Role Of The Internet In Business Essay Example | Topics and Well Written Essays - 500 words

Role Of The Internet In Business - Essay Example The Internet helped business in enhancing communication facilities. It is easy for Bill Gates to control his business activities in China or India, staying in New York. The Internet provides instant chat, audio and video conferencing like communication facilities so that it is easy for an executive in America to communicate instantly with his subordinates in any parts of the world. Outsourcing is a new concept developed across business circle because of the development of Internet-related technologies. It should be noted that in America and European countries, the labor cost is extremely high whereas, in India or China, it is extremely low. Thus, Chinese and Indian products are cheaper in the international market compared to that of America or Europe. This is really a problem for American and European companies. Outsourcing helps, these companies to exploit the cheap labor in overseas markets so that they can compete effectively with Indian and Chinese companies. The development of E-commerce is another contribution of the internet to the business world. Online business is growing much rapidly than offline business according to many studies. Offline business cannot provide the convenience of online business. For example, in order to purchase certain commodities, a consumer has to visit shopping malls. For employed people, it is difficult to spend too much time for shopping purposes. Such people can purchase goods while resting at home with the help of internet. Moreover, e-commerce helps a person to purchase goods from the international market. In other words, he can search for better options with the help of the internet before purchasing a certain item from the global market. Such facilities are not provided by offline businesses. Advertising is a major business function, which helps organizations to promote their product.

Consider the Importance of the Method of Narration Employed in Wuthering Heights Essay Example for Free

Consider the Importance of the Method of Narration Employed in Wuthering Heights Essay Wuthering Heights is written by Emily Jane Brontà « and narrated by Ellen Dean (Nelly), a servant of both Catherine Earnshaw and her daughter, Catherine Linton. Emily Brontà « must have thought she was the most convenient of characters to narrate this novel as Nelly was alive through each generation of both the Earnshaw and Linton families. Had someone like Catherine Earnshaw narrated the novel, it might have finished at her death or would have switched narration. Also, this could have made the narration more bias, whereas Nelly, who still plays a reasonably large role as she mixes with all the characters, witnesses and observes the goings on as an onlooker first hand. However, Nelly often interferes with the lives of the characters which could have altered the forth coming events. In my opinion, one of the key times of her meddlesome attitude in the novel is reflected when she carries a letter between Heathcliff and Cathy Earnshaw who also receives permission to visit Cathy when she is ill-against Edgars wishes. She is often seen to be carrying letters between different characters which are considered to be forbidden. On the other hand, she sometimes decides to hold onto information rather than pass it on, such as when Edgar’s wife Catherine becomes increasingly ill Nelly fails to inform him. A possible downfall to having Nelly as the narrator could be that her personal opinions are shown too much in the novel, creating a biased view. Her actions are also influenced by her opinions which again produce a bias outcome as she helps those characters she favours, such as the Earnshaw siblings she grew up with over Edgar. This concept is shown in her actions as she keeps some secrets to herself instead of revealing them to Edgar, like when his daughter and Hareton’s relationship grows and Nelly ignores it.

Psychedelic Drugs (aka Psychedelics) Essay -- essays research papers

Psychedelic Drugs (aka Psychedelics) Introduction: Throughout human history people have sought experiences that somehow transcend every day life. Some sort of wisdom that might progress their knowledge of self and of the world that they live in. For some reason they believed that the tangible world just could not be all there is to life. Some believed in a greater force that controlled them, some believed of invisible beings that influenced their lives, some of an actual other world that paralleled their own. Many of these people also believed that it was possible to catch a glimpse of these forces, beings, or worlds through a variety of means that propel individuals into altered states of consciousness. These techniques include meditation, hypnosis, sleep deprivation, and (what will be discussed here) psychoactive drugs, more specifically psychedelic drugs. Although in the modern world such drugs have developed an almost taboo status, it is impossible to ignore the tales of enlightenment reported by ancient cultures and even those rebels that use such drugs illegally today. While the American government has been one of the main influences on today’s society’s negative attitudes towards psychedelic drugs, they have granted some scientist and psychologists permission to experiment with such agents, and despite the controversy and varying results there seem to be many positive uses of psychedelic agents. These positive uses and the research that has been directed toward these uses will be reviewed in the following, as well as a brief history of psychedelic drugs. History:   Ã‚  Ã‚  Ã‚  Ã‚  Native Americans are probably the people most known for their use of psychedelic drugs. Being a very religious people, their entire society revolved around the spirit world, and some believed that access to this world was possible by eating certain plants that were abundant in their surroundings. In what are now Mexico and the Southwestern United States, tribes familiarized themselves with mescaline, the active ingredient in the peyote cactus. Another drug that was used by tribes in these and many other areas was psilocybin, the active hallucinogenic ingredient of the mushroom Psilocybe mexicana and other psilocybe and conocybe species that grow on the pacific coast of North, South, and Central America. Ritual use of psilocybin and mesca... ... research the government has allowed scientists and psychologists, there have been amazing discoveries of the capacities of these drugs. It has been proven that they are able to extend psychotherapy’s view of the human mind, they are able to promote massive personality changes, and to enhance the learning and problem solving experience. It has even been suggested that psychedelics are able to enhance any aspect of mental functioning.   Ã‚  Ã‚  Ã‚  Ã‚  One must look beyond the stereotypes that psychedelics have earned in the twentieth century, and also modern science, that presupposes that any thing that cannot be explained within its own contexts either does not exist or is but a fanciful idea. However, the realm of psychedelics is uncharted area, and when dealing with such experimental substances, such as these psychedelic agents, one must proceed with caution, as was mentioned earlier the agents are powerful tools and can be used with skill or reckless abandon, and therefore can yield positive responses or deadly consequences. If used with care psychedelics will allow many psychologists and patients to embark on a perhaps endless journey of self-discovery.

Technology Making Our Lives Easier

As we are raised in a society where everything is simply handed to us, we tend to take many things for granted that others in the world do not have. Things like GPS, phones, credit cards, cameras, and insulin pumps help us live a qualitative and productive life and NASA has played a very key role in developing many technologies like these. From invisible braces to long-distance communication devices, NASA has brought up inventions that we consistently use every day in our lives.A device that many people in the world rely on everyday and something that has made a huge difference in people's lives is the water filtration system(s). NASA first made it to be used on the space station or in a spacecraft, and since then the water filtration system is a must-have in any place in the world. NASA showed amazing ingenuity to control bacterial contamination in space, and because of that, we have learned how to control pollutants in water here on earth.We see water filtration systems more than w e think, and it allows us to enjoy a healthy lifestyle. Whether it's through swimming pools or manufacturing processes, the water filtration systems affects our lives every day in a positive way. There are many different types of water filters and you can classify them by the way they work, but they all need to do one job and that's effectively filter and purify water. One type of a water filtration system is the reverse osmosis, which is the process of removing dissolved inorganic solids out of a solution (water).This type of system involves using many different filters and membranes in order to purify and improve the drinking quality of water. There are also ultraviolet systems which do a remarkable job at disinfecting water. Ultraviolet systems can destroy 99. 99% of harmful microorganisms in the water very effectively and they do this by using a lamp or bulb which emits UV light which is then used as energy to attack the microorganism in the water and essentially destroy it, thu s making the water free of future bacteria.There are many other type of systems like the Carefree Clearwater systems (which are based on NASA'S late 1900's technology) which are not only used for drinking water in the home, but also for pool and shower water. These type of large-scale systems clean the water in a pool or hot-tub by using the same type of strategy as the UV systems. They release ions like copper and silver to destroy bacteria and algae in the system. These type of systems would work better than cleaning with chlorine because they have less nwanted side effects like burning eyes and bleached skin or hair (due to the copper and silver ions not dissipating from heat and sunlight, unlike chlorine) and they are more stable and productive to work with. Water filtration systems affect our lives everyday throughout everything we do. Without them, clean and purified water would be difficult to come across, and civilization would eventually come to a halt. Whether it's the wat er that we drink or the pool that we love to swim in, systems like the reverse osmosis and the Carefree Clearwater are at work and doing an incredible job in order to make our daily lives healthy and enjoyable.

