All About the Rise and Fall of the Berlin Wall

Erected in the dead of night on August 13, 1961, the Berlin Wall (known as Berliner Mauer in German) was a physical division between West Berlin and East Germany. Its purpose was to keep disaffected East Germans from fleeing to the West. When the Berlin Wall fell on November 9, 1989, its destruction was nearly as instantaneous as its creation. For 28 years, the Berlin Wall had been a symbol of the Cold War and the Iron Curtain between Soviet-led Communism and the democracies of the West. When it fell, the event was celebrated around the world. A Divided Germany and Berlin At the end of World War II, the Allied powers divided conquered Germany into four zones. As agreed at the  July 1945 Potsdam Conference, each was occupied by either the United States, Great Britain, France, or the Soviet Union. The same was done in Germanys capital city, Berlin.   The relationship between the Soviet Union and the other three Allied powers quickly disintegrated. As a result, the cooperative atmosphere of the occupation of Germany turned competitive and aggressive. One of the best-known incidents was the Berlin Blockade in June of 1948  during which the Soviet Union stopped all supplies from reaching West Berlin. Although an eventual reunification of Germany had been intended, the new relationship between the Allied powers turned Germany into West versus East and democracy versus Communism. In 1949, this new organization of Germany became official when the three zones occupied by the United States, Great Britain, and France combined to form West Germany (the Federal Republic of Germany, or FRG). The zone occupied by the Soviet Union quickly followed by forming East Germany (the German Democratic Republic, or GDR). This same division into West and East occurred in Berlin.  Since the city of Berlin had been situated entirely within the Soviet Zone of Occupation, West Berlin became an island of democracy within Communist East Germany. The Economic Differences Within a short period of time after the war, living conditions in West Germany and East Germany became distinctly different. With the help and support of its occupying powers, West Germany set up a capitalist society. The economy experienced such a rapid growth that it became known as the economic miracle. With hard work, individuals living in West Germany were able to live well, buy gadgets and appliances, and travel as they wished. Nearly the opposite was true in East Germany. The Soviet Union had viewed their zone as a spoil of war. They pilfered factory equipment and other valuable assets from their zone and shipped them back to the Soviet Union. When East Germany became its own country in 1949, it was under the direct influence of the Soviet Union and a Communist society was established. The economy of East Germany dragged and individual freedoms were severely restricted. Mass Emigration  From the East Outside of Berlin, East Germany had been fortified in 1952. By the late 1950s, many people living in East Germany wanted out. No longer able to stand the repressive living conditions, they decided to head to West Berlin. Although some of them would be stopped on their way, hundreds of thousands made it across the border. Once across, these refugees were housed in warehouses and then flown to West Germany. Many of those who escaped were young, trained professionals. By the early 1960s, East Germany was rapidly losing both its labor force and its population. Scholars estimate that between 1949 and 1961, nearly 2.7 million people fled East Germany. The government was desperate to stop this mass exodus, and the obvious leak was the easy access East Germans had to West Berlin. What to Do About West Berlin With the support of the Soviet Union, there had been several attempts to simply take over the city of West Berlin. Although the Soviet Union even threatened the United States with the use of nuclear weapons over this issue, the United States and other Western countries were committed to defending West Berlin. Desperate to keep its citizens, East Germany knew that something needed to be done. Famously, two months before the Berlin Wall appeared, Walter Ulbricht, Head of the State Council of the GDR (1960–1973) said, Niemand hat die Absicht, eine Mauer zu errichten. These iconic words mean, No one intends to build a wall. After this statement, the exodus of East Germans only increased. Over those next two months of 1961, nearly 20,000 people fled to the West. The Berlin Wall Goes Up Rumors had spread that something might happen to tighten the border of East and West Berlin. No one was expecting the speed—nor the absoluteness—of the Berlin Wall. Just after midnight on the night of August 12–13, 1961, trucks with soldiers and construction workers rumbled through East Berlin. While most Berliners were sleeping, these crews began tearing up streets that entered into West Berlin. They dug holes to put up concrete posts and strung barbed wire all across the border between East and West Berlin. Telephone wires between East and West Berlin were also cut and railroad lines were blocked. Soldiers closing off East Berlin with barbed wire fences. Keystone / Getty Images Berliners were shocked when they woke up that morning. What had once been a very fluid border was now rigid. No longer could East Berliners cross the border for operas, plays, soccer games, or any other activity. No longer could the approximately 60,000 commuters head to West Berlin for well-paying jobs. No longer could families, friends, and lovers cross the border to meet their loved ones.   Whichever side of the border one went to sleep on during the night of August 12, they were stuck on that side for decades. The Size and Scope of the Berlin Wall The total length of the Berlin Wall was 91 miles (155 kilometers). It cut not only through the center of Berlin, but also wrapped around West Berlin, entirely cutting it off from the rest of East Germany. The wall itself went through four major transformations during its 28-year history. It started out as a barbed-wire fence with concrete posts. Just days later, on August 15, it was quickly replaced with a sturdier, more permanent structure. This one was made out of concrete blocks and topped with barbed wire. The first two versions of the wall were replaced by the third version in 1965, consisting of a concrete wall supported by steel girders. The fourth version of the Berlin Wall, constructed from 1975 to 1980, was the most complicated and thorough. It consisted of concrete slabs reaching nearly 12-feet high (3.6 meters) and 4-ft wide (1.2 m). It also had a smooth pipe running across the top to hinder people from scaling it. Bettmann Archive / Getty Images By the time the Berlin Wall fell in 1989, there was a 300-foot No Mans Land established on the exterior, and  an additional inner wall. Soldiers patrolled with dogs and a raked ground revealed any footprints. The East Germans also installed anti-vehicle trenches, electric fences, massive light systems, 302 watchtowers, 20 bunkers, and even minefields. Over the years, propaganda from the East German government would say that the people of East Germany welcomed the Wall. In reality, the oppression they suffered and the potential consequences they faced kept many from speaking out to the contrary. The Checkpoints of the Wall Although most of the border between East and West consisted of layers of preventative measures, there were little more than a handful of official openings along the Berlin Wall. These checkpoints were for the infrequent use of officials and others with special permission to cross the border. Checkpoint Charlie. Express / Getty Images The most famous of these was Checkpoint Charlie, located on the border between East and West Berlin at Friedrichstrasse. Checkpoint Charlie was the main access point for Allied personnel and Westerners to cross the border. Soon after the Berlin Wall was built, Checkpoint Charlie became an icon of the Cold War, one that has frequently been featured in movies and books set during this time period. Escape Attempts and the Death Line The Berlin Wall did prevent the majority of East Germans from emigrating to the West, but it did not deter everyone. During the history of the Berlin Wall, it is estimated that about 5,000 people made it safely across. Soldiers investigating a tunnel dug beneath the Berlin wall. Michael Ochs Archives / Getty Images Some early successful attempts were simple, like throwing a rope over the Berlin Wall and climbing up. Others were brash, like ramming a truck or bus into the Berlin Wall and making a run for it. Still others were suicidal as some people jumped from the upper-story windows of apartment buildings that bordered the Berlin Wall.   