Components of Kangaroo Mother Care

Components of Kangaroo Mother Care The literature search has been divided in different categories to present the effects of kangaroo mother care (KMC). After stating the organization of the paper the first section will provide the definition, history, and components of KMC. The second section will describe the Universe of Developmental Care Model and its components. The next section will reflect on the effects of KMC in maintaining the temperature of premature and LBW infants. The fourth section will present the relationship of KMC with the frequency of feeds and how this intervention assists in resolving the issues related to breast feeding; while the fifth section will present the results of KMC with respect to achieving the weight gain. The sixth section will describe the effects of KMC in reducing suspected infections and length of stay in hospital. The last section will summarize the literature review stating the purpose of the literature review. The Search Strategy The literature search was done on two search engines: Pubmed and Science Direct will be use of key terms Kangaroo mother care (KMC) and skin-to -skin (STS) the Pubmed searched resulted in 100 hits. It was further filtered by adding the terms low birth weight (LBW). Finally twenty articles were reviewed. Similarly, the database of Science Direct showed 30 relevant articles .The second step was to search database in Google Scholar. The result showed very pertinent articles, including a website of the KMC foundation. This website facilitated the researcher in searching the systemic review and origin of KMC, original articles were then searched from the reference lists of these articles. Definition, History, and Components of Kangaroo Mother Care (KMC) Kangaroo Mother Care (KMC) is an alternative intervention for hypothermia among preterm infants by, keeping the baby close to the mothers skin (Lawn, Mwansa-Kambafwile, Horta, Barros, Cousens,2010). Dr Edgar Rey Sanabria, a pediatrician initiated the model of KMC at the Department of Health in Mobato, Colombia in 1978 Since then, KMC has been well known for provide a quality care to newborn infants especially to LBW babies in Colombia (Lawn et al.2010). A wide range of literature is available that evaluates the physiological, psychological, emotional, and developmental outcomes of KMC. However, this literature review will primarily focus on the physiological and breastfeeding outcomes of KMC in hospital. However, the secondary outcome variables like weight gain, infection and length of stay will also be presented in the this literature review.Gradually this model was adopted by many developed countries like US, UK, and Brazil, and in 2003, WHO provided international guidelines to implement KMC. Based on the effectiveness of KMC in hospital settings, it was recommended to incorporate KMC into a package of neonatal care and not as an individual intervention (Pattinson, Woods, Greenfield, Velaphi, 2005). According to Charpak It is not alternative medicine but a scientifically sound, multilevel intervention (Charpak Ruiz-Pelaez, 2001). Though it is initiated in the hospital, it can be continued at home until rejected by the infant usu ally towards the completion of gestation at 37 weeks (Charpak Ruiz-Pelaez, 2001). Universe of Developmental Care (UDC) The model is the renewal of Als Synactive theory of neonatal development. The theoretical concept of the model is shared surface; the manifestation of the shared surface is the skin. Through the skin the linkages are created among the body organism , and the environment. The key concept of the model is that an infants skin is considered as boundary of infant where as the shared surface includes environmental influences. The impact of these influences is inter- linked with care practices and the family (Gibbins, Hoath, Coughlin, Gibbins Franck, 2008). Components of Model This model is based on infant, environment, and staff. Infant: Infant is the core component of the model, who occupies central position, as shown in model (refer fig 1.). The first circle immediate to the central position of the infant in the model represents specific physiological systems, such as: respiratory, cardiac, and nervous, hematologic, metabolic, immunological, musculoskeletal, integumentry, and gastrology system. These physiological systems are interrelated with each other and they are highly influenced by the surrounding environment. Care Practices Specific care practices behaviors are symbolized as care planets of the UDC model. There are nine care planets surrounding the physiological system which depict care giving behaviors like monitoring/assessment, feeding, positioning, infection control, safety, comfort, thermoregulation, skin care, and respiratory care (Gibbins, et al., 2008, p. 145). Family: In the UDC model family is the central focus;however, staff and institution support is required to provide effective care to the infant, for