Treatments Of Frozen Shoulder Health And Social Care Essay

The term â€Å" Frozen Shoulder † was ab initio coined by Codman in the twelvemonth 1934. Before that Duplay in 1872, termed it as â€Å" Peri Arthritis † and the most recent Naviesar in 1945 labelled it as â€Å" Adhesive Capsulitis † ( Riyadh and Marwan 2007 ; Dias et Al. 2005 ) . It is defined as a upset in which the shoulder capsule and the connective tissue environing the glenohumeral articulation of the shoulder become inflamed and stiff. It grows together with unnatural sets of tissue called adhesions, greatly curtailing gesture and doing chronic hurting. Incidences of frozen shoulder are seen more in diabetic patients. Every twelvemonth 2 % instances of frozen shoulders are reported in US while 11 % happenings are found in single with diabetes every twelvemonth. About 40 % of patients developed frozen shoulder who were enduring from type – 1 diabetes ( Roy and Dahan 2009 ) . Most frequently there are no allied hurts or discernable cause. There are few patients who develop a frozen shoulder following a traumatic hurt to the shoulder but this is non the typical cause. Frozen shoulder is more common in people who are enduring from diabetes, thyroid jobs, bosom disease, shot, shoulder injury or surgery, station immobilisation etc. Frozen shoulder is rare under the age of 40 ; it typically strikes in the 5th and 6th decennary of life. The status occurs more normally in adult females than work forces F: M=1.4:1 ( Dias et al. 2005 ) . It may impact both shoulders either as at the same time or consecutive in every bit many as 16 % of patients ( Roy and Dahan 2009 ) . Harmonizing to Codman the three trademarks of frozen shoulder are insidious shoulder stiffness, terrible nocturnal hurting and near complete loss of inactive and active external rotary motion of the shoulder.The hurting is normally dull and hurting type. There are normally three phases of clinical presentation.Painful/Freezing phaseIt is badly painful phase in which the patient feels a perennial oncoming of chiefly nocturnal hurting. Patients do non comprehend any hurting during normal twenty-four hours to twenty-four hours activities but it may arouse with overhead activity or motion in utmost scope. This painful period stopping points for 2-9 months ( Walmsley et al 2009 ) .Frozen/Adhesive phasePatients feel same hurting as in stage 1 but it reduces a spot compare to stop deading phase. There is a celebrated capsular form progressive restriction in scope of gesture. Normal everyday activities are more badly affected. This phase lasts for 3 to 9 months ( Fitsialos et al. 1995 ) .Tha wing/Resolution phasePain in this phase bit by bit subsides, but restriction in scope of gesture increasingly increases over 1-2 old ages. Although around 40 % of patients have slight, unrelenting restriction in scope, merely 10 % may hold clinically singular long term functional restrictions ( Binder et al. 1984 ) . There are figure of intervention regimens established get downing from traditional interventions i.e. exercising therapy, galvanism, mobilisation to local infiltration of corticoids to surgical releases of the capsule, but the optimal direction of this status has been the topic of great argument, peculiarly because the status tends to decide spontaneously over months to old ages ( Carette et al. 2003 ; Dacre et Al. 1989 ) . So the focal point of this essay is on intervention modes of frozen shoulder i.e. either physical therapy or corticoids. Both are now widely used and besides researches related to its effectivity have been carried out in literature. So in the undermentioned subdivisions will be emphasizing on some of the plants done by research workers on the grade of effectivity of the two intercessions in handling frozen shoulder, along with the glance on future researches on the same. Before this will hold a brief mentality on the mechanism on which this therapy works.Mechanism of action – Corticosteroids and Exercise:Corticosteroids:From last 50 old ages steroids injections have been used for the intervention of a figure of musculoskeletal conditions. It has been proved that it is one of the cost effectual intervention besides ( Dacre et al. 1989 ) . Care should be taken while exposing persons for the steroids injection as the inauspicious effects is still an unsolved issue. Corticosteroids are fundamentally man-made parallels of the endocrine hydrocortisone. Cortisol in its physiological doses has a regulative consequence on glucose and protein metamorphosis and besides an anti-inflammatory consequence via action on polymorph and macrophage migration along with lymphocyte suppression. They prove to be an effectual anti- inflammatory drug by moving on cell atomic receptors in the control of mRNA synthesis on the production of proteins. This in bend has an consequence on the production of cytokines and other go-betweens of redness ( Saunders WB, 20 02 ) . It has been proposed that frozen shoulder or shoulder stiffness begins with an inflammatory stage, which is so followed by formation of cicatrix tissue. So the theoretical benefit of intra-articular steroid injection is that it inhibits this inflammatory stage and hence a pronounced lessening in the hurting ( Speed CA, 2003 ) . For this intent by and large in our pattern triamicinolone acetonide is used and it comes under class of medium authority drug, which carries a higher anti- inflammatory consequence along with a low degree of minerocorticoid consequence. Thus it helps in diminishing the hurting in the initial phases of frozen shoulder where hurting is the chief ailment and hence prevents farther stiffness from developing ( Saunders WB, 2002 ) . Its effectivity is mentioned and worked upon in literature. A survey conducted by Widiastuti and Sianturi ( 2004 ) compared the effectivity of unwritten vs. intra-articular triamicinolone injection and came to a decision that the subsequently provided faster betterment than the former path. Besides effectivity of steroids has been combined with exercising to accomplish a profound consequence on frozen shoulder and many other such conditions. Carette et Al. ( 2003 ) found that intra articular steroids injection in combination with exercising led to statistically notable betterment in compared to exert entirely. Ryans et Al. ( 2005 ) demonstrated in their survey that an intra-articular steroid injection was an effectual tool in bettering the shoulder related disablement which in combination with exercising plan led to an betterment in shoulder ranges 6 hebdomads following the intervention. These surveies will be discussed in item subsequently in this essay. So during the early stage of frozen shoulder where hurting is the chief concern and digesting physical therapy at this phase is about following to impossible, an intra- articular steroid injection might supply adequate alleviation for the patient to get down with an exercising plan.Exercises:Now, coming on to the effects of exercising so, physical therapy is by default the chief line of intervention for shoulder stiffness. As we know articulations require motion to remain healthy. A drawn-out period of inaction forces the joint to go stiffen and the next tissues to turn weaker. So an exercising plan that includes aerobic exercises, scope of gesture exercisings, power and strength preparation has benefits for the patients. Many patients who start an exercising plan, study less functional disablement and associated hurting ( Carette et al. 2003 ) A patient of frozen shoulder normally commences an exercising plan that includes chiefly active aided scope of gesture and soft inactive stretching exercisings ( Michlovitz et al. 2004 ) . There are a scope of combinations of exercising regimen used along with different signifiers of galvanism and massage techniques. Heat modes are by and large applied to the affected shoulder prior to the exercising and ice at the terminal of exercising. This regimen AIDSs in alleviating the uncomfortableness to an extent and hence improves the conformity with exercising. Prior to stretching it improves the musculotendinous tissue flexibleness ( Ruiz JO, 2009 ) . Now the reduced physical activity and shoulder immobilisation are of import factors of shoulder musculus wasting, reduced strength and endurance. The scope of gesture exercisings increases the sum of motion in a joint and musculus, beef uping exercisings helps in constructing the musculuss strength, while aerobic exercises helps in stabiliz ing and back uping the articulations ( Michlovitz et al. 2004, Ruiz JO, 2009 ) . Hakkinen et Al. ( 1998 ) in their survey proposed that betterment in shoulder musculus map might chiefly ensue from the nervous version taking topographic point due to the exercising preparation. It has besides been speculated that betterment in the intramuscular and intermuscular co-ordination, decreased shoulder hurting and shoulder musculus wasting along with an increased shoulder articulation mobility are all factors for betterment in shoulder musculus map in frozen shoulder patient after rehabilitation ( Jurgle et al. 2005 ) . It has besides been proved in a survey by Kibler et Al. ( 1998 ) that after an exercising plan, the shoulder muscles tends to go more free and elastic permitting chief motions in the shoulder girdle. Though it has been proved in certain surveies that rehabilitation entirely is non so effectual and in some instances it can really worsen the symptoms but physical therapy combined with other intervention regimens like steroids is decidedly a much better pick ( Jurgle et al. 2005 ; Carette et Al. 2003 )Effectiveness of Corticosteroid injections Vs. Physiotherapy intervention:Here will be foregrounding three surveies related to the above subject. Study one ( Van der Windt et Al. 1998 ) .The aim of this survey was to compare the efficaciousness of corticosteroid injection with physical therapy for the intervention of painful stiff shoulder. It was a randomised test carried out in a primary attention puting. They described painful stiff shoulder or capsular syndrome as a status that is characterized by a painful limitation of inactive scope of gesture, preponderantly of sidelong rotary motion and abduction. Based on the inclusion and exclusion standards there were 109 patients taking portion in the survey. Patients were indiscriminately allocated to 6 hebdomads of intervention. 53 took corticoid group while the remainder 56 were in the physical therapy group. Now intra-articular injections of 40mg Triamicinolone acetonide were given to the steroids group by trained general practicians utilizing the posterior path, three injections were given during the 6 hebdomads. Physiotherapy group received 12 Sessionss exercising of 30 proceedingss during which all patients received inactive joint mobilisation and exercising intervention. Besides ice, hot battalions and galvanism was used to pare down the hurting. The consequences were assessed at 3 and 7 hebdomads, with an extra follow up at 13, 26 and 52 hebdomads. The appraisal done at 13 and 52 hebdomads were by postal questionnaire and enclosed all primary result steps. Some of the appraisals were besides carried out by an perceiver blind to intervention allotment. The result steps were assessed in the signifier of Primary result steps where patients were asked to hit their advancement on a six point Likert graduated table, the hurting associated with their chief ailment and the badness of their hurting during twenty-four hours and dark on a 100mm ocular parallel graduated table and the functional disablement was evaluated with the shoulder disablement questionnaire, that consisted of 16 points on common state of affairs that may do shoulder hurting. The secondary result measured the limitation of mobility during inactive sidelong rotary motion and glenohumeral abduction with the aid of a digital inclinometer. The blind perceiver was aske d after each scrutiny to theorize which intercession the patient had been assigned to. The consequences were as follows, at the terminal of 7 hebdomads 40 ( 77 % ) out of 52patients exposed to injections were considered to be treated successfully as compared with 26 ( 46 % ) out of 56 treated with physical therapy ( difference between the groups were 31 % , 95 % assurance interval 14 % to 48 % ) . At appraisal at 26 and 52 hebdomads at that place was relatively little differentiation between the groups. So this randomized control test showed that corticoids injection were better compared to physiotherapy in footings of the success intervention, betterment in the scope of sidelong rotary motion, betterment in clinical badness and in alleviation of the major ailment, hurting and disablement. They proposed that the differences in the intercession group were chiefly due to the relatively faster alleviation of symptoms go oning in patients treated with injections. So injections may be preferred to physiotherapy in the initial intervention of painful stiff shoulder, but the physicians and patients should be cognizant of the mild but sometimes troubleshooting inauspicious reactions to corticoids that may happen. Similar to the above survey, Carette et Al. 2003 studied with an aim to mensurate the effectivity of a physical therapy intervention, intra-articular injection of corticoid, both the intervention combined and one group had merely placebo intervention of frozen shoulder. It was a placebo-controlled test. They recruited 93 patients and were randomized to one of the undermentioned 4 intervention groups: group-1 was applied steroid injection of Aristocort hexacetonide 40mg after 12 Sessionss of 1 hr supervised physical therapy which was performed under fluoroscopic counsel, given over a 4 hebdomad period ( combination group ) , group-2 had been given steroid injection entirely ( steroid group ) , group-3 had been given saline injection followed by supervised physical therapy ( physiotherapy group ) and group-4 had been used ( placebo group ) saline injection merely. All topics were asked to follow a simple place exercising plan. Two different Physiotherapy schemes were used for ague and chronic capsulitis. TENS, mobilisation, active ROM exercisings and ice application was used for the acute status while ultrasound, mobilisation, active and car assisted ROM exercisings, isometric strengthening exercisings and ice was used for the chronic 1. The patients were followed up at an interval of 6 hebdomads, 3 months, 6 months and 1 twelvemonth after randomisation. The primary result step was done by Shoulder Pain and Disability Index ( SPADI ) mark. The Short Form 36 ( SF-36 ) was used for general wellness measuring and the cosmopolitan goniometer was used to mensurate the active and inactive ROM. The response to intervention were: 6 hebdomads after the intervention the SPADI tonss had improved by ( average A ± SD ) 46.5 A ±- 5.0 in the combination group and 36.7 A ± 5.1 in the steroid group, which were significantly higher than the betterments of 22.2 A ± 4.8 observed in physical therapy group and 18.9 A ± 5.1 in the placebo group. In all the groups, scope of active and inactive gesture improved. There was a important risen in betterment of group-1 comparison to group-3. Group 1 and 2 had uninterrupted appreciably betterment in tonss of SPADI comparison to group 4 at 3 months. Group-3 and group-4 had non shown any i mportant difference at any of the follow up appraisal but it was found that at 3 months, gropu-3 had great sum of betterment in shoulder flexure scope of gesture. At 6 months following the intervention, there was no longer any important difference in SPADI tonss between the 4 groups. Active ROM was higher in steroid group than the placebo group. While at 12 months, the 4 group did non differ extensively in regard to any of the result steps. The consequences of this survey suggests that merely physical therapy intervention has limited consequence on joint scope of gesture and betterment is slow while combination of the steroid injection and physical therapy intervention improves shoulder scope of gesture at faster rate in frozen shoulder. The quality of this survey is good. The positive points of this survey are that it used valid inclusion and exclusion standards, injection disposal techniques, physical therapy intercessions all based on best grounds available. The restriction of this survey was that it had to be concluded early due to the troubles in enrolling patients who fitted the entry standards. Rest the concluding result perfectly mirrored the first survey with steroids holding a good consequence in the short term while physical therapy had limited consequence. Similar to the above survey, a recent survey was done by Ryans et Al. ( 2005 ) . They grouped the same patients as in above survey and gave triamicinolone ( 20mg ) and gave 8 Sessionss of standardised physical therapy and reviewed them at 6 and 16 hebdomads. Their outcome steps were based on Shoulder Disability Questionnaire ( SDQ ) mark, VAS for hurting appraisal, planetary disablement utilizing VAS and scope of inactive external rotary motion. They came up with the consequences that corticosteroid injection is effectual in bettering shoulder related disablement, and physical therapy is effectual in bettering the scope of motion in external rotary motion 6 hebdomads after intervention, but at the terminal of 16 hebdomads, the betterment was similar in every group with regard to all attendant steps. Though this survey used a really rigorous choice standards had used a placebo group and applied strict blinding, still they were merely able to track positive differences between interventions at 6 hebdomads compared to the old surveies. There were many losing informations in this survey by 16 hebdomads due to the deficiency of follow up of patients beyond 6 hebdomads. Besides there was no interaction noted between the two signifiers of intervention in any of the result step as was seen in the earlier surveies. So this survey is less likely a failure as compared to other surveies, it merely reinforced the grounds that corticosteroid injection is effectual for adhesive capsulitis of the shoulder in the short period of clip.Other Treatment Modalities:To handle the frozen shoulder many other progress intervention are used presents. Apart from physical therapy and intra-articular steroids the other proposed interventions are listed as follows: Traditionally unwritten and topical non-steroidal anti -inflammatory drugs are used, where necessary they are supplemented with different anodynes combination. This is chiefly prescribed in the painful freeze phases where hurting alleviation is the chief concern. However no randomised experiments that label the efficaciousness of NSAIDs in frozen shoulder are yet reported ( Dias et al. 2005 ) . Oral steroids is one of the proposed intervention for frozen shoulder in the initial phases, but as there were more inauspicious side effects, they should non be considered as everyday pattern for this status ( Buchbinder et al. 2004 ) . Suprascapular nervus blocks may turn out to be a powerful hurting stand-in, but non in motion Restoration and repeated joint dilatation may be so helpful in bettering the motion of the joint ( Dahan et al. 2000 ) . A different set of intervention is used in the adhesive stage, as the purpose here is non to alleviate merely hurting but stiffness is of more concern. Manipulation under anaesthesia is a intervention option in patients who are non able to bear the hurting and disablement connected with the status. This intervention is indicated merely if the functional disablement persists despite of proper conservative intervention for six months ( Hamdan and Al-Essa 2003 ) . Manipulation under anaesthesia helps to recover the scope of gesture and shoulder map within a period of 3 months. An arthroscopic release of the capsule is besides an advocated intervention. The plus point here in this intervention is it avoids the complication like break of the humerus as is common in use ( Dias et al. 2005 ) .Decision:In regard to the usage of this intervention option i.e. Physiotherapy and Corticosteroids farther high quality research is required, as there are still certain uncertainties which remains unreciprocated, like ; What dose precisely should be given ( 20 or 40mg ) for an effectual result? In which phase of frozen shoulder what intervention is best suited? How many injections should be administered for an optimal consequence? The path of administrating the injection, as in some surveies anterior path while in other buttocks or sidelong path has been preferred. How many hebdomads should the intervention be for an consequence to be prolonged? Therefore, a certain sum of information on these facets is still required. There is a literature on an on-going research by McDaid C ( 2010 ) , that is aimed at taking a broader position as compared to the old surveies that have focused on individual intervention and now they are happening out an overall effectual intervention regimen of the status. The undertaking will besides look into what intervention options are most cost-efficient. They will include all the patients of frozen shoulder undergoing steroid injection, physical therapies, arthrographic dilatation, use under anaesthesia and capsular release. The attack of alert waiting will besides be included and so they will seek to plot the patient attention tracts. So, to reason frozen shoulder is a most common musculoskeletal status, but no intervention has proved to be unequivocal. Though literature supports many signifiers of intervention, both operative and non operative, but this huge sum of information and conflicting nature of the grounds leads to confusion. All these interventions have possible advantages and disadvantages and as a wellness professional it becomes hard to follow grounds based thorough attack in the intervention of frozen shoulder. In the hereafter discoveries are anticipated that can take to the development of new intervention schemes and finally an improved result.

Juvenal and Rhetoric essays

Juvenal and Rhetoric essays Can we suppose that Juvenal is using a rhetorical theme to write serious political comment in the satire on the vanity of human wishes? The way Ive interpreted this question is that Juvenal was using Roman rhetorical language and themes that were currently popular, in his works. And that this was strategic in winning over the cases he was making in his satire, just as an orator did in his public speeches. And so I intend to show that Juvenal was writing serious political comment using this rhetorical theme. Firstly, I intend to discuss briefly the nature of Roman rhetorical theme, taking as examples both Quintilian ( first century AD) and Cicero ( first century BC). Then attempt to apply these themes to Juvenal Satire 10, working along the basic structure of the satire, but focusing mainly on the overtly political elements such as specifically the lust for military glory, but also the less obvious examples within themes that would appear non-political. Then reach a conclusion about the seriousness of the satire in this context. Both Cicero and Quintilian have defined the structure in which Roman rhetoric was set out. A rhetorical passage always starts with a prooimion (or exordium in Latin). This is intended to make the listeners more favourably inclined towards one particular argument, by posing questions that are impossible for the audience to disagree with, before launching into the actual attack. This stirs up pity and links the authors needs with that of the general audience , making it appear a moral issue that has only one answer, the one suggested in the rest of the work. After the exordium comes the narrative, which can be either wholly for or against a case . This is the section that traditionally was used to incriminate the people involved , by giving accounts of the facts . Using the moral element to expose hidden motives, which is also a main theme of a lot of Juvenals work. The rest of rhetoric is conce...

