Sole Proprietorship and Restaurant Free Essays

1. 0 Introduction 1. 1 Background of the Study There are lots of beautiful restaurants with expensive food that get big earnings but they’re not properly paying taxes. We will write a custom essay sample on Sole Proprietorship and Restaurant or any similar topic only for you Order Now It can also cause the state or other local government to shut down a restaurant completely if taxes aren’t paid. Other restaurants change their sales for good even before the recession has started. Restaurants have become successful but others fail because of some problems like a bad location, poor visibility, no parking or maybe no foot traffic. These can affect the restaurant’s progress. 1. 2 Theoretical Framework Mission: To serve great food at a reasonable price The restaurant is a single proprietorship; it has only one owner that provides the total needs of the business. It was established on February 13 2013. The restaurant starts at 6am until 12 midnight. The promos of the restaurant start at 10pm. The menus are based on their fixed menu just like fast foods; they’re not changing their list every day. The restaurant has 5 crew members which serve the customers every day. 1. 3 Statement of the Problem 1. 3. 1 General Problem This study tried to investigate the factors that affect the sales of the Dyulyus crepes and steaks. It answers the question â€Å"How do these factors affect the sales of the restaurant? † 1. 3. 2 Specific Problem This study also tried to answer the following questions: †¢ How do the employee’s skills affect the sales of the Dyulyus Crepes and Steaks? †¢ Can changes in climate affects the sales of Dyulyus Crepes and Steaks? †¢ How a new build competent restaurant affects the Dyulyus Crepes and Steaks? †¢ Does the weekly menu give a negative effect on the sales of Dyulyus and Steaks? 1. 4 Significance of the Study The Management This study provides the restaurant the factors and a suggested solution for the problems of the Dyulyus Crepes and Steaks. It can help them to improve the rate of their sales and it gives them some ideas on how to avoid a decreasing value of sale’s rate. The Customer This study gives some knowledge to the customers about the competition and problems that occur on the restaurant. It will provide reasons why some restaurant give some promos and use different strategies on selling their products. The Researcher Working on the research, the researcher gains some knowledge on how to strategize a single proprietorship restaurant. He becomes aware on how hard to manage a single proprietorship restaurant. The Future Researcher This system can help the future researcher for them to have an idea for their upcoming research. It can guide them in constructing a research paper. 1. 5 Scope and Limitation of the Study Scopes This study focuses only on the following topics: †¢ The factors that affects the sales of the restaurant †¢ The effects that this factors brings on the restaurant’s sales †¢ The suggested solutions on the following factors that gives a negative effects on the sales of the restaurant Limitations Despite of the following scope of the study, there are things that the study didn’t include. These limitations are the following: †¢ The ingredients or recipe of the restaurant’s menu †¢ The budget and the expense of the restaurant †¢ The solution for spoiled food 1. 6 Definition of Terms The following words are given with meaning for better understandings of this study: †¢ Sole Proprietorship – is a type of business entity that is owned and run by one individual and in which there is no legal distinction between the owner and the business. 2. 0 Review of Related Studies and Literature 2. Foreign and Local Studies Foreign Studies According to the research paper of Syed Saad Andaleeb and Carolyn Conway published at November 3, 2009, the following factors affect the restaurant’s sales. Product quality Because the â€Å"product offering† for a full service restaurant is likely to be assessed by evaluating an actual product (the meal ) and by where it is delivered (physical place), we decided to separate the tangibility dimension in SERVQUAL into its two aspects: food quality and the physical design/decor of the restaurant. The former has been discussed earlier along with reliability. From the perspective of physical design, environmental psychologists suggest that individuals react to places with two general, and opposite, forms of behavior: approach or avoidance (Mehrabian and Russell, 1974). It has been suggested that in addition to the physical dimensions of a business attracting or deterring selection, the physical design of a business can also influence the degree of success consumers attain once inside (Darley and Gilbert, 1985). This involves research on the â€Å"services cape† (Bitner, 1992) which is the â€Å"built man-made environment† and how it affects both customers and employees in the service process. Thus, we propose that; the better the physical design and appearance of the restaurant, the greater the level of customer satisfaction. Price The price of the items on the menu can also greatly influence Customers because price has the capability of attracting or Repelling them (Monroe, 1989), especially since price functions as an indicator of quality (Lewis and Shoemaker, 1997). The pricing of restaurant items also varies according to the type of restaurant. If the price is high, customers are likely to expect high quality, or it can induce a sense of being â€Å"ripped off. Likewise, if the price is low, customers may question the ability of the restaurant to deliver product and service quality. Moreover, due to the competitiveness of the restaurant industry, customers are able to establish internal reference prices. When establishing prices for a restaurant, an internal reference price is defined as a price (or price scale) in buyers’ memory that serves as a basis for jud ging or comparing actual prices (Grewal et al. , 1998). This indicates that the price offering for the restaurant needs to be in accord with what the market expects to pay by avoiding negative deviation (i. . when actual price is higher than the expected price). We propose that; the less the accordance of the actual price with expectations (negative deviation), the lower the level of customer satisfaction. Local Studies 2. 2 Foreign and Local Literature Foreign Literature According to the article of buzzle published at January 8 2013, the factor that affects a restaurant’s sales is the following: †¢ Demand and Supply †¢ Marginal and Total Utility †¢ Money and Banking †¢ Economic Growth and Development †¢ Income and Employment †¢ General Price Level †¢ Trade Cycles †¢ Inflation †¢ Recession †¢ Exchange Rate Rate of Interest †¢ Government Regulations Local Literature 3. 0 Research Methodology 3. 1 Researched Design The rese arches are base from the interview with the owner, observation and analysis of the researcher. The data was taken from the owner and was interpret and studied by the researcher. 3. 2 Data Gathering Procedures 3. 2. 1 Preparation The researcher talks to the owner and set a meeting date for the interview. After setting an interview, the researcher observes the transaction process of the restaurant and constructs some questions that can be use on the interview. 3. 2. 2 Interview with the owner The researcher conducts an interview with the owner. The following details are the coverage of the interview: †¢ Restaurant process †¢ Mission of the restaurant †¢ Menu of the restaurant †¢ Factors affecting their sales †¢ Promo’s of the restaurant †¢ Strategies of the restaurant 3. 2. 3 Analyze the Study The researcher analyzes the given data from the owner and come up with the following factors which include the: †¢ Price of their foods †¢ Employees skills †¢ Seasons/Climate †¢ Promo’s of the restaurant 4. 0 Presentation, Analysis and Interpretation of Data 4. 1 Sample Data 4. 1. 1 Restaurant Menu Cold Crepes Mango Crepe60 Choco Banana Crepe60 Strawberry Crepe60 Warm Crepes Cheese Steak75 Beef n’ Mushroom75 Chicken Ala King65 Ham n’ Cheese60 Bacon n’ Egg60 Sizzlers T – Bone Steak99 Sirloin Steak75 Pork chop Steak75 Liempo Steak75 Savory Chicken Steak75 Hotdog w/ Egg Steak55 Tapsilog70 Sisig120 Extra Java20 Extra Gravy20 Softdrinks15 4. 1. 2 Interview †¢ What are the promos that this restaurant gives to the customers? Dyulyus Crepes and Steaks gives unlimited rice and free iced tea from 10pm to 12 midnight when you order a food from our restaurant †¢ What are the reasons that affecting the way you sell your products? The reasons are having other competent restaurants, which give a confusion to the customers which restaurant they will choose to eat in. Another reason is the bad weather which cause a laziness to the customers to go outside and buy from a restaurant. †¢ What solutions do you implement when a new competent restaurant becomes popular? It’s natural in this kind of business, so we just act natural also. We don’t easily get affected and trying to be consistent on our foods. Sometimes we are also implementing an improvement on the recipes. Table 4. 1. 3; Sales of Having a Promo and Without February 18-22, 2013 and February 25-March 1, 2013 Table 4. 1. 4; Sales of hiring staff March 4-8, 2013 and March11-15, 2013 4. 2 Interpretation of Data The interview shows that the bad weather, climate and season can affect sales of the restaurant. In some way having a new competent restaurant near at the subject restaurant can also affect the sales. It just likes decreasing the chances that their products will sell. The table 4. 