durable product (5%) The survey of this indications help to study targets areas after make research and interviews with purchasing executive, quality managers and operation market managers in the BBL company. It help on making comparison of the other competitors of the same products manufacture The different types (or categories) of cross-company improvement initiatives that take place (eg. Manufacturing quality/cost/delivery, process, design, communication, knowledge sharing and learning, infrastructure improvement etc The, Company purchases sweeteners, carbon dioxide, plastic bottles, cans, closures, other containers and other packaging materials as well as equipment for the production, distribution and marketing of soft drinks. Except for sweeteners, cans, carbon dioxide and plastic bottles, the Company purchases its raw materials from multiple suppliers. Cross Company is the situation where by the manufactured company complete the whole procedure of manufacture product by intermediate with other company which supplied the initial materials which will be assembled together and forming products from origin company. Cross company involve the presence of other manufactured products which will combined together from different company and manufacture the product, this working as interlinking between companies where the communication are made and agreement established Who is involved in making it happen? Supplier relationship at BBL happened when involves the different level and types of intellectual persons who will evaluate and control the whole process of supply in order to achieve the targeted result. Any supplier who wishes to be BBL supplier needed to understand and accept BBL core values. Evaluation: BBL evaluates the request application for supplier membership in order to select the potential suppliers who can perform well in their position. Selection: After evaluation complete, source committees decide on the suppliers to be awarded as their requesting The supply chain management for BBL company has categories their distribution process at different levels as indicated from above cycle view, the cycle view of supply chains gives detail on how distribution taking place and the stage where products should passed and reached to consumer The first phase Supplier- manufacture:In this phase the process of procurement has been involved, suppliers are distribute materials and other facilities which are used to produce and manufacture product, Company purchases sweeteners, carbon dioxide, plastic bottles, cans, closures, other containers and other packaging materials as well as equipment for the production, distribution and marketing of soft drinks. Except for sweeteners, cans, carbon dioxide and plastic bottles, the Company purchases its raw materials from multiple suppliers. As describe by Coca-Cola Bottling Co. Consolidated(2006) The Company purchases substantially all of its plastic bottles (20-ounce, half liter, 390 ml and 2 liter sizes) from manufacturing plants which are owned and operated by two cooperatives of Coca-Cola bottlers, including the Company. None of the materials or supplies used by the Company are in short supply, although the supply of specific materials (including plastic bottles, which are formulated using petroleum-based products) could be adversely affected by strikes, weather conditions, governmental controls or national emergency conditions. Second phase, Manufacture-Distributer, After manufactured products by BBL company then it taking by the distribute/ supplier team who are arranged on how to conduct the all process of distributing in the place where having a duties to supply softness drinking, this distributors located and having distribution centre known as depot which is in each region where the company deal with. This involve the process of manufacture cycle where until manufacture process of the products will be completed, then the movement of products to the distributer will follower, the department of supply management take responsibility of known to whom, when and how the distribution will take place just in time without delay for update and motivate supply development. Third phase, Distributer- Retailer: the BBL company also introduces this system of supply where the retailers are invited to working together as agent for BBL company, after agreement between company, they will operate as agent and will be given discount when they buying products which will help them to survive in the market Fourth phase, Retailer Consumer: this is last stage where the products come to the hand of last consumer where BBL company intended to produce and manufacturing product to became consumed by the last consumer and the BBL supply management has read estimate the price where should paying by consumer to generate profit of suppliers. According to Ramsey ( 2001) Unique purchasing activities that are strategically oriented toward accomplishing firms goal, help the firm to sustain its competitive advantage As describe by Carr and Pearson (2002) The purchasing functions capabilities indicate that the activities performed by purchasing as well as the other functional areas, contribute to a firms total capabilities. How is it achieved (e.g. the various approaches that are used) using real life examples where