Pre-Pottery Neolithic - Farms and Feasts Before Pottery

Pre-Pottery Neolithic - Farms and Feasts Before Pottery The Pre-Pottery Neolithic (abbreviated PPN and often spelled as PrePottery Neolithic) is the name given to the people who domesticated the earliest plants and lived in farming communities in the Levant and Near East. The PPN culture contained most of the attributes we think of Neolithicexcept pottery, which was not used in the Levant until ca. 5500 BC. The designations PPNA and PPNB (for Pre-Pottery Neolithic A and so forth) were first developed by Kathleen Kenyon to use at the complex excavations at Jericho, which is probably the best known PPN site. PPNC, referring to the terminal Early Neolithic was first identified at Ain Ghazal by Gary O. Rollefson. Pre-Pottery Neolithic Chronology PPNA (ca 10,500 to 9,500 BP) Jericho, Netiv Hagdud, Nahul Oren, Gesher, Dhar, Jerf al Ahmar, Abu Hureyra, Gà ¶bekli Tepe, Chogha Golan, BeidhaPPNB (ca 9,500 to 8200 BP) Abu Hureyra, Ain Ghazal, Çatalhà ¶yà ¼k, Cayà ¶nà ¼ Tepesi, Jericho, Shillourokambos, Chogha Golan, Gobekli Tepe PPNC (ca 8200 to 7500 BP) Hagoshrim, Ain Ghazal PPN Rituals Ritual behavior during the Pre-Pottery Neolithic is quite remarkable, indicated by the presence of large human figurines at sites such as Ain Ghazal, and plastered skulls at Ain Ghazal, Jericho, Beisomoun and Kfar HaHoresh. A plastered skull was made by modeling a plaster replica of skin and features onto a human skull. In some cases, cowry shells were used for eyes, and sometimes they were painted using cinnabar or other iron-rich elements. Monumental architecturelarge buildings constructed by the community for use as gathering spaces for those communities and allied peoplehad its very first beginnings in the PPN, at sites such as  Nevali Çori and Hallan Çemi; hunter-gatherers of the PPN also constructed the significant site of  Ã¢â‚¬â€¹Gà ¶bekli Tepe, an apparently nonresidential structure built for ritual gathering purposes. Crops of the Pre-Pottery Neolithic Crops domesticated during the PPN include the founder crops: the cereals (einkorn and emmer wheat and barley), the pulses (lentil, pea, bitter vetch, and chickpea), and a fiber crop (flax). Domesticated forms of these crops have been excavated at sites such as Abu Hureyra, Cafer Hà ¼yà ¼k, Cayà ¶nà ¼ and Nevali Çori. In addition, the sites of Gilgal and Netiv Hagdud have produced some evidence supporting the domestication of fig trees during the PPNA. Animals domesticated during the PPNB include sheep, goats, and possibly  cattle. Domestication as a Collaborative Process? A recent study at the site of Chogha Golan in Iran (Riehl, Zeidi and Conard 2013) has provided information concerning the apparently wide-spread and perhaps collaborative nature of the domestication process. Based on the exception preservation of the botanical remains, the researchers were able to compare the Chogha Golan assemblage to other PPN sites from all over the Fertile Crescent and extending into Turkey, Israel and Cyprus, and have concluded that there might very well have been inter-regional information and crop flow, which might account for the nearly simultaneous invention of agriculture in the region. In particular, they note that crop domestication of seed plants (such as emmer and einkorn wheat  and barley) seems to have arisen throughout the region at the same time, leading the Tà ¼bingen-Iranian Stone Age Research Project (TISARP) to conclude that inter-regional information flow must have occurred. Sources This Guide to Prehistory is part of the About.com Guide to the Neolithic and the Guide to European Prehistory. Garrard AN, and Byrd BF. 2013. Beyond the Fertile Crescent: Late Palaeolithic and Neolithic Communities of the Jordanian Steppe. The Azraq Basin Project. Oxford: Oxbow Press.Goren Y, Goring-Morris AN, and Segal I. 2001. The Technology of Skull Modelling in the Pre-Pottery Neolithic B (PPNB): Regional Variability, the Relation of Technology and Iconography and their Archaeological Implications. Journal of Archaeological Science 28(7):671-690.Haber A, and Dayan T. 2004. Analyzing the process of domestication: Hagoshrim as a case study. Journal of Archaeological Science 31(11):1587-1601.Hardy-Smith T, and Edwards PC. 2004. The Garbage Crisis in prehistory: artefact discard patterns at the Early Natufian site of Wadi Hammeh 27 and the origins of household refuse disposal strategies. Journal of Anthropological Archaeology 23(3):253-289.Kuijt I. 2000. People and Space in Early Agricultural Villages: Exploring Daily Lives, Community Size, and Architecture in the Late Pre-Pottery Neolithic. Journal of Anthropological Archaeology 19(1):75-102. Lev-Yadun S, Abbo S, and Doebley J. 2002. Wheat, rye, and barley on the cob? Nature Biotechnology 20(4):337-338.Pinhasi R, and Pluciennik M. 2004. A Regional Biological Approach to the Spread of Farming in Europe: Anatolia, the Levant, South-Eastern Europe, and the Mediterranean. Current Anthropology 45(S4):S59-S82.Riehl S, Pustovoytov K, Weippert H, Klett S, and Hole F. 2014. Drought stress variability in ancient Near Eastern agricultural systems evidenced by d13C in barley grain. Proceedings of the National Academy of Sciences 111(34):12348-12353.Riehl S, Zeidi M, and Conard NJ. 2013. Emergence of agriculture in the foothills of the Zagros mountains of Iran. Science 341:65-67.

Using the Spanish Verb Haber

Using the Spanish Verb Haber Haber is one of the most common verbs in Spanish, used most of the time as an auxiliary or helping verb. Although haber is similar in form to have and is often translated that way, it is unrelated to the English verb. Haber has three main uses as seen below. Haber as an Auxiliary Verb in Compound Tenses When used as an auxiliary verb, haber is the equivalent of the English auxiliary to have (which is much different than the English to have when it means to possess). Haber is used to form what is known as the perfect tenses because they refer to actions that have been or will be completed. (Completed used to be a common meaning of perfect.) As in English, the perfect tenses are formed by following a form of haber with a past participle. He comprado un coche. (I have bought a car.) ¿Has estudiado? (Have you studied?)Han salido. (They have left.)Habr salido. (She will have left.)Habrà ­a hablado. (I would have spoken.) In English, it is very common to insert an adverb or another word between the two parts of a compound verb, such as in the sentence he has always gone. But in Spanish (except perhaps in poetry), the two verb parts arent separated. As a beginner, you dont need to learn all the tenses using haber now, but you should be able to recognize haber when it is used. You should also be aware that while the perfect tenses in Spanish and English are quite similar in form, they arent always used in exactly the same way. Haber for There Is or There Are One peculiarity of haber is that it has a unique conjugated form, hay (pronounced basically the same as the English eye) that means there is or there are. Hay una silla en la cocina. (There is one chair in the kitchen.)Hay dos sillas en la cocina. (There are two chairs in the kitchen.) Note that in the above examples, the English there isnt referring to location, but to mere existence. The most common word for there in terms of location is allà ­. Example: Hay una silla allà ­. There is a chair there. Haber can be used in this way in tenses other than the present, although not as commonly. In formal Spanish, as in the second example above, the singular form of the verb is used even when it refers to more than one person or thing. Haber  in Idioms Haber can be used in a number of idioms, which are phrases that have a meaning apart from the meanings of the words in them. The one youll run into most often as a beginner is haber que, which means to be necessary when followed by an infinitive. When used this way in the present tense, the hay form of haber is used. Hay que saltar. (It is necessary to jump.)Hay que conocerlo para comprenderlo. (It is necessary to know him in order to understand him.)Habr que salir a las dos. (It will be necessary to leave at 2 oclock.) Conjugating Haber As is the case with most other common verbs, haber is conjugated irregularly. Here is the conjugation for its present indicative tense, the one used most often. yo (I) he I have tà º (informal singular you) has you have usted (formal singular you), à ©l (he), ella (she) ha (sometimes hay) you have, he has, she has nosotros, nosotras (we) hemos we have vosotros, vosotras (informal plural you) habà ©is you have ustedes (formal plural you), ellos, ellas (they) han (sometimes hay) you have, they have

Event management strategy plan RE Essay Example | Topics and Well Written Essays - 2000 words

Event management strategy plan RE - Essay Example Organizing a trade fair is not quite complicated owing to the fact that there are effective event management practices which play a crucial role in determining the protocols. Furthermore, through the role of event management it becomes easier to organize trade fairs since such firms specialize in the task of organizing events. However, organizing an international trade fair is not an easier option since the international element adds to the involvedness of the event management process. Since international trade fairs involve a much wider audience, diverse practices, products, businesses and people, organizing an international event will be quite challenging. Great caution ought to be taken when dealing with international events to ensure that they are successful. This paper aims at providing a report outlining an event strategy plan for an International trade fair. The report will outline the relevant plans, events and activities that constitute the overall strategy plan of the international trade fair that is to be organized. In line with the relevant aspects of the plan strategy, the paper will include the following parameters that are paramount to the project; Strategic aims, objectives with actions, opportunities and Risks associated with the international dimension, evaluation methods to be utilized, pre- and post –event and summary along with recommendations. The paper also presents the Gantt chart and Risk Assessment Form which underscore the distribution of responsibilities, identification of risks along with their respective action plan; this represents the evaluation criteria for the international trade fair. The strategic aims of the international trade fair are quite diverse and involve the relevant parameters that constitute business and performance. The international event will serve several purposes all in one so as to take full advantage of the opportunity availed.

Article Presentation Assignment Example | Topics and Well Written Essays - 500 words - 1

Article Presentation - Assignment Example In addition, they should establish the ability to implement EBP in the day-to-day operations of a mental institution. The study focuses on the integration of the most effective measures available in current research. The methodology employs research evidence that is backed by clinical expertise and patient values in order to facilitate the clinical decision making process. The study is based on the ideologies that customs, norms, expert opinions and established rituals are no longer acceptable practices in the decision making process. Instead, there is a need for a deliberate process that takes the values and preferences of patients into account. The article argues that, this perception demonstrates that EBP is a clinical strategy that can aid problem solving. Consequently, emphasis is placed on identifying the best research evidence and integrating it in the decision making process. The process will ensure that clinicians are providing the best care that fulfills the needs of their patients. Increasing interest in mental health issues has prompted researchers to increase the body of knowledge available on the topic. As a result, mental health nurses can refer to a growing EBP base. However, many researches are done in a controlled environment. Consequently, effectiveness may be inappropriate in a real world setting where there are limitations such as limited organizational resources, workforce issues, lack of sufficient staff education and training. Many psychiatric mental health (PMH) issues have not been addressed. The failure to research or define them can be attributed to ethical issues. In this instance, the best recourse for mental health professionals is to hold discussions on the recommended intervention measures. They should also highlight the potential risks and benefits involved. In addition, they should study the available alternatives before settling on one course of action. In spite of the increasing application of

Macroeconomic Paper Essay Example | Topics and Well Written Essays - 500 words

Macroeconomic Paper - Essay Example Homeowners increasingly use them to refinance and consolidate household debts when their credit scores fall in the wake of bankruptcy, high medical bills, or other setbacks. (Blanton). It is generally believed that the subprime borrowers emerge due to lack of the good credit history on their back and since there number grew historically therefore banks and financial institutions by spotting the opportunity started lending to them at higher interest rates due to the perceived risks involved in these subprime loans. Having defined what subprime mortgages are, this article has articulately put forward the theory of predictable surprise in order to discuss the clues which the economic trends in US suggested specially after the collapse of dot com companies during 1990s. Due to the lack of policy attention by the government especially FED, the lowered interest rates in the economy created an inflated housing markets which thrived on the equity cushion created through the artificial and speculative surge in the market. The consequences of such behavior helped create a predictable surprise in the economy. Article has further discussed the role of securitization and its impact on the economy as a whole. The securitization through financial derivatives produced the results which authors predicted in their theory of predictable surprises. With the advent of innovation into the financial industry, Financial Derivatives provided a very efficient and effective tool to the financial managers to effectively manage these kinds of risks. However, financial derivatives itself are considered as detrimental if their use is made in more superficial way. Banks, in order to recoup the lost liquidity drained into the subprime mortgage loans have securitized them against the payments and real estate properties offered as securities in those mortgage loans. The process of

Introduction To Luke Term Paper Example | Topics and Well Written Essays - 1500 words

Introduction To Luke - Term Paper Example To begin with, it must be noted that there is no clear indication that the above mentioned text was written by Luke. It is the tradition of Church that attributes the Gospel to this apostle. However, there are several indications which contribute to acknowledgement of his authorship: Luke was a highly educated person for his time, had a personal acquaintance with the Biblical characters, respected people who belonged to a lower class and was wealthy enough to devote time to create a Gospel (Bock, 1994, 138). Similar to the authorship, there is not a direct indication of date. Just like many of the ancient texts, the originals were lost and the researchers are able to work with the copies which were created afterwards. According to one approach, the Gospel of Luke should be dated 80 or 90 Common Era; however, some researchers tend to move the creation of the text a decade further. In addition that that, some scholars point out that mentioning of various contemporary events, such as conflict in the manuscript families or heresy of Marcion, provides enough basis to move the time of the creation of the scripture even further. The question of sources is another interesting one when it comes to evaluation of the Gospel in question. The main basis for the narration is the Gospel of Mark which was written roughly a decade before. However, since this text featured more factual information, Luke uses the so called Q source in order to present the complexity of the teachings of Jesus. Finally, there a part of the Gospel, around one third, that is unique to Luke. The structure of the Gospel in question is traditionally divided into six sections. The first part is the formal introduction, containing address to Theophilus. The next section is the description of birth of Jesus and his boyhood. Afterwards there is a part which tells the readers about baptism of Jesus and his fight against the

Energy efficiency rating Math Problem Example | Topics and Well Written Essays - 500 words

Energy efficiency rating - Math Problem Example In comparing the means for both groups, using a 1% significance level, the two-tailed P value, at a 99% confidence interval, equals 0.6543. Thus, there is a 65.43% probability that the observed difference between the salaries between private and GOH nurses are actually more extreme than their true differences. At a 1% level of significance, this implies that there is not enough statistical evidence to indicate that the salaries in private hospitals are greater than those in GOH. b. Comparing the means between the previous and current salaries, the previous salaries' mean is higher than the current salaries. At a 99% confidence interval, the two-tailed p-value equal to 0.4699 indicates that there is no reason to conclude that the means have a significant difference. In addition, the lower confidence limit of -3739.9893 indicates a large decrease in the lower limit coupled with a large increase in the upper confidence limit of 2033.3093. Thus, there is no conclusive evidence that the previous salaries are significantly lower than current ones.

