Treatment and Interventions for Osteoarthritis

Treatment and Interventions for Osteoarthritis INTRODUCTION Osteoarthritis is very common among the old age people. It is also termed as wear and tear arthritis as it occurs when the protective cartilage, surrounding the bones, wears and tears down. In the present case study, an old woman, 87 years of age, is admitted into the hospital as she was found near her bed. Although she was lucid and conscious, she was incapable to walk on her own. This report studies intensively the case of Mrs. Mabel and outlines the problems faced by patients like her, who have had past history of osteoarthritis. The report also identifies the potential treatment options and the interventions necessary in such cases. ASSESSMENT The two basic nursing assessment tools for assessing the health condition of Mrs. Mabel are the Brief Pain Inventory (BPI) and the Geriatric Depression Scale (GDS). In the former, an intensive analysis of pain including its location, history and interference with activities (Seyed K. Malakouti et al. 2006). The pain is recorded on a scale of 10, with 0 representing no pain and 10 representing pain as bad as you can imagine. The latter tool was designed to assess the depression score in the older patients. Score 11 or greater than 11indicates severe depression. This tool has screening efficiency as it relies on affective rather than the physical symptoms (Tito Mendoza 2006). CLIENT’s HEALTH PROBLEMS Studying the case of Mrs. Mabel, it is evident that the three health problems related to her are the inflammation, severe joint pain and cold and cough. Inflammation occurs when the chemicals from the body are released to the site of infection or injury. Mrs. Mabel was found to have inflammation in her lower leg i.e. swelling and persistent pain, possibly due to leakage of fluid into the tissues. Since cold and cough is generally a symptom in every old patient, in case of Mrs. Mabel it is important to treat the joint inflammation first, followed by the pain and eventually the medications for addressing cough and cold. The pain in osteoarthritis is generally caused when the wear and tear of the cartilage, that surrounds the joint, is to a great extent, such that the ligaments and the tendons are completely stretched out, causing pain. The cartilage acts as a shock absorber and also reduces friction in the joints. Lastly, since we know that Mrs. Mabel had been a smoker in the past, the chances of suffering from cold and cough are pretty high. It is therefore necessary to address the inflammation first, so that the pain in that area is comparatively reduced and then give pharmacological or non pharmacological assistance in reducing the pain in other joints as well. To ensure safe and quality care of Mrs. Mabel, these problems should be addressed in accordance with their priorities. The age factor of Mrs. Mabel should also be taken into consideration as many treatment options, even most of the medications, will prove to be harmful for her age. She should be given the support to move along and also be encouraged to participate in daily activities. GOALS The major goals of osteoarthritis treatment include alleviation of pain and restoring the normal functioning of the person. Since Mrs.Mabel has a serious pain issue such that she complains about it frequently and it is hampering her normal being, it is important to address and treat her pain and reduce her discomfort. Another goal should be to restore her normal functioning. As we know that the right leg of Mrs. Mabel is comparatively shorter than the left leg, she faces problem in moving around and needs a constant support to assist her mobility. Therefore, it is important to address the inflammation in her lower leg and prevent its reoccurrence. To address these goals, the patient generally receives both pharmacological and non pharmacological treatment, the former comprising of drugs and NSAIDs, while the latter comprising of therapies and the physical exercises. Surgical interventions have also suggested that if the joints are severely damaged, then the only option available for treatment is the partial or complete replacement of the joint. INTERVENTIONS The first and the foremost goal is to relieve pain and that can be mediated by psychological intervention techniques like providing education through various programs, coping skills training (CST) and cognitive behavioral therapy (CBT). These techniques help in enhancing self efficacy, help in managing stress, reduce helplessness and catastrophizing. Most patients have easy access to the basic medical care but the psychological aspects are generally neglected. The most commonly used educational intervention is the community based Arthritis Self Management Program, which targets the self efficacy skills and helps in management of arthritis symptoms (Catherine Backman 2006). On the other hand, CBT and CST approaches include cognitive and behavioral exercises like guided imagery or relaxation, changing activity patterns, etc. These exercises help in active coping and alleviation of pain in the osteoarthritis’ patients. The second goal is t restore the normal functioning of the joints and this can be achieved by rehabilitation program that helps in motion of the knee and thereby reduces pain also. The patient is advised to do regular exercises including heel prop exercises, prone hang exercises and also the towel extension stretches. These exercises help in knee extension which is opposite and equal to the normal knee. If the patients do not receive any help from this exercise regime then a hyperextension device (Elite Seat, manufactured by the kneebourne Therapeutic) can be used along with other devices that are used for extension purposes (K. Donald Shelbourne 2007). The rehabilitation program also aims in educating the patients about their daily habits and they should change them in order to relieve tension on the knee and relax. Certain aerobic exercises