Managing customer and suppliers Assignment Example | Topics and Well Written Essays - 1500 words

Managing customer and suppliers - Assignment Example Place____________________________________________________________7 8. Item ____________________________________________________________7 9. Conclusion _______________________________________________________9 10. References ______________________________________________________10 Impact of the theory of six rights on the construction of the Aquatics Centre for Balfour Beatty Introduction The theory of the six rights clearly states the importance of supplying customer satisfaction by following six basic standards including timely delivery, quality and quantity assurance and price, place and item standardization. All suppliers, manufacturers and service providers try to follow these basic guidelines for success. Background The planning for the 2012 London Olympics have led to great amends and development in the London area and the transformation of the heart of East London by the development of the Olympics village. The total budget of 5254 million pounds was initially allocated for the Olympic Development Association (Sean Dodd, 2010)and Balfour Beatty, the large British infrastructure provider, won the contract for building the 17500 seater Aquatics centre. The company is an imminent infrastructure provider whose key aim is to continue reliable and responsible growth in shareholder value. (Beatty, 2008). Some of the most high profile projects of the company included Arsenal Emirates Stadium and the Terminal 5 of the Heathrow airport. For the aquatics centre, the key requirements of the Olympics had to be fulfilled within a certain time limit and a budget and the strict observation of both of them was essential. The project was to include different training and warming pools, adjustable spectator areas, changing areas and a cafe. Other requirements included the building to be sustainable with as little impact on the environment as well. This is besides the fact that the development and the functioning are expected to be extremely safe and family friendly. Thus di fferent user rights for satisfaction of the Olympians and spectators in particular and the public in general have to be fulfilled. Balfour Beatty has to ensure that these basic rights are not compromised on any occasion during construction and the following functioning. Following of these six rights is not only a stringent requirement of the contract providers but is also essential for the efficiency and increased productivity of Balfour Beatty. Time The time frame of the project is extremely crucial as it is no ordinary airport or building but an event centre being developed for a certain event. Thus it has to be ensured that the project is fully completed well before 2012 and the proposed deadline is 2011. (Balfour Beatty wins 2012 Aquatic centre, 2008). The time limit posed also tests Balfour Beatty's commitment to its projects as it measures its efficiency. The deadline of projection completion in 2011 also prevents any extra costs as late deliveries and late processing always s piral the cost of construction. Timely supply chain management, which is Balfour Beatty's trademark also reduces the cost by increasing the lead time while ordering and the just in time inventory assures that storage costs are further decreased. Thus the project time line if followed suitably will allow the project to be completed well within the proposed budget generating good revenues for the company. The most recent development showed that the Aquatics centre will be completed in 7 months which is almost a year ahead of the schedule.

Deviant behavior Essay Example for Free

Deviant behavior Essay The labeling theory and the social control theory are two explanations behind the concept of deviance. The labeling theory argues that society itself creates deviance by classifying certain behaviors or people as deviant. The social control theory, meanwhile, believes that deviance is a result of the failure of social institutions to enforce societal norms. Labeling and Social Control Theories Every culture has norms or standards that distinguish acceptable from unacceptable behavior. Actions or behaviors that go against cultural norms are referred to as deviance. To understand why some individuals resort to deviance, sociologists and criminologists first analyze how norms are created, modified and enforced. The labeling theory and the social control theory are just two of the explanations these experts have come up with regarding the nature of deviance. Labeling Theory The labeling theory argues that people assume deviant roles in society. No conduct or individual is inherently deviant – society itself creates deviance by classifying certain behaviors or people as deviant. Those who observe deviant manners acquire deviant identities by internalizing deviant labels that society imposes on them. Instead of finding the root cause of deviance, society will attribute it to particular behaviors or people (Kontos and Brotherton, 2008). Proponents of the labeling theory claim that the social group is the one responsible for deviance. It creates norms in order to differentiate conventional people from deviants. Norms, however, are detrimental in the sense that it does not recognize the difference between rule breakers or rule-breaking behavior and deviants or deviant behavior. A person is dismissed as deviant regardless of whether or not his or her actions actually violated any norm (Hamlin, n. d. ). The Stages of Labeling According to the American sociologist Howard Becker, a person undergoes three stages when he is transformed from being regarded as normal to being recognized and labeled as deviant. The first stage is the initial â€Å"public† labeling or the informal process of labeling that eventually becomes an official definition of a person as deviant. Examples of this are the shoplifter who is tried in court and is sent to prison as a â€Å"criminal† and the drunk whom the doctor or the psychiatrist diagnoses as an â€Å"alcoholic. † The process of labeling begins with just the doctor, psychiatrist and judge, and then finally spreads to the entire community (Slattery, 2003). The second stage involves the official label’s overriding of all the other statuses and symbols that a person previously had. Society will severe ties with this individual and deny him or her opportunities for advancement. The father who becomes an alcoholic, for instance, ends up being divorced by his wife and abandoned by his children. The ex-convict, meanwhile, is unable to buy a house or get a job because of his criminal record (Slattery, 2003). The third stage is characterized by the label severely damaging the self-esteem of the person involved. The â€Å"self-fulfilling prophecy† begins to take place – he or she may live up to the deviant label that society imposed on him or her by assuming a deviant lifestyle. He or she may also withdraw from â€Å"conventional† society by seeking support and status from other deviants who share similar lifestyles. An occasional drug user, for instance, may live up to his â€Å"reputation† as a junkie by going to underground bars and clubs frequented by drug addicts. The juvenile delinquent, on the other hand, may later become a professional criminal, in accordance to what society labeled him (Slattery, 2003).

