Understanding the Binge-Purge Cycle in Bulimia

Understanding the Binge-Purge Cycle in Bulimia Eating Disorders Print Dealing With the Binge-Purge Cycle in Bulimia By Susan Cowden, MS facebook linkedin Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders. Learn about our editorial policy Susan Cowden, MS Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on November 20, 2019 Justin Sullivan / Staff / Getty Images More in Eating Disorders Symptoms Treatment Diagnosis Awareness and Prevention In This Article Table of Contents Expand Triggering Events Binge-Eating Episode Results of Cycle Purging Episode Follows Calm Period View All Back To Top The binge-purge cycle is a cycle of behaviors, thoughts, and emotions experienced by many people who suffer from the eating disorder  bulimia nervosa. A portion of this cycle may also be experienced by people with binge eating disorder.?? The cycle looks like this: diet-binge-purge-repeat. It typically repeats itself over and over, and if you are suffering from bulimia nervosa, you may feel like its impossible to stop. But understanding this pattern of behavior is one of the best ways to figure out how to stop it and start on the road to  recovery. Triggering Events for Binge-Purge Cycle It is important to recognize that the model above, derived from cognitive-behavioral therapy, shows how a binge cycle is maintained. It does not indicate how the eating disorder first developed. Every binge cycle has an event or series of events that trigger the cycle. These triggers need not have caused the  eating disorder itselfâ€"in many cases, the triggering events or emotions are different every time. But these triggers do start a new cycle of bingeing and purging.?? Many binges stem from food deprivation. Individuals who diet or restrict their eating, even in subtle ways, set themselves up for binge eating. Food is a basic need and when that need is not met, it is normal to intake a larger than normal amount when you do allow yourself to eat again. Many people identify specific emotions as triggers for binges, such as sadness, loneliness, guilt, or feelings of helplessness or hopelessness. These emotions, which so frequently are difficult to handle, may be experienced throughout the course of a day or days. They may be caused by a specific event or series of events, such as an argument with a loved one, criticism at work, or self-criticism. People tend to be more vulnerable to emotional eating when they have been restricting their eating. Regardless of the specific emotion or event, identifying your own triggers is one way to recognize red flags which mean you need to do something different. Binge-Eating Episode Binge eating is defined as eating more in a single setting than most people would. Although this definition is very subjective, binges are much larger than a regular meal and can often contain several thousand calories. Many people describe binges in terms of feeling out of control or not really even knowing how much they are eating. Some people describe the experience as being zoned out as theyre eating â€" they then look down to find empty boxes/containers.?? Binge eating is one of the main behaviors in the binge-purge cycle. It may begin innocently with eating a small portion of food that is typically considered “off-limits.” After eating this portion many people feel guilty and decide to “eat the rest” as they’ve already “blown their diet” and would rather finish the rest of the forbidden food so it won’t be around to tempt them tomorrow. Challenging Forbidden Foods Alternatively, a binge can begin with eating comfort foods to soothe the negative emotions related to an upsetting event and then continue into a full binge. It can also be your bodys way of getting nourishment when you havent been eating enough food. Physical and Emotional Results of Cycle After a binge, most people feel uncomfortable, or even painfully, full. This feeling goes beyond the fullness you experience after, say, a major holiday meal with family and friends. Its simply the result of eating so much. Along with these physical pains comes emotional pain, possibly including feelings of embarrassment, shame, guilt, disgust and/or self-criticism. These emotions typically lead to the purge part of the cycle.?? Purging Episode Often Follows Quickly For many sufferers, the time span between binging and purging is very short. Purging becomes a way to relieve oneself of the negative feelings (physical and emotional) of the binge. 6 Steps to Stopping a Cycle of Binging and Purging Most people think of purging as self-induced vomiting, but it can also include  laxative  and/or diuretic use. Sometimes people use other behaviors, such as exercise, to compensate for the additional calories consumed in a binge.?? Some people will have one binge and purge episode and then go into a period of calm. Others may binge and purge multiple times before stopping. Calm Period Before Cycle Restarts After a binge and purge episode, there may be a period of calm. At this point, a person may resolve to never binge or purge again. He or she may even decide to begin restricting his or her food intake. Unfortunately, this will simply lead to binge eating again.?? There are also people who acknowledge that they will likely binge and purge again. They feel hopeless to stop the cycle. A Word From Verywell If you are experiencing bingeing and purging, the first thing is to know that recovery is possible. You may be able to apply some strategies on your own. Keep food records to understand your own patterns. Learn some strategies for breaking the cycle. Finally, seek help from a qualified professional. How to Challenge All-or-nothing Thinking

Literature Review Of Managing Risk In Farming Concepts Finance Essay - Free Essay Example

Sample details Pages: 7 Words: 2061 Downloads: 4 Date added: 2017/06/26 Category Finance Essay Type Research paper Did you like this example? Joy Harwood, Richard Heifner, Keith Coble, Janet Perry, and Agapi Somwaru (1999), Managing Risk in Farming: Concepts, Research, and Analysis, Agricultural Economic Report No. 774. Washington DC, Economic Research Service, U.S. Department of Agriculture. Risk and Risk Management Risk is the possibility of adversity or loss (Bodie and Merton) and refers to uncertainty that matters. Consequently, risk management involves choosing among alternatives to reduce the effects of risk. Risk management typically requires the evaluation of tradeoffs between changes in risk, expected returns, entrepreneurial freedom, and other variables. Understanding risk is a starting point to help producers make good management choices in situations where adversity and loss are possibilities. Some risk management strategies (such as diversification) reduce risk with-in the farms operation, others(such as production contracting) transfer risk outside the farm, and still others (such as maintaining liquid assets) build the farms capacity to bear risk. Don’t waste time! Our writers will create an original "Literature Review Of Managing Risk In Farming Concepts Finance Essay" essay for you Create order Sources of Risk in Farming Some risks are unique to agriculture, such as the risk of bad weather significantly reducing yields within a given year. Other risks, such as the price or institutional risks discussed below, while common to all businesses, reflect an added economic cost to the producer. If the farmers benefit-cost tradeoff favors mitigation, then he will attempt to lower the possibility of adverse effects. These risks include the following: (Hardaker, Huirne, and Anderson; Boehlje and Trede;Baquet, Hambleton, and