Soldiers patrolling the Death Strip. KEENPRESS / Getty Images In September 1961, the windows of these buildings were boarded up and the sewers connecting East and West were shut off. Other buildings were torn down to clear space for what would become known as the Todeslinie, the Death Line or Death Strip. This open area allowed a direct line of fire so East German soldiers could carry out  Shiessbefehl, a 1960 order that they were to shoot anyone trying escape. Twenty-nine people were killed within the first year. As the Berlin Wall became stronger and larger, escape attempts became more elaborately planned. Some people dug tunnels from the basements of buildings in East Berlin, under the Berlin Wall, and into West Berlin. Another group saved scraps of cloth and built a hot air balloon and flew over the Wall. Unfortunately, not all escape attempts were successful. Since the East German guards were allowed to shoot anyone nearing the eastern side without warning, there was always a chance of death in any and all escape plots. It is estimated that somewhere between 192 and 239 people died at the Berlin Wall. The 50th Victim of the Berlin Wall One of the most infamous cases of a failed attempt occurred on August 17, 1962. In the early afternoon, two 18-year-old men ran toward the Wall with the intention of scaling it. The first of the young men to reach it was successful. The second one, Peter Fechter, was not. West Berliners Protesting at Berlin Wall with pictures of Peter Fechters body. Corbis / Getty Images As he was about to scale the Wall, a border guard opened fire. Fechter continued to climb but ran out of energy just as he reached the top. He then tumbled back onto the East German side. To the shock of the world, Fechter was just left there. The East German guards did not shoot him again nor did they go to his aid. Fechter shouted in agony for nearly an hour. Once he had bled to death, East German guards carried off his body. He became the 50th person to die at the Berlin Wall and a permanent symbol of the struggle for freedom. Communism Is Dismantled The fall of the Berlin Wall happened nearly as suddenly as its rise. There had been signs that the Communist bloc was weakening, but the East German Communist leaders insisted that East Germany just needed a moderate change rather than a drastic revolution. East German citizens did not agree. Russian leader Mikhail Gorbachev (1985–1991) was attempting to save his country and decided to break off from many of its satellites. As Communism began to falter in Poland, Hungary, and Czechoslovakia in 1988 and 1989, new exodus points were opened to East Germans who wanted to flee to the West.   In East Germany, protests against the government were countered by threats of violence from its leader, Erich Honecker (served 1971–1989). In October 1989, Honecker was forced to resign after losing support from Gorbachev. He was replaced by Egon Krenz who decided that violence was not going to solve the countrys problems. Krenz also loosened travel restrictions from East Germany. The Fall of the Berlin Wall Suddenly, on the evening of November 9, 1989, East German government official Gà ¼nter Schabowski blundered by stating in an announcement, Permanent relocations can be done through all border checkpoints between the GDR [East Germany] into the FRG [West Germany] or West Berlin. People were in shock. Were the borders really open? East Germans tentatively approached the border and indeed found that the border guards were letting people cross. Corbis  / Getty Images Very quickly, the Berlin Wall was inundated with people from both sides. Some began chipping at the Berlin Wall with hammers and chisels. There was an impromptu and massive celebration along the Berlin Wall, with people hugging, kissing, singing, cheering, and crying. Corbis  / Getty Images The Berlin Wall was eventually chipped away into smaller pieces (some the size of a coin and others in big slabs). The pieces have become collectibles and are stored in both homes and museums. There is also now a Berlin Wall Memorial at the site on Bernauer Strasse. Luis Davilla / Getty Images After the Berlin Wall came down, East and West Germany reunified into a single German state on October 3, 1990.

Psychology And Christianity Integrative Approaches Essay

A 4MAT Review of Entwistle’s Text: Integrative Approaches to Psychology and Christianity Stacy H. McConville Liberty University Online A 4MAT Review of Entwistle’s Text: Integrative Approaches to Psychology and Christianity Summary David N. Entwistle in his book titled Integrative Approaches to Psychology and Christianity: An Introduction to Worldview Issues, Philosophical Foundations, and Models of Integration (2015) aims to address the process and purpose of integrating Christianity and Psychology. To assist in promoting the readers’ understanding of how integrating Christianity and Psychology can be practiced, and the importance of integrating the two (Entwistle, 2015, p. 5). Entwistle (2015) provides the reader with knowledge of the historical issues and beliefs of Psychology and Theology, helping the reader to understand how the negative relationship they have with one another at present developed. Entwistle shows how the historical exchanges between Christianity and Psychology has been versatile, being both allies and enemies in the past. An individual’s worldview impacts every area of that individual’s life. As explained by Entwistle, an individual s feelings as to scie nce and Christianity is directly related to their worldview, a point of convergence that focuses and reshapes our awareness of the world and our place in it (Entwistle, 2015). PointsShow MoreRelatedIntegrative Approaches Of Psychology And Christianity1495 Words   |  6 Pages Summary â€Å"Integrative Approaches to Psychology and Christianity, An Introduction to Worldview Issues, Philosophical Foundations and Models of Integration† is a book written by David N. Entwistle that offers insight and awareness to the relationship between psychology and theology. Psychology and theology share a common interest in the nature and purpose of human beings. This book introduces worldview issues and a philosophical source that provides a framework of the relationship between the scienceRead MoreIntegrative Approaches Of Psychology And Christianity1331 Words   |  6 Pages4-MAT Review: Integrative Approaches to Psychology and Christianity Summary Even though some people walk the same path they may see different things. Some may see things in the theological way with God’s presence everywhere they look and everything they do. Some may see it in a psychological way, always looking for the explanation of why something is the way it is. Together, theology and psychology can bring a different view and perspective that they never would have saw by themselves. Many peopleRead MoreIntegrative Approaches Of Psychology And Christianity1529 Words   |  7 PagesIn his book, â€Å"Integrative Approaches to Psychology and Christianity,† David Entwistle (2010) provides a persuasive discourse for the assimilation of psychology and theology; secular and religious disciplines that present a â€Å"multifaceted dialogue shaped by historical interactions and tensions.