1. 3 shows that promos can affect the sales of the restaurants. People are always looking for promo which gives them a higher discount. The more the discount on the restaurant the more they will avail on the restaurant. People nowadays are just being practical. The table 4. 1. 4 shows that hiring of additional employees will affects the sales of the restaurant. In a positive way this factor can increase the sales. Having many employees can contribute more in production and serving customers in a fast way. 5. 0 Summary of Findings, Conclusion, and Recommendations 5. 1 Summary 5. 2 Conclusions The price is a bit expensive that’s why they need to make it more affordable for students with a tight budget considering they only depend on their allowances. The students should also be able to enjoy their promos at their most convenient times and not during midnight where students have already went home. It’s also wise to add some crew during peak hours to assist the waves of students coming in during their breaks. Offer menus that are applicable or enjoyable with the weather and always keep the food presentable and delicious especially if you know you have a rival restaurant. 5. 3 Recommendations Bibliography http://www. technologyevaluation. com/search/for/sample-thesis-proposal-of-hrm-students. html http://www. ehow. com/way_6170764_thesis-ideas-management-degree. html Appendices ———————– [pic] How to cite Sole Proprietorship and Restaurant, Essay examples

Design Thinking And Entrepreneurial Activity †MyAssignmenthelp.com

Question: Discuss about the Design Thinking And Entrepreneurial Activity. Answer: Introduction The report is required to look into the concept of design thinking and entrepreneurship topics. Design thinking is a method framed by designers to solve complex issues and find worthwhile solutions for clients. The design basically assists in solving problems as they are action oriented towards a preferred future. The design principles when applied through a particular strategy and innovation, the success rate for innovation improves dramatically. Design thinking helps in the core effective strategy development and organizational change. Firms which involve themselves in design thinking stay ahead in their willingness to engage in the task of continuously redesigning and reforming their business, proceed in the field of innovation and efficiency, the combination which gives rise to a greater competitive edge (Amit Zott, 2012). Design thinking is drawn upon logic, imagination, intuition and systematic reasoning to explore possibilities of what could be and create desired outcomes tha t benefit the customer and also help achieve the goals and objectives of the organization. The important thing which design thinking brings in is an aspect of creativity on the minds of the designers (Audretsch, 2012). Creativity helps to make the business get moulded in the appropriate direction as per the needs and demands of different situations, which ultimately assists an organization to tackle unforeseen circumstances and walk towards the path of growth and development. Design thinking is essential to get people to work on the need to cultivate new ideas and adopt new approaches in order to be successful in a highly competitive work environment. Discussion The design thinking is a way through which complex problems are solved. The mindset adopted is not focused on problems but are concerned about possible ways to provide the solutions by taking action oriented approach towards creating a better future. Design thinking is based upon intuition, imagination, logic and systematic reasoning to ascertain possibilities of what could be and create appropriate outcomes that benefit the end user. This requires an approach to look ahead into the future, identify areas where one could cash on and thus develop a mindset to explore possibilities (Bocken, Rana Short, 2015). This helps in finding ways out on how to seek for constant upgradation and betterment along with delivering of services as per the needs and requirements of the customers. Entrepreneurship deals with the plans associated in setting up a business and design thinking plays a very important part in the activity (Carland, Carland Stewart, 2015). A business requires constant upgradat ion of plans as per the needs and requirements of the situations and thus thinking ways out to formulate certain strategies to enable the organization to keep up with the pace is a challenge, which can be achieved through implementing innovative thoughts and ideas. Critical Self Analysis And Reflection Now a critical self analysis and reflection is presented through the blogs which I have maintained on a weekly basis to develop an understanding of design thinking and entrepreneurial activity. Week 1 Activity: In the week 1 blog, I have mentioned that the teacher had given us certain questions to ask one another about the previous studies and experience. This was done in order to find out if similarities could be found on subjects studied and prior work experience gathered. Initially my comfort level was not high as I was not used to doing tasks related to design or critical thinking but gradually I could understand that one should always ask questions even when there is a feeling that a group of people is known for a long time. Interactions with people always helps in knowing them better (Glen, R., Suciu, C., Baughn, C. (2014). This blog mentions that only after interacting with other international students like me, I had understood about their thought processes on these activities. This proves that one should never underestimate anyone and try to have clarity while interacting, as interactions would help erase doubts and lead to removal of barriers, which is essential for any business t o succeed Week 2 Activity: In this week, the teacher had provided articles with respect to reflective thinking, which I had made note of in piece of paper and the students were asked for their responses in those sentences. Reflective thinking is nothing but how to relate the new knowledge gathered on the prior understanding (Koellinger Roy Thurik, 2012). So I made sure to relate the concept of reflective thinking on a daily basis in everyday activities. In business, reflective thinking is a necessity as evolution happens from time to time and there is always a requirement that fresh knowledge should be harnessed on the understanding one has already developed over a period of time. In practical life even, I had tried to implement those concepts to seek for the desired results. Relating the new knowledge in the business with the prior understanding is very crucial for the growth and development as an individual, which in turn would help the business expand and touch upon new avenues. Week 3 Activity: Week 3 dealt with ways to understand the core values of design and develop the idea of mindset. Mindset is required for instigating ways for the right thinking pattern of people and how a person would be able to think innovatively for bringing in necessary developments and activities which are feasible. I had seen a major change in the level of thinking over this period and got surprised by the way, the level of creativity within myself was developed and along with the observation skills (Massa Tucci, 2013). Creativity is a must for survival of any business over a length of time and similarly observation skills is equally important, as one needs to be always aware of possibilities for expansion and other challenges which the business might confront in near future. A creative mindset helps to make sure that the businesses are always tuned as per the expectations of the customers and needs of the industry, thereby reducing any threat from the competitors. Week 4 Activity: This weeks activity dealt with the ways to understand the difference between problem solving and problem finding and also develop ways to detect complicated problems. A brainstorming activity was involved with 30 circles in a white paper, through which an idea developed where all 30 circles had to be put inside a bigger circle (Naud, 2013), so that each and every circle was made a part of the bigger one. This activity made me realize the concepts of understanding the importance of right attitude towards the customers with right mindset, right empathy, right kind of stimulus, right kind of facilitation and right inspiration, (Goldschmidt Rodgers, 2013). All these characteristics are required for the development of healthy relationships among peers. These are essential elements which can be used in business, to create a rapport with the customers, create an urge to improve every single time, provide inspiration by understanding where we come from and facilitate on giving suggestions t o where we must go. Week 5 Activity: This 5th week revolved around understanding of the concept of mind mapping which help in bringing ideas together and organize them accordingly to fetch the desired results. The need for finding ways out to add value to an organization is of utmost importance as value creation helps develop confidence and understanding between the customers and business and mutual trust is built (Nicholls Murdock, 2012). Creating a value chain in a business perspective is a necessity to attain excellence and stand out from the crowd in a highly competitive work environment and survive in the long run. The more value an organization