Thyroid Gland And Thyroid Hormone Synthesis

Thyroid Gland And Thyroid Hormone Synthesis Hypothyroidism is a condition characterized by abnormally low amount of the thyroid hormone synthesis. This may be due to a thyroid problem or any other reason. Thyroid hormone affects growth, development, and many cellular processes. Inadequate thyroid hormone has many consequences for the body Thyroid gland and thyroid hormone synthesis Thyroid gland has two lobes connected by an isthmus. It attaches to the thyroid cartilage and trachea. Therefore it moves with swallowing. Thyroid gland consists of follicles lined by a cuboidal epithelial cell layer. These follicles filled with colloids.Parafollicular cells situated in between follicular cells which secrete calcitonine. Thyroid gland synthesizes mainly two hormones. They are L-thyroxin/tetraiodothyronine (T4) and triiodothyronine (T3).T3 is the active form that acts at the cellular level and T4 is the prohormone.Iodide enters the thyroid follicles primarily through a transporter. Thyroid hormone synthesis occurs in the follicular space through a series of reactions, many of which are peroxides-mediated. Thyroid hormones stored in the colloid in the follicular space that is released from Thymoglobulin by a hydrolysis reaction which occur inside the thyroid cell. E.g. Thyroglobulin (Tgb), monoiodotyrosine (MIT), diiodotyrosine (DIT), Triiodothyronine (T3), tetraiodothyronine (T4). If there is hereditary defect of enzyme in above process, Thyroid hormone synthesis could not occur. So its leads to congenital goiter and often results in hypothyroidism. Regulation of the synthesis of thyroid hormones Thyroid hormone synthesis is regulated by another gland located in the brain called pituitary. In turn the pituitary gland in part regulated by the thyroid hormone via feedback mechanism and other gland called hypothalamus. The hypothalamus secretes thyrotropin hormone (TRH), which give a signal to the pituitary gland to release thyroid stimulating hormone (TSH). TSH in turn sends a signal to the thyroid gland to release thyroid hormone. If some defect occurs in one of these levels, a lack of production of thyroid hormones can cause a deficiency of thyroid hormone (hypothyroidism). Hypothalamus TRH down arrow Pituitary- TSH down arrow Thyroid- T4 and T3 The rate of thyroid hormone synthesis is regulated by the pituitary gland. If there is an insufficient amount of thyroid hormone circulating in the body to normal functioning, the release of TSH from the pituitary increased in order to stimulate more thyroid hormone. However, when there is a large amount of thyroid hormones in circulation, TSH level decreases and pituitary attempts to reduce the production of thyroid hormone. In people with hypothyroidism have low levels of circulating thyroid hormones. Physiological effects of thyroid hormones à ¢-   Cardiovascular system increased cardiac output and heart rate. à ¢-   skeletal system increased bone turnover and resorption. à ¢-   Respiratory maintains normal hypoxic and Hypercapnic drive in respiratory centre. à ¢-   Gastrointestinal increases gut motility. à ¢-   Blood increases red blood cell 2, 3-BPG facilitating Oxygen release to tissues. à ¢-   Neuromuscular increases speed of muscle contraction and relaxation and muscle protein turnover. à ¢-  Metabolism of carbohydrates increases hepatic Gluconeogenesis/glycolysis and intestinal glucose Absorption. à ¢-   Metabolism of lipids increased lipolysis and Cholesterol synthesis and degradation. à ¢-   Sympathetic nervous tissue increases catecholamine Sensitivity and ÃŽÂ ²-adrenergic receptor numbers in heart, skeletal muscle, adipose cells and lymphocytes. Reduces cardiac ÃŽÂ ±-adrenergic receptors. If there is a defect in the synthesis or regulation pathways or thyroid lead to many disorders. They are mainly divided in two parts. They are hyperthyroidism and hypothyroidism. Hyperthyroidism, or an overactive thyroid, is the overproduction of thyroid hormones T3 and T4, and most often caused by the development of Graves disease which is an autoimmune disease in which antibodies are produced which stimulate the thyroid gland produces excessive amounts of thyroid hormones. This disease can lead to the development of toxic goiter due to the growth of the thyroid gland in response to the absence of negative feedback mechanisms. This is manifested by symptoms such as thyroid goiter, protruding eyes (exopthalmos), palpitations, excessive sweating, diarrhea, weight loss, muscle weakness and unusual sensitivity to heat. Appetite is increased. Classification of Hypothyroidism Hypothyroidism is often classified by association with the indicated organ dysfunction Type Origin Primary Thyroid gland The most common forms are Hashimotos thyroiditis which is an autoimmune disease and can be occur in radioiodine therapy for hyperthyroidism. Secondary Pituitary gland Occurs if the pituitary gland does not release enough thyroid-stimulating hormone (TSH) to stimulate the thyroid