† (p. 51) Of the two systems, psychology is by much of the Church thought to advocate reason over revelation whereas theology is, by more secular-leaning scholars, thought to be wanting of intellect. With TertullianRead MoreIntegrative Approaches to Psychology and Christianity: an Introduction1625 Words   |  7 PagesAbstract Integrative Approaches to Psychology and Christianity allowed me to comprehend fully the past occurrences of psychology and theology. The book displayed the faith and confidence that both psychology and Christianity must be combined in order for it to have a better understanding and allowing the client a better chance of healing. In order to do this there must be a complete understanding of each component in and of itself. Entwistle’s (2010) book presented all the facts from historyRead MoreEssay about Integrative Approaches to Psychology and Christianity1320 Words   |  6 Pages4-MAT Review Anita Cox Liberty University COUN 506 Integration of Psychology and Theology September 7, 2012 â€Æ' Integrative Approaches to Psychology and Christianity David N. Entwistle Cascade Books, 2010 Summary Just as the title describes, Entwistle explains within the book the attempts and varied approaches of integrating both psychology and Christianity, two entities which seem to have been at odds with each other since the time of Galileo. By explaining key historical conflicts, suchRead MoreBook Review of Integrative Approaches to Psychology and Christianity1265 Words   |  5 Pagesï » ¿ Book review Entwistle, David N. Integrative approaches to psychology and Christianity: An introduction to worldview issues, philosophical foundations, and models of integration. Eugene, OR:  Cascade Books, 2010. Summary Many Christians fear that their faith is incompatible with the discipline of psychology. Integrative approaches to psychology and Christianity by David Entwistle makes a persuasive case that the two disciplines are complementary rather than polarized worldviews. Faith andRead MoreIntegrative Approaches to Psychology and Christianity 4-Mat Review 1254 Words   |  6 PagesSummary In the book Integrative Approaches to Psychology and Christianity by David Entwistle compares and contrasts the secular view of Psychology and the biblical view of Psychology. Entwistle delves into the question is psychology and Christianity mutually compatibility. The Integrative Approaches, Entwistle communicates to us there is two human behavior perspectives which relate to each other. According to Entwistle (2010), In order to intertwine psychology and Christianity it is required to defineRead MoreDavid N. Entwistle Integrative Approaches Psychology And Christianity1594 Words   |  7 PagesSummary No doubt that in the book written by David N. Entwistle Integrative Approaches to Psychology and Christianity, the author leaves the truths embodied in his book. Truths that for many to this day are still trying to accommodate in their vast knowledge they have concerning the psychological science. Many still fail to understand that both psychology and theology when they go hand in hand they can become allies in treating those who for one reason or another have external and internal conflictsRead More4-Mat Review System: Integrative Approaches to Psychology and Christianity1397 Words   |  6 Pages4-MAT Review System: Integrative Approaches to Psychology and Christianity Keyanna Hawkins Liberty University A 4-MAT Review System: Integrative Approaches to Psychology and Christianity Summary In the book Integrative Approaches to Psychology and Christianity, David N. Entwistle explores the relationship between theology and psychology. Throughout time, intellectuals have supported or dismissed the idea of integrating both perspectives. In his book, Entwistle states that during theRead More4 Mat Review of Integrative Approaches to Psychology and Christianity 2nd Ed.1309 Words   |  6 Pages4 MAT Review of Integrative Approaches to Psychology and Christianity 2nd Ed. COUN 506 Sherrita L. Hedgepeth Liberty University July 14, 2012 Summary David Entwistles (2010) Integrative Approaches to Psychology and Christianity appears to be a text with a primary audience which appears to be conservative evangelical Christians. The basic ‘meat’ of the book is the premise that weaving together perspectives from psychology and Christian theology can help us understand and appreciate humanity

Mexican Cartels - 1044 Words

I. Introduction A. Greeting/ hello hows everybody doing? B. Attention getter/ Bullets begin flying, armored soldiers and drug cartel members fight it out on the steets killing each other and the surrounding civilians that are innocently just watching as they are caught in the cross fire. Now you may wonder where is this happening..Irag? Afganistan? No Its actually just south of us its happening in Mexico. C. I know this because as crazy as it sounds one of my cousins is in a drug cartel and I’ve seen the bullet holes, the blown up buildings, the blown up cars and the blood on the streets from the people that got shot when I visited Mexico. D. Thesis statement/ Although Mexico has been a producer and transportation route for illegal†¦show more content†¦c. Why are they going with the cartels? The Cartels intimidate them, tell them there going to kill them and there families if they don’t do what they tell them to do. 3. Sub point/ This is where the personal impact comes into play. a. As I told you guys earlier my cousin josue is in a Cartel to be specific it’s called Los Zetas. b. When I went to Mexico in 2008 (testimony) *Transition* Now that I told you about the Political and personal impact the drug cartels have in Mexico I’m going to wrap it up III. Conclusion A. Signal closing B. Restate thesis/ There has been a large increase in the smuggling of contraband, such as drugs, and firearms, into the U.S, and violence spilling onto our border cities due to the drug wars between the drug cartels in Mexico. C. Review main points 1. Main point #1 History of drug cartels and how they began 2. Main point #2 What is going on in present time Mexico 3. Main point #2 Political and personal impact D. Memorable statement / Now 47,515 people is way to many people to have been killed in a drug war that is happening right across our borders and that is why its something we need to know about and hopefully this speech filled you in something that you might have not known about. E.Show MoreRelatedThe Mexican Cartel, The Sinaloa Cartel1403 Words   |  6 Pages The Mexican Cartel Imagine living with your family and having a fear of leaving your house or even being in it? Many Mexican citizens are being killed by the narcotics in Mexico. Mexicans are not living in peace in their cities. Narcs never really had a time where it started, it always been around, of course it has increased, but there is no specific date or year. Important groups of the cartel is the Sinaloa cartel, the Beltran Leyva Organization and many more. This issue is important becauseRead MoreMexican Cartels1869 Words   |  8 PagesWhat is the impact of Mexican drug cartels in the United States? Andres F Urueta Dr. Maugh LIB-495-GS001 December 5, 2014 Abstract This research paper examines the impact of Mexican drug cartels in the United States. Most Americans are not aware of how far reaching these cartels are in the United States. Their power has an influence in our government and communities. 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But it was the American appetite for cocaine in the 1970s that gave Mexican drug cartels immense power to manufacture and transport drugs across the border. Early Mexican gangs were primarily situated in borderRead MoreMexican Drug Cartels1310 Words   |  6 PagesCartels Mexico’s is at its thinnest line of being uncontrolled. Cartels are a big problem in Mexico and are ruining the country; they are a serious mater in the world we live in today. The cartels are formed in groups and structures to control the production and distribution of narcotic drugs. They are criminal groups that develop and control drug trafficking operations. Mexico, the state that is right now is a very heavy situation that is difficult to control. Cartels range from wacky managedRead MoreThe Fight Against Mexican Drug Cartels1743 Words   |  7 PagesThe Uphill Battle Against Mexican Drug Cartels â€Å"Drugs continue to kill †¦ 200,000 people a year, shattering families and bringing misery to thousands† states Yury Fedotov, the Executive Director of the UN Office on Drugs and Crime (UN 2012). A modern crisis, drug abuse takes the will and freedom of hundreds of thousands, plunging their lives into despair. But this is only one side of the coin; those who supply the hazardous euphoria of drugs build their own volatile empires on foundations of violenceRead MoreMexican Cartels And Its Effects On America2267 Words   |  10 PagesThe Mexican cartels have impacted the society by violating many rights that human have and that are protected. The Cartels are causing too much trouble to the world especially in Mexico and its neighboring countries. They have trafficking tons and tons of drugs to world and spread its violence to nation that live in peace. The cartels have been operating for while and keep growing becoming more powerful each day and nothing has stopped the m yet. The Mexican cartels have constructed their empiresRead MoreThe Mexican Cartel On A Global Scale1582 Words   |  7 PagesThe Mexican Cartel on a Global scale The Mexican drug cartel is a major actor on the world scene. Even though it is not seen this way by the general public, those who pay attention know how far their reach is. The Mexican cartel has expanded. There seems to be no sign of them slowing. They have the perfect storm of money, military backing, political connections and Public intimidation. Their empire is growing by the minute. Unfortunately most people have not given these ruthless criminals the attentionRead MoreMexican Cartels And Its Effects On America2374 Words   |  10 Pagesby several drug cartels, and leaders. 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Net Present Value and Correct Answer - 850 Words