provides through their products and services, they would be able to seek customers on a regular basis and become more and more profitable. Value Chain refers to a series of activities linked together for the attainment of the desired goals and objectives. In business perspective, creating value and delivering valuable service to the customers is important to create a major impact and look to enhance customer base and thereby provide satisfaction and earn profit Week 6 Activity: This week dealt with the concept of Ethics, which is one of the most important things to be maintained by any organization. Ethics refer to the values and principles which need to be maintained by conforming to the rules and regulations (Plattner, Meinel Leifer, 2012). The activity involved providing lines to form a square and there was confusion regarding whether the lines must be continuous ones and the teacher had argued that a child would be able to draw in a much easier manner as adults have a sense of prejudgement. Childs thoughts are free by nature and not preoccupied by other thoughts. The concept of ethics in oil company like any other organization is of paramount importance (Trimi Berbegal-Mirabent, 2012). Week 7 Activity: The activity in this week which I have mentioned in the blog is about analyzing a large amount of qualitative data related to creating an original dessert in order to test our creativity on different food items. The fact that our teacher had showed us the preparation of a new kind of dessert based on chicken, the recipe had come as a surprise because chicken has always been thought of as a starter or a main dish. This is where mind mapping comes into play, which is a graphical representation of ideas and concepts (Shepherd, Williams Patzelt, 2015). The ability of mind mapping is important because, the ideas and concepts generated in the world of business has to be thought as something which could always be applicable and meaningful. Otherwise those ideas do not hold any meaning. One should be able to correlate any idea, which is thought of, with the practical scenario. Week 8 Activity: This weeks activity dealt with an app, known as spoilers app whose primary aim was to prevent unwanted content in the newsfeed on the phone or tablet. Different pictures were provided with team members numbered from 1 to 6. Initially there was some confusion as I had never used such app before but gradually through the passage of, developed an understanding which made me apply on my own smartphone (Shepherd, Williams Patzelt, 2015). This allowed to look into the aspect of working effectively in a team and the find possible ways to understand an unfamiliar concept or idea. In business world, unforeseen circumstances would always come up in some form or the other and in those situations, working as a team would help in getting through the phase. Week 9 Activity: The next activity dealt with getting ahead and understand the importance of marketing strategies in an organizations attempt to target the desired customers. The importance of target market can be clearly understood from the fact that the basic of any marketing strategy is to segment the customers from a wide base, then target the customers who fit the needs of the organization by meeting all the demands and then position those targets accordingly to specifically address their issues (Trimi Berbegal-Mirabent, 2012). Targetting those customers as per their purchase history is important as time and money would be used in a judicious manner and avoid wastage. In business perspective, utilizing resources effectively for targetting the right kind of customers is important. Identifying the appropriate customer base to target with the right the kinds of products is very much essential. Week 10 Activity: This activity was about adopting the principle to know the details about how to fund a business. Business funding requires looking into the type of business one is in, the products one are dealing with, whether the business is a partnership firm, joint venture or sole proprietorship. Accordingly the funding would vary. The art of finding a proper sponsor ahead of launching a business plan is a tough ask but an important one (Urbano Alvarez, 2014). This requires proper connection and the task needs to be carried out for proper execution of plan. The importance of understanding the requirements of funding a business is essential to have clarity over the products, the expansion plans so that wastage of resources is avoided. Week 11 Activity: The activity in this week was of a presentation, where I had talked about mind mapping and self confidence played a very important role because nervousness was there as I had never ever given any presentation before in my lifetime. Self-Confidence plays a significant role in the success of any individual and this can be seen even in influential persons, who have had success due to the self-confidence portrayed by them in the course of their career (Zahra Nambisan, 2012). For any business to flourish and excel in the highly competitive work environment, self-confidence is crucial because they help in giving customers the assurance that they would be able to cope up with the rising challenges. Week 12 Activity: This activity was related to how design thinking, which is used for confronting complex problems and align them with mind mapping and daily routine. Design thinking is basically a way through which any type of problem can be dealt with and solved in due time without much difficulty. In business world, I feel that this design thinking concept is crucial and should be implemented to the best of the abilities for finding ways to innovate, attract customers, implement strategies to go ahead and let the business flourish (Nicholls Murdock, 2012). Conclusion: Action Plan I would like to conclude by saying that the universities across the world should look to adopt tasks which I have gone through over this period and really helped to understand business situations and ways to tackle unforeseen circumstances. The concept of design thinking has been understood with great clarity and satisfaction. The action plan is to carry on implanting the learnings which I have gathered through these tasks to my everyday life. As far as the self development is concerned, the activities which I have gone through have certainly helped me develop the mentality to think rationally and also create an image on the mind about what to expect in a business environment. The essentials for succeeding in business have also been understood in a practical manner through those tasks as on most occasions, the tasks were related to the situations which I am supposed to face in the world of business. I have understood the importance of implementing strategies required for achieving su ccess and hold on to the position in a highly competitive work environment. I genuinely feel that these tasks should be carried out by one and all at least once in their lifetime to garner the essential learning required for understanding the necessities of business and life in general. References Amit, R., Zott, C. (2012). Creating value through business model innovation.MIT SloanManagement Review,53(3), 41. Audretsch, D. (2012). Entrepreneurship research.Management Decision,50(5), 755-764. Bocken, N. M. P., Rana, P., Short, S. W. (2015). Value mapping for sustainable business thinking.Journal of Industrial and Production Engineering,32(1), 67-81. Carland, J. C., Carland, J. W., Stewart, W. H. (2015). Seeing what's not there: The enigma of entrepreneurship.Journal of small business strategy,7(1), 1-20. Glen, R., Suciu, C., Baughn, C. (2014). The need for design thinking in business schools.Academy ofManagement Learning Education,13(4), 653-667. Goldschmidt, G., Rodgers, P. A. (2013). The design thinking approaches of three different groups of designers based on self-reports.Design Studies,34(4), 454-471. Grassl, W. (2012). Business models of social enterprise: A design approach to hybridity.ACRN Journal of entrepreneurship Perspectives,1(1), 37-60. Hobday, M., Boddington, A., Grantham, A. (2012). An innovation perspective on design: Part 2.Design Issues,28(1), 18-29. Koellinger, P. D., Roy Thurik, A. (2012). Entrepreneurship and the business cycle.Review of Economics and Statistics,94(4), 1143-1156. Massa, L., Tucci, C. L. (2013). Business model innovation.The Oxford handbook of innovation management,20, 18. Naud, W. (2013). Entrepreneurship and economic development: Theory, evidence and policy.Browser Download This Paper. Nicholls, A., Murdock, A. (2012). The nature of social innovation. InSocial innovation(pp. 1-30). Palgrave Macmillan UK. Plattner, H., Meinel, C., Leifer, L. (2012).Design thinking research. Springer. Shepherd, D. A., Williams, T. A., Patzelt, H. (2015). Thinking about entrepreneurial decision making: Review and research agenda.Journal of management,41(1), 11-46. Shepherd, D. A., Williams, T. A., Patzelt, H. (2015). Thinking about entrepreneurial decision making: Review and research agenda.Journal of management,41(1), 11-46. Trimi, S., Berbegal-Mirabent, J. (2012). Business model innovation in entrepreneurship.International Entrepreneurship and Management Journal,8(4), 449-465. Urbano, D., Alvarez, C. (2014). Institutional dimensions and entrepreneurial activity: An international study.Small Business Economics,42(4), 703-716. Zahra, S. A., Nambisan, S. (2012). Entrepreneurship and strategic thinking in business ecosystems.Business horizons,55(3), 219-229.