Chronic Disease In St Lucia Health And Social Care Essay

Chronic Disease In St Lucia Health And Social Care Essay Chronic disease is a disease of a long duration and generally slow progression (WHO, 2010). The U.S. National Center for Health Statistics states that a chronic disease is one lasting 3 months or more. These chronic diseases normally cannot be prevented by vaccines or cured by medication, nor do they just vanish. Chronic diseases are mainly caused by three major risk factors tobacco use, poor eating habits and physical inactivity. Majority of these risk factors are themselves worsened by poor socioeconomic determinants, such as lack of education and poverty. Most often these determinants are a indication of the main forces driving social, economic and cultural transition, including globalisation, urbanisation and an aging populations. Chronic diseases are affecting population health as the epidemiological transition progresses and are the lead cause of mortality worldwide and pose increasing problems for the burden of disease and quality of life in developed and developing countries (WHO, 2003). Non communicable diseases include a broad range of conditions, including cardiovascular disease, diabetes, cancers, chronic respiratory disease, mental-health problems and musculo- skeletal disorders. The first four mentioned above account for approximately 50% of mortality globally, and share behavioural risk factors, such as excess calorie consumption, diets high in saturated and transfatty acids, excessive intake of alcohol, physical inactivity, and tobacco smoking. Approximately 35 million people have died from heart disease, stroke, cancer and other chronic diseases in the year 2005. The burdens of these diseases are equally shared among men and women, and are more prevalent in people under the age 70 (WHO, 2004). 80% of chronic disease deaths occur in low and middle income countries. Figure 1: Global distribution of total deaths (58 million) by cause in 2005. The age-specific death rates between the years 2005 2015 are projected to fluctuate slightly, Nevertheless, the ageing populations will result in an overall increase in chronic disease death rates for all ages combined. In 2005, all chronic diseases account for 72% of the total global burden of disease in the population aged 30 years and older. The total lost years of healthy life due to chronic diseases, as measured by DALYs, are greater in adults aged 30-59 years than for ages 60 years and older. More than 80% of the burden of chronic diseases occurs in people under the age of 70 years. Table 1: Projected global deaths and burden of disease due to chronic disease by age 2005- 2015 Deaths (Million) DALYs (millions) Deaths per 10000 DALYs per 100000 2005 2015 2005 2015 2005 2015 2005 2015 0-29 years 17 15 220 219 48 40 6320 5994 30-59 years 7 8 305 349 311 297 13304 13375 60-69 7 8 101 125 1911 1695 27965 26396 à ¢Ã¢â‚¬ °Ã‚ ¥70 20 24 99 116 6467 6469 32457 31614 All ages 35 41 725 808 549 577 11262 11380 World Health Organization projects that, globally, NCD deaths will increase by 17% over the next ten years. The greatest increase of 27 %and 25 % respectively will be seen in the African region and the Eastern Mediterranean region (WHO,) 1.2 Types of chronic diseases 1.2.1Cardiovascular disease Cardiovascular disease CVD is the term used by the scientific community to embrace not just conditions of the heart [ischemic heart disease (IHD), valvular, muscular, and congenital heart disease but also hypertension and conditions involving the cerebral, carotid, and peripheral circulation. The risk of CVD is related to diet, physical activity, and body ( ). The patterns of food supplies and of food and nutrition that modify the risk of CVD are also well known. Whereas CVD was once largely confined to high-income countries, it is now the number one cause of death worldwide as well as in low- and middle-income countries, where 80 percent of the worlds 13 million annual CVD deaths occur. And at least 21 million years of disability-adjusted life years (or DALYs, a measure of future productive life) are lost globally because of CVD each year. The vast majority of CVD can be attributed to conventional risk factors such as tobacco use, high blood pressure, high blood glucose, lipid abnormalities, obesity, and physical inactivity. Cardiovascular diseases are major cause of chronic disease death and were accounted for of 17 million deaths in 2002. It is estimated that by the year 2030, 24 million will die of CVD, of which 80% will occur in low and middle income countries (5). 1.2.2 Cancer Cancer is a major and growing disease burden worldwide. The number of new cancer cases is projected to increase from 10 million in 2000 to 15 million in 2020, 9 million of which would be in developing countries. The epidemiology of cancer in developing countries clearly differs from that in developed countries in important respects. While developed countries often have relatively high rates of lung, colorectal, breast, and prostate cancer (some of which is tied to tobacco use, occupational carcinogens, and diet and lifestyle), up to 25% of cancers in developing countries is associated with chronic infections. Seven types of cancers account for approximately 60 percent of all newly diagnosed cancer cases and cancer deaths in developing countries: cervical, liver, stomach, esophageal, lung, colorectal, and breast. 1.2.3 Respiratory Diseases Chronic adult respiratory diseases-such as chronic obstructive pulmonary disease (COPD) and asthma-are a major and growing burden in terms of morbidity and mortality in the developing world. COPD (which includes emphysema, chronic bronchitis, and obstructive airways disease) is largely linked with cigarette smoking as well as exposure to unvented coal-fired cooking stoves; it accounts for 2 percent of lost DALYs on a worldwide basis. 1.2.4 Diabetes Mellitus Diabetes affects people worldwide and is one of the oldest diseases known. There are two common types of this disease: type 1and type 2 diabetes. Type-1 diabetes accounts for 5-10% of all diagnosed diabetes. Type-2 diabetes is the most common form of diabetes. It accounts for 90-95% of diagnosed diabetes. The World Health Organization (WHO) estimated the worldwide prevalence of diabetes in adults to be around 173 million in 2002 and predicted that there will be at least 350 million people with Type 2 diabetes by 2030. At present about two-thirds of persons with diabetes live in developing countries and the majority of new cases will originate from these areas. The global increase in the incidence of diabetes is related to high levels of obesity associated with a change from traditional diets, diminishing levels of physical activity, population ageing and increasing urbanization. Diabetes Mellitus is the most prevalent form of diabetes on the global scale (6). For the past few decades, Diabetes Mellitus has reached epidemic proportions in many parts of the world. The World Health Organization (WHO) has predicted the global prevalence of all Diabetes will increase from 194 million in 2003 to 330 million in the year 2030 (7). 