International Sustainable Tourism Management 2 Essay

International Sustainable Tourism Management 2 - Essay Example Current paper focuses on a particular form of tourism, the community based tourism as developed in countries internationally. Agencies and the local communities have extensively supported the particular type of tourism; however, its effectiveness is often doubted. The level of effectiveness of community-based tourism worldwide is the main subject of this paper; reference is also made to issues related to the above subject – as the types and the scope of community based tourism but also the challenges that this form of tourism faces in countries globally. 2. Community based tourism – main aspects In order to identify and evaluate the effectiveness of community based tourism it would be necessary to understand primarily the context of this form of tourism – a form that is standardized internationally. In accordance with a relevant report, the community-based tourism can be characterized as ‘the form of tourism in which local residents (often rural, poor and e conomically marginalised) invite tourists to visit their communities with the provision of overnight accommodation’ (Responsible Travel, 2011). ... rily separately for each visitor, a community-based telephone would be adequate) but also an accommodation that has certain standards (meaning the conditions of living that do not put the health of the visitors in risk), c) travelers need to be aware of the challenges of the particular form of tourism; in the context of community-based tourism visitors are expected to support people in the local community; it is meant that visitors will be possibly asked to be involved in tasks related to ‘the protection of the environment or of the cultural heritage’ (Sustainable Tourism, 2001). The relationship between the community-based tourism and specific social obligations, mostly the protection of the environment is emphasized in the study of Byrd (2007) who noted that ‘sustainability has become an important topic and concept in relation to tourism planning and development’ (Byrd 2007, 6); however, the participation of the stakeholders in the relevant projects is set by Byrd as a prerequisite for their success (Byrd 2007). The concept of the community-based tourism is explained in the literature using various approaches; in accordance with Beeton (2006) the community-based tourism focuses on ‘the creation of a more sustainable tourism industry, focusing on the host community in terms of planning and maintaining tourism development’ (Beeton 3006, 50). On the other hand, Spenceley (2008) refers to the community – based tourism as a tool for promoting sustainability but also ‘for achieving various socio-economic benefits’ (Spenceley 2008, 310) – it is assumed that reference is made to the economic developing of the local communities that support the relevant activities. From another point of view, Moscardo (2008) note that the development of the community-based

Energy efficiency rating Math Problem Example | Topics and Well Written Essays - 500 words

Energy efficiency rating - Math Problem Example In comparing the means for both groups, using a 1% significance level, the two-tailed P value, at a 99% confidence interval, equals 0.6543. Thus, there is a 65.43% probability that the observed difference between the salaries between private and GOH nurses are actually more extreme than their true differences. At a 1% level of significance, this implies that there is not enough statistical evidence to indicate that the salaries in private hospitals are greater than those in GOH. b. Comparing the means between the previous and current salaries, the previous salaries' mean is higher than the current salaries. At a 99% confidence interval, the two-tailed p-value equal to 0.4699 indicates that there is no reason to conclude that the means have a significant difference. In addition, the lower confidence limit of -3739.9893 indicates a large decrease in the lower limit coupled with a large increase in the upper confidence limit of 2033.3093. Thus, there is no conclusive evidence that the previous salaries are significantly lower than current ones.

Findyourdeal.com Thesis Proposal Example | Topics and Well Written Essays - 1250 words

Findyourdeal.com - Thesis Proposal Example Specifications for all these components are standardized and are available off the shelf in any computer store or an e-commerce website. We will extensively use open source software applications to run our IS resources. Most of the open source software applications are royalty free, and hence will shoot down our costs. Some examples of free and open source applications will be Ubuntu as the operating system, Open Office as the general productivity suite, Mozilla Firefox/Google Chrome as the browser, GIMP as photo editor. We will outsource annual maintenance contracts to local hardware providers, thereby nullifying the requirement of any dedicated manpower for maintenance of hardware resources at out office. We will also employ freelance technical help personnel from lower cost economies to drive down our software maintenance costs. 1. Aggregate deals from companies: To keep costs down in the initial phase, we will use the internet to scout for deals being offered by companies. Sourcing of deals may be done through 3 distinct processes: E-commerce businesses range from a multibillion dollar business like Amazon, to really small mom-and-pop-managed kind of a website that generates not more than$5000 revenues in a month. The set of features required in an e-commerce website obviously depends on the present status of an e-commerce business, and also perhaps on the future growth potential. While the initial two components are common place, it selecting appropriate e-commerce software that will be a critical activity. Available e-commerce systems may be categorized using a whole lot of parameters like, Open source / Proprietary, Off-she Shelf/Custom made, Microsoft Technologies/LAMP based or Product/SaaS. Every available e-commerce component have its own utility and caters to a specific set of customers, we have chosen to use LAMP based open source e-commerce systems for our business. LAMP is an acronym for Linux, Apache, MySQL and

Components of Supply Chain Management (SCM) Essay Example for Free

Components of Supply Chain Management (SCM) Essay The main elements of a supply chain include purchasing, operations, distribution, and integration. The supply chain begins with purchasing. Purchasing managers or buyers are typically responsible for determining which products their company will sell, sourcing product suppliers and vendors, and procuring products from vendors at prices and terms that meets profitability goals. Supply chain operations focus on demand planning, forecasting, and inventory management. Forecasts estimate customer demand for a particular product during a specific period of time based on historical data, external drivers such as upcoming sales and promotions, and any changes in trends or competition. Using demand planning to develop accurate forecasts is critical to effective inventory management. Forecasts are compared to inventory levels to ensure that distribution centers have enough, but not too much, inventory to supply stores with a sufficient amount of product to meet demand. This allows companies to reduce inventory carrying costs while still meeting customer needs. Moving the product from warehouses or manufacturing plants to stores and ultimately to customers is the distribution function of the supply chain. Supply chain integration refers to the practice of developing a collaborative workflow among all departments and components involved in the supply chain to maximize efficiencies and build a lean supply chain. 2 Walmart’s Method of Managing the Supply Chain Walmart has been able to assume market leadership position primarily due to its efficient integration of suppliers, manufacturing, warehousing, and distribution to stores. Its supply chain strategy has four key components: vendor partnerships, cross docking and distribution management, technology, and integration. Walmart’s supply chain begins with strategic sourcing to find products at the best price from suppliers who are in a position to  ensure they can meet demand. Walmart establishes strategic partnerships with most of their vendors, offering them the potential for long-term and high volume purchases in exchange for the lowest possible prices. Suppliers then ship product to Walmart’s distribution centers where the product is cross docked and then delivered to Walmart stores. Cross docking, distribution management, and transportation management keep inventory and transportation costs down, reducing transportation time and eliminating inefficiencies. Technology plays a key role in Walmart’s supply chain, serving as the foundation of their supply chain. Walmart has the largest information technology infrastructure of any private company in the world. Its state-of-the-art technology and network design allow Walmart to accurately forecast demand, track and predict inventory levels, create highly efficient transportation routes, and manage customer relationships and service response logistics. 3 Benefits of Efficient Supply Chain Management Wal-Mart’s supply chain management strategy has provided the company with several sustainable competitive advantages, including lower product costs, reduced inventory carrying costs, improved in-store variety and selection, and highly competitive pricing for the consumer. This strategy has helped Walmart become a dominant force in a competitive global market. As technology evolves, Walmart continues to focus on innovative processes and systems to improve its supply chain and achieve greater efficiency. How to Manage the Bullwhip Effect on Your Supply Chain The goal of any supply chain is to get the right selection of goods and services to customers in the most efficient way possible. To meet this goal, each link along the supply chain must not only function as efficiently as possible; it must also coordinate and integrate with links both upstream and downstream in the chain. The keystone for a lean supply chain is accuracy in  demand planning. Unforeseen spikes in demand or overestimations of demand stimulate the supply end of the chain to respond with changes in production. Production and supply issues then impact the consumer end of the supply chain and the effects ripple up and down the chain. This is often referred to as the bullwhip effect. 1 What Causes the Bullwhip Effect? Supply chain management is a complex process. There are several issues that can lead to the bullwhip effect and those issues can be exacerbated by delays in transmitting information, and a lack of coordination up and down the supply chain. Some causes of the bullwhip effect include: Consumer demand swings Natural disasters that disrupt the flow of goods and services Overcompensation when addressing inventory issues Ordering processes, such as order batching, can also contribute to thebullwhip effect. Organizations may accumulate larger orders before processing them in an effort to reduce costs and create transportation economics. They may also wait to place larger orders to benefit from lower prices offered during a promotion. Demand forecasting manipulation is another cause. By padding the forecast to compensate for possible errors, the organization loses sight of true customer demand. Customers can also contribute to the bullwhip effect by engaging in shortage gaming during periods of short supply by purchasing more than they need. Additionally, customers taking advantage of liberal return policies can create problems with developing accurate demand forecasts. 2 How to Minimize the Bullwhip Effect The first step in minimizing the bullwhip effect is to understand what drives customer demand planning and inventory consumption. Lack of demand visibility can be addressed by providing all key players in the supply chain  with access to point of sale (POS) data. Suppliers and customers must then work collaboratively to improve both the quality and frequency of information communication throughout the supply chain. They may also choose to share information through an arrangement such as vendor-managed inventory (VMI). Eliminating practices that introduce spikes in demand, such as order batching, can also help. The higher order cost associated with smaller or more frequent orders can be offset with Electronic Data Interchange (EDI) and computer aided ordering (CAO). Pricing strategies and policies can also help reduce the bullwhip effect. Eliminating incentives that cause customers to delay orders, such as volume transportation discounts, and addressing the causes of order cancellations or reductions can help create smoother ordering patterns. Offering products at stable and fair prices can prevent buying surges triggered by temporary promotional discounts. Special purchase contracts can be implemented to encourage ordering at regular intervals to better synchronize delivery and purchase. 3 Adopting Supply Chain Management Best Practices Using sound chain management processes and systems will result in the efficient flow of goods from a raw stage to the consumer while enhancing ROI for the company. Reviewing case studies and other resources detailing best practices can suggest opportunities for improvement. Adopting successful practices such as Walmart’s use of cross docking, or Dell’s process of bypassing the middle man by offering made-to-order computers directly to customers, can contribute to a lean supply chain and minimize the bullwhip effect. Reducing the bullwhip effect requires a thorough evaluation of organizational policies, measurements, systems, and practices. Based on the positive implications an efficient supply chain can have on costs, sales, profits and customer satisfaction, it’s an undertaking well worth the investment and effort.