Jose; Fleisher) Production or yield risk Yield risk occurs because agriculture is affected by many uncontrollable events that are often related to weather, including excessive or insufficient rainfall, extreme temperatures, hail, insects, and diseases. Technology plays a key role in production risk in farming. The rapid introduction of new crop varieties and production techniques often offers the potential for improved efficiency, but may at times yield poor results, particularly in the short term. In contrast, the threat of obsolescence exists with certain practices (for example, using machinery for which parts are no longer available), which creates another kind of risk. Price or market risk Price or market risk reflects risks associated with changes in the price of output or of inputs that may occur after the commitment to production has begun. In agriculture, production generally is a lengthy process. Livestock production, for example, typically requires ongoing investments in feed and equipment that may not produce returns for several months or years. Because markets are generally complex and involve both domestic and international considerations, producer returns may be dramatically affected by events in far-removed regions of the world. Institutional risk Institutional risk results from changes in policies and regulations that affect agriculture. This type of risk is generally manifested as unanticipated production constraints or price changes for inputs or for output. For example, changes in government rules regarding the use of pesticides (for crops) or drugs (for livestock) may alter the cost of production or a foreign countrys decision to limit imports of a certain crop may reduce that crops price. Other institutional risks may arise from changes in policies affecting the disposal of animal manure, restrictions in conservation practices or land use, or changes in income tax policy or credit policy. Human or Personal Risks Farmers are also subject to the human or personal risks that are common to all business operators. Disruptive changes may result from such events as death, divorce, injury, or the poor health of a principal in the firm. In addition, the changing objectives of individuals involved in the farming enterprise may have significant effects on the long run performance of the operation. Asset risk is also common to all businesses and involves theft, fire, or other loss or damage to equipment, buildings, and livestock. A type of risk that appears to be of growing importance is contracting risk, which involves opportunistic behavior and the reliability of contracting partners. Financial risks Financial risk differs from the business risks previously described in that it results from the way the firms capital is obtained and financed. A farmer may be subject to fluctuations in interest rates on borrowed capital, or face cash flow difficulties if there are insufficient funds to repay creditors. The use of borrowed funds means that a share of the returns from the business must be allocated to meeting debt payments. Even when a farm is 100-percent owner financed, the opera-tors capital is still exposed to the probability of losing equity or net worth. How Farmers Can Manage Risk Farmers have many options in managing agricultural risks. They can adjust the enterprise mix (diversify) or the financial structure of the farm (the mix of debt and equity capital). In addition, farmers have access to various tools-such as insurance and hedging-that can help reduce their farm-level risks. Indeed, most producers combine the use of many different strategies and tools. Producers must decide on the scale of the operation, the degree of control over resources (including how much to borrow and the number of hours, if any, worked off the farm), the allocation of resources among enterprises, and how much to insure and price forward. Enterprise Diversification Diversification is a frequently used risk management strategy that involves participating in more than one activity. The motivation for diversifying is based on the idea that returns from various enterprises do not move up and down in lockstep, so that when one activity has low returns, other activities likely would have higher returns. A crop farm, for example, may have several productive enterprises (several different crops or both crops and livestock), or may operate disjoint parcels so that localized weather disasters are less likely to yields risk for all crops simultaneously. Vertical Integration Vertical integration includes all of the ways that output from one stage of production and distribution is transferred to another stage. Farming has traditionally operated in an open production system, where a commodity is purchased from a producer at a market price determined at the time of purchase. The use of open production has declined and vertical coordination has increased as consumers have become increasingly sophisticated and improvements in technology have allowed greater product differentiation (Martinez and Reed). In practice, vertical integration in agriculture often involves owner-ship of both farm production and processing activities; like sorting, assembling, and packaging products for retail sales. While the above examples relate to individual operations, farmers may join together in a cooperative organization that is vertically integrated across functions. Production contracts Production contracts typically give the contractor (the buyer of the commodity) considerable control over the production process (Perry, 1997). These contracts usually specify in detail the production inputs supplied by the contractor, the quality and quantity of a particular commodity that is to be delivered, and the compensation that is to be paid to the grower. Firms commonly enter into production contracts with farmers to ensure timeliness and quality of commodity deliveries, and to gain control over the methods used in the production process. Production contracting is particularly favored when specialized inputs and complex production technologies are used, and the end product must meet rigid quality levels and possess uniform characteristics. Production contracting is also favored when oversupply and undersupply have been problems, the risk-return tradeoffs are advantageous to both the producer and the contracting firm, production technologies are specific, uniform, and knowled ge-based, centralized management is feasible, and the commodity is highly perishable (Kliebenstein and Lawrence; Harris). Evidence suggests that farmers enter production contracts to guarantee market access, improve efficiency, and ensure access to capital. Most production contracts lower farmers price risks when compared with risks on the open market. This suggests that farmers are well aware of the risk-shifting capacity (Perry, 1997). Marketing contracts Marketing contracts are either verbal or written agreements between a buyer and a producer that set a price and/or an outlet for a commodity before harvest or before the commodity is ready to be marketed (Perry, 1997). The contract terms vary across contracts, but typically establish a price (or contain provisions for setting a price at a later date) and provide for delivery of a given quality (or grade) within a specified time period at a flat price (or fixed price). In contrast, minimum-price contracts guarantee the producer a minimum price for harvest delivery, based on futures price quotes at the time the contract is established, with the incorporation of a pricing formula that gives farmers the opportunity to sell at a higher price if futures prices