like bike, stair stepping machine or elliptical machines are also the part of the program. The patients are also encouraged to maintain complet e motion so that the non pharmacological approach provides relief that is permanent as compared to the relief obtained via pharmacological drugs and other analgesics (K. Donald Shelbourn 2007). DISCHARGE There are various problems faced by the elderly patients post discharge after getting the treatment for osteoarthritis done. Like in case of Mrs. Mabel, even after getting the surgery for arthritis done, she still complains of persistent pain in her legs. Post discharge issues generally include comorbid physical health problems, depression, and limitation in the functional capacity and improper dietary regulation (T. James 2005). Among all the patients of osteoarthritis, majority of them report persistent pain, even after the surgery. Another issue is the tight check on the weight because osteoarthritis can be severely influenced by obesity and can prove fatal. Next problem or issue faced by the patients post discharge is the intake of medications on a regular basis. Post discharge medications like Acetaminophen and NSAIDs are generally given to the patients. The former is used to reduce pain if taken in prescribed dose and the latter helps in providing relief from swelling and the p ain due to it. Apart from the medications, the doctors generally advise regular physiotherapy exercises that will help in keeping the join in motion and gradually provide the necessary extension to the joints such that the normal functioning is restored. Therefore there are many issues governing the discharge from the hospital. In order to address these issues it important to discuss the problems with the health care specialist first. Older people find it very difficult to cope with the pain and the reduced mobility. They have to keep themselves dependent on various analgesics and the anti inflammatory medicines that help in relieving pain and providing the necessary comfort. In case of Mrs. Mabel she was detected with an inflammation on her lower leg. Likewise, post discharge, there is high risk of inflammation, blood clots and swelling. Even after being treated, the patient may encounter situations of helplessness and depression, which may arise as a result of incapability to part icipate in the routine or daily activities and thereby developing high levels of anxiety. In order to avoid or prevent these issues, the family must take the responsibility of their older loved ones, once they are discharged. Their support, care and continuous monitoring will enable the patients to cope with the prevailing situation and help in quick recovery. CONCLUSION This report gives a detailed description about the symptoms, causes and the crises faced by Mrs. Mabel. It outlines the major interventions and strategies that will her cope with her situation. Techniques like education through various programs, coping skills training (CST) and cognitive behavioral therapy (CBT), work on the psychological aspect of the patient. Along with these the rehabilitation regime also aids in helping the patient by reducing pain and swelling. The major goals of the patient care have also been outlined in this report like the goals of alleviating the pain and restoring the normal functioning of the joints. To summarize, this report is important as it throws light on the condition of the patient and the necessary plan of action that is adopted for the care. It also draws attention towards the post discharge problems, that the patient will face and lists out the strategies that can help and address those issues.

Christian Gospel Essay

This is an inspiring story of how a man of God grew into a man of great influence. Examining his life and ministry from the wise and humble perspective that has made him one of the world’s most beloved and respected leaders, in this memoir, Graham looks back at age 78 on his lifetime of personal relationships, ministry, leadership, and experiences. He chronicles such events and stories as his boyhood in North Carolina, his first steps in ministry, details of evangelistic trips and revivals, and meetings with world and local leaders. Billy Graham’s gift has been to appreciate that in matters of faith there is no approach too simple, no argument too crude, no question too basic. The most striking thing to notice about Graham’s career concerns the most important matter, his view of God. Here the question is whether Graham’s strategies of access and ecumenicity undermine his message. The charge that perhaps they do arises from two ways in which Graham has seemed to reduce the Christian Gospel to a utilitarian device existing for other, more ultimate purposes. In the first instance, it is possible to glimpse pressure on his message from the moral calculus, singularly American, of republican citizenship. This calculus suggests that in a republic the good health of the polity depends upon the morality of the citizenry; that the best thing for personal morality is religion; and that, since Christianity is the best religion, it is positioned to do the most for America. Especially in the first part of his career, Graham was prone to statements that seemed to make the destiny of the United States loom larger than the fate of the Christian Gospel. â€Å"I seriously doubt if the old America is going to exist another generation unless we have a turning to Christ. † Some who share Graham’s beliefs would agree with him, but also wonder if he was making the penultimate into the ultimate. In the second instance, Graham throughout his career has spoken of Christianity, again in his words, as â€Å"alone† pointing â€Å"the way to individual peace, social harmony, life adjustment, and spiritual satisfaction. † For a Christian, true enough again. But priorities seem disarranged when sermons conclude as, for example, one did in New York in 1957: â€Å"All your life you’ve been searching for peace