gland to produce enough thyroid hormones. Although not every case of secondary hypothyroidism has a clear-cut case, it is usually caused by damage to the pituitary gland, as by a tumor, radiation, or surgery. Secondary hypothyroidism accounts for less than 5% or 10% of hypothyroidism cases. Tertiary Hypothalamus Results when the hypothalamus fails to produce sufficient Thyrotropin-releasing hormone (TRH). TRH prompts the pituitary gland to produce thyroid-stimulating hormone (TSH). Hence may also be termed hypothalamic-pitu Autoimmune Atrophic (autoimmune) hypothyroidism. The most common cause of hypothyroidism and the associated with antithyroid auto antibodies leads to lymphoid infiltration Cancer and eventually atrophy and fibrosis. It has been six Times more common in women and the incidence increases with age. This can be associated with other autoimmune Diseases such as pernicious anemia, vitiligo and other endocrine disorders. In some cases, intermittent Hypothyroidism occurs when recovering from illness, antibodies which block the TSH receptor can sometimes be involved in the etiology. Hashimotos thyroiditis. This form of autoimmune thyroiditis, again, more common in women and the most common in the late. The average age is atrophic changes with regeneration, leading to the formation of goiter. This may be usually firm and Rubber but can vary from soft to hard. TPO antibodies very high amount (>1000 IU / L). Patients can be euthyroid or hypothyroid, but they can pass through the initial phase of the toxic Hashi toxicity, Levothyroxine therapy. The goiter may reduce the even if the patient does not Hypothyroid. Postpartum thyroiditis. Typically, this is a temporary phenomenon Observed after pregnancy. It can cause hyperthyroidism, Hypothyroidism or the two sequences. It is believed to cause changes in the immune system necesnecessary.In case of pregnancy, and histologically lymphocytic thyroiditis. The process is usually self-limiting, but when Conventional antibodies are there is a strong chance this procedure of permanent hypothyroidism. Postpartum Thyroiditis may be misdiagnosed as postnatal depression. Thyroid function test is done to detect this situation. Defects in hormone synthesis Iodine deficiency. Dietary iodine deficiency still exists in some areas as endemic goiter where goiter, occasionally massive is common. Patients may be euthyroid or hypothyroidism depending on the severity of iodine deficiency. The mechanism is considered borderline hypothyroidism leading to TSH stimulation and thyroid enlargement against iodine deficiency continues. Iodine deficiency is this still a problem in the Netherlands, the Western Pacific and South. East Asia for example, the mountainous regions of the Himalayas and Africa. Some countries affected by iodine deficiency, for example, China and Kazakhstan take measures providing iodine in salt, but others, such as Russia, have not yet done so. Of The 500 million with iodine deficiency in India about 2 million suffering from cretinism.Dyshormonogenesis is a rare disease is due to genetics. Defects in the synthesis of thyroid hormones, patients Develop hypothyroidism with goiter. One particular family Form is associated with sensorineural hearing loss due to the removal Mutation of chromosome 7, resulting in a defect Transporter Pendrin (Pendred syndrome author). Hypothyroidism causes many symptoms. The term myxedema refers to the accumulation of mucopolysaccharides.In the subcutaneous tissue. The classical pictures are Slow in working, dry hair, thick-skinned, deep voice, Weight gain, cold intolerance, bradycardia, and constipation. These features make the diagnosis easy. Milder symptoms, however, more common and difficult to distinguish from other causes Nonspecific tiredness. Many of the cases on the biochemical detection Screening Particular difficulties in diagnosis may occur in certain circumstances: à ¢-   Children with hypothyroidism may not classical Properties, but often have a slow growth rate, poor School performance and sometimes arrests of pubertal Development. à ¢-   Young women with hypothyroidism may not show obvious signs. Hypothyroidism is excluded in all Patients with oligomenorrhea / amenorrhea, Menorrhagia, infertility and hyperprolactinemia. à ¢-   the elderly show many clinical features that are difficult Distinct from normal aging. Investigation of primary hypothyroidism The Serum TSH is the examination of choice, a high TSH level Confirmed primary hypothyroidism. A low free T4 level confirms the hypothyroidism is (and is also essential for TSH to close a deficiency and clinical hypothyroidism is strongly suspected and TSH is normal or low).Thyroid and other organ-specific antibodies are present. Other exceptions are the following: à ¢-   Anemia, usually normochromic and normocytic In type but can macrocytic (sometimes this is by Associated pernicious anemia) or microcytic (in women, By menorrhagia) à ¢-   increased serum aspartate transferase levels, from Muscle and / or liver à ¢-   increased serum creatine kinase levels, with associated myopathy à ¢-   Hypercholesterolemia and hypertriglyceridemia à ¢-   Hyponatremia due to an increase in ADH and reduced Free water clearance. Treatment Replacement therapy with levothyroxine (thyroxine, that is to say, T4) is Data for life. The starting dose will depend upon the severity of the failure and the age and condition of the patient, especially their cardiac function: 100ÃŽÂ ¼g per day during the Young and fit, 50ÃŽÂ ¼g (up to 100ÃŽÂ ¼g after 2-4 weeks) for the small, old or weak. Patients with ischemic heart disease Illness an even lower initial dose, especially if the Hypothyroidism is a severe and prolonged. Most doctors Would then start with daily 25ÃŽÂ ¼g and performing serial ECG, increasing the dose at 3 to 4-week intervals as angina Not occur or worsen and the ECG is not Deteriorate. Monitoring The goal is to recover well within T4 and TSH The normal range. The adequacy of the replacement is reviewed Clinical and thyroid function tests after at least 6 weeks at a constant dose. If serum TSH remains high, the dose of T4 Should is increased in increments of 25-50 g Æ’Â ¬ the tests Repeated 6-8 week intervals until TSH returns to normal. Complete suppression of TSH should be avoided atrial fibrillation and the risk of osteoporosis. The usual The Maintenance dose is 100 to 150 g Æ’Â ¬ administered as a single daily Dose. An annual thyroid function test is recommended this is usually done in the first line, often assisted and in response to the district thyroid registers. Clinical improvement T4 cannot start 2 weeks or more and complete resolution of symptoms 6 months. The need for lifelong therapy should be emphasized and the possibility of other autoimmune endocrine disease development, Especially Addisons disease or pernicious anemia, Should be considered. During pregnancy, an increase of T4 Dosage of about 25-50ÃŽÂ ¼g is often necessary to maintain normal TSH and the need for replacement during optimal. Pregnancy is highlighted by the finding of the reduction of Cognitive function in children of mothers with elevated TSH during pregnancy. A few patients with primary hypothyroidism complain incomplete symptomatic response to T4 replacement. Combination T4 and T3 replacement is advocated in this Context, but randomized clinical trials show no consistent Benefit from the quality of life symptoms. Borderline hypothyroidism or Compensated euthyroidism Patients are often seen with a low-normal serum T4 levels and slightly elevated TSH values. Sometimes this follows surgery or radioactive iodine therapy when it can be reasonably seen as compensatory. Treatment with levothyroxine is normally recommended where the TSH is consistently above 10 mu / L, or if possible symptoms, high titers of thyroid Antibodies or lipid abnormalities are present. When the TSH is only marginally increased, the tests must be repeated three to six Months later. Conversion to overt hypothyroidism is more common in men or TPO antibodies are present in Practice, vague symptoms in patients with marginal Elevated TSH (less than 10 mu / L) rarely responds to treatment, However, a therapeutic trial of substitution may be required to confirm that the symptoms are not related to the thyroid gland. It is also is considered to be the best time (TSH level normalization, the ideal case, the former) Pregnancy, in order to avoid the side effects of the fetus.Myxedema coma severe hypothyroidism, especially in the elderly, may be with confusion and even coma. Myxedema coma is very rare. Low temperature is often there, the patient may have severe heart failure, hypoventilation, hypoglycemia, and hyponatriemia.The best treatment Controversial, there is no data, most doctors recommend T3 oral or intravenous injection, a dose of Æ’Â ¬2, and 5-5 grams every 8 hours then, such as the above-mentioned increase. High-dose intravenous cannot be used. Other measures, although there is no proof of Include: à ¢-   Oxygen (by ventilation if necessary) à ¢-   monitoring of cardiac output and pressure à ¢-   Gradual warming à ¢-   Hydrocortisone 100 mg intravenously 8-hour à ¢-   Glucose infusion to avoid hypoglycemia. Myxedema madness Depression is common in hypothyroidism but rarely with severe hypothyroidism in the elderly can the patient be said demented or psychotic, sometimes with prominent delusions. This may occur shortly after starting T4 replacement. Screening for hypothyroidism à ¢-   the incidence of congenital hypothyroidism is Approximately 1 in 3500 births. Untreated, severe Hypothyroidism produces permanent neurological and Intellectual damage (cretinism). Routine screening of the newborn with a bloodstain, like Guthrie test, a high TSH level as an indicator of primary detecting Hypothyroidism is efficient and cost effective; cretinism is prevented if T4 is started within the first few months of life. à ¢-   screening of elderly patients for thyroid dysfunction a low pick-up rate and is controversial