1.2.5 Hypertension Another commonly occurring chronic disease is hypertension. High blood pressure increases the risk of heart disease and stroke. Hypertension is sustained high blood pressure (à ¢Ã¢â‚¬ °Ã‚ ¥140/90mmHg). Blood pressure itself is the pressure exerted by the blood on the walls of the blood vessels. Each time the heart beats (about 60-70 times a minute at rest), it pumps blood into the arteries. Blood pressure is at its highest when the heart beats, pumping the blood. This is called systolic blood pressure. When the heart is at rest, between beats, blood pressure falls. This is diastolic pressure. Blood pressure itself is not harmful it is essential as it is the force that drives blood through the blood vessels to supply oxygen and nutrients to the bodys organs and tissues and carry away waste materials. However, when blood pressure becomes too high it has damaging effects on almost every part of the body and can lead to serious illness and death. Hypertension is an important public health challenge worldwide because of its prevalence and its role as a risk factor for cardiovascular disease. Some of the risk factors of hypertension include obesity, alcohol, family history, and smoking. There are two types of hypertension, namely primary hypertension and secondary hypertension. Primary hypertension is more common, occurring in 90-95% of the hypertension population. There is no identifiable cause and it develops gradually over many years. Secondary hypertension occurs in 5-10% of the hypertension population. () In the year 2000 it was estimated that the total number of adults with hypertension was 972 million. Of these, 333 million were estimated to be in developed countries and 639 million in developing countries (0). Kearney PM et al., predicted that by the year 2025, the number of people with hypertension will increase by approximately 60% to a total of 1.56 billion. (Kearney PM et al., 2005) the reasons are the continuing population increase and changes in lifestyle, which includes a diet high in sugar and high-fat processed foods and sedentarism. 1.3 Impact of chronic disease in the Caribbean Caribbean countries are in epidemiological transition, where not only nutritional deficiencies have considerably declined but infectious diseases have also been disappearing. However, over the last thirty years, nutrition-related chronic non-communicable diseases have slowly emerged as the major public health problems. Non-communicable diseases (NCDs) have gradually displaced communicable diseases in the Caribbean. Rates of chronic non-communicable disease such as diabetes, hypertension, cardiovascular disease and cancer have been increasing in the Caribbean and are the leading cause of mortality and mobility in the region (Ragoobirsinghet al., 1995, 2002; Wilkset al., 1998, 1999; Figueroaet al., 1999; Rotimi et al., 1999; Cruickshanket al., 2001, Figueroa, 2001; Sargeantet al., 2001; Henniset al., 2002a,b; Corbinet al., 2004; Wolfeet al., 2006). Of concern is the fact that while the prevalence and mortality rates of these diseases are highest in the elderly, they are not restricted to any one age group. An estimated 10% to 20% of the Caribbean population over 20 years of age suffers from diabetes and hypertension, respectively, with prevalence more than doubling at older ages (Hennis et al., 2002a, b). Hypertension and diabetes rank as the two leading chronic disorders among Caribbean populations and are also major risk factors for other diseases such as cerebrovascular disease (stroke) and coronary heart disease. Prevalence of chronic diseases in the Caribbean region over the pass 3 decades Another striking epidemic among the Caribbean population is the high prevalence of overweight [body mass index (BMI) >25 kg mà ¢Ã‹â€ Ã¢â‚¬â„¢2] and obesity (BMI >30 kg mà ¢Ã‹â€ Ã¢â‚¬â„¢2). Approximately half of the adult Caribbean population is overweight and 25% of adult Caribbean women are obese (Henry, 2004). The escalating trend in obesity is considered to be a major causative factor in chronic disease prevalence in the region. The increasing obesity levels, mainly among women, maybe associated with the changes in traditional diets and the adoption of sedentary lifestyles. In some the islands more than half of adult women are reported to be obese. Data from Barbados highlights the importance of obesity as a risk factor in chronic diseases. Based on available evidence, obese persons, (BMI>30) of 40-79 years had a 2.6 times greater risk of hypertension than persons with BMI 1.4 Impact of chronic disease in St. Lucia St. Lucia has undergone a significant demographic transition in the last 3 decades (Wilks, et al., 1998). Some features of this transition include the rise in the median age of the population from 20 years to 15 years between 1970 and 2010, the doubling of the proportion of persons older than 60 years old from 5000 to over 17,000 and the increase in life expectancy at birth from less than 50 years in 1950 to greater than 73 years in 2010 (World population prospectus, 2008). As a result, the main causes of illness and death in St. Lucia and many other Caribbean islands and regions at a similar state of development are the chronic non-communicable diseases (Sargeant et al., 2001). There is an increased prevalence of diet-related chronic non-communicable diseases, such as cardio-vascular diseases, diabetes and obesity. (Wilks et al., 1998). Between 1992-1999 in St. Lucia, preventable chronic diseases such as cardiovascular and circulatory systems accounted for 20.8% of deaths, with the major causes being cerebrovascular disease, ischemic heart disease, and hypertensive disease. Other major causes of death were cancers (14.5%), disease of the digestive system (8.7%), and diabetes (7.2%) (8). Approximately 1,304 deaths were due to diseases of the circulatory system and was accounted for 33% of all reported deaths, death due to cerebrovascular was (35.9%), hypertensive disease (14.8%), and ischemic heart disease (13.6%) (Health in America, 1998). There were 731 deaths due to cardiovascular disease from 1996 to 1999, accounting for 19% of all deaths and 53 % of deaths ratio of 5.8:1. Most (21 or 62%) occurred in the 15-44 years age group, and had a male-female ratio of 9.5:1. Cardiac arrest caused 268 cardiovascular deaths (37%), ischemic heart disease 174 (24%), pulmonary circulation and other forms of heart disease 134 (18%), and heart failure 153 (21%). Females accounted