possible. To establishing and maintaining to achieve Supply Development for BBL company considered the different aspect related with supply chain management There various approaches have been used to achieve Supply Development for BBL company the real life examples as also being involved. How its achieved has indicated by three stage where have been involved to make positive result of supply development. These three stages as following: PART 1. ANALYSIS The role of purchasing and supply chain Industrial buying behavior (Decision making in purchasing) Purchasing management process Purchasing and facilities management Buying business services Public procurement Market structure and supply market research PART 2. STRATEGY AND PLANNING Outsourcing and Risk management Purchasing and business strategy Category sourcing: Getting better result from supplier Purchasing, innovation and quality control Purchasing and supply chain management Getting organized for purchasing Purchasing Performance Management PART 3 PRACTISES Supplier assessment and supplier Development Supplies/ Buying for retailer company Purchasing, social responsibilities and ethics The risks, costs and benefits to each party, and if/how they are measured. Risk According to Bowerson, D.J ed al (2010) Risks that have substantial supply chain include: Production Complexity refers to the number of the product design variation that the firm decides to offer and corresponding support. The required activities include all actions related to product development, sourcing, manufacture, delivery, and aftermarket support. Complexity management is the collective set of decisions, supporting process, value systems and initiative pertaining to the most effective product portfolio such as the mix of product variants, features sets, and component choices Benefits for Production Complexity: Better product development Improved product quality and reliability Improved demand/ forecasting/ Customer Services Lower sales support cost/ resource Increased flexibility and reduce lead time Regulatory Supply chain management involve many interactions with external parties such as consumer, supplier, government, and competitors, As a result, supply chain management is increasingly subject to regulation protecting individual, commerce, and the environment. A promotional law may proved financial or tax advantages for completing supply chain activity in a specific country or region. National, regional, and local taxes can impact supply chain design in multiple ways including property, Income and value added taxes (VAT) Resource Availability While global supply chain operations can significantly increase firm opportunities in term of resource availability, technology, and market access, they also substantially increase dependence on critical resources including expertise and transport capability. Significant changes in the availability or cost of these resource can dramatically change supply chain design and operations. The main part considered when discussed on resource availability as following: Supply chain expertise Most important, Supply Chain Management professional should have experience in multiple supply chain functions and must be able to lead or direct the design, implementation, and management of cross-functional supply chain solutions Dischinger et al. have suggested that a true supply chain management executive must have skills and capabilities in five areas (1) Functional Skills (2) Technical Skill (3) Leadership Skills (4) Global Management (5) Experience and Credibility Transport capability The result of dramatic fluctuation in fuel and resulting transportation cost is that supply chain must be regularly reassessed to determine what network structure and strategy are best for a firm Outsourcing Another means that firms are using to manage risk is the use of logistics and supply chain outsourcing to third- party logistic (3PL) firms or Logistics intergrators. Security Cost The cost which has been involved in the supply chain of the products including the costs of acquired warehouse, transport, capital for storage. The supply developed will be sustain and continues if the warehouse will be allocated in the place where its targeted as point for develop supply chain network. Where by lease or by building new warehouse but in any way the cost will be involved Transport cost also are the cost which are always involved in the process of the supply development, this cost normally involved in the cost of the product when suppliers or supply management estimate on the price of the products. Benefits 10. What targets and measures are used to justify undertaking the development activity. To produce a large volume of BBL products and develop its internal and external market share through distribution and supply a large and wider range of products. To promote ability of the manufacture PET performs will also need for the presence of strategic for supply chain management this will help to measure and justify the development activities which has been undertaking by the BBL company. The way of communication between suppliers and buyer will also provide in which extent the development activities has been achieved. This may result for the The collection of performance measures, characteristics, and