The Effects of the Korea Division on South Korea after the Korean War

Introduction The division of Korea was an event, which stemmed from the 1945 World War II victory of the Allied nations. The victory marked the end of the 35 year long Japanese rule over Korea. The division, resulted from the declined proposal, for the United States and the Soviet Union, to transitorily occupy Korea, in the form of a trusteeship.Advertising We will write a custom research paper sample on The Effects of the Korea Division on South Korea after the Korean War specifically for you for only $16.05 $11/page Learn More The trusteeship, was intended to bring about the establishment of a Korean provisional government, which would be liberated to independence, after gaining stability. In line with the proposal, elections had been scheduled, a move that the Soviet Union refused consenting to. The refusal by the Soviet Union, was mainly because the elections would be administered in a free and fair manner, across the two Korean divisions. As a resul t of the non-cooperation, a communist nation was formed, under the directive of the Soviet Union, at the Northern division. A pro-western state was also established at the South Division, through the backing of the two super powers. Also, the two super powers, backed the different leaderships of the different territories, which led to the effective establishment of the two states. However, the two states claimed superiority over the entire Korean region (Landsberg 71). Discussion The Korean War of 1950 to 1953, was a war between the Democratic People’s Republic of Korea, backed up by China and the Soviet Union; and the Republic of Korea, backed by the United States of America. The war was primarily, the result of the political separation of Korea, which was made through the agreement by the Allied Nations after the World War II (Cumings 607). The impacts of the Korean division on South Korea are many, and they include land border issues, maritime incidents, and air attacks by the North Korean authorities. Other impacts include the democratization of South Korea. After the division of South and North Korea; the political climate was a cause for the political evolution of Soul, after running from authoritarian rule to democratic governance. Through the democratization of Southern Korea, the South Korean economy was able to establish an increased number of relations with foreign countries. As a result, the southern territory was able to develop security and foreign issues, which greatly affected the democratization of the state and the ability to establish cross-strait relations. This in turn contributed to the development of the state in its different aspects. These include the trade relations between South Korea and Taiwan (Lee 124).Advertising Looking for research paper on asian? Let's see if we can help you! Get your first paper with 15% OFF Learn More After the division, South Korea was forced into the domination of the territory by fore ign powers. The effects of this domination may be seen in the area of the victimization of the people of South Korea, especially the women living at the Cheju region. Long after the division, the women at Cheju have had to condone to sexual exploitation by foreigners, especially Japanese men. However, after a lengthy period of such victimization, the women at the Cheju region resolved to enter into prostitution business, a case that can be traced to the bereavement of a majority of them, after the 1988 attack on the group branded the Guerillas. The effect of their decision to move into sex tourism is evident up to date, and is a case which is known among church leaders and administrative authorities. For instance, during a 1988 International church seminar held at the YMCA, church affiliates were reported, as saying that there was a need to have more Japanese tourists visit the Cheju region, as they would bring money into the area. The same people are quoted as reporting that the in come from the sex tourism business, increases the endowment of the church in the area of giving (Lee 124). The division of Korea, also resulted in the instability of the South Korean state, a situation that pushed them into becoming reliant on nuclear war strategies, drawn from the superpowers backing them. For instance, it was reported that during the 1990s, there were enough nuclear bombs in the South Korean territory, enough to vandalize the entire Korean Peninsula biologically. According to the reports, there were between 120 and 1200 nuclear bombs, owned by the Unites States, at the South Korean state. During the same period, there were also more than forty thousand U.S ground troops in South Korea. Further, the autonomy of the U.S in the area of using nuclear bombs at the South Korean region, shows that South Korea fell into foreign dominance soon after the division. This is the case, as it is illegal for America to start the use of nuclear weapons in Europe, except at the Sou th Korean region, where they carry on such activities without the permission of local authorities (Lee 124). South Korea also became a pollutant-dependent nation after the division, mainly because of the establishment of poisonous production plants. For instance, there was the incidence of a boy who had died, after working at a mercury-producing factory for a period of six months. The case shows that South Korea, fell into chemical exploitation after the division of the different states. Further exploitation can be traced in the challenges placed in the way of the agricultural sector in the South Korean region.Advertising We will write a custom research paper sample on The Effects of the Korea Division on South Korea after the Korean War specifically for you for only $16.05 $11/page Learn More These include the strategy to keep South Korea under the rule of the U.S. During the 1990s, Korean farmers were under the threat of being faced out of the agricul tural production platform by the U.S. For instance, the U.S importation of beef products into South Korea, led to the loss of domesticated animals, like cows, and in other cases, the suicide of the indebted farmers. This was the case, as these farmers grew into debt, to the level that they could not keep their lands, thus becoming mere tenants. From the case, it is evident that foreign dominance was killing the Korean economy to its advantage (Oberdorfer 472). Other effects of the division of the two Koreas, include the land border attacks on South Korea by the North Korean forces. Some of these attacks include the April 1970 attempt, the November 1974, the recent 2006 attempts by the North Korean military, seeking to cross into South Korea, and the November 2010 attack on South Korean military training grounds. From these attacks, South Korea has had to remain on alert, ready for an attack from the North Korean forces, a case that led them into instituting readiness drills. These m ay be traced to the November 23, 2010 attack, which came after the Northern authorities had warned against planned military preparedness drills by South Korea. The drills were taking place at the Yeonpyong Island, where North Korean forces attacked. From the attack, there was an exchange of fire, which led to the death of 4 people and 15 others injured. This clearly shows the subjective treatment of South Korea by their North Korean counterparts, which has been the situation for South Korea, ever since the division. Other areas that South Korea has had to cultivate attack preparedness, include air operations and centers, especially after the 2003 attack by a North Korean jet fighter, which had entered the South Korean territory (Craig 75). Conclusion The division of Korea into the Northern and the Southern territories, took place after 1945 World War II victory of the Allied nations. The planned unification of Korea through a free and fair election failed, after the Soviet Union fai led consenting to the proposal, a case that led to the creation of two autonomous states, backed by the Soviet Union and the United States. However, that was not the end, as the two states and the respective leaderships, were competing for autonomous control over the entire Korean Peninsula. As a result, the conflict culminated into the Koran war of 1950-1953. After the war, the two states were declared autonomous. However, North Korea continued its revolt against the autonomy of the Southern state, attacking it both from land, borders and air. The effects of the division of Korea on the South Korean state, include the range of attacks by the Korean forces, the democratization of the South Korean economy, and the domination of the territory by foreign nations, these including Japan and the United States.Advertising Looking for research paper on asian? Let's see if we can help you! Get your first paper with 15% OFF Learn More Other effects include reliance on nuclear war strategies, South Korea hosting a pollutant – dependent economy, and the exploitation of the South Korean economy by foreign nations. The forms of exploitation evident at South Korea, include sexual exploitation from Japanese men, and economic exploitation by the United States. Works Cited Craig, Albert. The Heritage of World Civilizations, New Jersey: Pearson Prentice Hall Publishers, 2012. Print. Cumings, Bruce.  The Origins of the Korean War: Liberation and the Emergence of Separate Regimes,  Princeton: Princeton University Press, 1981. Print. Landsberg, Martin. â€Å"Korea: Division, Reunification, U.S. Foreign Policy.† Monthly Review 7.9 (1998): 71–77. Print. Lee, Ki-baik.  A New History of Korea, Seoul: Ilchokak Publishers, 1984. Print. Oberdorfer, Don.  The Two Koreas: A Contemporary History,  Boston: Addison-Wesley, 1997. Print. This research paper on The Effects of the Korea Division on South Korea after the Korean War was written and submitted by user The Twelve to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Free Essays on Disorders In Children