and not currently recommended. However, patients who have undergone Thyroid surgery or radioactive iodine should receive Regular thyroid function tests, should be as those who Lithium or amiodarone therapy. Signs and symptoms early hypothyroidism is often asymptomatic, can have very mild symptoms. Subclinical hypothyroidism normal levels of thyroid hormones, thyroxin (T4) and triiodo thyronine (T3), moderate to high thyroid-stimulating hormone, thyroid stimulating hormone (TSH) conditions. TSH and low free T4 at a higher level; the symptoms are more obvious in clinical hypothyroidism. Hypothyroidism may be associated with the following symptoms: Early à ¢Ã¢â€š ¬Ã‚ ¢ cold intolerance, increased sensitivity to cold à ¢Ã¢â€š ¬Ã‚ ¢ Constipation à ¢Ã¢â€š ¬Ã‚ ¢ weight gain, water retention à ¢Ã¢â€š ¬Ã‚ ¢ bradycardia (low heart rate less than 65 times per minute) à ¢Ã¢â€š ¬Ã‚ ¢ Fatigue à ¢Ã¢â€š ¬Ã‚ ¢ decreased sweating à ¢Ã¢â€š ¬Ã‚ ¢ Muscle cramps and joint pain à ¢Ã¢â€š ¬Ã‚ ¢ dry, itchy skin à ¢Ã¢â€š ¬Ã‚ ¢ thin, brittle nails à ¢Ã¢â€š ¬Ã‚ ¢ Quick thoughts à ¢Ã¢â€š ¬Ã‚ ¢ depression à ¢Ã¢â€š ¬Ã‚ ¢ muscle tension difference (hypotonia) à ¢Ã¢â€š ¬Ã‚ ¢ female infertility and problems in the menstrual cycle Hyperprolactinemia and galactorrhea à ¢Ã¢â€š ¬Ã‚ ¢ elevated serum cholesterol Late à ¢Ã¢â€š ¬Ã‚ ¢ goiter à ¢Ã¢â€š ¬Ã‚ ¢ slow speech and a hoarse, breaking voice deepening of the voice can also be noticed. Reinke edema. à ¢Ã¢â€š ¬Ã‚ ¢ Dry puffy skin, especially in the face à ¢Ã¢â€š ¬Ã‚ ¢ Thinning of the outer third of the eyebrows (sign of Hertoghe) à ¢Ã¢â€š ¬Ã‚ ¢ Menstrual cycle abnormalities à ¢Ã¢â€š ¬Ã‚ ¢ Low basal body temperature à ¢Ã¢â€š ¬Ã‚ ¢ thyroid related depression Uncommon Impaired memory Impaired cognitive function (brain fog) and inattentiveness. A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility Reactive ( post-prandial) hypoglycemia Hair loss slow reflexes Anemia caused by impaired hemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency from pernicious anemia Yellowing of the skin due to impaired conversion of beta-carotene to vitamin A (carotoderma) Difficulty swallowing(dysphagia) Shortness of breath with a shallow and slow respiratory pattern(dyphnea) Increased need for sleep Irritability and mood instability Impaired renal function with decreased glomerular filtration rate myxedema madness (a rare presentation) Decreased libido due to impairment of testicular testosterone synthesis Impairment of taste sensation and anosmia Puffy face, hands and feet (late, less common symptoms) Gynecomastia(enlarge breast tissue) Loss of hearing Diagnosis thyroid function test the only validation test diagnosis of primary hypothyroidism is thyroid stimulating hormone (TSH) and free thyroxin (T4) level. However, these levels can be varying without thyroid disease. High TSH levels, the thyroid gland does not produce enough thyroid hormone levels (primarily thyroxin (T4) and a small amount of iodine Thyroid three original leucine (T3)). However, measuring just TSH can diagnose secondary and tertiary thyroid function loss, resulting in the following recommended a blood test, if the TSH is normal hypothyroidism remains skeptical: Free triiodothyronine (ft3) Free thyroxin (ft4) Total T3 Total T4 Additionally, the following measurements may be needed: Free T3 from 24-hour urine catch Antithyroid antibodies for evidence of autoimmune diseases that may be damaging the thyroid gland Serum cholesterol which may be elevated in hypothyroidism Prolactin as a widely available test of pituitary function Testing for anemia, including ferritin Basal body temperature Exams and Tests A physical examination may reveal a smaller than normal thyroid gland, although sometimes the gland is normal size or even enlarged (goiter). The examination may also reveal: Brittle nails Coarse facial features Pale or dry skin, which may be cool to the touch Swelling of the arms and legs Thin and brittle hair A chest x-ray may show an enlarged heart. Laboratory tests to determine thyroid function include: TSH test T4 test Lab tests may also reveal: Anemia on a complete blood count (CBC) Increased cholesterol levels Increased liver enzymes Increased prolactin Low sodium Treatment the treatment of hypothyroidism is levorotatory forms of thyroxin (thyroid hormone) (L-T4) and triiodo thyroxin liothyronine (L-T3). Thyroxin is a name, and in the USA, the most common form of thyroxin tablets. Thyroxin is a doctor of the most common drugs, wherein a synthetic thyroid hormone predetermined. This medicine can improve symptoms of thyroid deficiency such as speech delay, lack of energy, weight gain, hair loss, dry skin, cold feeling. This will also help in the treatment of goiter. It can also be used to treat certain types of thyroid cancer, surgery and other medicines. Both synthetic and animal thyroid tablets available, and may be required in patients with the additional thyroid hormone. Daily doses of thyroid hormone, doctors can monitor blood pressure, in order to help ensure