and joy, happiness, forgiveness. I want to tell you, before you leave Madison Square Garden this night of May 15, you can find everything that you have been searching for, in Christ. He can bring that inward, deepest peace to your soul. He can forgive every sin you’ve ever committed. † The charge that may be laid against the utilitarian drift of Graham’s Christian message is the charge that so troubled Martin Luther as he struggled to find a merciful God nearly five centuries ago. The heart of Luther’s spiritual dilemma was the fear that his supposed search for God was really a search for his own ease of soul, the fear that he was seeking God primarily for what God could do for him. Luther may have been overly scrupulous, but he could tell idolatry when he saw it, and tell it most clearly when he saw it up close. Billy Graham claims for himself neither Luther’s theological acumen nor his penetrating powers of self-analysis. Yet what rescued Luther from himself was also what has preserved the authenticity of Billy Graham’s message. The reason that Graham’s message, though admittedly soft at the edges, remains solid as a rock is that at its center is the Cross. In the early 1950s Graham solidified early practice by dedicating himself to the saving work of Christ as the heart of his message: â€Å"I made a commitment never to preach again without being sure that the Gospel was as complete and clear as possible, centering on Christ’s sacrificial death for our sins on the Cross and His resurrection from the dead for our salvation. â€Å" At the close of his memoirs, as at the close of so many sermons, Graham restates the appeal for conversion that is the trademark of his career. As he makes that appeal in this book there is his customary attention to what the Gospel does for us. But under girding all, from first to last, is an equally full sense of what the Gospel does to us: We are not here by chance. God has put us here for a purpose, and our lives are never fulfilled and complete until His purpose becomes the foundation and center of our lives. . . . When you [open your heart to Jesus Christ], you become a child of God, adopted into His family forever. He also comes to live within you and will begin to change you from within. No one who truly gives his or her life to Christ will ever be the same, for the promise of His Word is true: â€Å"Therefore, if anyone is in Christ, he is a new creation; the old has gone, the new has come! All this is from God, who reconciled us to himself through Christ and gave us the ministry of reconciliation† (2 Corinthians 5:17-18). We have seen this happen countless times all over the world, and it can happen in your life as well. Open your life to Christ today. If in the hands of Billy Graham, the Gospel bends, nonetheless, it does not break. To conclude that Graham has remained faithful to the message that God saves sinners for His own purposes, as well as for theirs, is the highest accolade a fellow-believer can bestow on this remarkable man. But Graham, of course, has become more than just a rallying point for Christian believers. Graham’s apparently bottomless kindness, combined with the lightning pace of his narrative—so many visits, so many good friends, so many celebrities—means that Just As I Am is not a particularly challenging book. It is, nonetheless, worth reading carefully, both because Graham is the genuine article and because many of its details and much of its tone are in fact quite useful for attempting a more complex assessment of his career.

Global disaster management Essay

Disaster management became global; financial resources together with the establishment of several associate and group organizations sprang up. Mass media took up the root with each major and minor disaster reported universally. Disaster tradition were formed and disseminated by the mass media. Until this global agenda was affirmed, environmental issues were still in their infancy and the number of research or consulting organizations focused on disasters was exceptionally small. The concern of disaster research units (mainly university-affiliated) and disaster management units in public administrations only became noticeable in the second half of the century in the late fifties. By the start of new millennium, the number of disaster-related organizations had grown exponentially. The U. S. government alone has no fewer than twenty-six major agencies as well as dozens of regional offices dealing with disasters. There are a further ninety-five specialized units established for contradictory disaster situations. To this can be added eighty U. S. domestic non-govermental organizations (NGOs). This number can be used as a rough suggestion of the same process occurring all through the Western world. The sharing of disaster-related global-based agencies likewise grew, comprising over ninety major public agencies with offices all through the world. This guide of the globalization of disaster management also supported the hold of public administration on the area of disasters. It has also led to interagency divergences and problems of management, as well as protective imperatives, turf wars, and competition (International Decade for Natural Disaster Reduction, 1996). What was evident at the national or state level-at which public administrations subjugated the definition of disaster, who was capable to be a disaster victim, what help would be afforded, and so on-was now extensive at the global level by other forms of public administration in diverse guises. As some critical reports have noted, the results have been at the similar mediocre levels of disaster management (on a larger scale), where in several cases such â€Å"assistance† was more unfavourable than supportive. The most observable of these have been linked with the droughts in Africa, where NGOs and international aid have in fact harmed more people than they have helped.

Weakness and Greatness in Literature The Enormous Radio...

