Top down and control style management

Top down and control style management In the present economic world management Style can be defined as the style adapted to control or lead a business efficiently for the attainment of objectives set by the business. So the effective management style helps in maintaining the motivation of the employees and as a result enhances productivity. It is very important to look at the prominent management styles and how they function in the real world before we draw in to change process. A top-down/command and control style management can be defined as a style where the leader or small number of people takes all the decisions on their own and employees are told what to do and are closely controlled. The top management does not consult his subordinates or takes their opinion in consideration for decision making and dominates and controls the entire task. The person or persons who possess these personal qualities would be task oriented. In other way this can be described as a centralised way of governance. When the changes needed to be taken place involve high risks and the circumstances request quick and immediate decision making, this kind of management style proves to be the most effective. But it involves the use of power and fair amount of politics than the other management styles. As a result this causes demotivation as it implies the skills and ideas of others being ignored and it can also lead to the alienation of the staff. Typical characteristics of a centralised structure of decision making, or governance within an organisation would be an autocratic structure, because everyone is answerable to the leader or the top management. This brings advantages to the organisation in terms of focus and clarity of purpose; everyone is likely to know the companys goals and what is expected from them. Consistency is often a beneficial by-product, possibly because of lack of variety or maybe the attention to detail that becomes viable. The speed at which decisions can be made and passed down to the relevant persons is an obvious advantage. A high degree of flexibility is also associated with centralisation; the ability to change direction with the market is a valuable characteristic. However, it becomes clear that too much responsibility can be placed upon one person, usually the owner or manager. An autocratic nature usually has very little opinion, points of view or other valuable information passed up the hierarc hy; wholly undemocratic, emphasised by the lack of accountability and scrutiny. Centralised models of decision making tend to only work effectively in small organisations, most of the associated advantages are lost in large organisations, for example, it becomes much more difficult for employees to share one uniting aim or goal, speed of decision and information flow would undoubtedly be adversely affected in larger hierarchies etc, as would flexibility. Implementation of change in the organization will require the leader to weigh resistance to change at both the individual and organizational levels. Because change invariably threatens the status quo, it inherently implies political activity. The following chapter looks at different kinds of leadership qualities and how they managing the change process with in an organization. Leadership is cautiously defined as the process of influencing people and providing an environment for them to achieve team or organization objectives. (McShane, 2002). Effective leaders can help individuals or teams define their goals and identify ways to achieve them. Effective leaders also create conditions that enable others to realize their potential in the workplace. Leadership styles will influence the effectiveness of the change management process by recognizing and varying the style with the specific situation. The identification of when to give directions, times to empathize, times to use stretch goals, and times to involve subordinates in decision making will influence the effectiveness of the change management process under the guidance of specific leader. The Directive leadership style or task-oriented leadership is effective when clarification of performance goals, the means to reach the goals, and identification of the standards used to judge reaching the goals is need ed by the organization undergoing the change. The Supportive leadership style is effective when the need is for a leader that is understanding, approachable, friendly, and is able to guide the employees involved in organizational change through stressful situations while treating them with equal respect and showing concerns for their needs and well-being. The Participative leadership style is effective when employees undergoing change are motivated by involvement with the decisions beyond their normal work activities. The Achievement-oriented leadership style is effective when employees are motivated by encouragement to reach their peak performance and the leader shows a high degree of confidence in their ability to set and achieve change goals. Task structure, team dynamics, employee skill and experience, and locus of control are contingencies that will impact the effectiveness of the leaders impact on the change management process. (McShane, 2002). Over the following paragraphs I will be discussing two examples of participative change processes namely Appreciative Inquiry and Public Conversations Project and how they differ from the command-and-control styles of managing change. 1. Appreciative Inquiry In this process there will be ongoing discussion among the organization members at different levels and they will be actively participated on decision making. This type of process normally follows a problem solving method and involves identification of problem, analysis of causes, analysis of possible solutions and possible treatment. Appreciative inquiry takes off on this idea that how we think about, and talk about, our organizations influences how we work in them. Appreciative inquiry is based on the belief that if we conceive of organizations as problems to be solved, we end up in an endless cycle of problem definition and problem solution. This in turn saps energy for productive change since people end up feeling criticized or accused of having done something wrong. Appreciative inquiry removes organizational habits of distrust, animosity and blame, and replaces them with a willingness to learn, mutual respect, and cooperation. Appreciative inquiry sees organizations as miracles to be appreciated. If we see organizations in this way, we begin to understand what is working well and how this is coming about, and we can intentionally amplify those positive factors. This will create forward motion, positive energy and the possibility for lasting change. There are usually four steps of appreciative inquiry. a.  Appreciating what gives life (appreciating the best of what is) This phase is a quest to identify positive stories and spread them throughout the organization. The discovery phase shifts the attention from what isnt working to what is working and may possibly work in the future. In order to find out what is working, an appreciative interview is generally performed. This involves exploring a persons beginnings with an organization, what they value most about themselves, their work and the organization, and their hopes and dreams for the organizations future. b.  