that the correct dose. Thyroxin is the best 30-60 minutes before breakfast, because some foods can reduce absorption. Calcium can interfere with absorption levothryoxine. Compared with water, t he coffee can be reduced about 30% of the absorption of thyroxin. Some patients may be anti-thyroxin, in fact, they do not have good absorption sheet to solve the problem by spraying. There are several different treatment options for thyroid replacement therapy: T4 only such treatment methods include supplementary levothyroxin separately, a synthetic form. This is the current standard treatment of mainstream medicine. A combination of T4 and T3 in This treatment method involves the combination simultaneously manage two synthetic L-T4 and L-T3. Dried thyroid extract Dried thyroid extract is an animal thyroid extract; the most common is from porcine sources. It is also a combination therapy, containing a natural form of L-T4 and L-T3. Dealing with controversial T4 T3 generation has been investigating the potential benefits, but has proved to be no conclusive combination therapy benefit. Laboratory Medicine Practice Guidelines in 2002, the the clinical biochemical state of the U.S. National Academy of Sciences during pregnancy: L-T4 dose should be increased (usually 50 micrograms / day) maintained at 0.5 ~ 2.0 mIU / L and serum serum TSH FT4 within the normal reference interval the upper third. Doctors tend to assume that if your TSH is in the normal range, sometimes defined as high as 5.5 MIU / L has no effect on fertility. But there is an approximately 1.0 MIU / L, TSH level in healthy pregnant women Subclinical hypothyroidism there are a series of biochemical and point thyroxin treatment, the typical treatment of hypothyroidism symptoms views. Reference range has been debated. As of 2003, the American Association of Clinical Endocrinologists (ACEE) that within the normal range of 0.3-3.0 MIU / L. There is always an excess risk of hyperthyroidism. Some studies suggest that subclinical hypothyroidism does not require treatment. In 2007, the Cochrane Collaboration, a meta-analysis found that, in addition to the no benefit of thyroid hormone replacement lipids and left ventricular function in 2002 meta-analysis checks whether subclinical hypothyroidism may increase the risk of heart disease increase, some of the parameters previously thought, a slight increase, and recommended to be updated for the current recommendations for further research with the end point of coronary heart disease. Replacement therapy the connection has been a slow release combination of T3 and T4, supporters will be able to thyroid dysfunction symptoms and functional quality of life. This is still a matter of debate, refused by the traditional medical community. Remember, the important thing when are taking thyroid hormone are: à ¢Ã¢â€š ¬Ã‚ ¢ do not stop taking the drugs, and when you feel better. Continue the medication completely guidance of a doctor. à ¢Ã¢â€š ¬Ã‚ ¢ If you change the brand of thyroid drugs, let your doctor know. Your levels may need to be checked. Some dietary changes can change your body absorb thyroid drugs. Contact your doctor, if you eat a lot of soy products, or in the high-fiber diet. à ¢Ã¢â€š ¬Ã‚ ¢ Thyroid medicine best on an empty stomach, and if any other drugs before one hour. à ¢Ã¢â€š ¬Ã‚ ¢ do not take the thyroid hormone supplement fiber, calcium, iron, multivitamins, aluminum hydroxide, sulfuric acid agent, colestipol, or in combination with a bile acid drugs. You start taking replacement therapy, the doctor tells you, if you have any symptoms of increased thyroid activity (hyperthyroidism), such as Palpitations Rapid weight loss Restlessness or shakiness Sweating Myxedema coma is a medical emergency; the thyroid hormone the body becomes very low. Intravenous replacement thyroid hormone and steroids. Some patients may need support therapy (oxygen, breathing assistance, fluid replacement) and intensive care. Outlook (prognosis) in most cases, thyroid levels to normal, and appropriate treatment. However, thyroid hormone replacement for the rest of life.Myxedema coma can result in death. Possible complications Hypothyroidism, myxedema coma, the most severe form is rare. This can be caused by infection, illness, exposure to cold, or certain medications in untreated hypothyroidism. The symptoms and signs of myxedema coma include: à ¢Ã¢â€š ¬Ã‚ ¢ room temperature à ¢Ã¢â€š ¬Ã‚ ¢ Reduce breathing à ¢Ã¢â€š ¬Ã‚ ¢ low blood pressure à ¢Ã¢â€š ¬Ã‚ ¢ hypoglycemia à ¢Ã¢â€š ¬Ã‚ ¢ unresponsive Other complications include: à ¢Ã¢â€š ¬Ã‚ ¢ Heart disease à ¢Ã¢â€š ¬Ã‚ ¢ Increased risk of infection à ¢Ã¢â€š ¬Ã‚ ¢ Infertility à ¢Ã¢â€š ¬Ã‚ ¢ abortion Untreated hypothyroidism are at increased risk: à ¢Ã¢â€š ¬Ã‚ ¢ gave birth to birth defects à ¢Ã¢â€š ¬Ã‚ ¢ heart disease, the higher the level of LDL (bad cholesterol) à ¢Ã¢â€š ¬Ã‚ ¢ heart failure Too much thyroid hormone treatment are at risk of angina or a heart attack, as well as the risk of osteoporosis(the bone thinning).