How Theories Obstruct Or Assist Practice Social Work Essay

How Theories Obstruct Or Assist Practice Social Work Essay A requirement for Social Work Training is to ensure that the teaching of theoretical knowledge, skills and values is based on [students] application to practice (NHS, 2002 p.3). In response to the death of baby Peter, the Social Work Taskforce published fifteen recommendations including social work degrees requiring a greater focus on linking theory to practice (DCSF, 2009 p.18). This increased emphasis between theory and practice, will be considered in this essay, by discussing if theories of human growth and development obstruct or assist social workers practice. It is important to recognise that there are a vast amount of human growth and development theories, which cover the life span, although one assumption is that they only relate to childhood. This essay, in considering how theories obstruct or assist practice, will draw on those relating to working with older people. To clarify, this essay will use the word theory to mean both grand theories (those borrowed from other disciplines such as psychology, sociology etc) and middle range theories (those which combine the grand theories with practice experience) (Wilson et al, 2008 pp.106-107). The history of social work is helpful in understanding how theory became relevant for practice. The nineteenth century industrial revolution impacted on the community structures, which led to concerns over social unrest and disorder. These concerns influenced the growth of the social sciences with the idea being to understand and change society. Howe states, as new theories and explanations of human behaviour were generated by psychologists, so new social work theories and practices arose (Howe, 2009 p.17). The Charity Organisation Society (COS), founded in 1869, embraced the psychological theories in their charitable work. COS initially resisted any formal education for charity workers preferring supervision in the job. However, worries over the standard of staff and the impact of the job on them, together with the desire to be recognised as professionals in the social field initiated them to set up formal social work education (Howe, 2009; Payne, 2005b; Jones, 1996 p.191). The value of teaching human growth and development theories to social work students is still recognised today in university courses. Teaching on theory is included in the education as it is seen to legitimise social work, giving the social worker assurance, significance and understanding in their work without any taint of meddling (Jones, 1996 p.193). The use of theory helps the practitioner to feel that their views are knowledgeable and grounded (Milner and OByrne, 2002). Seckers research on social workers students found that those who had a comprehensible understanding of theory were more likely to be approachable and responsive with their service users, sharing their theoretical suggestions with the person (Howe, 2009; Payne, 2005a). Alongside this, is the professionalism a theoretical knowledge gives to social work (Howe, 2009). Thompson (2010) argues that other professionals and service users will be more confident in a social worker who is able to demonstrate that their work is based on a theoretical framework, thus showing skills to comprehend and make sense of the service users situation, rather than one who conjectures. Walker states, it is important that social workers have an understanding of human development to work effectively with other disciplines and to demonstrate a professional literacy commensurate with their status (2010, pp.xiv-xv). An example of this is a social worker working within a Community Mental Health Team alongside Psychiatrists and Community Psychiatric Nurses who advocate the medical model and its emphasis on diagnostics and cures (Parrish, 2010 p.10). Working in this setting does not mean that the social worker needs to ignore a psychosocial perspective. To advocate for service use rs effectively, the social worker needs to understand both the medical and psychosocial perspectives, as Parrish states it necessitate[s] the professional equivalent of being bilingual in being able to understand both perspectives simultaneously (Parrish, 2010 p.10). In 1992, Hindmarshs research on social work graduates, showed that an understanding of theory did provide the graduates with confidence. However, Hindmarsh argued that this confidence did not continue in practice as graduates viewed the use of theory as just a tool to justify their actions or provide accountability to their management (Payne, 2005a). Thompson argues that the professionalism of the social worker is being impacted on by what he describes as managerialism (2010, p.51). Thompson explains that governments budgeting tactics through performance indicators is pushing local government to meet targets. This is filtered down the management structure, so that middle managers are dictating what is required and should be implemented by social workers, in order to achieve the targets. Although social workers are dedicated to the use of theory in their practice, managerialism has led to them lacking professional confidence (2010 p.51). It is argued that theory is too complicated and restricts spontaneity, therefore it is pointless for practice. Instead a more realistic model of using facts about the person, an understanding of the law and practical skills (common sense) is more effective for social work practice (Parrish, 2010; Walker and Crawford, 2010). This view has been strongly argued against, as Coulshed states, theoryless practice does not exist; we cannot avoid looking for explanations to guide our actions, while research has shown that those agencies which profess not to use theory offer a non problem solving, woolly and directionless service (1991, p.8). Some theories become so familiar and accepted that they become incorporated into everyday life and language, for example, Anna Freuds defence mechanisms and Daniel Levinsons mid-life crisis. By the fact that these theories become so socially accepted and embedded into everyday language (described as informal theory), it is difficult for a social worker to avoid using it in their practice. Thompson argues, some sort of conceptual framework (and therefore theory) is therefore inevitable (2010, p.7). Our own life experience does not provide us with sufficient knowledge to be able to help others. It can cause us to filter assessments through our own experience, which may be prejudicial but we could be unaware of this. An advantage of having a theoretical understanding of human growth and development is that it gives us a broader view than our individual life experience and balances decision-making (Walker and Crawford, 2010). Research has shown that social workers have found it difficult or are unaware of how they apply theory to practice (Tanner and Harris, 2008; Smid and Van Krieken, 1984). Therefore, work is a routine procedure for social workers if they do not have an understanding of theory (Parton, 1996, p.92). Social worker education is blamed for this difficulty with universities either being too theoretical, or too practical, whichever emphasis taken, it results in making theory and practice appear as separate entities (Smid and Van Krieken, 1984). The different theoretical approaches to human growth and development can appear confusing to the social worker, as each stress different areas as a reason for the persons situation. An illustration of this is the process of ageing: a biological perspective is to focus on the physical impact of a person growing older; a psychological view however, will focus on the deterioration of cognitive functioning; and finally a sociological perception will look at the social structures and the older persons place in that structure. As Hughes states, The images created by the various theoretical perspectives biological, psychological, sociological, political-economic are intrinsically different and create quite distinct pictures of the experience and social condition of older people (Hughes, 1995 p.18). Although each approach emphasises different areas, they all potentially provide something helpful and equally true (Milner and OByrne, 2002 p.81). With each approach providing something useful in understanding the persons situation the social worker needs to support the service user in finding which one with be most helpful to use (Milner and OByrne, 2002). However, rather than seeing this confusion as a hindrance to social work practice, this is what is central to social work. It is what gives it its value and importance because it specialises in situations where there are no known solutions (Statham and Kearney cited in Howe, 2009 p.190). It is the ability of the social worker to draw together the various theoretical perspectives in order to prepare a realistic and balanced care plan. There are development theories that are in direct conflict and/or dismiss each other such as Disengagement and Activity theories (Hughes, 1995; Howe, 2009). Disengagement Theory proposes that as someone ages they naturally disengage from certain social roles and functions, which ensures continuity of the system and equilibrium between different social groups (Hughes, 1995 pp.25-26). Disengagement was viewed as fulfilling for the older person and providing well-being, as it freed them from certain roles and functions that they no longer were able to fulfill, such as retiring from work, thereby, helping people to age well (Hughes, 1995; Bond et al, 2007). Activity theory completely opposes this idea and proposes that remaining actively involved in the community, both physically and mentally, provided well-being and satisfaction for the person (Walker and Crawford, 2010). Both theories provide definite explanation for the difficulties in getting old. The activity / disengagement debate has led to a number of further theories either trying to resolve the conflict, such as Gubriums socio-environmental approach, or challenge one theory to support the other, such as Cowgills modernisation approach (Lynott and Lynott, 1996). The practitioners dilemma is similar, should they align themselves with one or disregard both theories. A danger for the social worker is that s/he uses theory as a way to discover the truth or ultimate solution for the person (Thompson, 2010, pp.11-12). Lee argues against this, theoretical statements are the general principles that give rise to hypotheses, or speculative facts (1985, p.22). No person or situation is exactly the same which means neither can there be a universal solution or theory to fit all (Lees and Lees, 1975). A postmodern view is that truth cannot be found in one solitary theory, instead a plethora of truths for a particular situation can be found in using multiple theories (Milner and OByrne, 2002). As Pease and Fook cited in Howe state, There are many perspectives and voices and it is now recognised that they all need to be heard if the complex nature of truth is to be established (2009, p.191). Walker (2010) argues that a persons growth and development cannot be clarified by one theory. Parrish takes this further by stating that if a social workers practice were based on one theory it would prove woefully inadequate (2010, p.6). An alignment to one specific theoretical viewpoint can be dangerous, as the social worker is unable to recognise important issues that do not correspond with that particular viewpoint. For example Eriksons eight stages of development although helpful in understanding age related activities, has been criticised for its male, patriarchal stance in lacking awareness of other factors that can impact on development, such as gender, race, social class etc. (Thompson, 2010; Parrish, 2010). This highlights the value of recognising and critically analysing a number of theories in a situation, rather than believing one is more superior to another. As Thompson illustrates, the reflective practitioner being a tailor cutting the cloth of the knowledge base to pr oduce a closely tailored solution to the practice challenges being faced, rather than looking for a ready-made, off-the-peg solution (2010, p.16). A social worker may consider amalgamating a number of theories so to provide one combined theory, which Payne describes as eclecticism (Thompson, 2010 and Payne, 2005a p.31). Eclecticism has been criticised as an inexperienced way to use theory (Payne, 2005a). Instead the current view is to take a critical, reflective approach, using the persons history, behaviour and circumstances. Theories should be considered and weighed up as to their usefulness for each person (Adams et al, 2009; Thompson, 2010). Using a range of theories allows a multi-dimensional understanding of situations to develop and enables the limitations of one perspective to be offset by the advantages of another (Tanner and Harris, 2008 p.37). By taking a critical and reflective approach to theory and practice this can help the social worker make sense of the differences and disagreements between the various human growth and development theories (Payne, 2005a). A critical and reflective approach, allows the social worker to value and accept the variety of theories applicable for a particular situation (Adams, 2009). As Fook argues, critical and postmodern practice therefore involves a recognition of different ways of knowing, in particular a reflexive ability to engage with changing situations (2002, p.44). According to Thompson (2010), the main significant purpose for applying theory to practice is that it defines our practice. Misca states, knowledge of human growth and development plays an essential part in assessing, planning and intervening in a successful, positive way in peoples lives (2009 p.116). Fook describes using theories, as our intellectual tools, rather than as rule books as they assist and direct practice (2002, p.69; Walker and Crawford, 2010). This means that a theoretical knowledge can provide a practitioner with the understanding and explanation of a persons behaviour and situation. Consideration of Bowlbys Attachment theory with aging and dementia will be used to illustrate this. Bowlby stated that typically within the first 9 months of a persons life, they develop an attachment to their primary caregiver. Ainsworth, working alongside Bowlby, extended attachment theory. Through the Strange Situation trials, she proposed three types of attachment behaviours: Anxious /Avoidant, Anxious/Resistant and Securely Attached (Parrish, 2010). Although Bowlby did not carry out any studies on older people, he did argue that, attachment behaviour continues to play a necessary role into adulthood (Browne and Shlosberg, 2006 p.135). It has only been since the late 20th century, that Bowlbys attachment theory has been applied throughout the human lifespan and in particular to dementia (Bond et al, 2007). Bowlby suggested that when adults are unwell or under stress then attachment behaviour is likely (Browne and Shlosberg, 2006). Miesen, an advocator for attachment theory, researched the general behaviours of people with dementia. He likened a demented state of crying, clinging and calling as being in Ainsworths strange situation (Bond et al, 2007). Miesen researched parent fixation which is when a person with dementia believes that his/her deceased parent is still alive. His study concluded that dementia triggers attachment behaviours (Browne and Shlosberg, 2006). De Vries and McChrystal state, Bowlbys attachment theory has provided a conceptual and empirical framework for examining some behaviours of people with dementia and provided a means of interpreting them in terms of responses to loss (2010, p288). A theoretical knowledge also provides solutions for approaches of intervention, to assist the service user and enables the practitioner to anticipate future issues (Parrish, 2010). Continuing to use the above example, two new ways of working within an attachment theory framework have recently been developed to assist working with people with dementia: simulated presence therapy (SPT) and doll therapy (Browne and Shlosberg, 2006). The difficulty for the social worker is that separate theories can lead to different approaches to practice, so that the social worker has to choose which is the right one (Walker and Crawford, 2010). Milner and OBryne (2002) argue that the theory, which provides the greatest insight and leads to an approach that meets the service users objectives, is the one to use. The problem with this is who decides which is the theory that gives the greatest insight, is it the social worker or managerial/government decision. If it is the latter then it disempowers the social worker. However, if it is the former it is dependent on the knowledge base of the social worker. Beckett and Taylor explain, Fortunately or unfortunately, no theory about human life can ever be completely objective or value free (2010 p.4). Human growth and development theories have been criticised for reflecting the dominant beliefs of the theorists society. As Thompson states, Theorising is by no means a pure activity, detached from the reality of the social and political world (1995, p.32). For example, Erikson, Levinson and Havighursts theories on adult stages of development have all been criticised This essay has noted some theories of human growth and development in aging. However, it is also important for a Social Worker in his/her practice to acknowledge that service users will have their own ideas to explain their circumstances and behaviour. As Gubrium and Wallace explain, We find that theory is not something exclusively engaged in by scientists. Rather, there seem to be two existing worlds of theory in human experience, one engaged by those who live the experiences under consideration, and one organised by those who make it their professional business systematically to examine experience (cited in Tanner and Harris, 2008 p.36). Erickson emphasised the need to look at a person as an individual and therefore, a social worker in his/her practice needs to take this into consideration, rather than trying to get a theory to fit the persons situation (Milner and OByrne, 2002). It is important for the social worker to be aware of anti-oppressive practice in considering a theoreti cal framework by not taking into account the service users views. S/he needs to be aware of his/her professional power and also the need to empower the service user in making decisions and changes (McDonald, 2010; Thompson, 2010). As shown, having a theoretical understanding of human growth and development can assist social work practice by legitimising the work done, giving the social worker confidence and providing a framework for the work. However, it is not the theoretical understanding itself that hinders practice but instead the application of the theory. Theory in practice is hindered by managerialism, the danger of anti-oppressive practice and limitations of social workers knowledge and experience .