uestion 1 (Worth 1 points) Which of the following NOT correct? Independent or non-mutually exclusive alternatives can be accepted at the same time. The modified internal rate of return assumes that inflow are reinvested at 80 percent of the internal rate of return This is a correct answer It is the difference in the reinvestment assumptions that can be significant in determining when to use the present value or internal rate of return methods. Under the net present value method, cash flows are assumed to be reinvested at the firm s weighted average cost of capital Points earned on this question: 1 Question 2 (Worth 1 points) A project has initial costs of $3,000 and subsequent cash inflows in years 1 – 4 of†¦show more content†¦has a lease term equal to 75% or more of the estimated property. is usually short-term and is often cancelable at the option of the lessee This is a correct answer must show up on the balance sheet. none of the above Points earned on this question: 1 Question 7 (Worth 1 points) A project has initial costs of $3,000 and subsequent cash inflows in years 1 – 4 of $1350, 275, 875, and 1525. The company s cost of capital is 10%. Calculate the payback period for this project. 3.33 years This is a correct answer 3.67 years 4.00 years 4.25 years Points earned on this question: 1 Question 8 (Worth 1 points) Leasing is a popular form of financing because... lease provisions are generally less restrictive than a bond indenture the lessor likely has experience with the equipment being leased. the lessee may not be financially able to purchase. all of the above This is a correct answer Points earned on this question: 1 Question 9 (Worth 1 points) One advantage of the payback period method of evaluating investment opportunities is that it provides a rough measure of a project s liquidity and riskiness. True This is a correct answer False Points earned on this question: 1 Question 10 (Worth 1 points) Heavy use of off-balance sheet lease financing will tend to... 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Cash and debt are constant.    Calculate its Enterprise Value.       | 20X1 | 20X2 | 20X3 | Free Cash Flow |   1933 |   1933 |   1933 | Cash |   147 |   147 |   147 | Debt |   435 |   435 |   435 | You Answered Correct Answer 8762.3  margin of error  +/-  3 Read MoreQuiz 7 Cost Accounting1450 Words   |  6 Pagesfacilities? A) capital budgeting B) working capital C) master budgeting D) project-cost budgeting Answer: A Diff: 1 Terms: capital budgeting Objective: 1 AACSB: Reflective thinking 2) The two factors capital budgeting emphasizes are: A) qualitative and nonfinancial B) quantitative and nonfinancial C) quantitative and financial D) qualitative and financial Answer: C Diff: 1 Terms: capital budgeting Objective: 2 AACSB: Reflective thinking 3) The stage of theRead MoreEco 550 Quiz 1 (2013) Essay examples691 Words   |  3 Pagesbe designed to: Correct Answer: create incentives so that managers act like owners of the firm. 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Which statement concerning the net present value (NPV) of an investment or a ï ¬ nancing project is correct? †¢ A ï ¬ nancing project should be accepted if, and only if, the NPV is exactly equal to zero. †¢ An investment project should be accepted only if the NPV is equalRead MoreSterling Household Products Company651 Words   |  3 PagesPlease provide an articulate, concise, and theoretically sound answer. Answers need to be supported with examples from the texts and Exhibits. This may require some due diligence on your part. Please retype the question and your response. 1. How much business risk is associated with Sterling’s proposed acquisition of the germicidal, sanitation, and antiseptic products unit of Montagne Medical? Be sure to define business risk in your answer. 2. Verify the growth rates for sales and inflation

Business Model Product Statement Health And Social Care Essay Free Essays

The respiratory system consists of the respiratory musculuss, carry oning air passages, lungs, pneumonic vasculature, and environing tissues and constructions ( Fig. 1 ) . Each plays an of import function in act uponing respiratory responses. We will write a custom essay sample on Business Model Product Statement Health And Social Care Essay or any similar topic only for you Order Now Figure 1. Respiratory Anatomy ( 1 ) Lungs There are two lungs in the human thorax ; the right lung is composed of three uncomplete divisions called lobes, and the left lung has two, go forthing room for the bosom. The right lung histories for 55 % of entire gas volume and the left lung for 45 % . Lung tissue is squashy due to really little ( 200 to 300 – 10-6 m diameter in normal lungs at remainder ) gas-filled pits called air sac, which are the ultimate constructions for gas exchange. There are 250 million to 350 million air sac in the grownup lung, with a entire alveolar surface country of 50 to 100 M2s depending on the grade of lung rising prices ( 2 ) . Conducting Air passages Air is transported from the ambiance to the air sac get downing with the unwritten and rhinal pits, through the throat ( in the pharynx ) , past the glottal gap, and into the windpipe or trachea. Conduction of air Begins at the voice box, or voice box, at the entryway to the windpipe, which is a fibromuscular tubing 10 to 12 centimeter in length and 1.4 to 2.0 centimeter in diameter. At a location called the Carina, the windpipe terminates and divides into the left and right bronchial tube. Each bronchial tube has a discontinuous cartilaginous support in its wall. Muscle fibres capable of commanding air passage diameter are incorporated into the walls of the bronchial tube, every bit good as in those of air transitions closer to the air sac. Smooth musculus is present throughout the respiratory bronchiolus and alveolar canals but is absent in the last alveolar canal, which terminates in one to several air sacs. The alveolar walls are shared by other air sacs and are composed of extre mely fictile and collapsable squamous epithelial tissue cells. The bronchial tube subdivide into subbronchi, which farther subdivide into bronchioli, which further subdivide, and so on, until eventually making the alveolar degree. Each air passage is considered to ramify into two subairways. In the grownup homo there are considered to be 23 such ramifications, or coevalss, get downing at the windpipe and stoping in the air sac. Motion of gases in the respiratory airways occurs chiefly by majority flow ( convection ) throughout the part from the oral cavity to the olfactory organ to the 15th coevals. Beyond the 15th coevals, gas diffusion is comparatively more of import. With the low gas speeds that occur in diffusion, dimensions of the infinite over which diffusion occurs ( alveolar infinite ) must be little for equal O bringing into the walls ; smaller air sac are more efficient in the transportation of gas than are larger 1s ( 2 ) . Alveoluss Alveoluss are the constructions through which gases diffuse to and from the organic structure. To guarantee gas exchange occurs expeditiously, alveolar walls are highly thin. For illustration, the entire tissue thickness between the interior of the air sac to pneumonic capillary blood plasma is merely approximately 0.4 – 10-6 m. Consequently, the chief barrier to diffusion occurs at the plasma and ruddy blood cell degree, non at the alveolar membrane ( 2 ) . Motion of Air In and Out of the Lungs and the Pressures That Cause the Motion Pleural Pressure Is the force per unit area of the fluid in the thin infinite between the lung pleura and the chest wall pleura. Alveolar force per unit area Is the force per unit area of the air inside the lung air sac. To do inward flow of air into the air sac during inspiration, the force per unit area in the air sac must fall to a value somewhat below atmospheric force per unit area. Transpulmonary force per unit area It is the force per unit area difference between that in the air sac and that on the outer surfaces of the lungs, and it is a step of the elastic forces in the lungs that tend to fall in the lungs at each blink of an eye of