Bureaucratic Management Essay

An organisation can be best describes as a unit which consists of individuals who, in order to achieve certain objectives, influence other people. They may be trying to achieve wealth or well being through differing processes, technologies, structures and cultures. In order to run an organisation well management is needed. Management then is the planning, organising, leading and controlling of human resources, s well as other resources, in order to achieve effective goals. Rosemary Stewart describes a manager as; â€Å"Someone who gets things done with the aid of people† (Boddy P11) Bureaucratic Management An important aim for most businesses today is to increase productivity and efficiency. In order to do so, many businesses adopt theoretical approached to management. The theory of bureaucracy is one in which is the underlying theme of control in many organisations of today. Bureaucratic management is described as â€Å"a formal system of organisation in order to maintain efficiency and effectiveness.† (Contemporary Management P48) Max Weber developed the theory of bureaucratic management and derived five main principles which should be adopted when using bureaucratic management. Although his theories were very sound, perhaps the most influential principles of management in organisations are that of Henri Fayol. He devised 14 theories of management however some of these theories are similar to that of Max Weber. Like Weber, Fayol believed in division of labour where workers would be given more job duties and responsibilities. He also believed in authority and responsibility similar to Weber’s theory, where authority should come from â€Å"personal expertise, technical knowledge moral worth and the ability to lead to generate commitment from subordinates† (Contemporary Management P50) Weber believed in dual command, similar to this, Fayol believed unity of command. This principle involves an employee reporting to and only receiving orders from one supervisor. Next he devised that there should be a line of authority which can be described as the line of command starting at the bottom of the organisation and following up to the very top of the organisation. In bureaucratic management it is important to control the number of levels in the hierarchy because the more managers there are the longer it takes to plan and organise activities. Similarly he believed that an effective bureaucratic work place should have a form of centralisation. Fayol believed that authority should not be centralised at the top of the chain of command. As a result of centralisation of authority, it would mean managers at the top of the hierarchy are able to make more decisions and therefore the people lower down the line of authority would simply follow their direction. In a bureaucratic organisation there is a need for unity of direction which Fayol picked up on. He believed that effective bureaucratic organisations which devised a plan of direction would eradicate ineffectiveness and unfocused activities. On the other hand, bureaucratic organisations should treat employees with equity and fairness as well as sustain order. Fayol described order as â€Å"the methodical arrangement of positions to provide the organisation with the greatest benefit.† (Contemporary Management P50). Linked to this he believed in the discipline within the organisation whereby employees could focus on obedience, energy and respect for authorititive figures. On the other hand, bureaucratic management according to Fayol should encourage employees to use initiative as well as a system whereby employees are rewarded in order to increase productivity and increase enjoyment for the employees. Included in these reward systems were profit sharing plans and bonuses. He recognised the need for long-term employment because through time people develop their skills. Similarly he believed that some form of agreement should be made by the organisation and its employees in order to maintain that employees are treated fairly and overall be rewarded for their performance. Espirit De Crops is an important part in the success of a bureaucratic organisation because it refers to a shared feeling of motivation and commitment to a specific cause. When managers are able to encourage personal and verbal relations between both managers and workers espirit de corps can be developed. Furthermore, this can be linked to Human Relations management. Human Relations Management Human relations management is the belief that a concern for human factors such as job specialisation in order to improve productivity. It was based on the belief that people have a social dimension and have important links not just to the workplace, but out with the organisation itself. Human relations was a move from a ‘rational economic’ view of man, where a employee will increase productivity with economic benefits such as wage rises and bonuses; to a social view of man, where productivity will increase with an increase in employee relation ships and in general better social conditions. Mary Parker Follet believed in the creativity of group processes. On the other hand she did not believe that division of labour was the right way to achieve optimised productivity unlike Fayols’ bureaucratic theories. Again, in comparison to strict lines of authority in bureaucratic management she believed that managers in an affective human relations organisation should not manipulate their subordinates. Instead, they should be trained to use their powers responsibility. She also argued against Fayols’ belief that there should be a clear hierarchy of authority by advising that it would be effective if leadership moves from person to person depending on the individual situation or who is best suited to the job. Unlike the principle of unity of command, Human relations theory allowed employees to work together and interact with managers giving their opinions and beliefs in order to optimise productivity. It also gives employees the satisfaction of knowing their opinions are valued. Elton Mayo elaborated on human relations management theory when he undertook the Hawthorne studies. He examined the social and psychological factors which affected performance. His studies concluded that physical conditions had a small impact on output and that it was social changes which impact productivity. These changed occurred because the teams