increase before the contract expires. Most types of contracts do not completely eliminate price risk except the flat-price contracts, which establish an exact price to be paid to the grower upon delivery and thus completely eliminate price risk. Liquidity Another aspect of financial risk management is liquidity, which involves the farmers ability to generate cash quickly and efficiently in order to meet his financial obligations (Barry and Baker). The liquidity issue relates to cash flow and addresses the question: When adverse events occur, does a farmer have assets (or other monetary sources) that can easily be converted to cash to meet his financial demands? Examples of liquid assets include grain in storage, cash, and company stock holdings, while illiquid assets include land, machinery, and other fixed assets. Leasing Inputs and Hiring Custom Work Producers can also manage their farming risks by either leasing inputs (including land) or hiring workers during harvest or other peak months. Leasing refers to a capital transfer agreement that provides the renter (the actual operator) with control over assets owned by someone else for a given period, using a mutually agreed-upon rental arrangement (Perry, 1997). Farmers can lease land, machinery, equipment, or livestock. Leasing reduces the long-term fixed payments on borrowed capital that may strain liquidity in years of reduced output, and can reduce both financial and production risk for the renter (Sommer and others, 1998). Crop Insurance Insurance is often used by crop producers to mitigate yield (and hence, revenue) risk, and is obviously prevalent outside of agriculture. Property, health, automobile, and liability insurance are all forms of insurance regularly purchased by individuals to mitigate risk. For an individual, the use of insurance involves the exchange of a fixed, relatively small payment (the premium) for protection from uncertain, but potentially large, losses (Ray). The Government should also reinsures private companies that sell policies (that is, the Government shares in the risk of loss) to help reduce financial losses in years of widespread disasters. Risk protection is greatest when crop-yield insurance (which provides yield risk protection) is combined with forward pricing or hedging (which provide price risk protection). Off-farm Employment and Off-farm Income Earning off-farm income is another strategy that farmers may use to mitigate the effects of agricultural risk on farm family household income. Farm household income can be categorized as earned off-farm income (wages and salaries), unearned off-farm income (social security, pensions, and investments), and farm net cash income. Off-farm income not only can supplement household income, it may also provide a more reliable stream of income than farm returns. In essence, off-farm income can offer a form of diversification to counter negative fluctuations in farm income. Farm household total income has been found significantly less variable if producers and their spouses worked off the farm (Mishra and Goodwin, 1997). Other Ways of Managing Risk Many other diverse strategies for farm risk management are commonly used by producers on their operations. Some of these additional strategies include the following: Adjusting inputs and outputs (Improve Technical and Allocative Efficiency) Producers can respond to risk by altering output levels, input use, or some combination of the two. Research indicates that greater output price risk results in lower levels of both input use and final output. Given that preferences toward risk and circumstances can vary greatly across producers, the final input and output levels chosen by producers can, accordingly, vary considerably for individuals in similar situations. Cultural Practices or Indigenous Knowledge Cultural practices can be used to enhance yield and, hence, reduce income risk. One such practice involves planting short-season varieties that mature earlier in the season, protecting against the risk of early frost and yield loss. Supplemental irrigation due to abnormal weather is another means to protect against yield loss. Excess Machine Capacity A farmer may have enough machine capacity so that planting and harvesting crops can occur more rapidly than needed under normal weather conditions. By having such resources, the farmer can avoid delays at either planting or harvest that may reduce yield losses.

Teenage Girls and Body Image Essay - 1291 Words

Teenage girls are at an impressionable time in their lives. Mass Media is a key idea in one of the factors of socialization that become important to teenagers. Teenagers look to the media for a sense of entertainment. Whether it is movies, magazines, or even some aspects of social media, teenagers get a lot of influence from the media’s message. The problem with this is the media has a specific way of doing things and can be negative to a susceptible teenage girl. Media’s way of portraying a woman can be skewed and unrealistic way from what reality is. Teenage girls then have a desire for this look or way. In this essay the three ways I will describe as to why the media can negatively affect a teenage girls body image is by showing†¦show more content†¦In a study done of female beauty icons, two time frames were studied, 1959-1978 and 1979-1988. In the research, the women who were portrayed as beautiful, and the icons in the media, were observed and over half o f them had fit into the standards of having one of the eating disorders, anorexia nervosa (Vonderen Kinnally, 2012). Mass media can have an adverse effect teenage girls by showing body types that are unrealistic as the normal and desirable type of body to have. Young women look to the mass media to see the societal norms for beauty, and what they see can influence the way that they view themselves. By portraying women who possess a body type that is uncommon, it shows teenage girls that they need to change themselves to reflect the images they are shown. Portraying body types that emphasize thinness and exaggerated features, the mass media try to establish what is socially acceptable. Teenage girls who see this message feel pressured to become what they see, often not realizing that the body types portrayed in media are unrealistic. One reason mass media is so effective at portraying unrealistic body types as normal is because the mass media helps to set what is perceived as normal. In an article about the mass media’s role in body image disturbance and eating disorders, J. Kevin Thompson and Leslie Heinberg state, â€Å"A sociocultural model emphasizes that the current societal standard for thinness, as well as other difficult-to-achieve standards of beautyShow MoreRelatedTeenage Girls and Media Essay576 Words   |  3 PagesTeenage girls receive around 40 hours of media exposure every week. This is the most time that teens spend on an activity other than school and sleeping. Teenage girls are highly influenced by the ideal body image that they see on screen. Girls have a difficult time trying to attain the ideal body image and may diet or develop eating disorders to take control of their weight and body figure. When girls fail to do so, they can become depressed and have a lower self-esteem. 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Position Paper Pepsico’s Restaurants Free Essays