for 359 (49%) of deaths due to cardiovascular disease, and persons 60 years of age or older accounted for 588 deaths (80%). (WHO statistics). Based on PAHO statistic St. Lucia is the tenth leading island in the Caribbean with high rates of non- communicable chronic disease, accounting for approximately 63%. Over the years prevalence of non communicable diseases have been increasing, in a survey done by the Kairi consultants limited in association with the national assessment team of St. Lucia concluded the following findings for the year 2005 to 2006 for the distribution of chronic disease in St. Lucia. Irrespective of per capita consumption quintile, high blood pressure was the most prevalent lifestyle disease affecting persons with diseases in St. Lucia. In every quintile group, it also shows that the prevalence of diabetes ranks second to high blood pressure as a life time disease affecting persons with diseases in St. Lucia. In each of the quintile groups, more than three fifths of the persons with diseases reported suffering from high blood pressure while more than one quarter reported suffering from diabetes. In the year 2007 diabetes and Hypertension were the two the most pervasive and worsening health problems facing the island of St Lucia. The diseases afflict a broad swath of people, young and old. St. Lucia has a population of approximately 160,000 thousand people, and of this 28.1%of the population have abnormal blood glucose or high blood sugar and 8.1% have diabetes (Graven et al., 2007). 20% of people over 40 years of age suffer with the disease (the ministry of health 2007). At least 35% of those with Type 2 Diabetes Mellitus do not know that they have the condition (The Ministry of Health, 2008). In rural area of St. Lucia the proportion with undiagnosed diabetes is considerably higher (St. Lucia Diabetic Society, 2008). At the time of diagnosis, every tenth person with diabetes has already developed one or more micro- or macro-vascular complications (Ministry of Health, 2008). Diabetes is among the leading cause of death. If inadequately treated, diabetes can cause blindness, kidney disease, nerve disease, amputations, heart disease, and stroke. Even conscientious and well-treated diabetics frequently suffer from these complications and have above-average medical costs. If observed, the Native St. Lucian has many barriers to health education, which basically involves their culture, lifestyle, accessibility and socio-economic status. For instance, St. Lucian is currently experiencing a crisis of poverty. People from lower socioeconomic status have poorer health than those in higher socioeconomic positions. Various studies have reported the relationship between low socioeconomic status and the development of chronic disease ((Lynch et al, 2000; Stelmach et al, 2009; Supriya et al, 2009). Recent poverty assessments in St. Lucia estimate that 18.7% of households and 25% of the population live in poverty. Income inequality is high, with 26% of the population characterized as chronically poor (MPDEH, 2003). That same report estimated that a decade later in 2005/06 the poverty rate had increased to 28.8% of the population( Government of St. Lucia( GOVST), The assessment of Poverty volume1, 2006) .The highest poverty rates in2005/06 were in the districts of Anse La Raye/Canaries (44.9%), Micoud (43.6%),Soufriere (42.5%) and Laborie (42.1%). The poverty gap and poverty severity also occurred in these same districts (GOVST, 2006) Furthermore, because of poverty and living in rural areas, most people consume less expensive and often high fat foods, and less fruits and vegetables (Henchy et al, 2000). Brown et al, (2005) described how socioeconomic position influences health among persons with diabetes. Diabetes is twice more prevalent in low income populations compared to wealthy populations (Stelmach W et al; 2009). Some explanations for this increased risk among people of low-income or resource-poor areas include increased stress, low access to medical and preventive care, and poor environment. 1.5 Diet, nutrition and chronic diseases There are clear associations between the various biomedical and behavioural chronic disease risk factors, and it is well established that diet quality and healthy eating practices play an important role in both preventing and managing chronic diseases and the factors that increase their risk (Kant A.K, 2004). The links with food and nutritional status are especially strong in the case of cardiovascular disease, diabetes and their risk factors (metabolic syndrome, obesity, hypertension and hyperlipidaemia). The food we eat, in all cultural selection, defines ones health, growth and development. Risk behaviours, particularly smoking and sedentarism, alter the result (). All this takes place in a social, cultural, political and economic environment that can exacerbate the health of populations. Diet is a key component in predisposing to chronic disease, mainly where diet is energy dense causing positive energy balance and obesity. Adoption of western diet which are high in fats , aminal protein, refined carbohydrates and low in fibre, fruits and vegetable can further increase one risk of developing no of more chronic disease(). Several studies have demonstrated a prudent diet rich in fruits, vegetables, fish and wholegrain to be associated with a decline in chronic disease risk such as diabetes (Van Dam et al., 2002; Anne-Helen Harding et al., 2004) Carbohydrates Carbohydrates food source are the most important source of calories for the worlds population mainly because of their low cost and wide availability (). Although Carbohydrates is easily accessible and widely eaten carbohydrate is a key dietary component affecting insulin secretion and postprandial glycemia and is implicated in the etiology of many chronic diseases (Brand-Miller JC et al., 2004). Both the quantity and type of carbohydrate eaten have consequences on insulin secretion and postprandial glycemia. Foods with a rich glycemic index (or glycemic load) produce high rates in blood glucose.  