Childhood-Onset Bipolar Disorder Childhood Onset Bipolar Disorder (COBPD) is one of the most debilitating mental disorders affecting children today. Bipolar Disorder is a mood disorder usually affecting adults that causes sometimes severe changes in mood. Childhood Onset Bipolar disorder is just what it sounds like, a bipolar disorder that occurs during childhood. Persons suffering from a bipolar disorder experience mood swings ranging from depression to mania. During a depressive episode patients can experience feelings of extreme hopelessness or sadness, inability to concentrate and trouble sleeping. Symptoms of mania include rapidly changing ideas, exaggerated cheerfulness and excessive physical activity. Hypomanic symptoms are the same as in mania, however, they are not so severe as to require hospitalization. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) outlines the diagnostic criteria for mood disorders. According to the DSM-IV, a per son must have at least 5 of the following symptoms during the same 2 week period to qualify as a major depressive episode: a depressed mood lasting most of the day for several days; a significant weight gain or weight loss; a loss of interest in activities; difficulty sleeping (insomnia) or an increased need for sleep (hypersomnia); restlessness or slowed pace observable by others; daily fatigue; feelings of guilt or worthlessness; inability to concentrate; or recurrent thoughts of death. These symptoms can only be diagnosed as a depressed episode if they are not better explained by grief, effects of a drug, or a medical condition. The person experiencing these symptoms must, also report an interference in their daily functioning because of the symptoms. Finally, the person’s symptoms do not meet the criteria for a mixed state. The criteria for a mixed episode state that the person must display symptoms of depression and mania every day during at least a 1... Free Essays on Disorders In Children Free Essays on Disorders In Children Childhood-Onset Bipolar Disorder Childhood Onset Bipolar Disorder (COBPD) is one of the most debilitating mental disorders affecting children today. Bipolar Disorder is a mood disorder usually affecting adults that causes sometimes severe changes in mood. Childhood Onset Bipolar disorder is just what it sounds like, a bipolar disorder that occurs during childhood. Persons suffering from a bipolar disorder experience mood swings ranging from depression to mania. During a depressive episode patients can experience feelings of extreme hopelessness or sadness, inability to concentrate and trouble sleeping. Symptoms of mania include rapidly changing ideas, exaggerated cheerfulness and excessive physical activity. Hypomanic symptoms are the same as in mania, however, they are not so severe as to require hospitalization. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) outlines the diagnostic criteria for mood disorders. According to the DSM-IV, a per son must have at least 5 of the following symptoms during the same 2 week period to qualify as a major depressive episode: a depressed mood lasting most of the day for several days; a significant weight gain or weight loss; a loss of interest in activities; difficulty sleeping (insomnia) or an increased need for sleep (hypersomnia); restlessness or slowed pace observable by others; daily fatigue; feelings of guilt or worthlessness; inability to concentrate; or recurrent thoughts of death. These symptoms can only be diagnosed as a depressed episode if they are not better explained by grief, effects of a drug, or a medical condition. The person experiencing these symptoms must, also report an interference in their daily functioning because of the symptoms. Finally, the person’s symptoms do not meet the criteria for a mixed state. The criteria for a mixed episode state that the person must display symptoms of depression and mania every day during at least a 1...

Chile Essay Example | Topics and Well Written Essays - 250 words

Chile - Essay Example Chile was marred with a lot of Europeanization and institutionalization of political parties. (Lederman, Daniel, 27) The ideological gaps were subsequently filled by the emergence of those organizations that were determined to do away with the ideologies of Gen. Augusto Pinochet Urgarte. Rather than been involved into political parties through the ideologist, the Chilean systematically found themselves involved with democratization specifically the working class. Study reveal that the appearance of populism was systematic and always did that in partial form. Mostly it came about through leadership style, as a redistributive program or as a multiclass collision. Several individuals have been associated with the move from populism to social democratization. One of these individuals was Arturo Alessandri Palma, particularly through his role, where he pioneered a demagogic crusade among the working class promising them of redemption. Alesandri eventually managed to be the president of Chile where he advanced the democratic socialism among the masses. (Lederman, Daniel, 40) In 1938, Carlos Ibanez got to power with the Chilean Nazis, also known as National Social Movement. Ibanez had managed to bring populist together, which was later utilized by Frei of Christian Democratic

International Hosptality Operations Essay Example | Topics and Well Written Essays - 3000 words

International Hosptality Operations - Essay Example This industry is considered by many people to now be the biggest industry in the world. It is one of the few industries where both the producer and the consumer must meet face to face. There is a great deal of diversity among both the tourists and those who serve them. Although the tourism industry can easily be subdivided into many sub-industries, this paper will focus only on international chain hotels and their concerns with managing the diversity among their employees. (Spillane, James J) In a study that was carried out to ascertain consumer satisfaction in the international hotel business, C. Mok and R. W. Armstrong (1998) distributed questionnaires to 600 guests of three mid- priced hotels in Hong Kong in early 1996. From these, 325 respondents completed usable questionnaires. Of these, only those whose country of origin sample size was greater than 30 were included in the final analysis. This included respondents from Australia, Japan, Taiwan, UK and the USA. SERVQUAL analysis was used to determine if tourists from different cultural backgrounds had significantly different expectations for hotel service quality. It was found that "Tourists from the UK have the highest overall expectation scores followed by tourists from USA, Australia, Taiwan and Japan. Intangible elements such as human qualities were perceived as more important by all guests than were the intangible elements such as furniture, facilities." (Spillane, James J) What is international Hospitality International hospitality is the provision of welcoming environments to visitors from foreign lands. The international hospitality industry is without doubt, a "human-resources", and people oriented industry. Some products of this industry include the rendering of services like Accommodation, Relaxation, Spas and Health Clubs, Functions and banquets, Meetings, Commercial catering, Security, Gaming, Food Service, Beverage Service Entertainment, Theme Parties & Festivals, and general, Recreation. The international hospitality industry is also closely related to some other sectors of the tourism industry like Airlines, Tourist Information Centers, Transport Operators, travel Agents, Tourist Attractions (like Theme Parks), Retail Outlets and Gift Shops. Industry Image Due to the importance of planning and development issues in the international hospitality and tourism industry, such as capacity planning, sustainability, structural activity re-alignments,Like some other service sectors, hospitality careers are often stereotyped as low-wage and entry-level, with little opportunity for advancement. As a result, qualified workers, especially the youth, are usually not aware of the range of hospitality careers that are available to them. Chinda Tejavanija Chang observed that Most of the hoteliers or professionals in Hotel or Tourism Industry have made their way to the top through their professional experiences and accumulating their competencies and skills through their various positions in the field as they climbed up their corporate ladder to be top executives of the organization they belong. (Chang, Chinda Tejavanija) HISTORY OF THE HOSPITALITY INDUSTRY The international hospitality industry is a multi billion-dollar enterprise. It is an exciting, sector, which offers unlimited opportunities, and

Risk Of Falls Among Elderly Health And Social Care Essay