Imagining what might be (envisioning what might be) This phase is a time for groups of people to engage in thinking big, thinking outside the box, and thinking out of the boundaries of what has been in the past. It is a time for people to describe their wishes and dreams for their work, their working relationships, and their organization. This phase takes place in a large group meeting during which data and stories collected in the previous phase are shared. Wishes and dreams for the future of the organization are often acted out to dramatize the positive possibilities envisioned for the organization. c. Determining what will be (dialoguing what should be ) This phase provides an opportunity for large numbers of employees and stakeholders to come together to co-create their organization. This phase allow members to make important decisions on what steps or actions are required to make the dreams come true. d. Creating what will be (innovating what will be) This phase focuses on action planning at both the personal and organizational levels. During this phase, commitments are made to ensure that their dream will be realized. This takes huge commitment from individuals to comply with the action plans, small groups to work on collaboration efforts, and new teams that have been established for new projects. Since all these phases involve large number of employees and stakeholders, the likelihood that these action plans for changes will be accepted and implemented will be high. Appreciative inquiry engages the whole organization in discovering the best of what has been and dreaming about the best of what might be. Appreciative inquiry focuses on what is right and do more of it rather than the traditional approach that focus on what is wrong and do less of it. It focuses on what works and determining how to do more of what works. Positive learning and innovation comes from studying, adapting, and replicating what works. Also, appreciative inquiry is based on the past of all the employees and aims to involve all the employee and stakeholder for the future of the organization. This can only lead to positive attitudes about the organizations future and brings unity among all the members of the organization. Comparing to control command style of management this process takes much longer time to give the result and it is quite obvious as a successful participative change process. 2. Public Conversations Project This is another example of participative change process where the management can work with groups in conflict with in the organization. The main task is to facilitate and create dialogue sessions among the conflict groups or participants and allow addressing their own issues regarding the problematic relationship. Questions like, How did you get involved?, Whats the key issue?, Whats your grey area? Will be asked from both parties. The main objectives are to discuss the popular misconceptions of stereotypes, how to promote better relationships among people and the importance of diversity among people living/working together. The facilitators meet with participants prior to each dialogue, in a pre-meeting designed to exchange their hopes, concerns and experiences. A draft of ground rules being given to the participants intended to prepare them to deal with issues in a way that results in a dialogue rather than debate. Group discussions will be carried out with a facilitator guiding the whole process under his observation, to be start with a series of questions will put forward that each person must answer. The outcome of the dialogue generally will be participants sharing their reflections on the process and exploring implications and next steps. As a main feature of this participation change process members who participated are also asked to fill out evaluation forms and will be requested by the facilitator to participate in follow-up conversations. There will be minimal degree of control, power and command will be involved just to progress with the process. Every participant contributes them selves for the conversation and during the progress a pattern will be identified which will guide them to disclose the information more freely among the members. The facilitator must take action to make sure that every member of the group will be pace with the ongoing conversation so they will be heard. To facilitate change of the information or knowledge they can be asked to interrupt the pattern of conversation or conventions of the group and contribute them selves. Contributions are linked together to conversation will be continued as a joint action. Narrative therapy is another way of participative change process where it views problems as separate from people and assumes people have many values, skills, beliefs, competencies, commitments and abilities that will assist them to change their relationship with problems in their lives. This is a kind of a non-blaming, respectful approach to counselling and community work, which centres people as the experts in their own lives. The client plays an important roll to decide which direction they should take during the consultation, making it more similar to a person centred counselling session. Always maintaining a curiosity stance and willingness to ask questions to which we dont know the answers genuinely are the main features of this process.

Social Oppression Exposed in Mulk Raj Anand’s Untouchable :: Untouchable

Social Oppression Exposed in Mulk Raj Anand’s Untouchable Untouchable by Mulk Raj Anand offers more than just a day in the life of a member of India's lowest caste. Anand manages to "touch" the reader with Bakha's untouchability. As he struggles to internalize his place in society, Bakha displays to the reader his potential, and how his low-caste birth has affected his spirit. As the story progresses, the reader experiences with Bakha the reality of his place in society and his struggle with that realization. At one point in the novel, Bakha is sweeping the courtyard of a Hindu temple, and is overpowered by his curiosity to see what lies within. Bakha's inner struggle over peering into the temple and the repercussions of his acting out that desire parallel the divided nature of his will: A murderer might have advanced like that, one confident in his consummate mastery of the art of killing. But he soon lost his grace in the low stoop which the dead weight of years of habitual bending cast on him. †¦After he had mounted the first two steps, he stood completely demoralized with fear and retreated†¦(Anand 58) This quotation is one of several in which Anand portrays a noble side to Bakha. Bakha's movement is compared with that of "a murderer†¦ confident in his consummate mastery of the art†¦" While the word "murderer" carries negative connotations, Anand's choice of metaphor is powerful in that it carries with it all the strength of purpose and artful skill required of the professional assassin. Long years of degradation and menial work have taken their toll on Bakha. His return to a stooping posture displays more than physical deformity. The "dead weight of years" rests heavily on his spirit as well, demoralizing him into a retreat from the forbidden temple steps, and recalling to his demeanor the "humble, oppressed under-dog that he was by birth."(58) Bakha's self-doubt is reinforced when he finally summons the courage to climb the temple steps and explore the mysteries within.