â€Å"Weakness and Greatness† Tragedy has a negative meaning. When we hear â€Å"tragedy,† we always link it to car accidents, people dying from crashes, or unfortunate aspect of disasters. A tragedy maybe reflects on both a person’s weakness and greatness, but it tends to emphasize on their problems within one’s self and with other people. It can also review the character’s personal qualities and moral standards through different circumstances. According to the Greek Tragedy, a tragedy never creates only downfall but brought by one’s own hand. In a tragedy, there is always a lesson to be learned despite the disastrous event has an unpleasant but meaningful ending. In a tragic literature, the protagonist tends to create their own tragic flaws resulting in different consequences. In â€Å"The Enormous Radio†, John Cheever uses moral and personality degeneration to foreshadow Irene’s changes. On the other hand, in â€Å"A Rose fo r Emily†, William Faulkner uses the changing of values and social experience to explain Emily’s tragic circumstances. Irene and Emily are lived in different social class. Irene Westcott and her husband, Jim Westcott are a middle class family who earn average income. They live â€Å"on the twelfth floor of an apartment house near Sutton Place† and â€Å"hope someday to live in Westchester†; they have pride. In contrast, Emily Geierson has a â€Å"big, squarish frame house that had once been white, decorated with cupolas and spires and scrolled balconies.† Emily is a wealth woman

Annual Report Project-WAL MART Example

Essays on Annual Report Project-WAL MART Essay Annual Report Project- Wal-Mart Wal-Mart is operated by a Board of Directors, which consists of fifteen members, divided into five separate committees. Committees include audit, strategic planning and finance, compensation, nominating and governance, executive and global compensation. Wal-Mart’s executive committee consists of Michael Duke, who is the Chief Executive Officer and Robson Walton acts as Chairman of the Board of Directors. Christopher Williams is also Chairman of the Board of Directors and is the Chief Executive Officer of an investment bank, The Williams Capital Group L.P. Wal-Mart currently has twelve executive officers, with each presiding over a different department. Though Wal-Mart is owned by the same subsidy as Sam’s Club, Brian Cornell is the President and Chief Executive Officer. He is the only executive entirely responsible for the management of Sam’s Club. Wal-Mart’s core values represent the company’s community commitment, Wal-Mart strives to create economic opportunity, achieve environmental sustainability, promote healthy living and community involvement and develop responsible sourcing (Wal-Mart). Wal-Mart created their sustainability program in 2005 and hopes to achieve three goals; 100% supplied by renewable energy sources, create zero waste and carry products which promote sustainability of the environment and people. Wal-Mart contributes too many charities around the world and works to end world hunger needs while also providing healthier choices for consumers. Due to continuous expansion Wal-Mart’s net sales increased in 2011, 3.4%, from 2010. Net sales combined from Wal-Mart International, Wal-Mart US, and Sam’s Club reached 418 million, with 63% of sales through Wal-Mart US and the largest increase was through Wal-Mart International, partly due to currency exchange rates which increased net sales profits by 4.5 billion, while comparable stores and fuel sources overall decreased by 0.6% and 0.8% (Wal-Mart 2011 Annual Report, 2012). Operating expenses increased by 1.7% in 2011 and operating expenses remained low due to improved productivity and organizational changes that were made during 2010. 2010 operating expenses outpaced net sales due to increased health benefit charges, restructuring and increased advertising prices. Free cash flow is the amount of funds available after the payments that are required for property and equipment and cash flow generated in 2011 equaled 10.9 billion, a decrease from 2010’s cash flow which equaled 14 billion, this difference is attributed to an increase in inventory investments and was also countered by an increase in accounts payable. Free cash flow is used to fund global expansion programs and to fund operations, remaining cash flow funds dividends on stock and share repurchases. Dividends are paid to shareholders through various compensation plans (Wal-Mart 2011 Annual Report, 2012, p 38) and the combined costs of these plans totaled 371 million, 335 million and 302 million for fiscal years 2009-2011. These expenses include restricted stock and performance share awards, restricted rights and stock options. A shareholder stock incentive plan was created in 2010 and grants stock options and other awards to associates and non-directors and 210 million shares have been registered, the company believes this to be a fair compensation plan for shareholders. As a company Wal-Mart is obviously a strong investment though growth returns and gains may be slow, they will be reliable as Wal-Mart continues to gain strength in markets internationally. Wal-Mart International shows the most potential for increased growth as many of these markets are new sources of funds that the company will be able to capitalize on. References Walmart 2011 Annual Report: Helping people live better. (2012). Walmart Stores à ¢Ã‚€Â“ We save People Money so They Can Live Better. Retrieved February 20, 2012, from http://walmartstores.com/sites/annualreport/2011/responsibility.aspx Wal-Mart 2011 Annual Report. (2012). Wal-Mart Stores. Retrieved February 20, 2012, from http://walmartstores.com/sites/annualreport/2011/financials/Walmart_2011_Annual_Report.pdf

Abortion Report Essay examples - 808 Words