Position Paper: PepsiCo’s Restaurants Pepsi Co’s Restaurants is a Harvard Business School Case which states PepsiCo’s large organization, its structure, its acquisitions and management approach. It also covers two companies, Carts of Colorado (COC) and California Pizza Kitchen (CPK) which are pursued from PepsiCo in 1991 to buy. In this position paper PepsiCo’s acquiring strategy and management approach will be evaluated to examine strengths and weaknesses of acquiring these two companies and possible solutions of other strategies. We will write a custom essay sample on Position Paper: Pepsico’s Restaurants or any similar topic only for you Order Now It will be also qualified whether it is a successful company in restaurant business. Pepsi’s acquiring strategy is diversified. First, it merged with Frito-Lay in 1965 and named PepsiCo. The case states the belief of Kendall that â€Å"snack chips went well with soda. † It was a product-extension merger. These two companies were selling different but related products in the same market. Snack foods and soft drinks are related. With the help of established distribution network and brand recognition the merge resulted higher growth and economies of scale. This synergy was the basis of further developments. After that PepsiCo. acquired restaurant chains, which was the third segment for the company. You can read also Classifications of Restaurants PepsiCo made market-extension and also product-extension with this purchase. It acquired the largest chains like Pizza Hut, Taco Bell at late 70’s and KFC in 1986. (Exhibit 1) With their economies of scale, it created market access for its own products and the restaurants could make cost reduction and cost efficiency with the growth of PepsiCo through soft drinks and also similar purchases. (PepsiCo Food Systems) Additionally, the acquirements of KFC with its franchises (Exhibit 5) was important because it helped PepsiCo to be internationally powerful. For this purpose, they used also a different strategy for their snack food segment and acquired Smith Crisps, Ltd from United Kingdom which was its competitor for European market. (horizontal acquisition) Besides, PepsiCo purchased supplier companies like bottling subsidiaries as backward integration (instruments of standard-cycle approach like PepsiCo Food Systems, cost efficiency is very important ) and also conglomeration like Wilson Sporting Goods, but they sold what they acquired when the parts are not greater than the whole. PepsiCo has decentralized management approach. Every decision didn’t taken by top management. The responsibility for authority and decision making is distributed. Pepsi commercial which included Michael Jackson with a 5$ million record fee was told CEO only a few hours before the contract. Moreover, Kendall encouraged managers to take risks and stated â€Å"If you go through your career and never make a mistake, you’ve never tried anything worthwhile† and the president of Pizza Hut, Steve Reinemund mentioned that Calloway, the follower CEO after Kendall, had never told him what to do. These are typical examples for decentralization, but it also shows us that there is a tradition at PepsiCo, the top management showed their managers their trust and tried to challenge their thought process. This is the result of PepsiCo investment on them. Calloway’s response for outstanding performance was â€Å"the three P’s people, people, people†. Such decision makers should be experienced. Actually their two phase system was very successful because it let successful managers to promote another divisions, challenging positions or different functional areas. Most of the top management which can be seen from organization chart (Exhibit 2) had participated at all levels of PepsiCo with different assignments, so they were generalists and great managers with different experiences. Their management approach can be described as Calloway states â€Å"We take eagles and teach them to fly in formation. † Carts of Colorado and California Pizza Kitchen were two companies that PepsiCo. were interested to acquire. The advantages and disadvantages of such acquisitions will be considered separately. But first of all, we have to consider what was the strategy of PepsiCo for the future and what PepsiCo has experienced. According to strategic planners of the company quick service restaurants would remain the largest segment over the following decade. Based on their analyses, quick service, casual dining and take out segments would be attractive. On the other hand, PepsiCo. invested to casual dining like Pizza Hut Cafe and experienced that their know-how for this segment is low. (Reinemund: â€Å"We needed people to come in and break the mold of our thinking. We knew enough to know what we didn’t) Additionally, Salsa Rio Grill which is also an investment for casual dining was a failure, but it has also mentioned it could be successful with a different setting. These are aspects that we have to think whether to acquire CPK. The case also mentions that PepsiCo. needed non-traditional program to increase points of distribution. That can be achieved with carts. The company also purchased carts from COC because they saw a potential future that the location of sales was really important. If COC is acquired, than PepsiCo ould acquire skills or technologies more quickly or at lower cost than they could be built in-house. This can be seen as a strength, however COC’s carts wouldn’t cover the core competence of PepsiCO, therefore its acquisition could be not cost efficient. There is also an opportunity of first mover with the know-how of COC PepsiCo could achieve the most efficient mobile storesi, might be also apply some strat egies for automats. The threat was that COC has a centralized organization, because of adaptation problems whole project could be a failure. Acquisition of CPK has strengths according to its operating segment of casual dining. The weakness could be because of its cost comparing to its benefit. Strategic planners saw casual dining segment a growth market and with its know-how they would expand their market. Its threat is centralized structure of CPK. They failed with Pizza Hut Cafe and Salsa Rio Grill and it could also happen with CPK if they apply their quick service strategies. According my point of view PepsiCo should not acquire CPK because PepsiCo. ’s tradition is very powerful and they want to adopt their strategies to CPK, but added value and core competence of this companies is its centralized structure. If they act so, they will fail, instead of acquiring synergy. Additionally, the economies of scale CPK is also small which would not add value to its soft drink segment, the acquirement of other restaurant chains was also beneficial for brand awareness and reputation, this wouldn’t happen for CPK. They would acquire it for know-how of this company, but the company is not public and centralized, everything will depend on cofounders of CPK, this a very big risk if we compare benefits and its cost. On the other hand, PepsiCo could acquire COC, but they could make a technology contract with such a company. In such a contract the threat is the benefit, the synergy with experience of PepsiCo and know-how of COC can be extraordinary. If COC shares the results to other competitors, that wouldn’t be a one sided gain, so comparing with its cost, it would be much better to acquire it because built-in of such department would be also very costly. As a result, I want also add my comments about the success status of Pepsi in restaurant business. I believe, it is successful. Although its history is short comparing with soft drink segment, its revenue is greater than soft drink segment and this is a success, PepsiCo differentiated its products, it made a great purchase system for cost effectiveness, but it had to increase its profitability according to 1991 data. Although it covered 