Filling the Gap in My Heart :: miscellaneous

Filling the Gap in My Heart Flavia Weedn once said that â€Å"some people come into our lives and leave footprints on our hearts and we are never the same.† Recently I had a life-changing experience that narrates to that notable quote. This experience opened my eyes to a whole other part of me that I never knew about. I learned that giving second chances doesn’t always have an unconstructive outcome and that building relationships aren’t effortless. When I opened my heart I faced a lot of poignant anxiety that guided me to a blissful and rewarding ending that I am grateful for. Growing up there was always a fraction of my heart absent that I had always wanted to have fulfilled. Not having a father throughout my childhood has put a mild affect on me expressively. In my eyes, having no father for eighteen years meant that it would be too late to ever have one in my life. That emotion came to an end on the day of my high graduation when my biological father showed up on my front porch. I was absolutely stunned and soundless of words. I didn’t recognize him in any way but the reaction that dispersed through my body when I opened that door led me to know that he was my father. Why was this stranger finally deciding to see his daughter? I kept asking myself that question repeatedly in my mind until we finally got the chance to sit down and converse. He informed me that I had three half siblings which consisted of one brother and two sisters. At that moment I felt left out like as if I didn’t do my role as a big sister all their lives. The hole in my heart seemed to get deeper as he spoke until he finally confessed the real truth to why he had abandoned me for all these years. He began explaining how he had been in prison for the last fifteen years for transporting illegal drugs over the U.S border. There was no method of contacting me and if there was he didn’t want me growing up knowing that my father was incarcerated. At that moment everything seemed to make sense and I actually wanted to give this gentleman a hug and perhaps even a chance to be in my life. Once he departed all I could feel was excitement within my heart.