espiration, called the kick force per unit area. Conformity of the Lungs The extent to which the lungs will spread out for each unit addition in transpulmonary force per unit area ( if adequate clip is allowed to make equilibrium ) is called the lung conformity. The entire conformity of both lungs together in the normal grownup human being norms about 200 millilitres of air per centimetre of H2O transpulmonary force per unit area ( 3 ) . Figure 2. Conformity diagram of lungs in a healthy individual ( 3 ) . Pathophysiology of Weaning Failure Reversible aetiologies for ablactating failure can be categorized in: Respiratory burden, cardiac burden, neuromuscular competency, critical unwellness neuromuscular abnormalcies ( CIMMA ) , neuropsychological factors, and metabolic and endocrinal upsets. Respiratory burden The determination to try discontinuance of mechanical airing has mostly been based on the clinician ‘s appraisal that the patient is haemodynamically stable, wake up, the disease procedure has been treated adequately and that indices of minimum ventilator dependence are present. The success of ablactating will be dependent on the ability of the respiratory musculus pump to digest the burden placed upon it. This respiratory burden is a map of the opposition and conformity of the ventilator pump. Excess work of take a breathing ( WOB ) may be imposed by inappropriate ventilator scenes ensuing in ventilator dysynchrony ( 4 ) . Reduced pneumonic conformity may be secondary to pneumonia, cardiogenic or noncardiogenic pneumonic hydrops, pneumonic fibrosis, pneumonic bleeding or other diseases doing diffuse pneumonic infiltrates ( 5 ) . Cardiac burden Many patients have identified ischemic bosom disease, valvular bosom disease, systolic or diastolic disfunction prior to, or identified during, their critical unwellness. More elusive and less easy recognized are those patients with myocardial disfunction, which is merely evident when exposed to the work load of ablactating ( 5 ) . Neuromuscular competency Liberation from mechanical airing requires the recommencement of neuromuscular activity to get the better of the electric resistance of the respiratory system, to run into metabolic demands and to keep C dioxide homeostasis. This requires an equal signal coevals in the cardinal nervous system, integral transmittal to spinal respiratory motor nerve cells, respiratory musculuss and neuromuscular junctions. Disruption of any part of this transmittal may lend to ablactating failure ( 5 ) . Critical unwellness neuromuscular abnormalcies CINMA are the most common peripheral neuromuscular upsets encountered in the ICU scene and normally affect both musculus and nervus ( 6 ) . Psychological disfunction Craze, or acute encephalon disfunction: Is a perturbation of the degree of knowledge and rousing and, in ICU patients, has been associated with many modifiable hazard factors, including: usage of psychotropic drugs ; untreated hurting ; drawn-out immobilization ; hypoxaemia ; anemia ; sepsis ; and kip want ( 7 ) . Anxiety and depression: Many patients suffer important anxiousness during their ICU stay and the procedure of ablactating from mechanical airing. These memories of hurt may stay for old ages ( 8 ) . Metabolic perturbations Hypophosphataemia, hypomagnesaemia and hypokalaemia all cause musculus failing. Hypothyroidism and Addison’s disease may besides lend to difficulty ablactating ( 5 ) . Nutrition Corpulence: The mechanical effects of fleshiness with reduced respiratory conformity, high shutting volume/functional residuary capacity ratio and elevated WOB might be expected to impact on the continuance of mechanical airing ( 5 ) . Ventilator-induced stop disfunction and critical unwellness oxidative emphasis Ventilator-induced stop disfunction and critical unwellness oxidative emphasis is defined as loss of diaphragm force-generating capacity that is specifically related to utilize of controlled mechanical airing ( 9 ) . Clinical Presentation of Patients Patients can be classified into three groups harmonizing to the trouble and length of the ablactation procedure. The simple ablactation, group 1, includes patients who successfully pass the initial self-generated take a breathing test ( SBT ) and are successfully extubated on the first effort. Group 2, hard ablactation, includes patients who require up to three SBT or every bit long as 7 yearss from the first SBT to accomplish successful ablactation. Group 3, prolonged ablactation, includes patients who require more than three SBT or more than 7 yearss of ablactation after the first SBT ( 5 ) . Clinical Outcomes and Epidemiology There is much grounds that ablactating tends to be delayed, exposing the patient to unneeded uncomfortableness and increased hazard of complications ( 5 ) . Time spent in the ablactation procedure represents 40-50 % of the entire continuance of mechanical airing ( 10 ) ( 11 ) . ESTEBAN et Al. ( 10 ) demonstrated that mortality additions with increasing continuance of mechanical airing, in portion because of complications of drawn-out mechanical airing, particularly ventilator-associated pneumonia and airway injury ( 12 ) . The incidence of unplanned extubation ranges 0.3-16 % . In most instances ( 83 % ) , the unplanned extubation is initiated by the patient, while 17 % are inadvertent. Almost half of patients with self-extubation during the weaning period do non necessitate reintubation, proposing that many patients are maintained on mechanical airing longer than is necessary ( 5 ) . Addition in the extubation hold between readiness twenty-four hours and effectual extubation significantly increases mortality. In the survey by COPLIN et Al. ( 13 ) , mortality was 12 % if there was no hold in extubation and 27 % when extubation was delayed. Failure of extubation is associated with high mortality rate, either by choosing for bad patients or by bring oning hurtful effects such as aspiration, atelectasis and pneumonia ( 5 ) . Rate of ablactating failure after a individual SBT is reported to be 26- 42 % . Variation in the rate of ablactating failure among surveies is due to differences in the definition of ablactating failure. VALLVERDU et Al. ( 14 ) reported that ablactating failure occurred in every bit many as 61 % of COPD patients, in 41 % of neurological patients and in 38 % of hypoxaemic patients. Contradictory consequences exist sing the rate of ablactating success among neurological patients. The survey by COPLIN et Al. ( 13 ) demonstrated that 80 % of patients with a Glasgow coma mark of more than 8 and 91 % of patients with a Glasgow coma mark less than 4 were successfully extubated. In 2,486 patients from six surveies, 524 patients failed SBT and 252 failed extubation after go throughing SBT, taking to a entire w eaning failure rate of 31.2 % ( 5 ) . The huge bulk of patients who fail a SBT do so because of an instability between respiratory musculus capacity and the burden placed on the respiratory system. High air passage opposition and low respiratory system conformity contribute to the increased work of take a breathing necessary to take a breath and can take to unsuccessful release from mechanical airing ( 15 ) . Economic Impact Mechanical airing is largely used in the intensive attention units ( ICU ) of infirmaries. ICUs typically consume more than 20 % of the fiscal resources of a infirmary ( 16 ) . A survey that analyzed the incidence, cost, and payment of the Medicare intensive attention unit usage in the United States ( US ) reveled that mechanical airing costs a amount stopping point to US $ 2,200 per twenty-four hours ( 17 ) . One survey shows that patients in the ICUs having drawn-out mechanical airing represents 6 % of all ventilated patients but consume 37 % of intensive attention unit ( ICU ) resources ( 18 ) . Another survey corroborates this Numberss besides demoing that 5 % to 10 % of ICU patients require drawn-out mechanical airing, and this patient group consumes more than or every bit much as 50 % of ICU patient yearss and ICU resources. Prolonged ventilatory support and chronic ventilator dependence, both in the ICU and non-ICU scenes, have a important and turning impact on health care eco nomic sciences ( 19 ) . Drumhead Treatment Option Weaning Failure Overview The procedure of initial ablactating from the ventilator begins with an appraisal sing preparedness for ablactating. It is so followed by SBT as a diagnostic trial to find the possibility of a successful extubation. For the bulk of patients, the full ablactation procedure involves verification that the patient is ready for extubation. Patients who meet the standards in table 2 should be considered as being ready to ablactate from mechanical airing. These standards are cardinal to gauge the likeliness of a successful SBT in order to avoid tests in patients with a high chance of failure ( 5 ) . Table 2 Standards for Measuring Readiness to Wean Clinical Appraisal Adequate cough Absence of inordinate tracheobronchial secernment Resolution of disease acute stage for which the patient was intubated Objective measurings Clinical stableness Stable cardiovascular position ( i.e. fC ?140 beats*min-1, systolic BP 90-160 mmHg, no or minimum vasopressors ) Stable metabolic position Adequate oxygenation Sa, O2 A ; gt ; 90 % on ?FI, O2 0.4 ( or Pa, O2/FI, O2 ?150 mmHg ) PEEP ?8 cmH2O Adequate pneumonic map f ?35 breaths*min-1 PImax ?