36% of PepsiCo sales, but operating profit was 29% and as we knew from case, PepsiCo main strategy was investing to where it believed it could achieve the highest returns. (Exhibit 4) Reference: http://www. mckinseyquarterly. com/The_five_types_of_successful_acquisitions_2635 PepsiCo’s Restaurants Harvard Business School Case How to cite Position Paper: Pepsico’s Restaurants, Papers Position Paper Pepsico’s Restaurants Free Essays Position Paper: PepsiCo’s Restaurants Pepsi Co’s Restaurants is a Harvard Business School Case which states PepsiCo’s large organization, its structure, its acquisitions and management approach. It also covers two companies, Carts of Colorado (COC) and California Pizza Kitchen (CPK) which are pursued from PepsiCo in 1991 to buy. In this position paper PepsiCo’s acquiring strategy and management approach will be evaluated to examine strengths and weaknesses of acquiring these two companies and possible solutions of other strategies. We will write a custom essay sample on Position Paper: Pepsico’s Restaurants or any similar topic only for you Order Now It will be also qualified whether it is a successful company in restaurant business. Pepsi’s acquiring strategy is diversified. First, it merged with Frito-Lay in 1965 and named PepsiCo. The case states the belief of Kendall that â€Å"snack chips went well with soda. † It was a product-extension merger. These two companies were selling different but related products in the same market. Snack foods and soft drinks are related. With the help of established distribution network and brand recognition the merge resulted higher growth and economies of scale. This synergy was the basis of further developments. After that PepsiCo. acquired restaurant chains, which was the third segment for the company. PepsiCo made market-extension and also product-extension with this purchase. It acquired the largest chains like Pizza Hut, Taco Bell at late 70’s and KFC in 1986. (Exhibit 1) With their economies of scale, it created market access for its own products and the restaurants could make cost reduction and cost efficiency with the growth of PepsiCo through soft drinks and also similar purchases. (PepsiCo Food Systems) Additionally, the acquirements of KFC with its franchises (Exhibit 5) was important because it helped PepsiCo to be internationally powerful. For this purpose, they used also a different strategy for their snack food segment and acquired Smith Crisps, Ltd from United Kingdom which was its competitor for European market. (horizontal acquisition) Besides, PepsiCo purchased supplier companies like bottling subsidiaries as backward integration (instruments of standard-cycle approach like PepsiCo Food Systems, cost efficiency is very important ) and also conglomeration like Wilson Sporting Goods, but they sold what they acquired when the parts are not greater than the whole. PepsiCo has decentralized management approach. Every decision didn’t taken by top management. The responsibility for authority and decision making is distributed. Pepsi commercial which included Michael Jackson with a 5$ million record fee was told CEO only a few hours before the contract. Moreover, Kendall encouraged managers to take risks and stated â€Å"If you go through your career and never make a mistake, you’ve never tried anything worthwhile† and the president of Pizza Hut, Steve Reinemund mentioned that Calloway, the follower CEO after Kendall, had never told him what to do. These are typical examples for decentralization, but it also shows us that there is a tradition at PepsiCo, the top management showed their managers their trust and tried to challenge their thought process. This is the result of PepsiCo investment on them. Calloway’s response for outstanding performance was â€Å"the three P’s people, people, people†. Such decision makers should be experienced. Actually their two phase system was very successful because it let successful managers to promote another divisions, challenging positions or different functional areas. Most of the top management which can be seen from organization chart (Exhibit 2) had participated at all levels of PepsiCo with different assignments, so they were generalists and great managers with different experiences. Their management approach can be described as Calloway states â€Å"We take eagles and teach them to fly in formation. † Carts of Colorado and California Pizza Kitchen were two companies that PepsiCo. were interested to acquire. The advantages and disadvantages of such acquisitions will be considered separately. But first of all, we have to consider what was the strategy of PepsiCo for the future and what PepsiCo has experienced. According to strategic planners of the company quick service restaurants would remain the largest segment over the following decade. Based on their analyses, quick service, casual dining and take out segments would be attractive. On the other hand, PepsiCo. invested to casual dining like Pizza Hut Cafe and experienced that their know-how for this segment is low. (Reinemund: â€Å"We needed people to come in and break the mold of our thinking. We knew enough to know what we didn’t) Additionally, Salsa Rio Grill which is also an investment for casual dining was a failure, but it has also mentioned it could be successful with a different setting. These are aspects that we have to think whether to acquire CPK. The case also mentions that PepsiCo. needed non-traditional program to increase points of distribution. That can be achieved with carts. The company also purchased carts from COC because they saw a potential future that the location of sales was really important. If COC is acquired, than PepsiCo ould acquire skills or technologies more quickly or at lower cost than they could be built in-house. This can be seen as a strength, however COC’s carts wouldn’t cover the core competence of PepsiCO, therefore its acquisition could be not cost efficient. There is also an opportunity of first mover with the know-how of COC PepsiCo could achieve the most efficient mobile storesi, might be also apply some strat egies for automats. The threat was that COC has a centralized organization, because of adaptation problems whole project could be a failure. Acquisition of CPK has strengths according to its operating segment of casual dining. The weakness could be because of its cost comparing to its benefit. Strategic planners saw casual dining segment a growth market and with its know-how they would expand their market. Its threat is centralized structure of CPK. They failed with Pizza Hut Cafe and Salsa Rio Grill and it could also happen with CPK if they apply their quick service strategies. According my point of view PepsiCo should not acquire CPK because PepsiCo. ’s tradition is very powerful and they want to adopt their strategies to CPK, but added value and core competence of this companies is its centralized structure. If they act so, they will fail, instead of acquiring synergy. Additionally, the economies of scale CPK is also small which would not add value to its soft drink segment, the acquirement of other restaurant chains was also beneficial for brand awareness and reputation, this wouldn’t happen for CPK. They would acquire it for know-how of this company, but the company is not public and centralized, everything will depend on cofounders of CPK, this a very big risk if we compare benefits and its cost. On the other hand, PepsiCo could acquire COC, but they could make a technology contract with such a company. In such a contract the threat is the benefit, the synergy with experience of PepsiCo and know-how of COC can be extraordinary. If COC shares the results to other competitors, that wouldn’t be a one sided gain, so comparing with its cost, it would be much better to acquire it because built-in of such department would be also very costly. As a result, I want also add my comments about the success status of Pepsi in restaurant business. I believe, it is successful. Although its history is short comparing with soft drink segment, its revenue is greater than soft drink segment and this is a success, PepsiCo differentiated its products, it made a great purchase system for cost effectiveness, but it had to increase its profitability according to 1991 data. Although it covered 36% of PepsiCo sales, but operating profit was 29% and as we knew from case, PepsiCo main strategy was investing to where it believed it could achieve the highest returns. (Exhibit 4) Reference: http://www. mckinseyquarterly. com/The_five_types_of_successful_acquisitions_2635 PepsiCo’s Restaurants Harvard Business School Case How to cite Position Paper: Pepsico’s Restaurants, Essay examples