Risk Of Falls Among Elderly Health And Social Care Essay The loss of strength, balance, and mobility are no longer considered inevitable consequence of aging. Physiological impairments related to functional dependency are potentially reversible with appropriate exercise intervention (Morgan, 2005; Nelson et al., 2004). Furthermore strength training research programs have been especially helpful in improving balance, physical performance and reducing falls (Hoglund, Sadovsky, Classie, 2009; Kruger, Buchner, Prohaska, 2009; Nelson et al., 2004). Several interventional researchers have been conducted to prevent falls among elderly people (Judge, 2003; Kim, Yoshida, Suzuki, 2010; McMurdo, Millar, Daly, 2000). In this study we will examine a home-based training intervention to improve strength of muscles which can directly improve balance and reduce the risk of falls among community dweller elderly or through increased self-efficacy. Problem statement Risk of falls due to balance impairment among elderly people is reversely associated with muscular strength (Clemson, Cumming, 2004). Effectiveness of muscle exercise interventions to improve balance and reduce the risk of falls in aged people with high risk for falling have been a matter of controversial in different studies (Salminen et al., 2001). While some found exercise training programs successful in reducing the risk of falls (Cheung, Au, Lam, Jones, 2008; Clemson et al., 2010; Gobbi et al., 2009a; Nelson et al., 2004), others have found contrary results (Au-Yeung et al., 2002; Clemson et al., 2010; Rubenstein et al., 2000). The need for a home-based training exercise program is felt by some researchers (Kamide, Shiba, Shibata, 2009). Muscle strengthening exercise intervention by home facilities has its own advantages and disadvantages. Home-based exercise program, in comparison to clinic-based interventions which are very luxurious and seem to be very tempting and promising (Takano et al., 2010), sounds to be more feasible. As a matter of fact, the lack of public availability of high-tech facility in developing courtiers, transportation barriers for elderly, the problem of cost-benefit and cost effectiveness of any high-tech program are major barriers to use clinical-based exercise programming for elderly people (Nelson et al., 2004). Moreover, it is estimated that about one half of seniors aged 85 years or above rarely leave their homes and interventional trials targeting on those housebound aged are scarce(Ashworth, Chad, Harrison, Reeder, Marshall, 2005). Nelson et al 2004 summarized that a home-based exercise program in community-dwelling elders with functional impairment is feasible and effective in improving functional performance, despite limited supervision. They also added that home-based exercise programs that focus on strength and balance training improve functional performance in elderly people and should be promoted by the allied health community (Nelson et al 2004). Low price and organizational flexibility make it an alternative or a supplement to other forms of physical exercise and active lifestyle (Hinrichs et al, 2009) On the other hands, compliance, which is a major problem in centered-based exercise among elderly people, can be achieved by home-based programs. Previous researches emphasis that adherence to any exercise program is low among elderly people especially in long run (Campbell et al., 1997; Dishman, 1991; Gobbi et al., 2009b; Sturnieks, St George, Lord, 2008e; Sun et al., 2005). Blanchard 2008 stated that less than 15 percent of elderly people participate in center-based exercise program. He added that to achieve a larger number of participants, there has been a shift toward implementing home-based rehabilitation programs. Home-based muscular strength training can be considered as an alternative to expensive and low compliance clinical-based muscle training (Blanchard, 2008). There have been some problems in previous home-based programs. They still rely on most expert personnel who closely supervise their patients and provide them with high standard care at their home (Gardner, Robertson, McGee, Campbell, 2002; Nelson et al., 2004; Luukinen et al., 2007a). The others emphasize on individualized tailored programs (Clemson et al., 2010) which raises the cost of intervention program. Moreover, these programs, although were reported to be effective, lack in large scale randomization was the main limitation of the studies (Nelson et al., 2004). Moreover, because of low health literacy among Iranian elderly population, any home-based training intervention without proper supervision and adherence will not be able to achieve its objectives (Carpenter, 2010a). A well cited study suggested that elderly people need supervision to improve strength in a home-based setting (Baker et al., 2001). To overcome the problem of health illiteracy among elderly people we plann ed to involve participants adult children who have the most interaction with the client in training program to supervise him/her during training and fill up the log books. Fear of falling, a risk factor for falls, is being understood as an emerging public health problem (Denkinger et al., 2010; Hill, Schwarz, Kalogeropoulos, Gibson, 1996; Li, Fisher, Harmer, McAuley, 2005). Evidence suggests that both fallers and non fallers experience psychological problems associated with falls (Honaker, 2001). Previous researches have termed psychological factors as fear, diminished self efficacy and loss of confidence(Topping, 1994; Gai, Gomes, Jansen, 2009; Legters, Verbus, Kitchen, Tomecsko, Urban, 2006; Pednekar, 2007). In community dwelling elderly, a complex interaction has been found among fear of falling, falls self- efficacy, increased physical impairments and diminished functional ability and activity participation (Legters et al., 2006; Maxwell, 2006; Mihalko, 1997; Tinetti, Richman, Powell, 1990b; Pednekar, 2007). This interactive cycle encompasses fear of falling which leads to activity restriction and further decreasing physical capabilities such as functional mobility, balance and strength which leads to decreased confidence and fear of falling (Pednekar, 2007). A home-based training exercise should be directed toward strengthening weak muscles and balance. The consequence of muscular weakness and co-contraction is lack of confidence (Tinetti, Richman, Powell, 1990a) which makes elderly people loss their self-confidence and fear of falls (Hill et al., 1996). Fear of falling deteriorates the balance reactions and leads to increased risk of falls and increased risk of injury (Okada, Hirakawa, Takada, Kinoshita, 2001). Loss of confidence among elderly people results in functional limitations and may cause restriction in activity due to fear of falling, which is very common problem among community-dwelling older adults with or without experience of falls (Hansma, Emmelot-Vonk, Verhaar, 2010). Under a public health perspective, the access to home-exercise programs seems to be easier. Once implemented, a home-exercise program should be capable to reach a broad audience (Ashworth et al 2005). So, it is logical that improved muscular strength can result in self-confidence, reduce fear of falls, increase balance and decrease risk of falls. A great number of studies have proposed that only additional research with frail elderly individuals will help answer if home-based training would improve balance in older ages (Nelson et al., 2004; Baker et al., 2001). We, therefore, decided to test the hypothesis that an individual home-based muscle strength training in high risk individuals (60 years old and above elderly people with previous history of falls in last 12 months) would be feasible with minimal expert supervision and would result in clinically important improvements in balance and functional performance. The role of care givers in this study is to fill the log books, because most of the elderly subjects have health illiteracy. Significant of the study This dissertation contributes to the scientific literature in different interrelated ways. Firstly, the finding of this study can contribute to the body of knowledge in regard to falls among elderly. Falls have been explored by several researchers from different aspects; however it needs more scientific and empirical investigations to find out the ways to prevent the fall or alleviate the incidence of falls among frail elderly community-dwellers. To achieve a better understanding of falls, its consequences and prevention of falls, this area of research needs a richer body of knowledge to illuminate the way for other researchers to explore the ways to reduce risk of falls. Secondly, the findings of this study, practically, can contribute to alleviate the problem of falls among frail elderly people in community. This study looks the problem of falls from both biological (muscular strength) and psychological (self-efficacy) point of view. So, any falls prevention program has to consider the results of this dissertation as evidence to plan a comprehensive program on falls. In addition, finding of this dissertation can be used by falls prevention planners. All programs designed to prevent falls can benefit from this study, because it is planned to reduce morbidity and reduces burden of falls for person, family and healthcare services. American Geriatrics Society recommends some activities including exercise and/or physical to prevent falls among elderly people. Health professionals after orienting to the program can deliver and supervise the exercise training program for older people. The program has been tested as a single intervention but could be delive red in a multifactorial falls prevention program, too. Thirdly, the findings of this study can be used by other health practitioners in different disciplines to utilize exercise training to reduce the risk of falls among their elderly clients. So many other researchers have investigated the benefits of the exercise for other high risk groups such as patients with chronic diseases e.g. Parkinson Disease (PD), Multiple Sclerosis (MS), Stroke, Arthritis and other neuromuscular or articular diseases, depression, anxiety, etc. This study highlights the importance of exercise training among elderly people. Moreover, the current study is one of the first studies on the problem of falls in Iranian elderly community. In developing countries where sources are limited, the exercise program can be offered first to those with high risk e.g. history of falls, aged 70 and older. However, other aged people can benefit the advantages of this program. Objectives This study is planned to investigate the relationship between muscular strength to risk of fall among community dweller elderly people. To achieve this objective, the following specific goals are followed: To describe the subjects muscular strength, self-efficacy, fear of falls and balance before and after intervention To examine the relationship between subjects background variables, muscular strength, self-efficacy and fear of falls before and after intervention To examine the relationship between subjects muscular strength and risk of falls before and after intervention Hypotheses The home-based training