Diabetes Mellitus Syndrome Chronic Hyperglycemia Health And Social Care Essay

Diabetess mellitus was described more than 2000 old ages ago, one time regarded as a individual entity disease impacting persons of higher socio economic strata but now even the person of lower economic strata are besides affected. It is a disease characterized by a province of hyperglycaemia ensuing from diversenesss of etiologies, environmental and familial playing jointly. By definition, diabetes mellitus is a syndrome characterized by chronic hyperglycaemia and perturbation of saccharides, protein and fat metamorphosis associated with absolute or comparative lack in insulin secernment and action. Harmonizing to WHO, there are two chief types of diabetes mellitus ie insulin dependant diabetes mellitus ( type I ) and non insulin dependant diabetes mellitus ( type II ) . Type II diabetes mellitus is a syndrome holding heterogenous and is associated with hazard of figure of complication like neurological, cardiovascular, nephritic, optic and musculoskeletal jobs. Out of these neurological and cardiovascular systems are normally affected. Diabetess is systemic upset of energy metamorphosis in which hyperglycaemia is the cellular opposition to the consequence of insulin or both. Diabetes affects both the cardinal and peripheral nervous system. Diabetic neuropathies are a household of nervus upset caused by diabetes. Peoples with diabetes can develop nervus harm throughout the organic structure. About 60 to 70 per centum of people with diabetes have some signifier of neuropathy. Peoples with diabetes can develop nerve jobs at any clip, but hazard rises with age and longer continuance of diabetes for more than 5 old ages. They appear to be more common in people who have jobs commanding their blood glucose besides called blood sugar. Type II diabetes is the most common signifier of diabetes and normally appears in center aged grownups. Approximately 60-70 % of type II persons develop diabetic neuropathy. It is frequently associated with fleshiness and may be delayed or controlled with diet and exercising. Diabetic neuropathy appears to be more common in people over 45 – 55 old ages of age. Causes: – Prolonged exposure to high blood sugar ( glucose ) can damage delicate nervus fibres, doing diabetic neuropathy. High blood glucose interferes with the ability of the nervousnesss to convey signals. It besides weakens the walls of the little blood vass that supply the nervousnesss with O and foods. Metabolic factors, such as high blood glucose, long continuance of diabetes and perchance low degrees of insulin. Neurovascular factors, taking to damage to the blood vass that carry O and foods to nervousnesss. Autoimmune factors that cause redness in nervousnesss. Clinical characteristics: – Functional instability Deep hurting most normally in the pess and legs Numbness Muscle failing Loss of sense of warm or cold Based on this Clinical characteristic that is functional instability, capable were evaluated with berg balance graduated table, incorporating 14 balance undertakings. Balance preparation to be an effectual agencies of forestalling falls in patients with diabetic neuropathy.1.1 STATEMENT OF THE PROBLEMThis is a survey on the effectivity of balance exercising in bettering balance in patients with diabetic neuropathy.1.2 AIMS AND OBJECTIVES OF THE STUDYTo happen out the effectivity of balance exercising in diabetic neuropathy patients1.3 NEED AND SIGNIFICANCE OF THE STUDYDiabetic neuropathy or nervus harm is a reasonably common diabetes related complication, approximately 60 % of individuals with diabetes have some grade of neuropathy and it is portion of regular tests and showings in individuals with diabetes about all individuals with diabetes will finally hold some signifier of neuropathy. Complication from neuropathy can run from mild to severe symptoms can include buzzing, firing o r prickling paraesthesia in the pess and increased hazard of falling. In this survey Berg balance graduated table was used to mensurate balance by measuring the public presentation of functional undertakings. This survey measure the effectivity of balance exercising to better balance in patients with diabetic neuropathy.1.4 HYPOTHESISNULL HYPOTHESISThere is no important difference in giving balance exercising to diabetic neuropathy patient.ALTERNATIVE HYPOTHESISThere is important difference in giving balance exercising to diabetic neuropathic patient.1.5 OPERATIONAL DEFINITIONSDIABETIC NEUROPATHY:Diabetic neuropathies are a household of nervus upsets that are associated with diabetes mellitus. These conditions are thought to ensue from diabetic micro vascular hurt affecting little blood vass that supply nervousnesss. Neuropathy is a nervus upset that consequences in deformation of nervus map.TYPE II DIABETES:Diabetess mellitus type II once called non insulin dependant diabetes mellitus or grownup oncoming diabetes is a upset that is characterized by high blood glucose in the context of insulin opposition and comparative insulin lack. It is a chronic disease characterized by high degrees of sugar in the blood. It develops when your organic structure does non react right to insulin.Balances:The ability to aline organic structure sections against gravitation to keep or travel the organic structure ( centre of mass ) within the available base of support without falling.2.REVIEW OF LITERATUREa ) Reappraisal of literature