Hamstring Tightness Is Common Health And Social Care Essay

Among the musculus undergoing adaptative shortening, hamstring is the 1 normally traveling for adaptative shortening. The hamstring comprises of three big musculuss viz. semimembranosus, semitendinosus, and bicep femur which arises from the tubercle of ischial bone. They are present over the posterior compartment of the thigh and cross the hip and articulatio genus articulations. Hence they are the extensors of the hip and flexors of the articulatio genus. Hamstringing stringency is common in normal single because of immobilisation of a tissue in a sawed-off place consequences in adaptative shortening. As the musculus shortens, its snap of the normal tissue was decreased and a alteration in the length tenseness relationship of the musculus, loss of flexibleness besides occurs. Hamstring stringency could do the musculo sinewy unit more susceptible to injury, increase opposition to assorted anatomical constructions, which may take to overdrive syndrome. Stringency could besides leads to pathological conditions at the articulation on which the musculus Acts of the Apostless, particularly on a musculus like hamstring which passes over the two articulations. Muscle stringency has a important impact on neuromuscular control. Muscle stringency affects the normal length tenseness relationships. When one musculus in a force twosome becomes tight or hypertonic, it alters the normal arthrokinematics of the involved articulation. This affects the interactive map of the full kinetic concatenation, taking to unnatural emphasis, soft tissue disfunction, nervous via media and vascular/lymphatic stasis. Muscle stringency besides cause mutual suppression. Increased musculus spindle activity in a specific musculus will do reduced nervous thrust to that musculus ‘s functional adversary. This alters the normal arthrokinematics of the involved section. Flexibility has been defined as the ability of a musculus to lengthen and let one articulation ( or more than one articulation in a series ) to travel through a scope of gesture. Anderson and Burke defined Flexibility as the â€Å" scope of gesture available in a joint or a group of articulation that is influenced by musculuss, ligaments and castanetss † . Loss of flexibleness agencies reduced ability of a musculus to deform. Loss of flexibleness may take to diminish in lumbar hollow-back, decrease of musculus strength and quadriceps disfunction during pace, lumbar pelvic beat was disturbed, anterior pelvic joust was restricted, lumbar gesture was increased. Excessive mobility of lumbar spinal column leads to pulling of lumbar ligaments and accordingly hurting and instability. ( Levangie and Norkin, 2001 ) Loss of flexibleness can besides do hurting originating from musculus, connective tissue or periosteum. ( Hardy, 1989 ; Tillmann and Cummings, 1992 ) With respect to of import function of hamstring flexibleness Restoration of its normal length is necessary. Muscle tissue length is thought to play an of import function in efficiency and effectivity of human motion. Benefits of flexibleness is to heighten the scope of gesture, improved organic structure place, possible alleviation of achings and hurting, protection against low back hurting and hurts, decrease of station exercising musculus tenderness, and promotes relaxation. Hamstringing stringency can be measured utilizing the ( 1 ) Active one-sided straight leg rise trial, ( 2 ) Passive one-sided straight leg rise trial, ( 3 ) Sit and make trial, ( 4 ) Active articulatio genus extension trial. Straight leg rise trial are widely used as a neurologic trials, hence they do non give valid steps of hamstring stringency because of pelvic rotary motion that occurs during the trial. Active articulatio genus extension trial is the dependable trial. Continuous ultrasound therapy additions tendon length by altering their viscousness and malleability ( Ziskin et al, 1986 ) . Skeletal musculuss have a higher rate of soaking up of ultrasound moving ridges when compared to fatty tissue. ( Dyson, 1987 ; Low and Reed, 1990 ) . Elevation of collagen tissue temperature affects on mechanical and physical features of tissues and facilitates distortion of the collagen. As hurting and uncomfortableness was reduced during stretching and collagen fiber ability to digest greater forces was increased. Ultrasound increases soft tissue extensibility and may be an effectual adjunct in the intervention of articulatio genus contractures secondary to connective tissue shortening ( Folconer et al, 1992 ) . Inactive stretching allow the musculus spindle to suit, cut down their fire rate ; hence inactive stretch is effectual in increasing the length of musculus. ( Gordon and Ghez, 1991 ) . Longer keep times during stretching of the hamstring musculuss resulted in a greater rate of additions in scope of gesture ( Feland et al, 2001 ) . Stretch continuance lower than 30 seconds did non increase musculus flexibleness ( Beaulien, 1981 ) . Inactive stretch of 30 seconds is sufficient to increases the hamstring musculus length. Combination of ultrasound therapy with 30 seconds stretch is more effectual than ultrasound therapy with 15 seconds stretch in increasing hamstring flexibleness ( A.Akbari, H.Moodi, A.A.Moein, and R.Nazok 2006 ) . Muscle energy techniques ( MET ) are manually applied stretching techniques that use rules of neurophysiology to loosen up hyperactive musculus and stretch inveterate shortened musculuss. Muscle energy techniques ( MET ) have the ability to loosen up hyperactive musculuss or stretch tight musculuss and their associated fascial constituents when connective tissue or viscoelastic alterations have occurred. When utilizing Muscle energy techniques ( MET ) , it is of import to relax/inhibit the neuromuscular constituent before trying to stretch the involved muscular structure. Two cardinal neurophysiologic rules account for the neuromuscular suppression. The first rule of Muscle energy techniques ( MET ) is post contraction suppression / autogenous suppression / station isometric relaxation. The 2nd rule is mutual suppression. Muscle energy technique produced an immediate addition in inactive articulatio genus extension in persons with hamstring stringency ( Ballantyne 2003 ) . Muscle energy technique is significantly bettering the hamstring flexibleness in collegiate males ( Wassim.M et Al 2009 ) .1.1 NEED FOR THE STUDY:Continuous ultrasound therapy, inactive stretching, musculus energy technique ( MET ) are important in bettering hamstring flexibleness in persons with hamstring stringency. These methods of intervention are good accepted and practised by assorted research workers harmoni zing to old literature, but there was no survey to compare the consequence of musculus energy technique ( MET ) and ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency. So the intent of this survey is to analyze the efficaciousness of musculus energy technique and ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.1.2 Purposes:To happen out the consequence of musculus energy technique versus ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.1.3 Aim:To analyze the consequence of musculus energy technique in bettering the hamstring flexibleness in persons with hamstring stringency. To analyze the consequence of ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency. To compare the consequence of musculus energy technique and ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.1.4 KEYWORDS:Hamstringing flexibleness, Muscle energy technique, Ultrasound therapy with inactive stretching, Active articulatio genus extension trial.1.5 HYPOTHESIS1.5.1 Null Hypothesis:There is no important consequence of musculus energy technique in bettering the hamstring flexibleness in persons with hamstring stringency. There is no important consequence of ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency. There is no important difference between the consequence of musculus energy technique and ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.1.5.2 ALTERNATE HYPOTHESISThere is a important consequence of musculus energy technique in bettering the hamstring flexibleness in persons with hamstring stringency. There is a important consequence of ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency. There is a important difference between the consequence of musculus energy technique and ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.II.REVIEW OF LITERATUREHamstring Stringency:Worrel et Al ( 2003 )Stated that hamstring hurts in jocks is chiefly due to the deficiency of hamstring flexibleness.Kishner and Colby et Al ( 2002 )Stated that equal mobility of soft tissues and articulations is thought to be an of import factor in bar of hurt ( or ) reinjury to soft tissues.Donald E Hartig et Al ( 1999 )Stated that addition in hamstring flexibleness lessenings overuse hurts in lower appendages.Sarhmann.S et Al ( 1997 )Stated that musculus stringency and hypertonicity has a important impact on the neuromuscular control. Muscle stringency affects the normal length tenseness relationship.Bullock-Saxton.J, Lewit.K et Al ( 1997, 1984 )Stated that musculus stringency alters the normal arthrokinematics of the involved arti culation. This affects the interactive map taking to abnormal joint emphasis, soft tissue disfunction, nervous via media and vascular or lymphatic stasis.Ronald F, Zernickle et Al ( 1996 )Stated that pull outing flexibleness alterations related with structural and physiological alterations influence the degree of physical activity.Zachazewski et Al ( 1989 )Stated that loss of flexibleness of hamstring may take to diminish in lumbar hollow-back, decrease of musculus strength and quadriceps disfunction during pace.Cummingss, GS, Crutchfeld, CA, Barnes et Al ( 1983 )Stated that stringency is referred to mild shortening of a healthy musculo sinewy unit otherwise referred to as a mild transeunt contracture. A musculus that is â€Å" tight † can be lengthened to all but the outer bounds of its scope. Normal person who do non on a regular basis take part in a flexibleness plan can develop mild myostatic contractures or stringency, peculiarly in two joint musculuss such as hamstrings , rectus femur or gastronemius.Fox E.L et Al ( 1979 )Stated that flexibleness enhances motion by bettering organic structure consciousness with greater easiness and sleight.Lawrence Gold et AlStated that the hamstrings are the musculuss that run from buttocks and below the articulatio genuss up to the dorsum of the thigh till the â€Å" sitbones † . Soft tissue hurts, articulatio genus hurting, lacerate semilunar cartilage, chondromalacia kneecap and hapless position frequently come from tight hamstrings. Tight hamstrings can forestall the person from making full extension or from flexing over wholly.ULTRASOUND THERAPY WITH STATIC StretchingShadmer.A, Astaneh.H.N, et Al ( 2010 )Conducted a survey to analyze the consequence of two different manners ( Continuous versus Pulsed ) in diminishing the shortening of hamstrings. Thirty non impaired work forces aged 20 to 30 old ages were included. Ultrasound was applied over short hamstrings. Hamstringing flexibleness was measured by inactive articulatio genus extension trial. Continuous ultrasound of 2W/CmA? , 1MHZ, five proceedingss and Pulsed ultrasound of 200A µs explosion of 1MHZ, 0.5W/CmA? , five proceedingss was used. They concluded that the warming effects of uninterrupted ultrasound may be more effectual than not thermic belongingss of pulsed ultrasound for increasing the flexibleness of sawed-off hamstrings.Meroni, Roberto, Cerri, Cesare Giuseppe, Lanzarini, Carlo, Barindelli, Guido, Morte, Giancesare Della, Gessaga, Viviana, Cesana, Gian Carlo, DeVito, Giovanni et Al ( 2010 )Stated that the addition in flexibleness was maintained for a period of 4 hebdomads after the surcease of preparation. This betterment was more significantly noticed in active stretching group by utilizing active articulatio genus extension trial than the inactive stretching group.Buker N. , Aslan E. , Kitis A. , Carluk U et Al ( 2008 )Stated that the superficial ( or ) deep heat applications before inactive stretching exercisin gs shows positive effects to increasing flexibleness of hamstring musculuss.Nichole Lee Lounsberry et Al ( 2008 )Stated that the ultrasound intervention produced greater immediate additions in hamstring extensibility than moist heat battalions intervention.A.Akbari, H.Moodi, A.A.Moein and R.Nazok et Al ( 2006 )Stated that the additions in scope of inactive articulatio genus extension obtained in uninterrupted curative ultrasound and 30 seconds stretch group were significantly greater than curative ultrasound and 15 seconds stretch group in topics with tight hamstrings.Denegar C, Saliba E, et Al ( 2006 )Stated that 3 MHZ ultrasound provides superficial warming, 1MHZ ultrasound heats tissue at deepness of 3-5 centimeter and is considered to be a deep warming agent.Odunaiya N.A, Hamzat T.K, Ajayi O et Al ( 2004 )Stated that statically stretching tight hamstrings for any continuance between 15 and 120 seconds on surrogate yearss for six hebdomads would significantly increase its flexibl eness. The consequence was besides sustained for upto 7 yearss post intercession.Trae Sakiyo Tashiro et Al ( 2003 )Stated that the clinically practical parametric quantities of thermic ultrasound in concurrence with inactive stretching is an effectual manner of increasing hamstring extensibility but ultrasound application location did n't showed difference in increasing articulatio genus extension scope of gesture in a healthy population.C.D.Weijer et Al ( 2003 )Stated that the inactive stretching is one of the safest and most normally performed stretching methods used to mensurate musculus length.Feland et Al ( 2001 )Reported that longer keep times during stretching of the hamstring musculuss resulted in a greater rate of addition in scope of gesture.Prentice WE, McClure M, Becker RO et Al ( 2001 )Stated that when slow stretch applied to muscle, golgi tendon organ get stimulated and thereby muscle tenseness is reduced. This leads is to an addition in length of musculus.Robert and W ilson et Al ( 1999 )Stated that inactive stretching additions muscle length by leting musculus spindle to accommodate overtime and cease fired. It besides elicits golgi sinew response and hence provides an effectual flexibleness preparation stimulation.William D Bandy et Al ( 1996 )Stated that a inactive stretch of 30 seconds at a frequence of individual session is sufficient to increase the musculus length.Bandy WD, Irion JM et Al ( 1995 )Stated that the continuance of 30 seconds of stretching is an effectual clip of heightening the flexibleness of the hamstring musculuss.Bandy WD, Irion JM et Al, Lentell G, Hetherington T et Al, Madding SW et Al ( 1994 )Stated that Inactive stretching is a method of stretching in which the musculuss and connective tissue being stretched are held in a stationary place at their greatest possible length for some period. When utilizing inactive stretching on a clinical footing, stretches should be held a lower limit of 15 to 30 seconds.Chan et Al ( 19 93 )Stated that sinew ranges greater temperature and heat more rapidly than musculus and the sinew was able to keep vigorous heating for longer period than musculus.Draper D, Sunderland S, Kirkendall et Al ( 1993 )Stated that tendon tissue is less vascularized than musculus tissue ; sinews will retain heat for longer periods of clip.Folconer et Al ( 1992 )Stated that ultrasound additions soft tissue extensibility and may be an effectual adjunct in the intervention of articulatio genus contractures secondary to connective tissue shortening.Gordon and Ghez et Al ( 1991 )Stated that inactive stretching may be effectual in increasing the length of musculus due to the drawn-out stretching which allows the musculus spindle to accommodate over clip and cease fire.Low and Reed et Al ( 1990 ) , Dyson et Al ( 1987 )Stated that low soaking up of ultrasound moving ridges is seen in tissues that are in H2O content ( eg. , fat ) , whereas soaking up is higher in tissues rich in protein ( e.g. , s keletal musculus ) .Warren C, Lehman J, Koblanski J, Strickler T, Malone T, Masock A, Garrett W et Al ( 1990 )Stated that ultrasound therapy can be used to aim the collagen rich sinewy unit of the hamstring musculus because of its ability to perforate deeper tissues, and shown that increasing the temperature of collagen to 40A ° Celsius will increase the snap of the tissue. This increased extensibility allows for an even distribution of force and reduces the emphasis on localised countries of the tissue.Gajdosik RL, Godges JJ et Al ( 1989 )Stated that a low strength maintained stretch that is applied bit by bit is less likely to ease the stretch physiological reaction and increase tenseness in the musculus being lengthened. This is called inactive stretch.Ziskin et Al ( 1986 )Stated that an increasing in tendon length following uninterrupted ultrasound therapy is due to alter of their viscousness and malleability.Beaulien et Al ( 1981 )Stated that stretch continuance lower than 30 seconds did n't increase musculus flexibleness.Coakley et Al ( 1978 )Stated that frequence of 1MHZ ultrasound used for patients with more hypodermic fat who sustained hurts at deeper degree because of its incursion to a deepness of 3 to 5 centimeter.Lehman et Al ( 1968 )Emphasized on the thermic effects of uninterrupted ultrasound compared to other heating modes in increasing hamstring flexibleness.De Vries HA et Al ( 1962 )Stated that inactive stretching offers advantages of utilizing less overall force, diminishing the danger of transcending the tissue extensibility bounds, lower energy demand, and a lower likeliness of musculus tenderness. Inactive stretching besides has less consequence on the Ia and II spindle sensory nerve fibers than ballistic stretching, which would be given to increase a musculuss ‘ opposition to stretch and ease Golgis tendon organ, thereby cut downing the contractile elements opposition to distortion.MUSCLE ENERGY TECHNIQUE:Ahmad Faheem, Ahmad Sham in, Anjani Agarwal, Begum Shabana, Ram C.S, Waseem Mohd et Al ( 2010 )Conducted a survey in Indian collegiate males on hamstring flexibleness by comparing the effectivity of musculus energy technique and bizarre preparation. Sum of 20 males with hamstring stringency falling between age group of 18-25 old ages were included in the survey. Hamstring stringency was measured by popliteal angle/active articulatio genus extension trial. One group was treated with musculus energy technique and the other with bizarre preparation. This survey stated that hamstring flexibleness can be improved with musculus energy technique utilizing station isometric relaxation than bizarre preparation.Wassim M et Al ( 2009 )Reported that musculus energy technique utilizing station isometric relaxation significantly bettering the hamstring flexibleness ( by active articulatio genus extension trial ) in normal Indian collegiate males with hamstring stringency.Azadeh Shadmehr, Mohmmed Reza Hadian, Sedigheh Sad et Naiemi, Shohreh Jalaie et Al ( 2009 )Concluded that the hamstring stretches in normal immature adult females utilizing either inactive stretch or musculus energy technique had similar effects on reconstructing flexibleness to hamstrings.Madeline Smith, Gary Fryer et Al ( 2008 )Stated that the musculus energy technique is effectual in increasing hamstring extensibility, and at that place appeared to be sustained betterment one hebdomad following the initial intervention.Ross A, Clark et Al ( 2008 )Stated that musculus energy technique can bring forth creep and fictile alterations in the connective tissue thereby the length of the musculus can be increased.Lindsey Samilian et Al ( 2007 )Stated that musculus energy technique is a method used to beef up weak musculuss, lengthen the short musculuss ( or ) increase a musculus ‘s scope of gesture. These techniques involve stretch during which a mutual force is imposed on the targeted musculus for short period of clip, doing the mu sculus to loosen up and stretch farther.Ballantyne F, Fryer G, MC.Laughlin P et Al ( 2003 )Conducted a survey to happen the effectivity of musculus energy technique in increasing inactive articulatio genus extension and to research the mechanism behind any ascertained alteration. Forty symptomless topics between age of 18 to 45 old ages were indiscriminately allocated to experimental and command group. Experimental group was given with musculus energy technique and Control group with no intervention. They concluded that musculus energy technique produced an immediate addition in inactive articulatio genus extension. This ascertained alteration is due to an increased tolerance to stretch.Chaitlow L, Liebenson C et Al ( 2001 )The other name for Muscle energy technique is active muscular relaxation technique.Freyer G et Al ( 2000 ) , Richard L, Gajodsik, Melonie A, Rieck and Debra K et Al ( 1993 )Stated that an addition in flexibleness after musculus energy technique occurred due to bi omechanical or neurophysiologic alterations or due to an addition in tolerance to stretching.Lewit et Al ( 1999 )Concluded that station isometric relaxation is directed towards relaxation of hypertonic musculus, particularly if this relates to reflex contraction or the engagement of myofascial trigger points.Lewit, Libenson, Murphy et Al ( 1999 )Stated that station isometric relaxation is an first-class technique for handling neuromuscular component musculus of a stiff, shortened or tight musculus.Lewit et Al ( 1999 ) , Greenman et Al ( 1989 )Suggested that in musculus energy technique, the keeping clip of 7-10 seconds is more effectual than 3-5 seconds.Kuchera et