Diets including large quantities of high GL foods increase the risk of diabetes, breast cancer, colorectal cancer, endometrial cancer, and overall chronic disease (Barclay AW et al., 2008). Dietary fibres Epidemiological evidence has shown that foods rich in fibre help glycaemic control in diseases such as type 2 diabetic patients(). A diet high in fibre helps in control blood sugar levels in those with type 2 diabetes. It also helps with colon health as the high fibre diet with smoothing the stool and facilitates to weight loss (). Fats Dietary fat is one of the most influential nutrients in health. Fats has many functions in the human body, As well as to providing more than twice the energy supplied by carbohydrates and proteins and supplying essential fatty acids, fats slows digestion of carbohydrates in order to fuel the brain he fats serve as carriers for fat soluble vitamins (A, D, E and K) and as parts of cell membranes(). The overconsumption of fat, mainly saturated fat, has been linked to six of the 10 leading causes of death worldwide ().Coronary heart disease and cancer ().There is a strong link between dietary fat consumption and risk of chronic diseases such as cancer, such as colon, breast, prostate, and ovary cancer (). Several studies over the past 30 years have verified the relationship of high dietary fat intake with higher mortality due to various cancers (). Some saturated fatty acids raise blood cholesterol levels and, thus, increase the risk of atherosclerosis (). High fat, intake is a main cause of obesity, hypertension, diabetes, metabolic syndrome and gallbladder disease (). Studies have show that countries with higher per capita intakes of fat, especially animal fat, have higher incidence rates of certain cancers, including breast, colon, prostate, and pancreas.[41] Migrational studies show that when individuals move from a country of low fat intake to one of high fat intake, the risk of some cancers increases [42] . Vitamins Vitamins are essential nutrients hey are required in small amounts, but have important and specific functions such as promoting growth, reproduction and the maintenance of health. Nutritionally, they form a cohesive group of organic compounds that are required in the diet in small amounts (micrograms or milligrams per day) for the maintenance of normal health and metabolic integrity. They are thus differentiated from the essential minerals and trace elements (which are inorganic) and from essential amino and fatty acids, which are required in larger amounts. Vitamin deficiency however, may increase the risk of chronic diseases (). Suboptimal folic acid levels, along with suboptimal levels of vitamins B(6) and B(12), are a risk factor for cardiovascular disease, neural tube defects, and colon and breast cancer() and low levels of the antioxidant vitamins (vitamins A, E, and C) may increase risk for several chronic diseases. . Nutritional Transition There are now approximately 350 million obese and more than 1 billion overweight people in the world, living in both developed and developing nations. Previously, underdeveloped nations grappled with undernutrition. Now many of these countries like St. Lucia are in a transitional state and are dealing with the twin evils of under- and over nutrition. In the Caribbean nations between the 1970s and 1990s, the prevalence of overweight/obesity increased from 7% in men and 20% in women in the 1970s to 22% in men and 58% in women (Ragoobirsingh D et al., 2004). The global prevalence of overweight amongst preschool children is estimated at 3.3%. Within the Caribbean region and St. Lucia has one of the highest incidences for this age group with St. Lucia having 2.5% of the 0-5 yr. population ( De Onis M et al.,October 2000) .Obesity in children and adolescents is known to have significant impact on both physical and psychosocial health, these soaring rates of obesity leads to an increase in hyperlipidaemia, hypertension, insulin resistance and abnormal glucose tolerance later in life (Reilly et al., 2003; Weiss et al., 2004). Urbanization, industrialization and transformation processes have been the main cause of this public health accomplishment. In modern cultures, demographic factors interact with social and economic factors and lead to changes in the patterns of health and diseases as hypothesized by Omrans epidemiological transition theory in the early 1970s (Orman et al., 1971). Omrans theory describes the changing pattern of mortality from the predominant communicable diseases to the emerging non-communicable diseases. In his study, Omran defined three stages of epidemiological transition, i.e. the age of pestilence and famine, the age of receding pandemics, and the age of degenerative and man-made diseases (Orman et al., 1971). 1.6 Dietary habits of St. Lucians Food habits reflect the plantation past: the typical diet contains a lot of starches, animal protein content that varies by location, and until recently, little in the way of green vegetables. Starches include various kinds of yams, dasheen, eddos, bananas and plantains, sweet potatoes, cassava and breadfruit. Most of these are boiled, served with some kind of stewed fish or meat, and accompanied by a sauce. Pepper (capsicum) sauce is always present at the table, as most dishes are not prepared spicy hot. Animal protein sources reflect the historical scarcity of this element: pork hocks, pig tail (fresh and salted), chicken back, and saltfish, (cod) salted beef, fish (tuna, flying fishing, red snapper, barracuda, sharke, sardines, jack fish). Most of the dishes are prepared with fats such as; coconut oil, lards, yellow butter. As much as St. Lucia has a wide variety of fruit they are only eaten Fruits such as; mangoes, golden apple, papaya, grapefruit, oranges, cherries, cashew, suga r apple(love apple).Main dishes are accompanied by vegetables such as, avocado, calaloo, spinach, tomatoes, okras, carrots, pigeon peas and lentils, Imported processed foods have been available for decades, but more recently account for larger parts of many meals. Foods such as pasta, rice, 1.7 Cause for chronic non-communicable diseases in St. Lucia Chronic diseases have numerous risk factors, which function at different levels, from the most proximal (i.e. biological), to the most distal (i.e. structural). These risk factors can be classified as modifiable and non-modifiable risk factors. Modifiable determinants include factors that can be altered, such as individual and community influences, living and working conditions and socio-cultural factors, non-modifiable determinants include those factors that are beyond the control of the individual, such as age, sex and hereditary factors. 1.7.1 Biological factors Some populations are susceptible to chronic disease because of inherited genes. In a south Africa a tribal group Afrikaners have been found to have familial hypercholesterolemia, a rare genetic disorder, characterised by very high low-density lipoprotein, cholesterol and early cardiovascular disease.