instance, for any care practice approach like provision of comfort to an extremely low birth infant. If the parental touch is been replaced in an intensive care unit with staff support and institutions policy, the care planet of comfort will not only be affected, but it may alter the other planets like sleep, positioning, safety, and like. Therefore, within the hospital environment the family is shown as very close to the infant in the UDC model, which demonstrates the natural family-infant dyads bonding. Environment: The macro-environment of the model, based on the infrastructure and physical environment such as lay -out, lighting, noise levels, units physical design, affects the shared surfaces. Moreover, interpersonal behavior and hospital culture are also considered as part of enviroment in the UDC model (Gibbins, et al., 2008, p. 145). These environmental influences can affect any of the care planets of the universal model. Due to interdependence of care planets of the UDC model, the care practice that alters any one of the care planet will automatically affect the other care planets. (Ludington, 2009). Just like the laws of solar system movement, an infant is expected to respond to the environmental influences by showing some developmental behaviors (Gibbins, et al., 2008, p. 143). Staff: The position of staff in the model is just as a protective orbit that supports family of very high risk and critical infants. The authors have emphasized the role of education and staff training in the context of UDC model in order to apply the theoretical concepts of developmental care model in clinical practices (Gibbins, et al., 2008, p. 144). Application of the Model The UDC model is applicable for infants care providing clinical approach for nurses to follow. The model captured an extensive list of nursing care, which involves holistic developmental care. Therefore, it can be easily applied as bedside practice; in addition this model provides opportunities to the nursing researchers to explore any one of the care planets and then identify its interdependence with other care planets. Since the model is based on Nightingale, environmental theory can be widely applied in nursing care practices.However, a lot of research work is needed to validate the concept of shared surfaces of the model. The literature review,so far,has not depicted any scholarly work for the application of the model to kangaroo mother care, though it is one of the essential components of the models comfort care planet ( Ludington, 2009).The intention of the current study is to apply this model to explore the physiological and developmental effects of kangaroo mother care among low birth weight and preterm infants. The application and modification of the model would be discussed in detail in chapter 3. However, the model also guided us to present the effectiveness of KMC through literature review. Thermoregulation Kangaroo Mother Care (KMC) has been recognized as an effective model for thermal stability (Charpak et al., 2005; Ludington-Hoe, Nguygen, Swinth Satyshur, 2000; Cong, 2006). Due to large body surface, little fat size LBW infants are at high risk of heat loss. When this loss exceeds the ability of infant to produce heat, hypothermia develops (WHO, 1997). Infants are more susceptible to hypothermia immediately after birth, during bath or during weighing. It has been found that countries with high neonatal morbidities deaths showed higher rates of hypothermia (Kumar, Shearer, Kumar Darmstadt, 2009). Therefore, to minimize the risk of hypothermia a set of procedure has been recommended for thermal regulation of newborn infants. These procedures include warm delivery room, drying of infants body and skin-to-skin contact, breast feeding and postponing bathing and weighing of infants and keeping mother-infant together etc. In case of breaking in this warm- chain infant can be at risk of c old stress (WHO, 1997). In such cases thermal protections can be fulfilled by either keeping infant in warmer incubator or under radiant heat. The positive outcome of randomized trials among preterm has suggested the KMC as an alternative of incubators (Bergman et al., 2004; Cattaneo et al., 1998; Chwo et al., 2002; Kadam et al., 2005; Ludington-Hoe et al., 2000; Ludington-Hoe et al., 2004). The abdomen of mother due to the appropriate temperature for newborn is considered as the best means for immediate postnatal interventions (AAP AAH, 2000). It is also suggested in the guidelines of World Health Organization that skin-to-skin contacts should be continue during transfer as well as after shifting of infant in ward (WHO, 2003). The consistence findings of KMC among various trials and metaanalysis (conde, et, al, 2010), systemic review of kangaroo care (Brett, Staniszewska, Newburn, Jones, Taylor, 2011) and literature review by (Bulfone, Nazzi, Tenore, 2011) made it possible to include kangaroo care as one of the integral component of newborn care (Carlo, et al., 