related to diabetic neuropathyRENUKA DHARMADHIKARI ( 2007 )Mellitus is a common disease in people with about 50 % of type 2 diabetic patients being over 45 to 55 old ages of age. Insulin opposition is common in people, with big Numberss besides have impaired insulin secernment. Exercise with a peculiar accent on balance and stableness is an of import constituent of the direction and intervention of diabetic neuropathy patients.D. FEEDLE, G. CUCINOTTA, DA GREENE ( 2005 )A common complication of diabetics called neuropathy was determined in diabetic patients recruited from 109 out diabetic clinics. An i ncreased consciousness of the high prevalence of neuropathy can take to early curative intercession and possible bar of ulterior neuropathic complication such as infection and pes ulcer.ALI CIMBIZ, OZGE ( 2004 )Diabetic neuropathy disturbed particularly the balance on the dominant leg. Done with 60 voluntary grownups of both sexes from Kuhatya, Turkey were divided in to two groups. A type 2 diabetic neuropathic group ( DG ) and a non diabetic control group ( CG ) . The CG was selected to fit the diabetic features such as age, organic structure mass and sex. Standing on dominant, non dominant leg and functional range were used for the appraisal.STEFANO BALDUCCIAN, GIAN LUCA, LEOLCA PARISIC ( 2004 )Exercise preparation can modify the natural history of diabetic neuropathy. This survey suggests for the first clip that long clip exercising preparation can forestall the oncoming or modify the natural history of diabetic neuropathy.MARK J BROWN, JOHN R. MARTIN, ARTHUR K, ASBURY ( 1996 )Di abetic patients whose neuropathy was characterized by hurting and autonomic disfunction with loss of balance and saving of musculus stretch physiological reactions.YASUDA H DYCK P ( 1987 )Hypothesized that neuropathy consequences from diseased developments in the little vass in diabetes by the observation of thickener of the walls of endoneurial capillaries in the nervus of diabetic patients as a consequence of an accretion of periodic Acid Schiff.B ) Reappraisal of literature related to balance and diabetic neuropathyANN V. SCHWARTZ AND TERESA A. HILLIER ( 2001 )Peoples with diabetic had increased hazard of falling in their survey conducted in patients with diabetic neuropathy. Postural stableness is the of import factor to keep the balance which reduces the hazard of autumn. Diabetic neuropathy topics may lose their Centre of force per unit area information for commanding postural sway in stance stage of pace.HORAK FBB, DICKSTERIN R AND PETERCA R.J. ( 1998 )Concluded that diabetic patients with neuropathy show higher scope and root mean square value compared with those of control topics and diabetic patients with out neuropathy quiet standing balance was investigated in 24 diabetic patients with or with out neuropathy with eyes opened and eyes closed.DANIK LAFOND, HELENE CORIVEA AND FRANCIOS PRINCE ( 1998 )Motor schemes at the mortise joint articulation are altered in diabetic neuropathy patients in his work subjected for postural control mechanism during quiet standing in patients with diabetic neuropathy.BEVERLEIGH H PIEPERSA ( 1996 )Many as one in two people with type 2 diabetes finally develops a status of chronic nervus harm in their pess known as diabetic neuropathy. Diabetic are at greater hazards for falls when they have fewer centripetal inputs to counterbalance for the loss of experiencing in their pess. Closing your eyes, or walking a across a dark room will ensue in more falls. Even standing on one pes is harder for a diabetic to make with their eyes closed, but easier if eyes are unfastened.TABASSOM GHANAVATI, ALI ASGHAR ARASTOO: ( 1995 )Diabetic neuropathy patients seems to do postural instability which may impact quality of maps and activities of day-to-day life of these patients.ROTHWELL ( 1994 )Ocular vestibular and proprioceptive subsystem response to somewhat different perturbation in balance. The visuo spinal system controls both inactive and faster inputs with proprioceptive system which is besides Sensitive to faster stimulation.LORD ET.AL ( 1994 )A survey in Australia reported that hapless balance is a factor in the causal tract between diabetes and increase hazard of falling. Thus the persons with diabetes had increased organic structure sway.degree Celsius ) Review of literature related to consequence of exercising programme on balance upsetEMILY SPLICHAL: ( 1996 )Diabetic neuropathy causes loss of distal strength and esthesis. Research has shown that diabetics with neuropathy are 15 times more likely to descri be falling or faltering in a one twelvemonth period. Research has proven balance preparation to be an effectual agencies of forestalling falls in patient with diabetic neuropathy. All balance exercising can be done in a patient place with small or no equipment.RICHARDSON J.K, SANDMAN D, VELA S.A ( 1995 )Focused exercising regimen improves Clinical steps of balance in patients with diabetic neuropathy. Participants are 20 topics with diabetes mellitus and diagnostically confirmed patient. Ten subjects underwent a 3 hebdomad intercession exercising regimen designed to increase quickly available distal strength and balance. The other 10 topics performed a control exercising regimen. The intercession topics but non the control subjects, showed important betterment in all 3 clinical steps of balance that is impedal stance clip, Functional range and tandem stance clip.vitamin