Developing Professional Competence In Health Information Industry

Question: Discuss about the Value Of Reflective Practice And Its Role In Developing Professional Competence In Health Information Industry. Answer: Introduction To develop professional competence, the first step is to develop self-awareness and an understanding of the self. Reflective practice is an important exercise that contextualises this self with healthcare practice, thus enabling the improvement of healthcare services, as well as development of practitioners having comprehensive outlook, simultaneously alarmed with health inconsistencies, and keeping in mind access, justice and diversity to healthcare services. The first step to reflective practice is an exploration of values within self that mobilises health professionals facilitating a dialogue through peers, and helps in discovering the social and chronological milieus of healthcare practice. This also includes the levels of methodological and applied reflection as encompassing practitioners consider ethical, principled and historical frameworks of their training (Gardner, 2009; Hickson, 2011). This approach also appeals to means of significance, and training improvement techniques thus developing involved and appreciated action as a context for the development of health professionals teaching (Ghaye, 2007; Dewing, 2010). The aim of critical reflection exercise is to enable scholars and specialists to inquire critical questions of themselves about their practice, and thus addressing the significant issues, which were first encountered during their practice. Role of Reflective Practice in developing professional competence Reflective practice has an extensive history in nursing education. It developed from the efforts of distinguished educationalist, John Dewey, and thus practice of reflection was originally hypothesized as an energetic, tenacious, and cautious contemplation of any belief or knowledge in the light of the grounds that maintain it, and the further conclusions to which it trends. Thus reflection is a skill as well as the aptitude, to contemplate critically about ones own decisions and actions, and simultaneously to realize the larger contexts within which these decisions were made (Fook, and Gardner, 2007). People learn not only by contemplating but by doing: and also by reflecting about things they were doing and the circumstances in which they were doing it that way. Reflection therefore, is a part of the course of doing some work explicitly and hence, to bring about the foreseen consequences which in turn challenge the hypothesis at the first place. Donald Schn was another academician who drawn-out on this way of contemplating, thus cultivating his impression of reflection-in-action, as the practice through which professionals makes choices in the process of their healthcare work. This idea facilitates a constant interaction between thought and action, thus increasing the capability to be proactive in real time, which represented the truly reflective health practitioner. The approach, in which reflective exercise has derived to be understood and applied in the healthcare, is now far indifferent from its original conception (Rolfe, 2014). Although healthcare professionals are now obliged to reflect as part of their registering and specialized growth, for example over the Nursing Competency Assessment Schedule and the Australian Nursing and Midwifery Board (Levett-Jones et al 2013), this has become a justly powerless application which healthcare practitioners employ once a year, rather than in their commonplace practice. Rolfe cries this turn of events, contending that reflection should led to radical critique based on the principle that knowledge produced by healthcare practitioners reflecting on their own understandings, is of at least equal value to knowledge derived by academics from pragmatic research. The reflective practice had traditionally been developed by health educators who understood the importance of evidence based practice and information based on academic research. During those timings, reflections were focused on clinical events and the objective was to identify researchable questions. This was difficult for a number of reasons. Firstly it positioned burden of learning on one subject that necessitated students to move very quickly and superficially through self-reflection identifying research questions to actually conduct and write academic literature reviews. Secondly, this approach placed a burden on the teaching staff that required teaching both research and reflective skills within the same course. At the universities, with the starting of a separate research subject in the postgraduate programs, the focus shifted towards developing meaningful and lifelong skills of critical reflection. Academicians should embolden reflection as a way of life, not just a one off task. It is only in this way that reflective practice could reach its potential to be a radical technology, capable of producing health care practitioners providing person centred care, and act as agents of social change, simultaneously placing health and wellness in its wider social context (Nelson, 2012). They should buttress their approach with well-known theory and methods of reflection recognising the unique issues of health professionals as adult learners (Dewing 2010). This requires more innovative and creative ways of practicing reflection and exploring options for online portfolios as a means of learning and assessment (Ghaye, 2007; Ross, 2011) Conclusion Thus Critical reflection enables deep analysis of ethical issues in healthcare practice. Reflection often reveals deep discomfort of students, or other peoples practicing within health systems that were based on risk management, rather than on patient centred, compassionate care. Reflection should aim towards providing patient-centered care. The patient-centred nursing framework could provide tools and concepts that students could relate to when faced with ethical dilemmas in their practice and workplaces. Most students can strongly commit to providing compassionate, patient-centred care, and critical reflection is aimed to validate and reinforce ethics in nursing profession. This is a consistent theme in students reflections which can be sought to challenge students right through the first assessment asking students to equally consider the personal, ethical, aesthetic and empirical aspects of their nursing practice. Thus reflective practice plays a vital role in inculcating professi onal competence in healthcare industry.