Al ( 1997 )Stated that addition in scope of gesture of a joint after Muscle energy technique is based on neurological mechanism via repressive golgi sinew physiological reaction. Muscle energy technique activates this physiological reaction during isometric musculus contraction. Muscle energy technique produces a stretch o n golgi sinew organ and a automatic relaxation of musculus.Goodridge and Kuchera et Al ( 1997 )Suggested that 3 repeats of isometric contractions is optimum in using musculus energy technique.Lederman et Al ( 1997 )Stated that a viscoelastic alteration in musculus is responsible for the addition in musculus flexibleness after musculus energy technique.Chaitlow L et Al ( 1997 )Stated that the isometric contraction should be held for 10 seconds. This is the clip required to excite the excitatory threshold of the Golgi sinew organ, which has a neurophysiologic inhibitory consequence on the musculus spindle. This provides the chance to take the musculus into a new scope of gesture. Following the isometric contraction, there is a latency period of about 25 to 30 seconds, during which the musculus can be stretched.Philip Greenman et Al ( 1996 )Stated that manual medical specialty intervention process includes Muscle energy technique which involves the contraction of the topic ‘s mus culus by the voluntary attempt in a exactly controlled way, at different degrees of strength, against a counterforce applied by the operator. This process can be used to lengthen a sawed-off, contracted or spastic musculus ; to beef up a physiologically diminished musculus ; to cut down localised hydrops, to mobilise an articulation with restricted mobility.Ward, Robert C et Al ( 1990 )Stated that musculus energy technique is an active, direct technique ( prosecuting the barrier ) that promotes musculus relaxation by triping the Golgi sinew physiological reaction.Libenson et Al ( 1989 )Stated that musculus energy technique is effectual in handling the musculus tenseness upset and it efficaciously relaxes stretches, strengthens the musculuss and re-educate unnatural sensory motor tract.Lewit et Al ( 1986 )Stated that when a musculus is isometrically contracted its adversary will be inhibited and cut down tone instantly.Stiles and Greenman et Al ( 1984 )Suggested that musculuss which requires stretching ( agonist ) should be the chief beginning of energy for isometric contractions and achieves a more important grades of relaxation and so a more utile ability to later stretch the musculus were the relaxation consequence being achieved through usage of adversary ( utilizing mutual suppression ) .ACTIVE KNEE EXTENSION Trial:C.M. Norris et Al ( 2005 )Stated that active articulatio genus extension trial when used in concurrence with goniometry, accurate surface devising, and manual monitoring of the trial leg is a dependable step of hamstring musculus length.M.Mathews et Al ( 2005 )Stated that active articulatio genus extension represents maximal length of hamstring musculuss.Denise M. Cameron, Richard W. Bohannon et Al ( 1985 )Stated that active articulatio genus extension trial is said to be a utile option to the consecutive leg raise trial for supplying an indicant of hamstring musculus length.Gajdosik R.L et Al ( 1983 )Stated that active articulatio genus extensi on trial is a more nonsubjective step of hamstring stringency which produces high dependability co-efficient.III. METHODOLOGY3.1 STUDY DESIGN:Pre trial and station trial experimental group survey design.3.2 STUDY Setting:Study will be conducted at Physiotherapy Out Patient Department, KG College of Physiotherapy, Coimbatore.3.3 STUDY DURATION:Entire continuance was one twelvemonth. Individual received the intervention for the continuance of one hebdomad.3.4 POPULATION STUDIED:30 normal persons with hamstring stringency who fulfilled the preset inclusive and sole standards were selected and divided into two experimental groups by simple random trying method. Each group consists of 15 patients. Groups are named as group A and group B3.5 CRITERIA FOR SELECTION3.5.1 Inclusive Standards:Age between 18 to 25 old ages Both males and females Normal persons with tight hamstrings ( inability to accomplish greater than 160A ° knee extension with hip at 90A ° flexure. )3.5.2EXCLUSIVE Standards:Low back pain – Acute accent or chronic. Hamstringing hurt – Acute accent or chronic. Soft tissue hurts around articulatio genus. Pregnancy. Metallic element implants in lower appendage. Recent break and stiffness in lower appendage.3.6 Variables:3.6.1 Independent Variables:Muscle energy technique. Ultrasound therapy with Inactive stretching.3.6.2 Dependent Variables:Hamstringing flexibleness.3.7 Parameters:Hamstringing flexibleness3.8 MEASUREMENT TOOLS:Active articulatio genus extension trial.Active articulatio genus extension trial was used for measuring of hamstring stringency. The topic was instructed to lie on their dorsum with hip and articulatio genuss bent 90 grades. Pelvic motion was controlled by the usage of straps. By utilizing the sidelong condyle of thighbone as the goniometric axis, the stationary arm positioned along the thighbone, and the movable arm was positioned parallel to the leg. Keep hip and articulatio genus in 90 grades so instruct the topic to unbend the articulatio genus every bit for as possible boulder clay a esthesis of stretch being felt. Repeat the same for three times and mean were measured as the concluding consequence.3.9 Procedures:GROUP A: MUSCLE ENERGY TECHNIQUE.Technique USED: Post isometric relaxation. INDIVIDUAL ‘S Position: Supine prevarication. Procedure: Ask the persons to presume supine place. Therapist flexes the affected hip to the full and so extends the flexed articulatio genus with the dorsum of lower leg resting on the shoulder of the healer who stands confronting the caput of the tabular array. Individual is asked to flex i.e. doing downward force per unit area against the therapist shoulder with the dorsum of lower leg at the same clip therapist defy the persons voluntary attempt so that, slight isometric contraction of hamstrings develops and persons hold this for 10 seconds. After this attempt, the person is asked to expire and loosen up the musculus wholly. Then the healer takes the musculus to its new limitation barrier without stretch. Get downing from this new barrier, the same process is repeated two or three more times. FREQUENCY OF TREATMENT: Once in a twenty-four hours. TREATMENT DURATION: One hebdomad.GROUP B: ULTRASOUND THERAPY WITH STATIC Stretching:ULTRASOUND Therapy:INDIVIDUAL ‘S Position: Prone lying Parameters: Frequency: 1 MHz Intensity: 2W/cmA? Manner: Continuous. AREA OF APPLICATION: Hamstring country Duration: Five Minutess daily ( Two proceedingss for median hamstrings, Two proceedingss for sidelong hamstrings and One min for between the two sinew ) . FREQUENCY OF TREATMENT: Once in a twenty-four hours TREATMENT DURATION: One hebdomadInactive Stretching:Technique USED: Active inactive stretching. INDIVIDUAL ‘S Position: Standing place. Procedure: Subjects performed the hamstring stretch by standing erect with the pes planted on the floor and toes pointed frontward. The heel of the pes to be stretched was placed on a pedestal with the toes directed towards the ceiling. The topic so flexed frontward at the hip, keeping the spinal column in impersonal place while making the arm forward. The topics continued to flex the hip until a soft stretch was felt in the posterior thigh. Then keep this place for 30 seconds and so loosen up for 10 seconds and reiterate the same process for three more times a twenty-four hours. FREQUENCY OF TREATMENT: Once in a twenty-four hours. TREATMENT DURATION: One hebdomad3.10 STATISTICAL TOOLSThe undermentioned statistical tools used in this survey is Paired t-test and Unpaired t-testFormula: Paired t-test=Where, = difference between the pre trial versus station trial = mean difference = entire figure of topics = criterion divergence Unpaired t-test was used to compare the average difference between Group A and Group B.Formula: Unpaired t-testWhere, = Mean of Group A = Mean of Group B i = amount of the value n1 = figure of topics in Group A n1 = figure of topics in Group B S = criterion divergenceDegree of significance: 5 %IV.DATA ANALYSIS AND INTERPRETATIONTABLE-1PAIRED ‘t ‘ TrialPRE TEST AND POST TEST VALUES OF GROUP AGroup A – MUSCLE ENERGY TECHNIQUEHAMSTRING FLEXIBILITY – ACTIVE KNEE EXTENSIONThe comparative mean values, average differences, standard divergence and Paired ‘t ‘ trial values of Group A, who were treated with Muscle energy Technique.S.NOGroup AMeanMEAN DEVIATIONStandard DEVIATION‘t ‘ VALUE1. Pre trial 135.2 22.87 6.46 30.03 2. Post trial 158.07 4.50GRAPH-1GRAPHICAL REPRESENTATION OF PRE TEST AND POST TEST VALUES OF GROUP A ( MUSCLE ENERGY TECHNIQUE ) .TABLE-IIPAIRED ‘t ‘ TrialPRE TEST AND POST TEST VALUES OF GROUP BGROUP B – Ultrasound THERAPY WITH STATIC StretchingHAMSTRING FLEXIBILITY – ACTIVE KNEE EXTENSIONThe comparative mean values, average differences, standard divergence and Paired ‘t ‘ trial values of Group B, who were treated with Ultrasound therapy with inactive stretching.S.NOGROUP BMeanMEAN DEVIATIONStandard DEVIATION‘t ‘ VALUE1. Pre trial 134.5 17.5 5.95 21.6 2. Post trial 152 5.11GRAPH-IIGRAPHICAL REPRESENTATION OF PRE TEST AND POST TEST VALUES OF GROUP B ( ULTRASOUND THERAPY WITH STATIC STRETCHING )TABLE-IIIUNPAIRED't ‘ TrialCOMPARISON BETWEEN THE PRE TEST VALUES OF GROUP A AND BHAMSTRING FLEXIBILITY – ACTIVE KNEE EXTENSIONThe comparative mean values, average differences, standard divergence and Unpaired't ‘ trial values of Group A and Group B, who were treated with Muscle energy technique and Ultrasound therapy with inactive stretching.S.NOGroupMeanMEAN DEVIATIONStandard DEVIATION‘t ‘ VALUE1. Group A 135.2 0.67 6.46 0.2940 2. Group B 134.5 5.95GRAPH-IIIGRAPHICL REPRESENTATION OF PRE TEST VALUES FOR GROUP A AND GROUP B:TABLE-IVUNPAIRED ‘t ‘ TrialCOMPARISON BETWEEN THE POST TEST VALUES OF GROUP A AND BHAMSTRING FLEXIBILITY – ACTIVE KNEE EXTENSIONThe comparative mean values, average differences, standard divergence and Unpaired ‘t ‘ trial values of Group A and Group B, who were treated with Muscle energy technique and Ultrasound therapy with inactive stretching.S.NOGroupMeanMEAN DEVIATIONStandard DEVIATION‘t ‘ VALUE1. Group A 158.07 6.07 4.50 3.53 2. Group B 152 5.11GRAPH-IVGRAPHICL REPRESENTATION OF POST TEST VALUES FOR GROUP A AND GROUP B:Analysis OF RESULTS:30 persons with hamstring stringency were divided into two groups. Group A were treated with musculus energy technique. Group B were treated with ultrasound with inactive stretching. Hamstringing flexibleness was measured by active articulatio genus extension trial. Statistical analysis was done by utilizing Student't ‘ trial. Paired ‘t ‘ trial was used to happen out the betterment within the group. Unpaired ‘t ‘ trial was used to happen out the difference between two groups.Paired't ‘ trial:Group A – MUSCLE ENERGY TECHNIQUEUsing Paired ‘t ‘ trial with 14 grades of freedom and 5 % at degree of significance, the deliberate ‘t ‘ value is 30.03 which is greater than table ‘t ‘ value 1.761.This trial showed that there is a important consequence of musculus energy technique in bettering the hamstring flexibleness in persons with hamstring stringency.Group B – Ultrasound THERAPY WITH STATIC StretchingUsing Paired ‘t ‘ trial with 14 grades of freedom and 5 % at degree of significance, the deliberate ‘t ‘ value is 21.6 which is greater than table ‘t ‘ value 1.761.This trial showed that there is a important consequence of ultrasound t herapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.Unpaired't ‘ trial:Comparing pre trial values of active articulatio genus extension trial between Group A and Group B:Pre trial values of Group A and Group B is analysed by Unpaired ‘t ‘ trial. The deliberate ‘t ‘ value is 0.294 which is lesser than table ‘t ‘ value 1.701 at 5 % degree of significance. This trial showed that there is no important difference between the consequence of musculus energy technique and ultrasound therapy with inactive stretching in bettering hamstring flexibleness in persons with hamstring stringency.Comparing station trial values of active articulatio genus extension trial between Group A and Group B:Post trial values of Group A and Group B is analysed by Unpaired ‘t ‘ trial. The deliberate ‘t ‘ value is 3.53 which is greater than table ‘t ‘ value 1.701 at 5 % degree of significance. This trial showed that there is a important difference between the consequence of musculus energy technique and ultrasound therapy with inactive stretching in bettering hamstring flexibleness in persons with hamstring stringency.V.DISCUSSIONThe intent of this survey was to happen out the consequence of musculus energy technique versus ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency. 30 topics were selected who fulfilled the preset inclusive and sole standards. The topics were divided into two groups, 15 in each group. Group A underwent musculus energy technique and Group B underwent ultrasound therapy with inactive stretching. Statistical analysis utilizing Unpaired ‘t ‘ trial showed that there was a important difference between Muscle energy technique and ultrasound therapy with inactive stretching in bettering hamstring flexibleness in persons with hamstring stringency. Paired ‘t ‘ trial concluded that there was a important betterment in hamstring flexibleness in both muscle energy technique and ultrasound therapy with inactive stretching, which was supported by surveies as follows. Overuse hurts in lower limbs are reduced by increasing flexibleness of hamstring musculuss. ( Donald E Hartig, 1999 ) Extracting flexibleness alterations related with structural and physiological alterations influence the degree of physical activity. ( Ronald F, Zernickle 1996 ) Loss of flexibleness of hamstring may take to diminish in lumbar hollow-back, decrease of musculus strength and quadriceps disfunction during pace. ( Zachazewski, 1989 ) Continuous ultrasound therapy additions soft tissue extensibility and may be an effectual adjunct in the intervention of articulatio genus contractures secondary to connective tissue shortening. Ultrasound soaking up is higher in tissues rich in protein like skeletal musculus. Continuous ultrasound therapy additions tendon and musculus length due to alter of their viscousness and malleability. ( Folconer 1992, Dyson 1987, Low and Reed1990 ) Elevation of collagen tissue temperature affects on the mechanical and physical features of tissues and facilitates distortion of collagen. Therefore hurting and uncomfortableness was reduced during stretching and collagen fiber ability to digest greater force was increased. ( Coakley, 1978 ) Thermal effects of ultrasound additions collagen temperature which will increase snap of tissue. Increased snap allows for an even distribution of force and reduces the emphasis on localised countries of tissues. It besides increases blood flow within the musculus. ( Warren C, Lehmann J, Stricker T, 1970, 1990 ) Longer keep times during stretching of hamstring musculuss result in greater additions in scope of gesture. ( Feland, 2001 ) Inactive stretching additions muscle length by leting musculus spindle to accommodate overtime and cease fired. It besides elicits golgi sinew response and hence provides an effectual flexibleness preparation stimulation. ( Robert and Wilson, 1999 ) Addition in length of the musculus which occurs after the application of musculus energy technique consequences in effectual venous or lymphatic drainage and addition in scope of gesture. ( Ballantyne F et Al 2003 ) Stated that musculus energy technique can bring forth creep and fictile alterations in the connective tissue thereby the length of the musculus can be increased. ( Ross A, Clark, 2008 ) An addition in flexibleness after Muscle energy technique occurred due to biomechanical or neurophysiological alterations or due to an addition in tolerance to stretching. ( Freyer G, Richard L, Melonie A, Rieck 1993, 2003 ) Addition in scope of gesture of a joint after Muscle energy technique is based on neurological mechanism via repressive golgi sinew physiological reaction. Muscle energy technique activates this physiological reaction during isometric musculus contraction. Muscle energy technique produces a stretch on golgi sinew organ and a automatic relaxation of musculus. ( Kuchera, 1997 ) By station isometric relaxation, consequence of sustained contraction on Golgi sinew organ set the sinew and musculus to new musculus length by suppressing it. Muscle energy technique utilizing station isometric relaxation resulted in maximal betterment when compared to eccentric preparation on hamstring flexibleness. ( Ahmad Faheem, Ahmad Shamin, Anjani Agarwal, Begum Shabana, Ram C.S, Waseem Mohd, 2010 ) Muscle energy technique utilizing station isometric relaxation significantly bettering the hamstring flexibleness ( by active articulatio genus extension trial ) in normal Indian collegiate males with hamstring stringency. ( Wassim M, 2009 ) Muscle energy technique produced an immediate addition in inactive articulatio genus extension. This ascertained alteration is due to an increased tolerance to stretch. ( Ballantyne F, Fryer G, MC.Laughlin P, 2003 ) Muscle energy technique is an active, direct technique ( prosecuting the barrier ) that promotes musculus relaxation by triping the Golgi sinew physiological reaction. ( Ward, Robert C, 1990 ) The warming effects of uninterrupted ultrasound may be more effectual than not thermic belongingss of pulsed ultrasound for increasing the flexibleness of sawed-off hamstrings. ( Shadmer.A, Astaneh.H.N, 2010 ) Initiation of inactive stretching exercises involves the applications of superficial ( or ) deep heat agencies which show a positive consequence to increase the hamstring flexibleness. ( Buker N. , Aslan E. , Kitis A. , Carluk U, 2008 ) The additions in scope of inactive articulatio genus extension obtained in uninterrupted curative ultrasound and 30 seconds inactive stretch group were significantly greater than curative ultrasound and 15 seconds inactive stretch group in topics with tight hamstrings. ( A.Akbari, H.Moodi, A.A.Moein and R.Nazok, 2006 ) The clinically practical parametric quantities of thermic ultrasound in concurrence with inactive stretching is an effectual manner of increasing hamstring extensibility but ultrasound application location did n't showed difference in increasing articulatio genus extension scope of gesture in a healthy population. ( Trae Sakiyo Tashiro,2003 ) The continuance of 30 seconds of stretching is an effectual clip of heightening the flexibleness of the hamstring musculuss. ( Bandy WD, Irion JM, 1995 ) Inactive stretching is one of the safest and most normally performed stretching methods used to mensurate musculus length. ( C.D.Weijer, 2003 ) Inactive stretch of 30 seconds at a frequence of individual session is sufficient to increase the musculus length. ( William D Bandy, 1996 ) Inactive stretching may be effectual in increasing the length of musculus due to the drawn-out stretching which allows the musculus spindle to accommodate over clip and cease fire. ( Gordon and Ghez, 1991 ) Muscle energy technique activates golgi sinews organ and bring forth a automatic relaxation of musculus. Ultrasound therapy increases the collagen temperature and increases the snap of tissue. Inactive stretching addition musculus length by leting musculus spindle to accommodate overtime and cease fire and besides elicits golgi tendon response. This survey concluded that musculus energy technique showed greater betterment in hamstring flexibleness than ultrasound therapy with inactive stretching in persons with hamstring stringency.V1.SUMMARY AND CONCLUSIONThe purpose of this survey was to happen out the consequence of musculus energy technique versus ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in single with hamstring stringency. 30 topics were selected in the age group between 18-25 old ages after due consideration of inclusion and exclusion standards. The topics were allotted into two groups. Group A received musculus energy technique and Group B received ultrasound therapy with inactive stretching. Hamstringing flexibleness was measured by active articulatio genus extension trial. The values of result steps were recorded before the beginning of intervention government Day1 and at the terminal of intervention government Day7. Statistical analysis was done by utilizing Student ‘t ‘ trial. Paired ‘t ‘ trial was used to happen out the betterment within the group. Unpaired ‘t ‘ trial was used to happen out the difference between two groups. The consequences showed that there was a important difference between musculus energy technique and ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency. This survey concluded that musculus energy technique is more effectual than ultrasound therapy with inactive stretching in bettering the hamstring flexibleness in persons with hamstring stringency.VII.LIMITATION AND RECOMMENDATIONThis survey is a short term survey, it is hence necessary to make a long term survey to do the consequence more valid. Hamstringing flexibleness can besides recorded by inactive articulatio genus extension trial. Sample studied was little and the survey reduces the generalising ability hence survey with a much larger population is recommended. Surveies aimed to happen out the consequence of musculus energy technique ( by utilizing station isometric relaxation ) with other electrotherapy modes such as hot battalion, short moving ridge diathermy and with other techniques like PNF, Irish burgoo ‘s grip straight leg rise technique, mutual suppression, etc can be conducted for farther research.