-20- -25 cmH2O Ve A ; lt ; 10 l*min-1 P0.1/PImax A ; lt ; 0.3 VT A ; gt ; 5 mL*kg-1 VC A ; gt ; 10 mL*kg-1 f/VT A ; lt ; 105 breaths*min-1*L-1 CROP A ; gt ; 13 ml*breaths-1*min-1 No important respiratory acidosis Adequate thinking No sedation or equal thinking on sedation ( or stable neurologic patient ) Taken from ( 5 ) and ( 15 ) . fC: cardiac frequence ; BP: blood force per unit area ; Sa, O2: arterial O impregnation ; FI, O2: inspiratory O fraction ; Pa, O2: arterial O tenseness ; PEEP: positive end-expiratory force per unit area ; degree Fahrenheit: respiratory frequence ; PImax: maximum inspiratory force per unit area ; VT: tidal volume ; VC: critical capacity ; CROP: integrative index of conformity. 1 mmHg=0.133 kPa. Harmonizing to an adept panel, among these standards merely seven variables have some prognostic potency: minute airing ( VE ) , maximal inspiratory force per unit area ( PImax ) , tidal volume ( VT ) , take a breathing frequence ( degree Fahrenheit ) , the ratio of take a breathing frequence to tidal volume ( f/VT ) , P0.1/PImax ( ratio of airway occlusion force per unit area 0.1 s after the oncoming of inspiratory attempt to maximal inspiratory force per unit area ) , and CROP ( integrative index of conformity, rate, oxygenation, and force per unit area ) ( 20 ) . Minute Ventilation Minute airing is the entire lung airing per minute, the merchandise of tidal volume and respiration rate ( 21 ) . It is step by measuring the sum of gas expired by the patients lungs. Mathematicly, minute airing can be calculated after this expression: It is reported that a VE less than 10 litres/minute is associated with ablactating success ( 22 ) . Other surveies found that VE values more than 15-20 litres/minute are helpful in placing if a patient is improbable to be liberated from mechanical airing but lower values were non helpful in foretelling successful release ( 15 ) . A more recent survey concluded that short VE recovery times ( 3-4 proceedingss ) after a 2-hour SBT can assist in finding respiratory modesty and predict the success of extubation ( 23 ) . When mechanical airing takes topographic point, this parametric quantity is calculated monitoring flow and force per unit area by the ventilator in usage itself or by an independent device attached to the air passage circulation system such as the Respironics NM3Â ® by Phillips Medical. Other ways to find minute airing are by mensurating the electric resistance across the thoracic pit ( 24 ) . This method though, is invasive and requires deep-rooted electrodes. Maximal Inspiratory Pressure Maximal inspiration force per unit area is the maximal force per unit area within the air sac of the lungs that occurs during a full inspiration ( 21 ) . Is it normally used to prove respiratory musculus strength. On patients in the ICU or those non capable to collaborate, the PImax is measured by obstructing the terminal of the endotracheal tubing for a period of clip close to 22 seconds with a one-way valve that merely allows the patient to expire. This constellation leads to increasing inspiratory attempt mensurating PImax towards the terminal of the occlusion period. However PImax is non plenty to foretell faithfully the likelihood of successful ablactating due to low specifity ( 15 ) . The measuring of PImax can be performed by devices equipped with force per unit area detectors. Tidal Volume Tidal volume is the sum of air inhaled and exhaled during normal airing ( 21 ) . Spontaneous tidal volumes greater than 5 ml/kg can foretell ablactating result ( 25 ) . More recent surveies found that a technique that measures the sum of regularity in a series analysing approximative information of tidal volume and external respiration frequence forms is a utile index of reversibility of respiratory failure. A low approximate information that reflects regular tidal volume and respiratory frequence forms is a good index of ablactating success ( 26 ) . Tidal volume can be measured utilizing a pneumotachographic device. Breathing Frequency The grade of regularity in the form of the external respiration frequence shown by approximative information instead than the absolute value of the external respiration frequence is been proven to be utile in know aparting between ablactating success and failure ( 26 ) . The take a breathing rate or frequence is measured by numbering the external respiration rhythms per a defined period of clip. The Ratio of Breathing Frequency to Tidal Volume Yang and Tobin [ 18 ] so performed a prospective survey of 100 medical patients having mechanical airing in the ICU in which they demonstrated that the ratio of frequence to tidal volume ( rapid shoal take a breathing index ( RSBI ) ) obtained during the first 1 minute of a T-piece test and at a threshold value of ?105 breaths/minute/l was a significantly better forecaster of ablactating results However, there remains a rule defect in the RSBI: it can bring forth inordinate false positive anticipations ( that is, patients fail ablactating outcome even when RSBI is ?105 breaths/minute/l ) [ 35-36 ] Besides, the RSBI has less prognostic power in the attention of patients who need ventilatory support for more than 8 yearss and may be less utile in chronic clogging pneumonic disease ( COPD ) and aged patients [ 37-39 ] . The Ratio of Airway Occlusion Pressure to Maximal Inspiratory Pressure The airway occlusion force per unit area ( P0.1 ) is the force per unit area measured at the air passage opening 0.1 s after animating against an occluded air passage [ 42 ] . The P0.1 is attempt independent and correlates good with cardinal respiratory thrust. When combined with PImax, the P0.1/PImax ratio at a value of A ; lt ; 0.3 has been found to be a good early forecaster of ablactating success [ 11,43 ] and may be more utile than either P0.1 or PImax entirely. Previously, the clinical usage of P0.1/PImax has been limited by the demand of particular instrumentality at the bedside ; nevertheless, new and modern ventilators are integrating respiratory mechanics faculties that provide numerical and graphical shows of P0.1 and PImax. Air manner Resistance Crop The CROP index is an integrative index that incorporates several steps of preparedness for release from mechanical airing, such as dynamic respiratory system conformity ( Crs ) , self-generated external respiration frequence ( degree Fahrenheit ) , arterial to alveolar oxygenation ( partial force per unit area of arterial O ( PaO2 ) /partial force per unit area of alveolar O ( PAO2 ) ) , and PImax in the undermentioned relationship: CROP = [ Crs – PImax – ( PaO2/PAO2 ) ] /f where: PAO2 = ( PB-47 ) – FiO2 – PaCO2/0.85 and PB is barometric force per unit area. The CROP index assesses the relationship between the demands placed on the respiratory system and the ability of the respiratory musculuss to manage them [ 18 ] . Yang and Tobin [ 18 ] reported that a CROP value A ; gt ; 13 ml/breaths/minute offers a moderately accurate forecaster of ablactating mechanical airing result. In 81 COPD patients, Alvisi and co-workers [ 39 ] showed that a CROP index at a threshold value of A ; gt ; 16 ml/breaths/minute is a good forecaster of ablactating result. However, one disadvantage of the CROP index is that it is slightly cumbrous to utilize in the clinical scene as it requires measurings of many variables with the possible hazard of mistakes in the measuring techniques or the measuring device, which can significantly impact the value of the CROP index. Clinical Treatment Profiles CONCLUSIONS AND RECOMMENDATIONS How to cite Business Model Product Statement Health And Social Care Essay, Essay examples

Quality Management System free essay sample