Tourism Tour Guide free essay sample

I am Nurul Hasanah, your tour guide for today. I am willing to guide and assist you all. And now we’re going to explore and see the beauty of Makassar. Okay, Makassar formerly called Ujung Pandang is the provincial capital of South Sulawesi and the largest city in Sulawesi Island. Makassar has become the primary port and airline hub of the eastern archipelago, the thousands of remote islands being developed and incorporated into the mainstream of Indonesian society and economy. Makassar also famous with the Phinisi Ship as a symbol and the time is in GMT+7. Okay, Ladies and Gentlemen our first destination is Fort Rotterdam. Fort Rotterdam also knows Benteng Makassar or La Galigo. This is a historical artifact of the greatness of the past kingdom of South Sulawesi. During the Dutch colonialism, the fort was rebuilt and renamed Fort Rotterdam. During the period the fort and its area started to be the center of governmental and commercial activity. We will write a custom essay sample on Tourism Tour Guide or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page During the Japanese colonialism the fort functioned as the center of agricultural and language studies. The shape of this building is like a turtle want to go to the sea because fort Rotterdam located near of sea. To enter the Fort Rotterdam, it is about Rp 5000,-. In there you can find many things about the history of South Sulawesi like the culture until the government. In this place you also can buy a book which helped you to get more information about the history of fort Rotterdam. Well, we move to the next destination is Karebosi Square. This is one of the famous soccer field in Makassar. Under the ground of the soccer field, there is a shopping center called Karebosi Link. There, you can buy many things such as shirts, skirts, shoes from the famous brand until many kinds of food. Near from the K-Link, also there is shopping center again called Mall Trade Center. First floor for shoes and bags, second floor for many kinds of shirt , third floor for hand phone and accessories, fourth floor for computers, accessories computer and camera. And the top of the building is food court, the place that you can rest and eat. Third destination is Phinisi Tower UNM. The concept this building is based on the Phinisi as Buginesse people famous as excellent sailor. This building as a new icon of South Sulawesi and become the pride of UNM society. In this place of course you can take a picture and walk around in this area and you can see miniature of UNM. Next destination is Somba Opu is a fort but now the function of this building as a miniature of traditional houses from every regency in south Sulawesi like Bugis, Toraja and Mandar. Not too far from here you can find water park called Gowa discovery. To go in the water park you have to pay about Rp 50. 000,-. And in there you can buy some traditional souvenir like t-shirt or others. Ladies and gentlemen, now welcome to Trans World Studio which located in the Regions and the Global Tourism Business Tanjung Bunga Makassar, the area of integrated tourism object in Makassar. Trans Studio was built of 12. 7 hectares with investment of 1 trillion more rupiahs. Facilities built in the shopping center which includes the Trans Walk and Rodeo Drive, and Studio Trans, Trans Hotel with the best hotel amenities, office of Bank Mega. Trans Studio building was built around 22. 000 m? ith 20 meters high which is the largest indoor amusement park in eastern Indonesia. But at this time, it becomes as the second large indoor theme park after Trans Studio Theme Park Bandung. If you want to play in there you have to buy the tickets about Rp. 150. 000,-. In theme park you can buy some souvenir like dolls, glass symbol of mascot Trans studio theme park. Well ladies and gentlemen this is the last destination, th e famous waterfront in Makassar, Pantai Losari. There is Mesjid terapung and statue of hero of south Sulawesi where they were built recently. Near of losari waterfront you can walk around for the leisure to buy special souvenirs of south Sulawesi. Around the Losari waterfront, you can eat Pisang Epe, Pisang ijo, es kelapa until the famous coto from Makassar, Coto Daeng. Okay, Ladies and Gentlemen, that is the end of our city tour today. I am very glad to see you all enjoy the wonderful vacation today with our tour and travel and see you next time.

Career as Periodontist Essay Example

Career as Periodontist Essay Example Career as Periodontist Essay Career as Periodontist Essay Dentistry is a rewarding career option that deals with the study relating to mouth, teeth, gums and other hard and soft tissues of the oral cavity. It is the occupation concerned with prevention and treatment of supporting tissues, oral disease and particular diseases of the teeth. Dentistry, in recent times, is offering great career opportunities to the professionals in the field. Dental disorder has become a common problem among people of all sections of the society. With the development of recent science and technologies, the treatment procedures have also changed considerably. The opening of more specialized subjects like periodontics, oral pathology and orthodontics have all enhanced the scope in this field. Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, diseases and conditions that affect them. The supporting tissues are known as periodontium. A professional who practices this speciality field of dentistry is known as a periodontist. Periodontist practices a full scope of periodontics with expertise ranging from dental implants to cosmetic periodontal surgery, gum grafting and crown lengthening and specializes in a wide variety of periodontal disease devoted to restoring and enhancing the natural foundation of the smile using conservative, state-of-the-art procedures that will result in beautiful, long lasting foundation of one’s smile. Apart from the routine oral hygiene maintenance, other faculties which form the scope of periodontics are treatment of periodontitis, depigmentation of oral tissues, laser surgeries, reattachment procedures, gingivoplasty, implant surgeries, etc. Gum disease is the most common disease that afflicts mankind. It may be 20 years before a patient realizes they have it and by then it may be too late, as teeth may become loose and cannot be saved. Many people don’t realize that the issues that they are having with their teeth really are gum conditions, not teeth problems. In the early stages of the disease a dentist or hygienist can treat it; but as it progressively worsens a specialist is required to treat the gum disease. The periodontal team includes the periodontist, dental assistants and dental hygienists. The periodontist screens the patient, performs the surgical care, and provides continual care according to the patient’s needs. The dental assistant performs chair side assisting duties while the dental hygienist performs traditional hygiene procedures. The goals of periodontal therapy are to preserve the natural dentition, periodontium