information describing the current supply environment is called the situation analysis. There some of the topics frequently covered during an internal review. The purpose of the internal review is not detailed data collection but rather a diagnostic look at current logistic processes and procedures as well as probe to determine what type of data are available. The market assessment is review of the trend and service demands required by customers. The market assessment objective is to document and formalized customers perceptions and desires with regard to potential changes in the firms supply capabilities. Any lessons learnt or mistake made. There are Common Supply Chain Problems Do BBL Face Regardless of the Economic Situation? The BBL company has been always working on establishing the performance of the supply chain network but there some mistakes has been done which remain has hindrance of achieving some of the objectives. For example, they know that they cant tread water on developing their people, while their competitors maintain focus. They know the time will never be better to address the strategic issues they face: The mistakes which have being involved that should be addressed and finding for solutions are: Too Much Slow-Moving and Obsolete Inventory Companies struggle with stepping up to the problem of disposing of obsolete product in a timely manner. There is always the resistance to reduce price. Unfortunately, this product never gets more valuable. It sits there month after month consuming cash, and incurring inventory holding costs until it is finally scrapped or sold at a steep discount, sometimes literally years afterward. Its a classic case of pay me nowà ¢Ã¢â€š ¬Ã‚ ¦.or pay me more later. Supply Chain Considerations Not Part of the Product Design Process When product design engineers develop a new product, they rarely consider inventory, transportation, or warehousing issues. Sometimes small changes in a product configuration  can yield big logistics savings. This applies to retailers as well as manufacturers. Retailers should not ignore the new product development process in their suppliers. No Supply Chain Strategy It is surprising that few firms have a documented supply chain strategy. Such a strategy starts with assessing the future needs of their customers. The strategy development process then determines the new supply chain capabilities the company will need in the future to meet its customers needs. Eventually specific initiatives need to be chartered to deliver these capabilities. Unfortunately most supply chain organizations are so consumed with the daily battles of cutting cost, managing inventory, and delivering good customer service that that they dont plan properly for the future, sometimes with disastrous results. Ineffective Matching of Supply with Demand This problem stems from the classic struggle among functional silos in most companies. On an overly simplistic basis, Sales is driven by revenue generation, while Operations strives to cut cost. Often these goals conflict with each other. Leading firms address this issue by establishing a Sales and Operations Planning process to align the various corporate functions around a plan that matches supply capabilities with demand requirements. Most firms attempt to do this, but most would acknowledge that they still have a long way to go. Physical Network Problems Where should warehouses be placed in this era of incredibly volatile transportation costs? This question is a very prominent topic today. Just a few months ago it seems, transportation cost were being driven up rapidly driven by the cost of fuel, driver shortages and other factors. Now everyone expects that situation to return, but who knows when? Logisticians are confused to say the least; and the old answers dont work anymore. One thing is certain however. All firms should question their physical network configuration under a wide range of future fuel prices. Global Issues and Outsourcing Problems The global arena offers an even more confusing picture. Many firms are re-thinking the mad rush to outsource outside the United States. The long supply lines, incredibly volatile fuel costs, exchange rates, the geopolitical risks have all come home to roust. Yet few firms consider the total cost of an outsourcing decision, and even fewer incorporate the additional risk of a global source in their analysis. Conclusion Since almost all companies face some combination of these seven issues, a rich database of best practices exists that can be transferred across highly diverse industries. It is critical that all firms engage in outreach activities such as forum participation and benchmarking to make sure they understand these best practices. Once they see how other companies address these issues; they need to develop an urgent action plan to implement the essential changes. Supply chain is the frontier of competition. Only by aggressively addressing challenges like those listed above can firms effectively compete in the increasingly intense global environment of the future Future trends in this subject area. Designing Distribution Networks The Role of Distribution in the Supply Chain of the BBLs products Distribution: the steps taken to move and store a product from the manufacture/supplier