exercise can improve muscular strengths among elderly people. Strong muscles can directly increase physical balance which is considered as proxy for decreased risk of falls among elderly people. Moreover stronger muscled can increase self-efficacy and reduce fear of falling and decreased risk of falls among elderly people. Definition of key words History of falls Conceptual: History of falls is previous experience of the event of falls. In this study, fall is an unexpected, involuntary loss of balance by which a person comes to rest at a lower or ground level (Kelly Dowling, ). Other researchers have defined falls as An unintentional descent that may or may not result in an injury, and in which any motion of descent may not necessarily result in a landing. (Berry et al., 2010). Operational: In this research, history of falls is defined as any report of falls incidence by which a person comes to rest at a lower or ground level, in subjects of the study. Any incidence of falls in last 12 months is considered as history of falls. Moreover, the number of falls during intervention is questioned. Data are collected by a questionnaire. In the questionnaire history of falls during last 12 months and causes of falls are questioned. No history of falls, one incidence of falls and two or more falls are categorized as non-faller, accidental faller and recurrent faller, consecutively. Fear of Falls Conceptual: fear of falling, first described as ptophobia, by Bhala, ODonnell, Thoppil, 1982, which means a phobic reaction to standing or walking and was subsequently classified by Murphy Isaacs in 1982 as Post fall syndrome (Jung, 2008). Operational: In this study Falls Efficacy Scale (FES) is used to assess clients fear of falling. It is a rating scale with 10 items to assess clients confidence in performing daily activities. Each item is rated from 1, meaning extreme confidence to 10, meaning no confidence at all. Participants with lower self-efficacy report avoiding most of activities because of fear of falling and get higher FES scores. On the other hands, participants with higher self-efficacy report less avoiding most of activities because of fear of falling and represent lower FES scores. Balance Conceptual: Benjuya, Melzer, Kaplanski defined balance as the ability to maintain an upright posture during both static and dynamic tasks (Bird, Hill, Ball, Williams, 2009). Operational: In this study balance is the subjects score in Berg Balance Scale. Total Score is varies between 0 and 56. In interpretation of Berg Balance Scale low, medium and high risk of falls are corresponded to 41-56, 21-40 and 0-20, respectively. Muscular strength Conceptual: Muscular strength is defined as the maximal ability of a muscle to contract and generate force (Hanney, Kolber, Schack-Dugre, Negrete, Pabian, 2010). Operational: operationally muscular strength in lower extremity and hand grip are assessed. For lower extremity muscular strength the chair stand test commonly used. The chair stand test is a physical performance test used to assess lower-extremity function. A 5 repetition test is a measure of strength (Ward et al., 2010). Subjects hand grip force score in their left and right hands will be recorded. Individual patients whose grip strength is less than the lower limit of the confidence intervals can be considered to be impaired grip (Bohannon, Peolsson, Massy-Westropp, Desrosiers, Bear-Lehman, 2006). Exercise Conceptual: A subset of physical activity. It is planned and repetitive body movement, which improves or maintains one or more components of physical fitness (e.g., cardiovascular endurance, muscular strength, balance, flexibility)(Pate, 1995). Operational: operationally exercise is a set of muscular strengthening action used to increase balance in terms of Berg Balance Score (BBS) and reduce the risk of falls among participants of the study. Self efficacy: Conceptual: Bandura (1986) defined self-efficacy as, Peoples judgments of their capabilities to organize and execute courses of action required attaining designated types of performances (p. 391). Self efficacy means ones self confidence towards learning. People usually engage in certain behaviors when they believe they are capable of implementing those behaviors successfully, this means that they have high self-efficacy (Bandura, 2007). Operational: In this study subjects scores in the Activities-specific Balance Confidence (ABC) Scale are considered as their self-efficacy. The Activities-specific Balance Confidence Scale is a scale with 16 items; each item is rated from 0% (no confidence) to 100% (complete confidence). Clients are asked to rate the level of confidence that they will lose their balance in daily activities. Conceptual Model This study will be conducted based on a modern biologic theory called wear and tear theory and Orems self-care theory. In this study the wear and tear theory is used to explain why muscular strength and balance deteriorates during old ages. Orems self-care theory is utilized to explain how self-care through exercise can maintain and improve an old persons ability for balance and reduce the risk of falls. Moreover, Banduras self-efficacy explains the moderating role of self-efficacy between muscular strength, fear of falls and balance to risk of falls among elderly people. Proposed conceptual framework Background Age Gender Marital Status Education Mental status SES Chronic Diseases Medication Health literacy ADL/IADL Self-rated Health (IV) Muscular Strength Fear of Falls Self-Efficacy (DV) Falls Risk (Balance) Chapter Two There has been a lack of investigation on effectiveness of home-based exercise, since there have been few randomized control trials (RCTs) evaluating home-based exercise (Kamide et al 2009). Home-based exercise programs are thought to be effective in improving functional performance and balance in functionally impaired elders (Nelson et al 2004). It is demonstrated that participation in a supervised home-based exercise program was associated with significant improvements in exercise beliefs, including exercise self-efficacy and outcomes expectation (Matsuda, Shumway-Cook, Ciol, 2010). This study is trying to investigate effectiveness of home-based exercise on reducing the risk of falls among elderly people based on theoretical framework and review of related literature. This chapter is devoted to disclose two main sections of the dissertation. First, the theoretical framework of the study will be discussed and then the main related literature to this study will be reviewed. Theoretical Framework In this section, theories of wear and tear and self-care are introduced. The wear and tear theory explains the process of biologic changes during old ages which makes humans cells and tissues degenerated. Moreover, self-care theory explains how anyone (self-care agent) can exert some measurements and actions to maintain health and well being. Wear and Tear Theory Wear and tear theory of ageing was first introduced by Dr. August Weismann in 1982 (Salvi, Akhtar, Currie, 2006). The wear and tear theory of aging believes that the effects of aging are caused by damage done to cells and body systems over time. Essentially, these systems wear out due to use. Once they wear out, they can no longer function correctly (Giampapa Williamson, 2004). According to the theory, aging occurs through wear and tear that leads to the progressive accumulation of damage(Murphy Partrige, 2008) The theory postulates that the daily grind of life, in particular disuse or overuse, literally wears the body out, leading to disease states (tears). The degeneration of muscles, cartilage and eventual grinding of bone on bone is examples of the aging process on body joints, as wear and tear exceed the bodys ability to repair (MacWilliam, 2002). The wear and tear profile over the course of time determines such degradations as loss of information (genetic and epigenetic mutations during the life course), loss of structural integrity (increases in entropy), and breakdowns in the emergent property of complexity (Juckett, et al. 2009). Based on wear and tear theory, senile muscular muscles atrophy starts after middle ages, especially when muscles are disused or overused (Giampapa et al., 2004). The process of degeneration is associated with senile changes in body and progressively reduces muscular bulk. There are good evidences to support that type 2 muscles are more prone to degenerated than type 1 muscles (Mannion et al., 2000). Deterioration in muscular size and number in old ages causes muscular atrophy and in combination of other senile changes in other organs (neurons) (Klitgaard et al., 2008) eventually ends up a loss of muscular strength and balance disorder which may predisposes old people to risk of falls (Sturnieks, 2008). Lack of muscular strength and balance affects patients self-efficacy and make them more susceptible to falls (Campbell et al., 1997), because of fear of falls(Denkinger et al., 2010). Self-care theory Self care theory was given by Dorothea Orem between 1959 and 2001 with a unique philosophy that patients have different level of independently. Orems self-care framework is based on the three components of self-care deficit theory, self-care theory and the nursing system theory (Denyes, Orem, Bekel, 2001). Self-care is defined by WHO as activities individuals, families, and communities perform in order to enhance their health, prevent diseases, limit illnesses, and restore health (Klainin Ounnapiruk, 2010). These activities are undertaken by lay people on their own behalf, either independently or in participative collaboration with healthcare professionals. There are several examples for self-care behavior including seeking health-related information, exercising and consuming healthy diets (Klainin et al., 2010). Self-Care Agency Self-care agency, as defined by Orem (2001), refers to the power of individuals to engage in self-care and their capability for self-care. The person who uses this