were paid more attention to and their opinions mattered to managers. On the other hand, it concluded that financial initiatives helped increase productivity (similar to bureaucratic practises). The study later found that people performed less effectively because they began to practice specific social norms. In bureaucratic management employees have to behave in strict ways whereas human relations management theories found differing social behaviour. During the Hawthorne studies employees devised that they should behave in specific way and therefore those who did not abide by these social norms were classified as rate busters; who were people who tried to more in order to gain more, chisellers; employees who underperformer and squealers; who told tales to managers. Relevance Today Bureaucratic management has been proven to be very successful today. The Hilton hotel group are a relevant example because they have many outlets through-out the world. They must set out global standards and procedures in order for managers to run them it effectively. Included in these procedures is how staff is recruited and trained. Similarly rules and regulations set out in manual should be followed precisely, whether its how to treat their customers or how to run their accounts. On the other hand, bureaucratic management is not suitable for organisations which are prone to change. On the other hand, management control in bureaucratic management is very high because authority is clearly marked out, with managers being the imperative and employees must follow their orders. Human Relations Management is successful in some organisation today. Organisations that tend to benefit from Human Relations Management are call centres because employees tend to work in teams and have a closer interaction with their managers. However the influence on performance that Mayo discussed is much more complicated than assumed because by providing good supervision and adequate working conditions can increase satisfaction within the organisation but does not always mean it will increase productivity. Management control in an organisation which is adopts Human Relations management does have management control however it is less centralised. Employees are able to put across ideas and perspectives. Similarly, in some organisations the role of management can be shifted depending on who is best suited to the job. Overall, adopting theories of management in an organisation is very important because it can shape the way you run your business, but more importantly it can increase productivity and effectiveness by all who are involved in the organisation. Bureaucratic management is a system of management which is widely used today and more classical compare to human relations management. It is clear to see that there are differences between bureaucratic management and human relations management, the most obvious being that human relations management takes into consideration the social behaviours of employees whereas bureaucratic management concentrates more on hierarchy and strict division of labour.

Baz Luhrmann’s appropriation “Romeo and Juliet” Essay

Baz Luhrmann’s film, Romeo and Juliet, is very successful as an appropriation of the original play by Shakespeare. Transforming the pre-16th century play into a contemporary popular culture film was done creatively by keeping the same values and language, but changing the context. This is illustrated by the use of anachronisms. For instance, daggers and swords are replaced by guns as well as cars stand in for horses. The disputes between members of the two families (the Capulets and the Montagues) evoke associations with multi-ethnic gang warfare. Their feud reflects the behaviour of mafia families. Using these modernising elements, he achieves an appeal to the contemporary teenage audience and the changes in the film create a more comprehensible meaning to the audience because people can relate to it better and this is why the film is so engaging. The film is set in a modern day city where violence occurs regularly. In the opening scene, a television screen is in view and a news reporter is talking. This immediately allows people to realise the time period which the film is set in. Then there is a sequence of scenes which includes shots of scenery, people fighting, newspaper articles and loud string music is played in the background. There is a lot of editing and cutting in this sequence which makes it move very fast. The next scene is where the Montague gang is at the petrol station. Loud upbeat music is played in the background. The loud music and bright coloured costumes represent the life of this city. The use of guns and convertible cars contribute to the contemporary atmosphere. The film techniques include using a handheld camera which creates a â€Å"realistic† effect. This is used in the sequence of different shots where there is fire and helicopters and guns. The reason why it is so realistic is because the quality of the shot and the way it is presented make it seem like something that would be seen on the news. But the words that appear between the shots, for example, â€Å"In fair Verona† and â€Å"a pair of star-cross’d lovers take their life† is taken from the play so it is Shakespearean language. The text is placed with contemporary visual graphics, yet they do not clash together. The effect of this is that people do not take their attention away when they are presented with language that they may not completely understand. Instead, they can connect the text and the sequence together. Also, the characterisation used in the film is done well to add to the contemporary atmosphere. For example, the Montague gang is not presented as â€Å"well-behaved servants†. Instead, they are loud, extrovert, and outrageous. Paris is â€Å"bachelor of the year† instead of being a â€Å"kinsman of a prince† type figure. No one in the film is presented as a model of a â€Å"perfect citizen†. The Capulet gang wears Hawaiian shirts, one even unbuttoned to reveal their bare chest. They have more rebellious styles of hair; pink, shaved and bleached. Luhrmann uses the images of the families to make one appear submissive and docile while the other is unscrupulous and aggressive. The Capulet’s have quite clearly been portrayed as the ‘baddies’ of the story. The reason why Luhrmann have done this is to portray the typical â€Å"villain† role, which