These principles have been identified to facilitate the achievement of quality objectives and form the foundation for effective quality management. 1. Customer Focus Organisations depend on their customers and therefore should understand current and future customer needs, should meet customer requirements and strive to exceed customer expectations. Satisfying customer needs and requirements should be the prime objective for any organisation because organisations will generate profits mainly through the sales of their goods and services to customers. Without customer satisfaction any business will ultimately fail. Any organisation also needs to have ways of keeping in touch with how customers perceive its performance, that is, how well they think the organisation has met their requirements. ISO 9001:2008 places much emphasis on customer focus. Organisations can obtain customer needs through surveys and the surveys are normally conducted by an ISO auditor. Conducting a survey is a form of documentation. In fact customer needs can be obtained in many forms. We will write a custom essay sample on Quality Management System or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Other than formal surveys, customer needs can also be obtained during customer visits, customers complaints and customer feedback. These data can be used as an input in the ISO system. By applying the principle of customer focus, managers will be able to research and understand customer needs and expectations. By encouraging open dialogue and feedback from their customers will allow them the opportunity to better understand their needs and how they may better serve them. This, in turn, allows these managers to set goals to improve customer satisfaction and retain customer loyalty. Some methods that allow businesses to better communicate with their customers include the use of suggestion boxes, comment cards and providing a telephone number for customers to call when they have questions or comments. Moreover, the managers must also ensure that the goals and targets of the organisation are perfectly aligned with the customer needs and expectations and that these needs and expectations are properly communicated to all employees throughout the organisation. The customer focus principle is also associated with some benefits that the organisation is likely to gain. Firstly, revenues and market shares obtained are likely to increase through flexible and fast responses to market opportunities, that is, when organisations focus more on satisfying customer needs, their sales are more likely to increase ultimately this also leads to an increase in market shares. They also have access to more market opportunities due to competition advantage that they will gain. Secondly, customer focus principle helps to improved customer loyalty which leads to repeat business and referrals on part of the customers. When customers are satisfied with a product or service that an organisation providing to them, they will be willing to come back to this organisation and continue to purchase with it. Thus they develop a brand loyalty for this organisation’s products and they will not want to switch to its competitor. Satisfied customers will also refer the organisation’s products to their friends and family which will increase the number of sales for this organisation and thus leads to more profits. 2. Leadership The strategy, direction and ultimate success of any business is largely dependent upon its leadership, along with the environment and even the culture that is encouraged throughout the organisation. Leaders establish unity of purpose and direction. They should create and maintain the internal environment in which people can become fully involved in achieving the organizations objectives. A good leadership is important to influence and motivate others to follow him/her into areas of uncertainty. What it means here is that the crucial leadership role is concerned with change. In times of uncertainty, change is the only constant to the organization’s survival and hence longevity. As changes bring anxiety to employees, a good leader must help the people to know the organization through its values, guiding principles and underlying philosophy in such times. Under the ISO 9001 requirements, the leadership role is defined as management responsibility in Clause 5, â€Å"Management Responsibility†. The standard requires that top management to provide evidence of its commitment to the development and implementation of the quality management system and continually improving its effectiveness. However, the implementation of a quality management system will hardly be successful if there is lack of commitment from top management. As such, it is critical that top management has a sound appreciation and understanding of all facets of quality management and, in particular, issues pertaining to quality assurance. This understanding and appreciation should be obtained through appropriate training and experience. It must also be remembered that leadership can be found at all levels within an organization and identifying this quality may be of great benefit in establishing a quality culture within a specific section of an organisation or throughout the organisation as a whole. By applying the principle of leadership, a leader will be able to establish a clear vision of the organisation’s future. A clearly communicated vision and purpose on the part of management is a key to ensuring business improvement. It is important to have a clear vision so that employees can work towards this vision in order to achieve the organisational objectives. Without a clear vision, employees will not know in what direction to work and what top management is expected from them. The role of a good leader is to guide its employees towards the achievement of organisational objectives. As a good leader, it is also important to set challenging goals and targets. A good leader must be passionate about the objective of the organization and to achieve the desired target. It is the responsibility of the top management to ensure customer requirements are determined and satisfied in order to achieve total customer satisfaction. All the resources of the organization are aligned towards this goal. Moreover, a good leader should be able to eliminate fear in his or her employees, that is, he or she should be constantly present for the employees, encourage them to share their ideas, give them the opportunity to voice out and to express themselves freely about any issues or problems. He must establish trust in the mind of his or her employees, that is, these employees must feel that they can trust their leader. Thus, people will understand and be motivated towards the achievement of organisation’s goals and objectives. They will be more motivated to perform in the interest of the organisation. 3. Involvement of People People at all levels are the essence of an organization and their full involvement enables their abilities to be used for the organizations benefit. Being a member of an organization provides the opportunity for an individual to contribute. However, the extent to which an organization achieves its desired objectives will depend on how it is able to organize and involve its people in the manner that will enable them to use their abilities and contribute to the organization’s objectives. The most effective way to achieve quality is by involving people across all levels of the organization. Everyone contributes to the success of an organisation and has a part to play in it, as well as a responsibility for quality. Staff must be suitably qualified and competent in their jobs, as the quality of their work directly affects the quality of service. This can be achieved through the provision of appropriate training and evaluation. Quality awareness training should also be provided to all relevant staff to heighten responsibility, accountability and quality consciousness, that is, to assist in building a quality-focused culture. With the implementation of the quality management system, staffs need to take on additional responsibilities such as the day to-day consistency checks as part of the data for product quality assurance and control processes. By applying the principle of involvement of people in an organisation, people will understand the importance of their contribution and role in the organisation. The top management’s role is to provide the environment where people are empowered to realize the organization’s objectives. Top management needs to establish the quality policy, ensure the quality objectives are established at relevant functions and levels in the organization, communicates to all employees on the importance of meeting customer as well as stator and regulatory requirements, conduct management reviews and ensure the availability of resources. Moreover, people will be able to openly discuss problems and issues among themselves and with their managers and also will freely share their knowledge and experience in the workplace which can be a plus in the achievement of organisational objectives and goals. One main benefit of this principle is that people will be more motivated, committed and involved within the organisation and this will lead to more innovation and creativity in the organisation. 