( Steyn K et al.,1996). Genetic and lifestyle factors are considered to be the main contributors in causing type 2 diabetes (ORahilly et al; 2005). The genetic makeup of a person is as essential to the development of the disease but a person lifestyle and environmental factors can contribute significantly. Some of the major contributing factors include overweight, abdominal obesity and physical inactivity and to lesser extent intrauterine and early childhood factors (Alberti et al, 2007) 1.7.2 Early life origin The time between intrauterine growth and the development is the most vulnerable period in the life cycle and places major physiological, metabolic and psychological demand on the mother to support the growth and the development of the fetus (Allen, 2001). Good growth and development is dependent on a sufficient supply of energy and nutrients. Under nourishment during pregnancy is linked with poor pregnancy and neonatal outcomes which can have negative long term implications for the infant such as a reduction in intelligence, growth disorder, low immunity, increased morbidity, mortality and the development of a range of diseases during adulthood (Rasmussen, 2001) It is proposed that type 2 diabetes results from relative intrauterine malnutrition and the latter leads to lifelong programming (Baker et al; 1986). Children with low birth weight are most likely to experience growth restraint, whether due to intrauterine nutritional restriction or genetic predisposition to low birth weight; similar associations of low birth weight have been made for the development of diabetes (Lindsay et al; 2001). Babies who are born low birth weight tend to grow fast after birth catch-up growth, often become overweight as young children. They are most likely to develop high blood pressure and abnormal blood glucose level early in life, which future increase their risk of developing chronic diseases, such as heart disease and diabetes (Barkeret al., 1997). The prevalence of Low Birth Weight (LBW) is approximately 6 and 9% in the Caribbean. The association between low birth weight and adult disease makes urgent the concern of these high LBW prevalence rates in the Caribbean (Henry; 2000). An under-nourishes child is normally a smaller and shorter child (0) Stunting is an indication of long standing mal and under-nutrition and is often accompanied by fat deposition, particularly around the abdominal section when faced with food in abundance. Predisposing individuals to obesity in adulthood. () Likewise children who are born to large mother and are large for their gestational age are most likely to induce insulin resistance and type 2 diabetes later in life (Bennett et al; 2002). In Jamaica children shortness at birth and increased current weight are independent predictors of insulin resistance (Bennett et al; 2002). There is significant amount of evidence, mainly from developed countries, that states intrauterine growth retardation is connected with an increased risk of coronary heart disease, stroke, diabetes and elevated blood pressure (WHO, 2002; Godfrey et al., 2000; Forsà © et al., 2000). It may be the pattern of growth, i.e. restricted fetal growth followed by very fast postnatal catch-up growth that is vital in the underlying disease pathways. Likewise, large size at birth is also associated with an increased risk of diabetes and cardiovascular disease (McCance DR et al., 1996; Leon DA et al., 1998). Behavioural risk factors (lifestyle factors) Lifestyles play an important role in determining chronic diseases and lifestyle changes are likely to be responsible for a significant proportion of their increase over time. 1.7.3 Poor diet Nutrition is a major modifiable determinant of chronic diseases, with scientific evidence supporting the view that modifications in diet have effects on health outcome of a person. Non-communicable diseases are linked to high consumption of energy dense foods, made of animal origin and of foods processed or prepared with added fat, sugar and salt.() St. Lucia is undergoing rapid nutritional transition (Boyne, 2008). There has been an increase of fast-food restaurants, and an increased in the consumption of meals high in fat, sugar, and salt and a reduction in the consumption of cereals, grains, fruits, vegetables, tubers, and legumes (Jacoby et al.,2008). The increased consumption of imported foods high in fat and sodium has led to a decline of the health status of people throughout the region, with an increase in health problems such as obesity and diabetes (Report from WHO, 2003). 1.7.4 Physical inactivity Physical inactivity and sedentary lifestyle is linked with increased levels of obesity, breast cancer, colon cancer

Analysis of Two Kinds by Amy Tan :: Two Kinds, Amy Tan

Analysis of Two Kinds by Amy Tan In the story â€Å"Two Kinds†, the author, Amy Tan, intends to make reader think of the meaning behind the story. She doesn’t speak out as an analyzer to illustrate what is the real problem between her and her mother. Instead, she uses her own point of view as a narrator to state what she has experienced and what she feels in her mind all along the story. She has not judged what is right or wrong based on her opinion. Instead of giving instruction of how to solve a family issue, the author chooses to write a narrative diary containing her true feeling toward events during her childhood, which offers reader not only a clear account, but insight on how the narrator feels frustrated due to failing her mother’s expectations which leads to a large conflict between the narrator and her mother. By stating how other people behave or interact, the author offers a great chance for readers to interpret fairly for themselves what the reason for any conflict may be, or the nature of any essential contrast between the narrator and other adults in the story. In the story, there are many self-righteous opinions from people, which seem to be ironic to the readers; For example, her mother’s aggressive attitude of showing off her daughter, her piano teacher’s self-praise claiming him as â€Å"Beethoven.† All of the narrations including conversation clearly depict a different characteristic between the narrator and other people. For instance, a conversation occurs between the narrator and her mother when the mother criticizing a girl who seems similar to the author on TV which reveals dissimilar understanding for both of them to each other’s behavior. At first, the daughter speaks out for the girl by questioning her mother by saying â€Å"why picking on her [†¦] She’s pretty good. Maybe she’s not the best, but she’s trying hard.† The daughter actually is defending for herself and reflecting that she feels uncomfortable with her mother’s disregard of her hard work. She wants to get her mother’s compliments instead of her criticisms. However, her mother response of, â€Å"just like you,† and, â€Å"not the best. Because you not trying.† Here, her mother doesn’t really answer her question, instead wants her put more effort on trying, neglecting how much she has tried before. However, in her mother’s perspective, she has never tried hard enough. By narratively stating the conversations she has encountered, readers perceive a strong implication of the reason for a future conflict between her and her mother.