D ) Review of literature related to berg balance graduated tableTRINA SMITH ( 2005 )Berg Balance Scale used to qua ntify the balance of patients with diabetic neuropathy. Twenty one female and five males were selected. Participants completed each balance trial one time during 2 testing Sessionss for that inter rates dependability was good for the BBS. The balance trial showed moderate to good dependability for this population. The BBS appear to be valid steps of motor ability to keep balance.GATEV ( 1999 )Balance trials have been developed and presented to obtain appropriate information of balance measuring. The choice of mensurating clip and stance conditions is indispensableALEXANDER ( 1996 )Balance trial have been developed and presented to obtain appropriate information of balance capablenesss during standing. Functional balance graduated tables are easy to execute and suitable for daily clinical usage that give more elaborate information about balance.BEIG ETAL ( 1995 )Berg Balance Scale in patients with damage of balance. It is a staff completed assessment graduated table of ability to kee p balance either statistically or while executing assorted functional motions to assist do determinations about the patients equilibrate degree, comprises 14 discernible undertakings common to every twenty-four hours life.3. RESEARCH DESIGN AND METHODOLOGY3.1 REASEARCH DESIGNThis survey belongs to experimental design.3.2 Variables USED IN THE STUDY3.2.1 Independent variablesBalance exercising Medical intervention3.2.2 Dependent variableBalance3.3 Setting OF THE STUDY:Physiotherapy Rehabilitation Centre, Kannur3.4 CRITERIA FOR SELECTIONInclusion standardsDiabetess with a continuance of more than 5 old ages Type 2 diabetes with diagnosed neuropathy Persons between the age group of 45-55 old ages were selected. Both males and females wee included in this survey. Patients who reported atleast one autumn in the past 6 monthsExclusion standardsLower appendage amputation Patients with inability to walk without any assistive devices Patients with musculoskeletal damage Patients with neurological damage Diabetess with any other systemic engagement3.5 SAMPLE POPULATION30 Capable and 15 in each group3.6 METHOD OF SAMPLINGRandom Sampling Technique.3.7 METHODOLOGY30 Subjects are selected and divided in to two groups The process was explained to subject. GROUP A: Balance exercising with medical intervention GROUP B: Medical intervention3.8 Materials USEDRuler Two standard chairs ( one with a arm rests, one without ) Foot stool Stop ticker or carpus ticker Berg balance graduated table Outcome measuring by utilizing Berg Balance graduated table3.9 DURATION OF THE STUDY:Four hebdomads3.10 ProcedureThe topics were given balance exercising like inactive and dynamic exercising for five yearss for four hebdomads. Entire intervention clip was 60 proceedingss /session/ twenty-four hours with 5 minute remainder after every 15 proceedingss.Balance exercisingImprove balance by executing simple balance exercising. The individual leg stance is a really effectual exercising for bettering balance. This exercising can be modified balance stableness. The exercisings are categorized in to two different types inactive and dynamic of balance preparation.Inactive exercisingToe base Tandum base One – legged base Heel baseDynamic exercising in walkingToe walk Tandum forward walk Heel walk Tandum backward walk1. Toe base†¢ Stand about one and a half pess off from the counter. †¢ Raise up every bit high as possible on the balls of your pess. Your pess should be shoulder width apart. †¢ Try to remain every bit still as possible. Make non travel your pess around to keep balance. †¢ Hold the toe base for 10 seconds. Rest. Repeat 5 times.2. Tandem Stand†¢ Stand about one and a half pess off from the counter. †¢ Place one pes straight in forepart of the other pes so that the heel of one pes is merely touching the toes of the other pes. †¢ Try to remain every bit still as possible. Make non travel your pess around to keep balance. †¢ Hold the tandem base for 10 seconds. Rest. Repeat 5 times.3. One-legged BaseStand about one and a half pess off from the counter. Slowly lift one leg off of the floor, while keeping your balance with the other leg. Try to remain every bit still as possible. Make non travel your pes around to keep balance. Keep the one-legged base for 10 seconds. Rest. Repeat with other leg 5 times.4. Heel StandStand about one and a half pess off from the counter. Raise up every bit high as possible on the heels of your pess. Your pess should be shoulder width apart. Try to remain every bit still as possible. Make non travel your pess around to keep balance. Keep the heel base for 10 seconds. Rest. Repeat 5 times.Dynamic exercising1. Toe walki »? †¢ Go to one terminal of a hall and easy raise up every bit high as you can onto your toes. Walk down the hall on your toes. †¢ When you reach the other side, come down onto your pess and stand usually. †¢ Rest. Repeat 5 times.2. i »? Tandem Forward WalkTravel to one terminal of a hall and topographic point one pes in forepart of the other so that the heel of one pes touches the toes of the other pes. Walk down the hall in a tandem walk. It is of import that with each measure the heel of one pes touches the toes of the other. If you make a error, merely topographic point one pes in forepart of the other and go on down the hall. When you reach the other side stand