2010; Darmstadt et al., 2006; Kumar et al., 2008; Moore McDermott, 2004; Senarath, Fernando, Rodrigo, 2007; Tinker, Paul, Ruben, 2006), including preterm infants. Bergman et al. (2004) investigated effects of one hour dose of KMC after birth to assess the rate of hypothermia. Out of 20 LBW infants 18 maintained their temperature with KMC, whereas in control group six out of 14 infants maintained their temperature. Similarly, Cattaneoet al. (1998) assessed the KMC interventions by continuous skin-to-skin contact, day night with an average of 20 hrs /day by mothers. Researcher found 13.5 episodes of hypothermia in a sample of 100 infants in intervention group as compared to 31.5 episodes in control group. It is highly recommended from literature that staff need to be sensitize about this serious issue Kumar, et al, 2009). It has been observed that in the study settings that there are modern equipment to provide warmth to infants are available. However, space and equipment remain the limitation of any organization due to high influx of premature and LBW infants delivery. Though an infant gets thermal control in nursery setting but there is need to implement some strategies which protect high risk infants in the ward environment and mother need to educate about monitoring of infant. She should be acknowledging about its management as well. In order to compare the effects of environmental temperature and kangaroo care interventions, three groups of newborns were selected. One group was given skin-to-skin contact in prone, while another group was prone to mother chest with clothes, while third group of neonates were kept in nursery. After 90 minutes of repeated measures of temperature post birth (30-120 minutes after birth) the infants who were in skin-to-skin contact showed more variation in temperature than their counterparts. This variation was found to be related with sensory stimulation caused by mother infant skin to skin contact. Moreover, researchers have concluded that early suckling promotion also facilitated in oxytocin release which further enhanced metabolism and heat production(Bystrova et al., 2007). The literature review supports the concept of shared surface of UDC model also. The relationship between infants brain and environment is apparent through skin-to-skin contact. As parasympathetic nervous system gets stimulated which enhances peripheral circulation (Bystrova et al., 2007) and manifestation of this process is apparent through infants skin temperature. According to the recent meta-analysis of KMC, there is a significant reduction of hypothermia (Conde, 2010). Developing counties like India and Bangladesh have shown progress in implementing KMC in low and high technical settings. It can be applied for all healthy newborn >28 weeks of gestation and weight >600 grams safely (Browne, 2007). Initially preterm and LBW infants were given KMC for 24 hrs. Gradually his model was modified to intermittent kangaroo care for minimum 30 to 60 minutes (Nyqvist, 2009). The researchers found KMC effective in thermal protection even if was given for short duration (Boo Jamli, 2007). In addition to it KMC can be applied to all newborn care setting. There is no need to have a separate setting to implement this model other than privacy to practice in clinical settings. Some of the challenges identified in implementation of KMC model initially in India (Ramanathan, Paul, Deorari, Taneja, George, 2001) participated mothers showed reluctance at the initial stage to change the traditional behavior of neonatal care. Similarly, in Uganda values and beliefs of mother were challenging. As mother considered vernix as napaki and it should be removed, and infant cannot be placed on mothers abdomen before bathing (Byaruhanga, BergstrÃÆ' ¶m, Tibemanya, Nakitto, Okong, 2008). Another challenge is reluctance in modifying the newborn care policies and protocols. Despite multiple benefits of KMC, there is still a gap in application of this model (Byaruhanga et al., 2008). One Pakistani study also found cultural beliefs as barrier to provide thermal protection; mothers felt blood on newly born infant as napaki and they were not in favour of breastfeeding infant soon after birth (Aziz, Akhtar, Kaleem). This way all live healthy born infants were given bath before feeding. This behavior is considered as one of the major hazard for newborn health; this gap can be fulfilled by research evidences in our cultural context and by following the international guidelines of newborn care. Effects of KMC in Promoting Lactation Another major challenge of preterm births is ineffective breastfeeding. These infants need a great deal of struggle while attachment to mothers breasts. The epidemiological studies have provided sufficient evidences that breast feeding contributes in reducing morbidities and mortalities of infants (Heinig, 2001). It was further evident that preterm and LBW infants who received donors breast milk were at lower risk of necrotizing