Culture of Chinese Family Stereotype Essay

Taiwan, my mother country, though suffering under complicated identification obscurity, is still applying Chinese culture and values. We still commemorate Chinese New Year, QingMing Festival, Dragon Boat Festival, Mid-Autumn Festival, and so forth. We still believe in Confucianism and Chinese ethic moral rules like â€Å" †, â€Å" †, â€Å" , †, to name but a few. In addition, we also share the similar diet culture, since our staple food mostly based on rice and noodles. There are surplus parallels between Taiwanese culture and those adopted in the mother China even though we’ve been separated geographically for centuries. Though Taiwan is politically independent from China, as a Chinese, I would still accept the perspective that I’m belonging to part of the Great Chinese Culture Region( ), as we can call it â€Å"Chinese Family†. Although modern technology and knowledge keep flourishing, people nowadays may think that western culture somehow influence people more, included religion believing , fast food culture, insight of democracy and freedom, western literature, and so on. However, as a Chinese, I can’t deny that Chinese culture did affect our daily living physically and mentally. Many values originated from the ancient people and philosophers, included those in ,,,, still maintain clear and essential in our mind , since we have been taught to follow the concept and the worship the good deeds those ancient sages and virtuous, like Confucius, Zhuangzi, Mencius, Yao and Shun( )†¦ have conducted. â€Å" †, â€Å" †, â€Å" †, â€Å" †, â€Å" , , †Ã¢â‚¬ ¦ these values not only affect the way Chinese people think, but also become a sub consciousness which lead to the way we live. As we often emphasis the importance of studying, Chinese parents are willing to spent their whole life working hard so their children can accept better education because they believe the sayings, â€Å" †, â€Å" , †. In contrary, western families take less focus on their children’s academic performance; they would rather think that children should seek out their interest instead of obtaining all A grades at school. Furthermore, it would also affect how parents educate their children, and this educating concept would pass on by generations. And the phenomenon is just the same in Taiwan as that in Mainland. As most Chinese parents always believe and hope their children to be the best( , ), they usually devote more than western parents do, just to provide the best resources for their children. This may somehow spoil a child, too. As Chinese family often pass their fortune to their descendants, rather than considering parents’ fortune as their own, offspring of a wealthy family may no longer eager to achieve his own life goal and seek his own fortune. In contrary, western children usually gain their own fortune by their hand, on their own, which is considered more independent and responsible. There’s a real story of a business man. Because he’s so busy and so was his wife, they’ve decided to send their 13 years old son to New Zealand for a couple of months, and there was a friend named Marry, who could take care of their child. When the child met Marry, the first thing she said was, â€Å"Listen, my sweet heart, I’ll like to notice you that I’m here only to take care of your living, but doesn’t mean I should make you breakfast, do your laundries and dishes, you should do it all by yourself. You’re now 13, which is definitely able to start taking care of yourself. Parents aren’t responsible to look after your whole life; thus, you should be independent from now on. You live your life and I do mine own business, is that clear enough? † After 6 months, while the business man and his wife picked their son back from New Zealand, they’re totally stunned; their son had changed thoroughly mature. He began to make breakfast, woke up early himself and was able to schedule his own life, which he never did before. This dramatically change simply based on how western and eastern parents educate their children. As a result, it leads to the circumstance that western children are usually more independent. In addition, the value of women rights also maintain deeply in Chinese people’s mind, though we are now in a world advocating gender equality. Even nowadays, some people still believe the concept â€Å" †, â€Å" †, â€Å" , , †, but mostly the elders. Thanks to the revolution New Culture Movement ( ) brought to the Chinese society. People started to explore and accept new technology and knowledge, not only the perception of Democracy() and Science( ), but also the new century values. For instance, in the old days, women are forced to bound their feet from their young ages, so that their feet may look tiny and delicate, which ancient Chinese regarded as sexy and beauty. They even worshiped tiny feet as â€Å" †. This social usage only happened in the upper classes which higher status women did not need to deal with tuff tasks that rural area women did. On the other hand, it also lead to the phenomenon that women were having lower social position than men were. But after the New Culture Movement and other further revolutions, women gradually stopped to suffer from the pain bounding feet brought to them, and started to handle more housework; little by little, women’s social status had been raised. When it comes to the argument of women’s right and discrimination, it’s no doubt that Chinese ancient culture and concept have deeply influenced the way the majority behaves. Not only in Mainland, but also the whole Chinese cultural region, included Japan, Korea, Vietnam, Thailand, and other South East Asian countries. Take Japan as an example, Japanese girls are well known for their virtuous behavior, while men are quite accustomed to chauvinism( ). This may be somewhat resulted from the old sayings originated from China; for instance, â€Å" , †, â€Å" †, and so on. However, women status obviously do rise in this century, modern parents may be more willing to give birth to a girl because they may think girls are sweeter than boys, ignoring the stereotype that having a boy is better than a girl. This stereotype is resulted from the traditional custom that boys are able to pass the family name, while girls no longer belongs to the family after they’re married. Plus, this is also a chief reason why ancient Chinese family sent a