Abortion Report nbsp;nbsp;nbsp;nbsp;nbsp;I have chosen for my topic Abortion. I think that it is a topic that is very important in todays society however it is often dodged or avoided. Different Presidents say different things and have different stances about it, and often it is had to know what to think about it. Basically there are two different ways of looking at it: Pro-Choice, which takes the stance of saying that it is the womans choice if she wants to have an abortion and that it is only her business. So basically they want it to remain legal. Then there is the other stance of Pro-Life which says that it should not remain legal and that it is just about as bad as cold-blooded murder. I happen to agree with this. This is†¦show more content†¦Several cases have been fought for the right to choose. Many of these have been hard cases but they stuck with it, and many people believe that that is why we have some of the rights we do today. Here are some important cases: 1. 1965 - Griswold vs. Connecticut. Upheld the right to privacy and ended the ban on birth control. Eight years later, the Supreme Court ruled the right to privacy included abortions. 2. 1973 - Roe vs. Wade. The state of Texas had outlawed abortions. The Supreme Court declared the law unconstitutional, bur refused to order an injunction against the state. On January 22, 1973, the Supreme Court voted the right to privacy included abortions. 3. 1976 - Planned Parenthood vs. Danforth. Ruled that requiring consent by the husband and the consent from a parent if a person was under 18 was unconstitutional. This case supported a womans control over her own body and reproductive system. nbsp;nbsp;nbsp;nbsp;nbsp;To conclude about Pro-Choice I will state what Dana Pentoney has said: Abortion deals with ones private life and should have nothing to do with the government. However, abortion should not be used as a means of birth control, but if a fetus will be unwanted, it is better to be aborted than to be abused or neglected. nbsp;nbsp;nbsp;nbsp;nbsp;Now onto Pro-Life. This is whatShow MoreRelatedA Report On Behalf Of Abortion1710 Words   |  7 Pages A report on behalf of Abortion Rights has been filed against the country of Northern Ireland regarding their current laws on abortion. Abortion Rights is a Non-Governmental Organization (NGO) as well as a national pro-choice campaign to defend the rights of women and their access to safe, legal abortions. Abortion laws in Northern Ireland have long been considered draconian and thus creating dangerous situations for women. Currently in Northern Ireland, it is illegal to receive an abortion unlessRead MoreAbortion Report823 Words   |  4 PagesAbortion Report I have chosen for my topic Abortion. I think that it is a topic that is very important in todays society however it is often dodged or avoided. Different Presidents say different things and have different stances about it, and often it is had to know what to think about it. Basically there are two different ways of looking at it: Pro-Choice, which takes the stance of saying that it is the womans choice if she wants to have an abortion and that it is only her business. SoRead MoreA Report on Anti-Abortion1466 Words   |  6 PagesAnti-Abortion Abortion, by definition, is the early termination of a pregnancy through medical intervention. Opponents of abortion and supporters both have strong reasons for their perspectives and neither side is usually willing to accept the arguments of their opposition. Just as the Pro-Choice activists will site a variety of evidence types to support their position on the debate, so too Pro-Life activists wholeheartedly believe that their perspective on the subject is correct. In the UnitedRead MoreEssay on The Right to Life: Pro-Life 863 Words   |  4 Pagesall over the globe against abortion and none more prevalent that of churches all over the world. For Pro-Life activists, there is no middle ground; human life begins at the moment of conception. Terminating that life is MURDER. Abortion: Induced termination of a pregnancy with destruction of the embryo or fetus. Any of various procedures that result in the termination of a pregnancy. Also called induced abortion. (The American Heritage Medical Dictionary). Abortion: the termination of a pregnancyRead MoreAbortion And The Social Aspects Of Abortion1495 Words   |  6 Pageswomen in Australia will an abortion procedure in their life . Abortion data is only gathered by South Australia, Western Australia and the Northern Territory. However, South Australia is the only state to publish data and report findings annually. Abortion is a heavy topic which has the nation spilt into two groups; pro-life or pro-choice. Pro-life is in favour of the foetus and they believe that by killing the foetus it is equivalent to murder. Pro-choice is for abortion, as they believe that theRead MoreAbortion And The Social Aspects Of Abortion1683 Words   |  7 Pagesin Australia will have an abortion procedure in their life . Abortion data is only gathered by South Australia, Western Australia and the Northern Territory. However, South Australia is the only state to publish data and report findings annually. Abortion is a heavy topic which has the nation s pilt into two groups; pro-life or pro-choice. Pro-life is in favour of the foetus and they believe that by killing the foetus it is equivalent to murder. Pro-choice is for abortion, as they believe that theRead MoreThe Issue Of The Abortion1597 Words   |  7 Pagesissue There are about 31 abortions per 100 live births in Canada: 330,000 live births and 100,000 abortions each year. Top reasons for getting an abortion are: relationship issues, financial issues, ‘not being ready’, emotional issues, birth control failure, and genetic reasons. The abortion rate has increased each year. History of the issue Canada is currently one of few nations where no legal restrictions on aboritons exist today. It has been 143 years since abortion was first criminalized. TheRead MorePro-Life: Abortion is Unethical and Immoral Essay example1606 Words   |  7 PagesAmong the Nations leading controversy’s, the bilateral issue of abortion seems to be a popular yet, contentious debate. For several decades, abortion has been a never ending conflict that has caused a division among society. This bitter political brawling has created a pointless stalemate that has left the abortion issue unresolved. What is right and what is wrong? Should a woman be allowed to have an abortion and deprive a child from life or should she be forced to forfeit her right to make herRead MoreAbortion : Causes And Effects1738 Words   |  7 Pagesafter having an abortion. People are led to believe abortion is safe, and that it will only fix your problems rather than create more or different problems. Research may sugges t otherwise, and proposes that abortion can cause severe depression, breast cancer, and even death (Brind, 1996; Notman, 1976; Reardon, 2000). Abortion related depression can be caused for many different reasons. The three most common reasons for depression are guilt, shame, and anger. Breast cancer from abortion is believe toRead MoreAbortion And Its Effects On Health1558 Words   |  7 Pages Elective abortion is common in the United States; according to one estimate approximately 21% of pregnancies, excluding miscarriages, are aborted (Jones Jerman, 2014, p. 5). Opponents of abortion correlate it with various negative mental health outcomes for the women who choose to terminate a pregnancy. The risks claimed to be associated include depression, anxiety, substance abuse, and suicide. Some analyses have shown a meaningful increase in risk, and even assert that this risk can be directly

Effective Strategies for Cooperative Learning

Question: Discuss about the Effective Strategies for Cooperative Learning. Answer: Introduction: Organisational behaviour is the study about human activities and conduct in the context of business organisation. This essay discusses about an incident, happened in my workplace, few years back, when I was working as one of the team members for a project management team. Such incident hampered team dynamics, motivation and communication. Actions were taken to resolve the issues and restore the situation. There were serious conflicts in my team having twenty members assigned with different duties and responsibilities. People in the group were not cooperative and formed two separate groups within the team. This segmentation was hampering work flow, efficiency and above all, group dynamics. These two groups had opposing perceptions about each other and hence, us and them situation was very much explicit within the aforesaid team. I used to feel helpless at times especially when I observed that these groups were not thinking in line with organisational objectives and more concerned about their own personal benefits out of the organisation. Some of the outcomes I witnessed are absenteeism, lack of communication and consequently low productivity. I noticed that the primary reason of this problem was probably one team member who used to behave unprofessionally at times. He always used to make gossip and spread rumour among the team members. He had been very casual and irregular to come to office. Once, he was caught intoxicated during office hours. His last years performance appraisal was not satisfactory to him. He was warned for this unprofessional behaviour at work place. He used to make abusive language. My team leader was also not at all satisfied with his behaviour and performances. Long absenteeism and unprofessional behaviour were hampering his performances. Situation worsened when he suddenly went for long unplanned leave. It hampered the work flow as we needed to deliver a report to our client by the end of next week and we were running short of time. Everyone was working day and night to meet the deadline. In such a situation, long unplanned leave made our senior management concerned. When being contacted, the person communicated that due to some personal problems, he would not be able to come for two weeks. He confirmed that he was not i ll but facing some personal difficulty to come to office. I was informed by my other team members that this was not the first time the person took such unplanned leaves. Ultimately, one person was recruited on contractual basis. We put our utmost effort to wrap up the project and finish the assignment within the stipulated deadline. We were finally able to complete the task one day before the day on which the job was supposed to be delivered to the client. My team leader and management were happy. Management, thereafter, finally took the decision to sack the person. He was communicated via email. He, in his farewell speech, admitted that his contribution to the organisation should have been much more and he himself was not able to add any value to the business. He also confessed that it was his fault to attempt to divide the team, based on vested interest and he assured that he had learned from his mistake. My team leader wished him best of luck and we finally bade him adieu. After such incident, the team finally regained its old spirit of group dynamics. Members were motivated. Communications became fair and unambiguous and productivity increased. Motivational theories As a team member, I was observing how my team leader was trying to resolve the issues by analysing the current situation and examining the performance of team members. In the context of above mentioned scenario, importance of motivation; group dynamics and communication are discussed. Firstly, two motivational theories are enumerated. Once is Maslows need hierarchy theory and second one is Herzbergs two factor theory. In Maslows hierarchy of needs theory, there is five different level of motivation an employee feels about at a workplace. These are physiological needs, safety needs, social needs, esteem needs and self actualization needs. The physiological needs refer to the very basic need in which the most basic needs of human beings are considered such as need for biological and maintaining, shelter, food, water and physical wellbeing needs consists in physiological needs (Spinks and Wells, 1995). The other part wherein the team member can be motivated in an organization in the given case is safety needs wherein the need for security, stability in the routine life and protection is essential. When one need is satisfied, the other need arouses and team members would again try to achieve the next level of need such as social needs (Barkley et al. 2005). This includes the affection, belongingness and love in relationships which is an important element to be observed and satisfied. Team members havi ng some issues can be motivated to achieve the esteem needs where respect, recognition, self esteem, prestige