usually. Rest. Repeat 5 times.3. Heel WalkTravel to one terminal of a hall and easy raise up every bit high as you can onto your heels. Walk down the hall on your heels. When you reach the other side come down onto your pess and stand usually. Rest. Repeat 5 times.4. i »? Tandem Backward WalkTravel to one terminal of a hall and topographic point one pes behind the other pes so that the heel of one pes touches the toes of the other pes. Walk down the hall in a backward tandem walk. It is of import that with each measure the toes on one pes touch the heel of the other. If you make a error, merely topographic point one pes behind the other and go on down the hall. When you reach the other side, stand usually. Rest. Repeat 5 times.i »?3.11 Measurement ToolBERG BALANCE SCALEThe Berg Balance Scale ( BBS ) was developed to mensurate balance among people with damage in balance map by measuring the public presentation of functional undertakings. It is a valid instrument used for rating of the effectivity of intercessions and for quantitative descriptions of map in clinical pattern and research. The BBS has been evaluated in several dependability surveies. 14 points scale designed to mensurate balance of the grownup in a clinical scene.4. DATA ANALYSIS AND INTERPREATIONThe information collected was subjected to partner off ‘t ‘ trial separately for group A and group B utilizing expressions.Formula 1vitamin D = ? d/n Where, vitamin D = difference between pre trial and station trial values vitamin D = is the average value of vitamin D n = is the figure of topicsFormula 2: ( d-d ) 2 ( n -1 ) Standard divergence SD =Formula 3:Standard Error ( S.E ) = SD N ‘t ‘ calculated value = vitamin D S.EFormula 4:‘t ‘ cal = vitamin D S.E Where, t cal is the ‘t ‘ calculated value dI†¦ = mean of divergence n = entire figure of topics s = criterion divergence d? = amount of squared divergence4. Independent ‘t ‘ trialWhere S == Mean of Control group = Mean of Experimental group n1 = Number of Subjects in Control group n2 = Number of Subjects in Experimental group S = Standard Deviation Datas were collected from 30 patients analysed utilizing paired ‘t ‘ trial and Independent ‘t ‘ trial to happen out within group difference. All information was analysed utilizing SPSS version 10.0.Table 1DESCRIPTIVE DATA OF EXPERIMENTAL GROUPS.NoAgeYearSexual activityBerg Balance ScalePre-testPost trial1 48 Meter 37 47 2 50 Meter 38 45 3 46 F 36 46 4 45 F 36 45 5 49 Meter 38 47 6 48 F 35 46 7 49 Meter 37 48 8 50 Meter 37 47 9 48 F 39 48 10 48 Meter 38 47 11 47 Meter 36 46 12 50 Meter 35 46 13 49 F 38 48 14 46 Meter 35 46 15 49 Meter 39 47TABLE-11DESCRIPTIVE DATA OF CONTROL GROUPS.NoAgeYearSexual activityBerg Balance ScalePre-testPost trial1 47 Meter 38 41 2 46 Meter 38 42 3 46 Meter 36 41 4 47 F 37 37 5 48 Meter 35 37 6 49 Meter 39 42 7 48 F 39 42 8 48 F 38 40 9 50 Meter 36 39 10 49 Meter 37 40 11 46 Meter 38 41 12 45 F 37 40 13 47 Meter 36 39 14 47 F 39 42 15 49 F 37 41TABLE – II1DEMOGRAPHIC PRESENTATION OF SEXContentControlEXPERIMENTALMale 9 10 Female 6 5 Entire 15 15GRAPH- ISexual activity WISE DISTRIBUTION IN CONTROL GROUP AND EXPERIMENTAL GROUPThe above saloon graph shows, in control group 9 males and 6 females were selected ; and in experimental group 10 males and 5 females were selected.Table FourPRE TEST MEAN AND STD. DEVIATION OF BBS CONTROL AND EXPERIMENTAL GROUPGroup N ( No. of Subjects ) Mean STD. Deviation Control 15 37.33 1.234 EXPERIMENTAL 15 36.93 1.387Table VoltPOST TEST MEAN AND STD. DEVIATION OF BBS IN CONTROL AND EXPERIMENTAL GROUPGroup N ( No. of Subjects ) Mean STD. Deviation Control 15 40.27 1.67 EXPERIMENTAL 15 46.66 1.051GRAPH-IIMEAN DIFFERENCE OF BBS IN CONTROL AND EXPERIMENTAL GROUPInterpretation OF DATA:Statistical ANALYSIS OF BERG BALANCE SCALE IN CONTROL GROUP USING PAIRED ‘t ‘ TrialTable — VIGROUP CONTROL Mean South dakota T DF Sig t value Bulletin board system PRE 37.3 1.234 10.33 14 2.1447 Post 40.27 1.67Interpretation-Berg Balance Scale in control group-Above tabular array shows the mean of the pre trial informations for the control group as 37.3+_1.234 ( SD ) and post trial value as 40.27 ±1..67 ( SD ) . The deliberate T value is 10.33. It indicates that there is important difference between pretest and station values of Berg Balance graduated table in control group.GRAPH-IIIMEAN DIFFERENCE AND STANDARD DEVIATION OF BBS IN CONTROL GROUPInterpretation of informationsStatistical analysis of Berg Balance Scale in experimental group utilizing paired ‘t ‘ trialTABLE – SevenGroupMeanS.D‘t ‘dfExperimental Pre trial 36.67 1.54 27.04 14 Post trial 46.13 1.45 Interpretation – Berg balance graduated table Above tabular array shows the mean of pre trial informations for the experimental group as 36.67 ± 1.54 ( SD ) and post trial value as 46.13 ±1.45 ( S.D ) the deliberate ‘t ‘ value is 27.04 which is greater than that of table value. It indicates that there is important difference between pre trial and station trial values of Berg balance graduated table in experimental group.i »?GRAPH- IVMEAN DIFFERENCE AND STANDARD DEVIATION OF BBS IN EXPERIMENTAL GROUPSTASTICAL ANALYSIS OF BERG BALANCE SCALE OF PRE TEST VALUE USING INDEPENDENT T TrialTable EightEXPERIMENTAL AND CONTROL GROUP PRE TEST VALUE Mean South dakota T DF Bulletin board system EXP 36.93 1.39 1.83 28 CTRL 37.33 1.23INTERPRETATION-BERG BALANCE SCALECONTROL AND EXPERIMENTAL GROUP PRETEST VALUEAbove TABLE shows the mean of pre trial informations for