and peri-implant tissues; to maintain and improve periodontal and peri-implant health, comfort, esthetics and function. A periodontist is a dentist with a specialty. The specialty is the area supporting the teeth and its structures. He diagnoses and treats diseases by checking on the state of the patient’s mouth, gums and teeth. He is fully certified and qualified to prescribe antimicrobial medication and drugs to treat an infection or anything else that may need a prescription. Periodontists are able to perform specific surgeries that can improve problems that affect the gums that cannot be helped through nonsurgical means. Some of the periodontal surgeries conducted by these dental providers have a cosmetic element to them and can enhance and beautify the smiles of the people who have the work done. Dental implants are also part of the surgical options that this oral health care provider may offer. These are not the limit[pic], though and he or she may also offer other services that involve his field of expertise. The scope of a periodontist’s practice includes the diagnosis and delivery of care in a variety of areas:- Full periodontal diagnosis, treatment and management Gingival augmentation grafting procedures (free gingival grafts, connective tissue grafts) Root coverage pedicle and free soft tissue graft procedures Implant dentistry Interdental papilla reconstruction Regenerative therapy Crown lengthening procedures Gingival preservation at ectopic tooth eruption Removal of aberrant frenulum Prevention of ridge collapse associated with tooth extraction. Correction of the deformed edentulous ridge Cosmetic periodontal procedure Temperomandibular joint disease – diagnosis and treatment Supportive periodontal therapy for cancer patients Comprehensive management of dental care for elderly patients [pic] [pic] [pic] [pic] [pic] [pic] A broad range of therapies exist in periodontics. No single treatment approach can provide the only means of treating any one or all periodontal diseases. One treatment modality may be appropriate for one section of the mouth while another approach may be suitable at other sites. The treatment procedures include:- Chemotherapeutic agents Resective procedures comprising of soft tissue procedures like gingivectomy, gingivoplasty, various mucogingival flap procedures; osseous procedures like ostectomy, osteoplasty; and dental tissue procedures like root resection, tooth hemisection and odontoplasty. Periodontal regenerative procedures include soft tissue grafts, bone replacement grafts, root biomodification and guided tissue regeneration. Periodontal plastic surgery Occlusal therapy include minor tooth movement, occlusal adjustment and splinting. Preprosthetic periodontal procedures Replacement of teeth by dental implants Procedures to facilitate orthodontic treatment Management of periodontal systemic interrelationships when appropriate. A significant recent development in periodontal research has been the convergence of basic and clinical research resulting in a logarithmic increase in the rate of progress. Throughout the 20th century, investigators and clinicians sought to discover the causes and trace the natural history of periodontal disease. Noteworthy progress has been made on several fronts. It was once believed that oral hygiene and age accounted predominantly for variances in the prevalence and severity of periodontal disease; now, a number of innate, acquired and environmental risk factors have been identified. Insight into periodontal wound healing has fostered promising approaches to promoting regeneration of damaged periodontal structures. The progress made in understanding the nature of periodontal disease have been  complemented by equally noteworthy therapeutic advances. The coupling of surgical and medical approaches to treatment ushers in a new era in the management of periodontal disease. Laser-assisted new attachment procedure, the LANAP protocol, is a surgical therapy designed for the treatment of periodontitis through regeneration rather than resection. This therapy and the laser used to perform it have been in use for more than a decade. The last 25 years have brought unprecedented advances to our understanding of periodontal disease. Consider that in 1970 periodontitis was believed to effect most individuals over the age of 35 years, to progress steadily in an individual once initiated until teeth were lost, to be the primary cause of tooth loss. In the 25 years then, impressive research advances in the epidemiology of periodontal disease, the specific bacterial etiology and immunoinflammatory mediators of periodontal tissue destruction have greatly altered our view of periodontal disease. Thus, given these research advances in the understanding of periodontitis, what may the future hold for improved diagnosis and treatment of periodontal disease ? Impressive research into new ways to diagnose the periodontal diseases is well underway. Investigators are seeking new ways to diagnose an individual’s degree of risk for periodontal disease initiation, susceptibility to disease progression, level of disease activity and the likely response to treatment and recurrence of active disease. New diagnostic tests should greatly advance our ability to more accurately and specifically diagnose periodontal disease. The future also looks promising for new treatment strategies to slow or arrest periodontal disease progression. Likely, we have barely scratched the surface in studying the efficacy of locally delivered antimicrobial agents to alter the disease progression. The future also holds promise for slowing disease progression by blocking inflammatory pathways important in periodontal tissue destruction. Last, research into regenerating periodontal structure lost as a result of disease has had a noteworthy record of progress in the past 25 years. Techniques that utilize bone grafts, root treatments, tissue guiding membranes or polypeptide growth factors have ably indicated that it is  possible to regenerate new attachment structures in humans. As investigators continue to unravel the mysteries of the embryonic development of periodontium, the ability to predictably regenerate lost periodontal attachment structures hold great promise for the future. CONCLUSION A standard of excellence in personalized periodontal care enables us to provide the quality periodontal services our patients deserve. As periodontal health care professionals, we should pride ourselves in providing the care the patient needs to keep his smile healthy. Building a foundation of trust by treating our patients as special individuals is vital to our success. As a periodontal practitioner, we must truly believe that preventive care and education are the keys to optional dental health. We must strive to provide dental health care vs. disease care and overwhelmingly dedicated to provide excellent personalized care and service to make the patient as comfortable and pleasant as possible. GINGIVAL GRAFTING ROOT COVERAGE FRENECTOMY DENTAL IMPLANT PERIODONTAL PLASTIC SURGERY