and personal sense are the main needs for getting involved in the work. Self actualization needs are the last stage and team members can work better to achieve this need while this is the highest level of self fulfilment that helps to grow the abilities in the most creative manner (Punnett, 2004). This is the way how the motivation theory helps to mainly respond to the given situation and impacts the work while resolving the issues. Figure -1: Maslows Need Hierarchy Theory (Source: www.bbc.com, 2016) In the instant case, the person who was creating so much of trouble within the team probably belonged to second and third stages. He very much knew his drawbacks such as his drinking habit. He was scared of losing his jobs. He was having insecurity issues. On scrutiny of the situation, it was identified that his personal life was also disturbed. He grew up by his single mother. He is a divorcee having no child. He had always been occupied thinking his personal problems and that hampered his performance. As per Herzbergs two factor theory, there are two factors such as motivators and hygiene factors which motivates people in an organisation. The motivator factors are achievement, growth, responsibility, recognition, advancement and work. These factors help team members to perform well at the workplace without disputing and making conflicts. When these are satisfied by the company, team members would work well and focus on the desired goals by agreeing to what is correct. On the other hand, hygiene factors are those dissatisfying factors which make employees feel unhappy with the working conditions and these include company policy, relationship with supervisor, work conditions, salary and security and health factors. Figure -2: Herzbergs Two Factor Theory (Source: www.bbc.com, 2016) In the given case, the aforesaid team member was not getting recognition as he was not doing something which needed such. He adversely affected team dynamics and hence his scope of career advancement was lower. Secondly, he divided the entire team and his relationship with his team leader was also not satisfactory. Group dynamics Group dynamics is the force that helps to operate the groups and affects in a manner so that group performance is increased while it assists in increasing group members satisfaction (Spinks and Wells, 1995). As per Tuckmans team development model, stages of group development include the forming, storming, norming, performing and adjourning. Forming is initial stage with uncertainty, conflict and confusion. Brain storming stage assimilates disparities and disagreements of team members. Chaos is finally settled down in norming stage. Team starts performing once all the conflicts are reduced to an acceptable range and members get devoted and motivated for accomplishment of the task given. However, group comes to an end in the adjourning stage. It is needless to mention that not all groups undergo adjourning as some groups are relatively permanent. Groups may be of various types such as task groups, command groups and functional groups. Task groups are formed to complete the given task for the accomplishment of which the groups are formed. Command groups are, on the other hand, are relatively stable and do not come to an end. These groups supervise the subordinates. Functional group is simil ar to task group with the exception that this group if formed for an unspecified period of time to provide specific functional services. Various HR models, till date, have identified that the emergent behaviours and the required behaviours are two primary factors to be considered to analyse team dynamics (Soucy and Larose, 2000). The required behaviours include contribution for continuous affiliation and the team support that is requested from the group members. Emergent behaviours include the formal and informal behaviour of the team members. Theories on group dynamics suggest that group norms, roles and emotions should be analysed in a group context to identify the issues, if any and also to set the standard behaviour expected from a member to display at the workplace. Roles are one of the important factors in behaviours (Peled, 2000). Conflicts created due to different perceptions make the emotions and spirits of a group turbulent and unstable. It has been identified that cohesive group performs better. The figure below shows the mutual relationship between group cohesiveness and group productivity. It is needless to mention that higher the unity and cohesiveness; higher the efficiency and productivity. Cohesiveness Performance High Productivity Moderate Productivity Low Productivity Moderate to Low Productivity Figure -3: Relationship between group cohesiveness and group productivity (Source: Created by author) In the instant case, the sacked team member posed serious concern for the team dynamics. He diluted the very basic purpose of team development which is unity and efficiency. His behaviours affected the teams productivity and hence business got suffered. He vitiated the justification of group formation. He impacted the group dynamics adversely. He did not provide direct coaching to anyone, rather always tried to mend the way of doing things in his favour. He obstructed intra group dynamics and consequently communication process and motivation of the team members. Communication Communication refers to the process of exchange of information which helps the team members to understand the goals of an organization. It works well when there are unsaid disputes and said conflicts in the group. Communication assists in achieving future goals of the organisation within stipulated time (Leider, 1955). Interpersonal communication can be improved by focussing on various sub elements of communication process such as source of information, encoding the message, transmission of the message, channels, receiving the message, decoding the message, feedback and noise. There are two or more parties in a communication process, namely, sender and receiver (Beebe and Masterson, 2003). In the case where the team members do not agree on a particular decision, it is essential to communicate with them in a formal manner and explain them the