experimental group as 36.933  ±1.39 ( SD ) the deliberate T value is 1.8310 and command group mean 37.33 ±1.3810 and calculated T value is 1.8310 for both experimental and control group. It indicates that there is no important difference between experimental and control group.GRAPH-VMEAN DIFFERENCE AND STANDARD DEVIATION OF BBS IN EXPERIMENTAL AND CONTROL GROUP USING INDEPENDENT‘T ‘ TrialSTASTICAL ANALYSIS OF BERG BALANCE SCALEPOST TEST VALUE USING INDEPENDENT T TrialTABLE – NineEXPERIMENTAL AND CONTROL GROUP POST TEST VALUE Mean South dakota T df Bulletin board system EXP 46.6 1.0521 12.6626 28 CTRL 40.27 1.6701INTERPRETATION- BERG BALANCE SCALECONTROL AND EXPERIMENTAL GROUP POST TEST VALUEAbove tabular array shows the mean of station trial informations for experimental group as 46.6  ±1.058387 ( SD ) the deliberate T value is 12.6626 and command group mean 40.27 ±1.6701 and calculated T value is 12.6626 for both experimental and control group. It indicates that there is a important difference in experimental group value than control groupGRAPH-VIMEAN DIFFERENCE AND STANDARD DEVIATION OF BBS IN POST TEST VALUES OF EXPERIMENTAL AND CONTROL GROUP USING INDEPENDENT ‘T ‘ Trial5. ResultEffectiveness of Control Group ( Medical intervention ) While comparing the pre-test and station trial values of control group utilizing Paired ‘t ‘ trial, the deliberate T value is 10.33 whereas the tabular array value is 2.145, it states that there is important difference between the pre-test and post-test values of control group. When comparing the average values of both, the station trial mean value is 1.67 which are greater than the pre trial mean value 1.234. Hence it confirms that there is a important betterment group. Effectiveness of Experimental Group ( Balance exercising with medical intervention ) While comparing the pre-test and station trial values of experimental group utilizing Paired't ‘ trial, the deliberate value is 31.8590646 whereas the tabular array value is 2.145. Since the deliberate value is more than the critical value, it states that there is important difference between the pre-test and post-test values of experimental group. When comparing the average values of both, the post-test mean value 46.6 which is greater than the pre-test mean value 36.933. Hence it confirms that there is a important betterment in post-test experimental group than pre trial experimental group.6. DiscussionDiabetess Mellitus is a Chronic status which encroaches about all the systems in the organic structure. Diabetic neuropathy is a complication of long standing diabetes, which affects nervousnesss of the organic structure. Diabetic neuropathy can impact all the tissues and the variety meats of the organic structure. Approximately about 60-70 % of the people with diabetes suffer from neuropathy and the oncoming can be at any clip in life. The incidence of neuropathy in diabetic patients increases with the period of diabetes. This survey was an experimental attack, which studied the effectivity of balance exercising in diabetic neuropathy patients. The result was measured utilizing Berg Balance Scale. It has been shown to a valid and dependable tool for the measuring of balance by measuring the public presentation of functional undertakings. The control group was given medical intervention and the patient besides given balance exercising in experimental group. Harmonizing to Shahin Goharpey, diabetic neuropathy consequences in functional instability which cause these patients to danger of falling during activities of day-to-day life and becomes more terrible as the badness of neuropathy aggravates. Balance exercising improves clinical steps of balance in patients with diabetic neuropathy. Loss of force per unit area sensitiveness was independently associated with the hazard of falling more than one time a twelvemonth and histories for 3- 6 % of relationship between diabetes and falling. Based on above survey, the present survey concluded that balance preparation to be an effectual agencies of cut downing frequence of autumn in patients with diabetic neuropathy.MechanismThe mechanism by which balance preparation affect the balance of diabetic neuropathy is due to, 1. During exercise whole organic structure O ingestion additions in the musculuss. 2. Addition in the concentration of Na+ / K+ adenosine triphosphatase ( ATPase ) pumps. 3. Exercise works to cut down insulin opposition which lowers blood sugar degrees. So heavy insulin opposition will set less strain on the organic structure to do insulin. 4. Exercise is helpful in keeping strength, mobility, map and besides provides stableness7. DecisionThe survey concludes that balance exercising seemed to be good in bettering balance and thereby cut downing the frequence of autumn in patients with diabetic neuropathy.LIMITATIONS AND SUGGESTIONSRestrictionStudy was conducted for a short period of clip. The survey assessed merely short term advancement of the patients. Since survey clip was short merely limited sample since could be considered for the survey.SuggestionTo set up the efficaciousness of the intervention a big sample size survey is required. To do the consequence more valid a long term survey may be carried out. The same survey can be done by modifying the exercising by increasing the complexness. The same survey can be done by increasing the exercising by its repeats. The same survey can be carried out in males and females individually.