4. Process Approach A desired result is achieved more efficiently when activities and related resources are managed as a process. Efficiency is better achieved when things are managed as processes, rather than as individual tasks or separate departments. A process is a set of interrelated or interacting activities that transform inputs into outputs. A quality management system can be thought of as a single large process that uses many inputs to generate many outputs. In turn, this large process is made up of many smaller processes. A work process is a series of operations/steps or activities that transform input into intermediate output at each step until the final output that meets the customer specified requirements. A common term to remember the structure of a process is SIPOC – Suppliers, Input, Process, Output and Customers. The process approach using the SIPOC model creates processes that will produce products and services that conform to customer specified requirements. Understanding and improving process capability is superior to inspecting and sorting the final output. It is the responsibility of management to identify processes needed to produce and deliver the products or services to satisfy the requirements of the customer and other interested parties (suppliers, employees and other affected parties). However, in order to consistently meet customer requirements, a high degree of standardization must exist in the processes. To apply a process approach means that an organisation first decides what it plans to do ( e. g. , provide a particular service/create a particular widget), and then work out what processes it will need in order to provide that service/create that widget. For example, an organisation has to decide what the tasks are, how and where they relate, what resources and inputs it will need, and how to do things in order to arrive at the result this organisation wants. By applying the principle of process approach in the production process, structured methods will be used to undertake the activities necessary to obtain a desired result. Top management will focus more on the factors such as resources, methods and materials that will be used in the production process to improve the key activities of the organisation. Top management will have to do a proper planning so as to avoid wastage of resources and unnecessary costs spent on raw materials. The main benefit with process approach is that when top management uses resources effectively, this will lead to lower costs and shorter cycle times as there will be proper planning, that is, with planning top management will spend money only on the amount of raw materials that will be needed in the production process and there will be no need to reorder each time. 5. System Approach to Management Identifying, understanding and managing a system of interrelated processes as a system contributes to the organisations effectiveness and efficiency in achieving its objectives. This means understanding what a management system is, its various parts and how you want it to work. It also means having consistent ways to do and manage things. Management should view all business activities and processes as parts of an integrated system. This will then encourage greater efficiency and effectiveness throughout the organisation. The system approach is a crucial concept for maintaining the integrity of the management system when improvement changes are made to quality management system, as it can provide the mental picture on the interactions of the parts in the system. By applying the principle of the system approach to management, top management will be able to understand the interdependencies among the processes of the system and also understand organisational capabilities. Moreover, top management will be able to identify the resource constraints. For e. g. departments where resources are limited, thus top management will be able to find solution to overcome this problem. One benefit is that top management has the ability to focus effort on the important processes. 6. Continual Improvement Continual improvement of the organizations overall performance should be a permanent objective of the organization. This should be a permanent feature of any organisation that really wishes to excel within its marketplace. Whatever the organisation does to improve performance should be subject to a continuing cycle of review, and this may result in the further raising of targets and goals to new levels. This is necessary to keep ahead of the competition. Continual improvement drives the organization to continually address ways to reduce costs, improve organizational performance and customer satisfaction. Management reviews have to be conducted regularly using the data collected from the monitoring and measurement process to identify areas for further improvement. Channels may need to be established to allow all staffs in the organization to make suggestions on ways to improve the service. By applying the principle of continual improvement, top management needs to provide people with appropriate training in the methods and tools of continual improvement, that is, they must be trained on how to continually improve the quality of goods and services. Top management should provide these people with appropriate tools and methods that will be used in the improvement process. Top management should also recognise and acknowledge employees for their effort and work towards the improvement process. For this it shout use proper rewards system. One benefit is that an organisation is more flexible to react quickly to opportunities. 7. Factual Approach to Decision Making. Effective decisions are based on the analysis of data and information. All key strategic decisions should be based on sound data that has been gathered via predetermined measures. Management use these data and information to make decisions. This allows for objective decision making that will lead to positive actions. The basis for factual approach to decision making is the performance based management system. By applying the principle of factual approach to decision making, top management can ensure that data and information are sufficiently accurate and reliable. The data itself is made accessible to whoever needs it. Moreover, top management can also analyse the data and information by using valid methods. The benefits of this approach are that, firstly management has the ability to demonstrate the effectiveness of the past decisions through reference to formal histories and secondly, it also can review, challenge and change options and decisions. 8. Mutually Beneficial Supplier Relationships An organization and its suppliers are interdependent and a mutually beneficial relationship enhances the ability of both to create value. Smaller firms traditionally supplied parts or materials to larger manufacturers to meet a specified order. An organisation and its suppliers depend on each other. More however can be derived from the supplier/customer relationship by seeing it instead as an interdependent partnership that provides mutual benefits to both sides. The suppliers should be evaluated and selected on the basis of their ability to meet purchase order requirements and on their past performance. By applying the principles of mutually beneficial supplier relationships, organisations can identify and select their key suppliers, that is, they will be able to find suppliers who supply best materials at a reasonable price. Moreover, Organisations and suppliers can also establish a clear and open communication path with each other while doing business together. The main benefits of this approach are that it can create value for both organisations and suppliers. They are more likely to response to any changes occurring in the market or customer needs and expectations.