power or self-care ability is the self-care agent. Self-care agency is acquired and affected by family members and care giver. They specifically may affect the clients adherence to behavioral changes and treatment regimens and overall outcomes (Rutledge et al., 1999). There is a power component to self-care agency, which addresses the importance of knowledge, attitudes, and skills that enable the individual to engage in self-care (Kumar, 2007) Nursing System Nursing system are interventions needed when individual is unable to perform the necessary self-care activities and categorized in three distinct levels as follow: Wholly compensatory in which care givers provides entire self-care for the client. An example of this category is an elderly person hospitalized in critical care unit who need a care giver for his basic needs to survive. Partial compensatory in which a care giver and client perform care; client can perform selected self-care activities, but also accepts care done by the care giver for needs the client cannot meet independently. An example of this category is an elderly person who needs help for some activities such as ambulating, but is able to perform most activities by his own. Supportive-educative in which training is planned to help the client develop/learn their own self-care abilities through knowledge, education, support and encouragement. A good example of this category is educating the elderly client to perform exercise to strengthen the muscles or to teach how to do insulin self-injection. In this research, the third category of nursing system will be applied among elderly people to strengthen their upper and lower extremities muscle to improve their balance and reduce the risk of falls Review of literature A recent study, by Matsuda et al 2010, proposed that effectiveness of any exercise to improve physical function varies with level of frailty, format and intensity of exercise program, and kind of supervision. A systemic review summarized the best evidence for effectiveness of interventions designed to reduce the incidence of falls in older people living in the community, concluded that home-based exercises and Tai Chi were specific exercise programs that showed benefit (Carpenter, 2010b). Home-based exercise program among relatively healthy older adult are proven to be effective in functional performance than group-based programs. In an Iranian study researchers conducted a 12 weeks home-base exercise training in 40 -65 years old Iranian women to prevent osteoporosis and increase muscular strength and balance (Shirazi et al., 2007). In another study researchers conducted a home base training exercise on Parkinson disease patient. They concluded that individuals with Parkinsons disease can significantly improve functional performance measures utilizing a convenient, cost effective, home-based exercise intervention (Nocera, Gainesville, Horvat, Athens, 2008). Other recent studies on standing exercise and balance training program on balance confidence, balance performance, and gait in debilitated, ambulatory community-dwelling older adults supported that exercise can improve balance, However, definitive conclusions need to await validation from more rigorously designed studies before the present training program can be confidently recommended to physical therapists engaged in home care practice(Miller, Magel, Hayes, 2010). In New Zealand, the Otago Exercise Program is designed as a home-based training exercise with combination of strength, balance exercises and walking program to prevent falls. The program is individually designed program three times a week and progressed over time. Four randomized controlled trials in different setting disclosed the effects of training program among elderly people. In another supervised 6-week, multidimensional home-based exercise program, researchers found that the program was safe and associated with improvements in physical and exercise-related belief outcome measures(Matsuda et al., 2010). Some researchers have used some technical instrument to improve balance and reduce the risk of falls among elderly people (Runge, Rehfeld, Resnicek, 2000). However, any community home-based program should integrate the training into peoples everyday life. It would be feasible, economic and more acceptable for elderly people rather than high technical procedures. A randomized controlled pilot study with 12-week physical and/or nutritional intervention program was followed by six months of home-based exercises for the training groups, followed up with training diaries aiming to describe the effects of a physical training and nutritional intervention program on the physical activity level and activities of daily living (ADL) in frail elderly people found moderate correlations between increases in physical activity level and ADL as well as between the amounts of home-based exercises and ADL for the two training groups (Rydwik, Frandin, Akner, 2009). Another study found that a 6-month, home-based exercise program consisting of progressive strength training, balance exercises and general physical activity improves functional performance and balance in functionally impaired elders (Nelson et al., 2004). Finding of another study concluded that an exercise class even once every 2 weeks is very effective in enhancing physical function in ambulatory i ndividuals aged over 73 years, provided that it is supplemented by a home-based exercise program (Suzuki, Kim, Yoshida, Ishizaki, 2004). However they suggested a large scale study to confirm their results and to evaluate the most effective exercises for the prevention of falls. Researchers concluded that incorporation of exercises in daily life is important in maintaining an appropriate level of physical function in the elderly. Prevention of falls and injuries is not easy, however, because they are complex events caused by a combination of intrinsic impairments and disabilities (Kannus, Niemi, Parkkari, Palvanen, Sievznen, 2007) fall prevention in elderly people consists of regular strength and balance training, vitamin D and calcium supplementation, reduction of the number and doses of psychotropic medication, cataract surgery, and professional home-hazard assessment and management in people with a history of falling (Kannus, Sievenen, Palvanen, Jervinen, Parkkari, 2005). On the other hand, a single-factor intervention such as exercise could also reduce many impairments and disabilities and more distant risk factors for falling simultaneously. Muscle mass diminishes considerably between the ages of 20 and 80 years (Sturnieks, St George, Lord, 2008d). Sarcopenia is a common problem among elderly people and is associated with loss of muscle mass and strength (Iannuzzi-Sucich, 2002). Understanding age-related changes in the physiological systems imperative to balance is of importance to prevent falls in older people and reduce the injury-related burden on individuals and society (Sturnieks, St George, Lord, 2008c). It has been estimated that the human beings in their 4th to 8th decade of life lose approximately half of muscle mass and muscle strength (Spirduso, 2005). Senile muscular atrophy predominantly occurs in type 2 muscle fibers which ends up a degenerated muscular bulk in which remaining muscle mass is not only smaller and weaker but slower as well (Kostka, 2010; Faulkner, 1995). The most primary atrophy occurs in quadriceps, hamstrings and back muscles with the highest concentration of type II fibers (Kostka, 2010). It has also been consistently proven that power-generating capabilities of type II fibers is approximately four times more than of type I fibers (Faulkner, 1995; Metter, 1997). Muscular strength is typically maintained at peak levels until the fifth or sixth decade, after which accelerated losses occur, with strength decreasing approximately 50% by the age of 80 year (Sturnieks, St George, Lord, 2008b). Deficits in skeletal muscle strength, balance, and gait, being major causes of frailty and risk factors for falls, are equivalently and potentially reversible by exercise training (Suzuki et al., 2004). One proposed intervention for preventing falls and fall-related injuries in the elderly is exercise. If falls occur at least in part because of physical deficits in balance, strength, reaction time, and flexibility, then it is plausible to believe that exercise targeted to improve these deficits might result in fewer fall and/or injury events. The role of strength exercise in falls prevention is under investigation. In a recent study, researchers evaluated the balance and weight training to alter gait characteristics of elderly to reduce the likelihood of slip-induced falls. The results indicated decreases in heel contact velocities and the friction demand characteristics after 8 weeks of training, although fundamental gait characteristics, such as walking velocity and step length, were not changed (Kim Lockhart, 2010). Latham, et al 2003 in a randomized control trial found that among older people recently discharged from hospital quadriceps strengthening exercises failed to reduce falls rates and was associated with a significant risk of musculoskeletal injury (Sturnieks, St George, Lord, 2008a). A recent study investigating the effects of a multifactorial fall prevention trial on the specified risk factors of falling, incidence of falls and injurious falls did not find significant difference between control and intervention groups (Sjosten et al., 2007). However there are some evidences to support effectiveness of training program among elderly people (Kruger et al., 2009; Madureira, Bonfb, Takayama, Pereira, 2010) Review of literature reveals that self-confidence deteriorates because of muscular weakness and make old people to fear of falls (Davis, 1999; Evitt, 2003; Gai et al., 2009). Bandura in his book 1997 wrote that: People make causal contributions to their own psychosocial functioning through mechanisms of personal agency. Among the mechanisms of agency