is given to the Capulet gang. In Shakespeare’s time, homosexual men were not accep ted in the society and different ethnic groups did not mix together. In the film, Mercutio is a homosexual and also black, and in today’s society the different sexuality and race are accepted. Even the master of the household, Mr. Capulet, is not perceived as an archetypal â€Å"wealthy and noble† character. The priest is also not a typical Christian and he would have been a controversial character if he was presented during Shakespeare’s time. Also, Baz Luhrmann has chosen two beautiful, â€Å"blonde hair and blue eyed† actors to play the part of Romeo and Juliet. This makes their role idealistic. All of the characters in the film are not â€Å"refined†, as they would have been in the play. This is a reflection of today’s culture and the audience can relate to the film better. And because of this, the dialogue will not affect the audience too much and they would still be able to follow along with the storyline. Although the characterisation of the film is quite different from the characterisation of the play, Baz Luhrmann has kept the original values and issues and has presented them well in the film. The issue of â€Å"peace and order† is presented with the police captain talking to the Capulets and the Montagues in a conference room. Once again, Luhrmann has used elements of today’s culture in the film to replace the existing culture in the play. The police are used to deal with justice and punishment instead of the prince. The character’s religion is very important in the film and the crucifix is a  symbol that is used. Romeo and Juliet get married in the church where they are accompanied by the priest and a chorus. The large statue that reoccurs in many scenes is a religious figure and inside the building, where Juliet lays on her deathbed, is filled with crosses and candles. All of these elements make up a very observable fact that religion is, to a great extent, acknowledged in the film. Luhrmann has made the values and issues raised in the play more distinctive in the film by using these modernized elements. A change in the context of the play also add to the modern atmosphere. A creative interpretation of the original text is used, when Luhrmann turns the Queen Mab speech, which Romeo gets from Mercutio before they go to the Capulet’s party, into an Ecstasy pill. Furthermore he leaves a few text-passages out by presenting it visually. In a few cases he even changes Shakespeare’s plot. This becomes obvious when Juliet awakes before Romeo has died. This differs from Shakespeare’s original text. With the use of special film-techniques, Luhrmann achieves a dramatisation of the scene. In the scene when Juliet awakes before Romeo has drank the poison, the change of the plotline results to a more astonished reaction from the audience, as they would be expecting the clichà ©d ending, which is the one in the original play. Baz Luhrmann’s film is very successful as an appropriation of the original play not only because of his creative ways in modernizing the play, but because the film itself can make one understand the extremeness of the situation in the storyline. That is, in the original play, horses and swords were used in the battles and when people read the play, they may not realise how severe and dangerous the circumstances are because there are too many historical references to swords and horses that it has lost its effectiveness. But in the film, Luhrmann has used fire, guns, cars, and explosions to emphasise the seriousness of the situation. People are more familiar with this sort of violence because it is seen in the media and therefore it will appear more realistic to them. And the sentiment that people may obtain will be more practical and dynamic. This is why the film is so successful, it compels people to understand the original play a lot better.

Parental Attachment and Substance Abuse - 1976 Words

Attachment and Substance Abuse Parental attachment, defined as a persevering emotional bond and involved interaction between parent and child, has not been critically studied with respect to the development of substance use disorders (SUDs) (Zhai, Kirisci, Tarter, Ridenour, 2014). One probable reason for this is the consideration that attachment is generally established by two years of age and the manifestation of SUDs often appears nearly two decades later (Zhai et al., 2014). Therefore, long-term documentation is necessary to track the influence of parent-child bonding on SUDs and SUD etiology (Lander, Howsare, Byrne, 2013). Additionally, there are several factors occurring during the developmental period, which have an impact on†¦show more content†¦This dysfunctionality is attributed to a higher incidence of addictive disorders (Lander et al., 2013; Wedekind et al., 2013). Addiction is often regarded as an attachment disorder. Possible harmful drinking patterns are often associated with insecur e attachment and an inability to regulate emotions (Wedekind et al., 2013). Recently, De Rick and colleges (2009) proposed a correlation between characteristics of personality disorders, depression, anxiety, and alcohol addiction. According to Wedekind et al. (2013) childhood experiences as well as biological factors contribute to the developing attachment styles of individuals. When observed together, the capacity for coping with anxiety, a person’s temperament (arguably inborn), and personality style may correspond with attachment styles and the creation of distinct psychopathologies which over the course of time may lead to alcohol addiction (Wedekind et al., 2013). In addition, research conducted by Wedekind et al. (2013) indicated that a high prevalence of insecure attachment styles is found in alcohol addicted inpatients, and that those who are insecurely attached, display a significantly higher expression of cognitive avoidance (Wedekind et al., 2013). Barnett (2012) considers childhood trauma as the most significant public health challenge inShow MoreRelatedSubstance Abuse Is An Addiction1626 Words   |  7 PagesIntroduction Substance abuse is an addiction and it is the addition, which is referred to a chronic disease. It is this chronic disease that is a significant and growing issue, especially among family units where either one or two parents and/or parental guardians suffer from. 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