Battle of Chattanooga in American Civil War

The Battle of Chattanooga was fought November 23-25, 1864, during the American Civil War (1861-1865) and saw Union forces relieve the city and drive away the Confederate Army of Tennessee. Following its defeat at the Battle of Chickamauga (Sept. 18-20, 1863), the Union Army of the Cumberland, led by Major General William S. Rosecrans, retreated back to its base at Chattanooga. Reaching the safety of the town, they quickly erected defenses before General Braxton Braggs pursuing Army of Tennessee arrived. Moving towards Chattanooga, Bragg assessed his options for dealing with the beaten enemy. Unwilling to incur the heavy losses associated with assaulting a well-fortified enemy, he considered moving across the Tennessee River. This move would force Rosecrans to abandon the city or risk being cut off from his lines of retreat north. Though ideal, Bragg was forced to dismiss this option as his army was short on ammunition and lacked sufficient pontoons to mount a major river crossing. As a result of these issues, and upon learning that Rosecrans troops were short on rations, he instead elected to lay siege to the city and moved his men into commanding positions atop Lookout Mountain and Missionary Ridge.   Opening the Cracker Line Across the lines, a psychologically shattered Rosecrans struggled with the day-to-day issues of his command and showed no willingness to take decisive action. With the situation deteriorating, President Abraham Lincoln created the Military Division of the Mississippi and placed Major General Ulysses S. Grant in command of all Union armies in the West. Moving quickly, Grant relieved Rosecrans, replacing him with Major General George H. Thomas. While en route to Chattanooga, Grant received word that Rosecrans was preparing to abandon the city. Sending word ahead that it was to be held at call costs, he received a reply from Thomas stating, We will hold the town till we starve. Arriving, Grant endorsed a plan by the Army of the Cumberlands chief engineer, Major General William F. Baldy Smith, to open a supply line to Chattanooga. After launching a successful amphibious landing at Browns Landing on October 27, west of the city, Smith was able open a supply route known as the Cracker Line. This ran from Kelleys Ferry to Wauhatchie Station, then turned north up the Lookout Valley to Browns Ferry. Supplies could then be moved across Moccasin Point to Chattanooga. Wauhatchie On the night of October 28/29, Bragg ordered Lieutenant General James Longstreet to sever the Cracker Line. Attacking at Wauhatchie, the Confederate general engaged Brigadier General John W. Gearys division. In one of the few Civil War battles fought entirely at night, Longstreets men were repulsed. With a way into Chattanooga open, Grant began reinforcing the Union position by sending Major General Joseph Hooker with the XI and XII Corps and then an additional four divisions under Major General William T. Sherman. While Union forces were growing, Bragg reduced his army by sending Longstreets corps to Knoxville to attack a Union force under Major General Ambrose Burnside. Armies Commanders: Union Major General Ulysses S. GrantMajor General George H. Thomas56,359 effectives Confederacy General Braxton BraggLieutenant General William Hardee44,010 men The Battle Above the Clouds Having consolidated his position, Grant began offensive operations on November 23, by ordering Thomas to advance from the city and take a string of hills near the foot of Missionary Ridge. The next day, Hooker was ordered to take Lookout Mountain. Crossing the Tennessee River, Hookers men found that the Confederates had failed to defend a defile between the river and mountain. Attacking through this opening, Hookers men succeeded in pushing the Confederates off the mountain. As the fighting ended around 3:00 PM, a fog descended on the mountain, earning the battle the name The Battle Above the Clouds (Map). To the north of the city, Grant ordered Sherman to attack the north end of Missionary Ridge. Moving across the river, Sherman took what he believed was the north end of the ridge, but was actually Billy Goat Hill. His advance was stopped by Confederates under Major General Patrick Cleburne at Tunnel Hill. Believing a frontal assault on Missionary Ridge to be suicidal, Grant planned to envelop Braggs line with Hooker attacking the south and Sherman from the north. To defend his position, Bragg had ordered three lines of rifle pits dug on the face of Missionary Ridge, with artillery on the crest. Missionary Ridge Moving out the next day, both attacks met with little success as Shermans men were unable to break Cleburnes line and Hooker was delayed by burned bridges over Chattanooga Creek. As reports of slow progress arrived, Grant began to believe that Bragg was weakening his center to reinforce his flanks. To test this, he ordered Thomas to have his men advance and take the first line of Confederate rifle pits on Missionary Ridge. Attacking, the Army of the Cumberland, which for weeks had endured taunts about the defeat at Chickamauga, succeeded in driving the Confederates from their position. Halting as ordered, the Army of the Cumberland soon found itself taking heavy fire from the other two lines of rifle pits above. Without orders, the men began advancing up the hill to continue the battle. Though initially furious at what he perceived to be a disregard for his orders, Grant moved to have the attack supported. On the ridge, Thomas men advanced steadily, aided by the fact that Braggs engineers had mistakenly placed the artillery on the actual crest of the ridge, rather than the military crest. This error prevented the guns from being brought to bear on the attackers. In one of the wars most dramatic events, the Union soldiers surged up the hill, broke Braggs center, and put the Army of Tennessee to rout. Aftermath The victory at Chattanooga cost Grant 753 killed, 4,722 wounded, and 349 missing. Braggs casualties were listed as 361 killed, 2,160 wounded, and 4,146 captured and missing. The Battle of Chattanooga opened the door for the invasion of the Deep South and the capture of Atlanta in 1864. In addition, the battle decimated the Army of Tennessee and forced Confederate President Jefferson Davis to relieve Bragg and replace him General Joseph E. Johnston. Following the battle, Braggs men retreated south to Dalton, GA. Hooker was dispatched to pursue the broken army, but was defeated by Cleburne at the Battle of Ringgold Gap on November 27, 1863. The Battle of Chattanooga was the last time Grant fought in the West as he moved East to deal with Confederate General Robert E. Lee the following spring. The Battle of Chattanooga is sometimes known as the Third Battle of Chattanooga in reference to the engagements fought in the area June 1862 and August 1863.