stage to the customer stage in a supply chain. Distribution done by BBLs product conducted in two different ways, first way by one to one door and secondly by distributers directly affects cost and the customer experience and therefore drives profitability Choice of distribution network can achieve supply chain objectives from low cost to high responsiveness Factors Influencing Distribution Network Design Design Options for a Distribution Network BBL manage the warehouse depots as distributer centre for their products at Arusha, Kilimanjaro Singida and Manyara the plant warehouse currently has total of 150,000 tons The following is the estimation of BBL distribution cost for 2011 Region Quantity demand (Create) Transportation cost per create Tsh Kilimanjaro 470,000 200 Arusha 600,000 300 Manyara 450,000 350 Singida 500,000 350 The cost of a warehousing solution is a function of or the total cost of transport cost, holding (inventory) cost, and warehousing (leasing) cost. For this year 2011 , the constraint from the 4 regions is given as (470,000, 600,000, 450,000, 500,000). Thus, the total demand is 2,120,000 creates which is less than the 2,000,000 time limit of one small warehouse. For one warehouse the lease expense is 500,000; the total inventory expense is =70,110,125. The Transport expense for the year 2011 is calculated as follows: (320,000*200+200,000*300+160,000*350+220,000*350) = Total distribution costs are 505,000+710,125+4432500-4275000=1372625. According to Cousins, P en al (2008) supplier Collaboration module will help to ensure that future supplier capacity requirement will be in place to meet future demand requirement for new products and services. In effect, this linked system would enable a single view of the entire supply chain. Managers could analyses the factors and the supply chain simultaneously and synchronize demand and supply. Distribution centre would act as a s

Sleeping Disorders Essay -- essays research papers

Sleeping Disorders I am going to start by telling you what a sleeping disorder is. A sleeping disorder is a problem that affects something to do with sleep. Not all sleeping disorders have symptoms that are obvious to a person or their family and friends, here are some common sleep disorders. - Insomnia - Sleep Apnea - Narcolepsy - Restless Leg Syndrome - Parasomnia - Bruxism - Jet Lag - Shiftwork I will be discussing the sleeping disorders listed above and what symptoms they can cause. Insomnia is a chronic sleeping disorder in which it is very difficult to start and continue sleeping. One of the other symptoms of insomnia that is most recognized is waking up repeatedly in the middle of the night. Lack of sleep leads to two other things, daytime fatigue and restlessness. These are bad on the job and at school while doing tests or other important work. The amount of sleep that each person needs to feel alert during the day varies. If you have a night of sleep which is much less than the amount of sleep you need, then you will more than likely feel quite sleepy the next day. Thirty-three percent of adults in America have a case of insomnia at least once in their life. Most cases only last one or two nights, but insomnia can continue for weeks or possibly even months. There have only been three standard types of insomnia that have been identified by doctors. They are as follows: - Transient insomnia is considered a few sleepless nights that is usually brought on by stress, excitement, or environmental changes. A person could have trouble sleeping the evening before a big meeting or shortly after a breakup or a fight with his girlfriend. - Short-term insomnia is usually two or three weeks of poor sleep caused by continual stress at work or at home, as well as medical and psychiatric illnesses. Eliminating the source of the stress usually takes care of the irregular sleep patterns - Chronic insomnia is considered poor sleep that lasts two weeks or longer. It can possibly be related to medical, behavioral, or psychiatric problems. Usually poor sleep leads to decreased feelings of well-being. Chronic insomnia can usually recur. If difficulty sleeping was the only problem with i... ...h other sleep disorders, such as obstructive sleep apnea and sleep terrors. Sleep Eating The causes of sleep-related eating are many. Most of them arise from a background of more conventional sleepwalking. In some cases, the sleep-related eating was brought on by medications prescribed for depression or insomnia. It may be a display of other sleep disorders, such as obstructive sleep apnea or periodic limb movements. The "sleep-related eating disorder" has only recently been described. Common concerns about this disorder are excessive weight gain, choking while eating, potential injury from starting fires while cooking or cutting oneself while preparing food, and sleep disruption. Approximately two- thirds of those afflicted with this disorder are women and the symptoms typically begin in the late 20s. The overwhelming majority do not suffer from a waking eating disorder. Sleeping disorders can be very weird, I did not know that until I wrote this paper. I was not aware that people could eat in their sleep, I thought that only happened in TV I have learned a great deal from this paper and I hope you did also.