boy to school rather than a girl, cause only when a boy achieve high social status after , will the whole family gain benefits. Thus, brought out a novel which the feminine role have to disguise herself as a guy so as to be able to pursue education. We can see that phenomenon changes not only in giving birth to a baby, but also in education providing. In the old times, there were mostly boys that could access complete education instead of girls, but now, we may even discover that the numbers of girls are surprisingly higher than boys. Which some researches declaim that it’s because girls are innately more careful and thoughtful than boys are. The case is similar in industries and working places, more and more â€Å"Iron ladies† exist and keep on controlling the whole company, which may be more success than men. What’s more there’re even throngs of specific phrases for modern women, like â€Å" — †, â€Å" †, â€Å" †(which refers to women that haven’t married but are successful in their carriers), and so forth. There is an awkward circumstance that women in upper social status are mostly unmarried, and so as men within lower social status. This is due to two main reasons; first, women education is relatively emphasized than that in the past; second, traditional concept has that a woman should marry a man better than she is. As the result, a woman graduated from high school may marry a man finished college studying; woman finished college studying may marry a guy accomplished graduated school; woman accomplished graduated school marry a PHD guy; and a PHD woman may marry a professor; then who will a female professor marry? Obviously not a guy graduated from high school! This worrying case lead to a sad ending, which then somehow may strictly proofed the saying â€Å" †. However, to my opinion, I think this is a controversial issue because being married involves mostly on love itself, we shouldn’t blame it all to the Chinese cultural effects. But frankly speaking, we can’t ignore truth that these old sayings somehow match to the phenomena we’re now facing. Even though women are now capable enough to compare with men in industry fields, there still exist â€Å" †, which means however hard women try, the promotion rate and the salaries are relatively lower than that of men’s. This may also be an outcome of the Chinese stereotypes that men are more capable then women are when it comes to work. For conclusion, old Chinese concepts really influence modern society deeply in an unmeasurable degree. All in all, although ancient Chinese empires had faded into history, glorious kingdoms had turned into dust, brilliant philosophy of ancient saints only exist in books now, the influence they brought to this Chinese world still remain and just couldn’t be erased from our mind. Chinese culture and ancient concepts couldn’t be ignored. They’re now the biggest part of our life because they’re what we come from, and what foster us. It’s our soul, our mother characteristic. Also, they’re things that allow us to identify ourselves as a member of this huge â€Å"Chinese Family†. And because it’s uniqueness and specialties, we’re always able to find our loyalties. In this complex culture integrated world, finding a sense of belonging is really important, because it may make us feel comfortable and gleeful to be part of this big family. We can even say that, without Chinese culture, we can’t be who we are now. Cherish our culture and maintain it well so as to pass the Chinese spirit on and on is what our generation should do. Despite of focusing and arguing on whether I’m a Taiwanese or a Chinese, It’s more vital and meaningful to define myself as a member part of Chinese culture. I’m from Taiwan, and I’m a Chinese. I’m proud of my identity; I’m proud of this Chinese family I belong to. It’s where my mind and spirit mature, where my ancestor struggled for their lives and for the next generation, for us.

Clerk & Squire Contrast “The Canterbury Tales” Essay

In Chaucer’s â€Å"The Canterbury Tales,† two young men of the Middle Ages, stand in sharp contrast to each other. The clerk and the squire are of similar ages but are very different. The clerk is a member of the middle class, has attended Oxford and studied Aristotle, while the squire, a member of the upper class, has been educated in the arts of chivalry. In appearance wise the clerk is a â€Å"grave† or somber individual. He is thin â€Å"hollow-cheeked† and dresses poorly (â€Å"outer cloak threadbare†). On the other hand the squire is a bright, cheerful person. He is lusty, strong and nimble and dresses extravagantly â€Å"red and white embroidery; short coat with long wide sleeves.† His facial appearance is similar to his dress habits, his hair is curled and he is very handsome. The two differ in personality as well. The clerk is formal and modest when he speaks and he only speaks (gives his input) if it is needed. He is also considerate of others, â€Å"pray diligently for the souls of them that gave him wherewith to stay at the schools† and his speech is of moral virtue. The royalty of the squire was apparent in his personality. He is courteous, modest and helpful to others. His royal roots show that he is a respectable man and in his youthful state, he is full of energy. Finally, we can see that the two have very different interests. The clerk is interested in lectures on logic, reading Aristotle and studying Philosophy. He also loves to learn and teach and convey his knowledge to others. The squire is engulfed with the many campaigns/battles of the country and loves jousting in his spare time. He also enjoys singing, playing the flute, riding horses, making songs, dancing drawing and writing. The squire’s royalty shows through his interests because the middle class would not have the time or resources to commit to these interests. The portrait of the clerk and the squire in â€Å"The Canterbury Tales† shows two men of similar age; in the same time frame, â€Å"The Middle Ages†. We learn that the two are very different in appearance, personality and interests. This can be attributed to the fact that they grew up in different classes. The clerk in the â€Å"Middle Class† and the squire in the â€Å"High Class†, in this time  frame classes molded how an individual grew and learned. Chaucer shows in his novel how two individuals can be the same in some ways but very different in others.