importance of group dynamics while encoding the objectives of the project implementation and the strategies used with the help of this method. E fficient communication minimises the cost and enhances the group productivity (Keyser, 2000). In this context, communication channel may be discussed to understand the channel richness and how the information flows between parties. Communication channels are both formal and informal. It is important for an organisation to set up proper communication channel within the organisation and off course within various teams or groups within such organisation. Channel richness refers to the volume of information that is transmitted or passed through those channels. More the information passed; richer the channel. Important mails and video conferencing are effective communication channels. However, live speech contains high level channel richness. It is imperative for the success of business that organisation adheres the basic rules of communication and follow such protocol throughout. Grapevine is considered to be a negative element in communication channel and hence, should be avoided. Face to face communication is better when it comes to live speeches, video conference and group discussions. It can be switched from routine to non routine while achieving the basic purpose of a particular type of conversation (Cicmil, 1999). At times, people feel barriers in communication such as physical distractions, technical issues and sometimes cultural differences. Semantic noise can be a barrier which is called noise for instance. Lack of feedback while receiving the message from a source can be a distraction and consequently a barrier in communication. Close mindedness as such with the preconceived ideas can be a major distraction (Felder and Brent, 2001). This arises in a conflict situation and was observed in this situation where team members had different perceptions. In the instant case, communication within the team got seriously affected by the behaviour and activities of the sacked person. He circulated noises among the team members. Two way communications with him had never been fruitful. His close mindedness and preconceived ideas dampened the team morale. Recommendations Rationale 1. On motivation front: People in the group could be communicated about the proposed performance appraisal system, starting from next month, whereby, great work would be appreciated and hard work would be recognised. People in the organisation might feel that their hard work are not recognised and so they feel de-motivated. If their effort is acknowledged with gift or thank you note as a token of appreciation, it would be a good motivator for them (Al-Mashaan, 2001). 2. On group dynamics front: Functioning of the group might be effectively enhanced by introducing proper team hierarchy and appointing a team supervisor and a team manager. Team supervisor will act under existing team leader and team manager will be the ultimate authority of decision maker of the group. Existing structure of one team leader might be dicey for the effectiveness of the group as personal bias and sense of autocracy might creep in such scenario. Moreover, control mechanism and supervision make the leadership stable and help the group to perform better and efficiently. 3. On communication front: Communication could be made better by implementing and adhering to proper communication protocol. Training on soft skills and communications could be held on regular basis to reduce the chance of improper communication due to lack of knowledge of the team members. Existing communication process might be risky for the effective and efficient functioning of the group. Gossip and rumour are very frequent in the instant team, In such case, establishment of proper communication channel through frequent team meeting, review and feedback mechanism and one to one session would contribute significantly to success of the team. References Al-Mashaan, O.S. 2001 Job stress and Job Satisfaction and their Relation to Neuroticism, type a behavior, and locus of control among Kuwaiti Personnel, Psychological Reports, Vol. 88, No.3, p. 1145. Barkley, E. F., Cross, K. P., and Major, C. H. 2005. Collaborative learning techniques: A handbook for college faculty. San Francisco; Jossey-Bass Publishers Beebe, S. A., and Masterson, J. T. 2003. Communicating in small groups. Pearson Education Inc. Boston: Massachusetts Business studies 2016Business studies motivation theories. Available at: https://businessstudiesmotivation.weebly.com (Accessed: 21 December 2016) Cicmil, S. 1999 An insight into management of organizational changes projects, Journal of Workplace Learning, Vol. 11, No.1, pp. 515. Felder, R.M. and Brent, R. 2001. Effective strategies for cooperative learning. Journal of Cooperation and Collaboration in College Teaching, vol. 10, no. 2, 6975. Keyser, M.W. (2000) Active learning and cooperative learning: Understanding the difference and using both styles effectively, Research Strategies, Vol. 17, No.1, pp. 3544. Khana, M. A., and Afzalb, H. 2011. High level of education builds up strong relationship between organizational culture and organization performance in Pakistan. The International Journal of Human Resource Management, vol. 22, no. 7, 1387-1400. Kowske, B. J., and Anthony, K. 2007. Towards defining leadership competence around the world: What mid-level managers need to know in twelve countries. Human Resource Development International, vol. 10, no.1, 21-41. Leider, H.J. (1955) Intrathoracic Alimentary duplications communicating with small intestine, Archives of Surgery, Vol. 71, No. 2, p. 230. Peled, A. (2000) Politicking for success: The missing skill, Leadership Organization Development Journal, Vol. 21, No. 1, pp. 2029. Punnett, B. J. 2004. International perspectives on organizational behavior and human resource management. New York, NY: M.E. Sharpe. Soucy, N. and Larose, S. (2000) Attachment and control in family and mentoring contexts as determinants of adolescent adjustment at college, Journal of Family Psychology, Vol. 14, No.1, pp. 125143. Spinks, N. and Wells, B. (1995) Communicating with groups, Executive Development, Vol. 8, No. 5, pp. 1319.