enterocollitis than those who fed formula feed (McGuire Anthony, 2003). A breadth of literature supports kangroo care as one of the best way to promote early attachment of infants to mother breast. A number of barriers to breast feeding among preterm infants are, immature systems, poor coordination while sucking, and difficult to keep them awake (Ludington, 2010). As a result mother does not receive sufficient stimulation from infants sucking. Therefore, infants are fed supplement milk either with spoon, gavage or bottle feeding. Since exclusive breast feeding is strongly associated with child survival (Bhutta, 2008) it is recommended that breast feeding should be initiated within an hour of birth to produce sufficient calories and to keep the infant warm (WHO, 1996). KMC has shown substantial improvement in promoting exclusive breastfeeding. The literature review has shown suckling outcome of preterm infants with KMC (WHO, 1996). Even one hour session of KMC for two weeks was found to be helpful in attachment of infants with mothers breasts. (Nyqvist et al., 2006). The researchers found increase in breast feeding rate and duration among 32 -35 weeks of gestation (Nyqvist et al ., 2006). This early attachment behavior of infants with the help of Skin-to-skin contact, stimulates sucking behavior and more oxytocin releases to produce more milk (Matthiesen, Ransjà ¶ Arvidson, Nissen, Uvnà ¤s Moberg, 2001). The experimental study on infants exposed to skin-to-skin contact immediately after birth shows that they continue to nurse more efficiently. There was a significant production of milk and weight gain (Andreson, 2004; Charpak 2001; Dewey, 2003). The literature supports KMC to achieve successful breastfeeding among 90% of infants compared to 61% in hospital (Bier et al., 1996). Moreover, infant on KMC found to be relaxed; therefore, gut is prepared by hormones to digest milk adequately. This helps again in reducing the chances of necrotizing of gut and infants gain weight, resulting in a shorter stay at the hospital(Bergman, Linley, Fawcus, 2004). In addition improve frequency and duration of breastfeeding; it is also evident from literature that mothers receive extra support for lactation from nurses while giving intervention of KMC. This support also motivates mothers to continue breastfeeding (Carfoot Moore, 2005). Due to sustained breastfeeding cholecystokinin releases more and it further stimulates parasympathetic nervous system which aids in growth and development of infants. A comparative study of three group of infants discussed in the section of thermal regulation (Bystrova et al., 2007) also support early sucking reflexes with skin-to-skin contact. A systemic review by Ahmed and Sands (2010) found eight studies to support breastfeeding outcome among preterm infants. Effects of KMC on Weight Gain As discussed earlier the preterm and LBW infants are prone to hypothermia, poor lactation, and infections during hospitalization which contribute to infants weight gain or prolonged stay in hospital just to gain weight. KMC has been found to be effective in growth of infants (Ali, 2009; Anderson, 1991; Boo, 2007; Conde, 2010; Rao, 2007). However, Charpaks study did not suggest significant difference in weight gain of infants (Charpak, 2005). On the other hand, KMC also did not show adverse effects and none of the studies found that infants with KMC intervention were failing to thrive. Thus the literature shows positive effect of KMC in terms of improving the feeding of LBW infants and weight gain. Studies among LBW infants depicts significant improvement in growth of infants, with mean weight gain of 29gms among infants Effects of KMC in prevention of Infection and length of stay reduction Recently it is evident from the literature that KMC reduces the morbidities and mortalities among infants (Lawn, 2010). Total 15 trials were reviewed and researchers found significant decrease in mortalities i.e. (RR =0.49) and morbidities which was (RR= 0.34).The scientist are predicting that by placing infants in skin-to-skin contact may improve barrier function of the skin (Abufatteh, Ludington, Burant -Visscher, 2011). The researchers found only one case of infection at the time of completion of KMC. The progress of KMC in reducing infection is also depicted in developing countries. A substantial reduction in infections among LBW Infants is demonstrated from the literature. For instance Ali in (2009) found 6.9% of sepsis in KMC group as compared to 23.2% in control group during hospitalization. In addition the research findings were consistent at follow-up; incidences of severe infections were high in control group (17.9%) as compared to (5.2%) in KMC (Ali, 2009). This impact is also associated with improvement in breastfeeding through skin-to-skin contacts. The Immunoglobulin and lactoferrin properties of human milk help in prevention of infection. (FurmanKennell, 2000). Reducing the length of stay is another goal of KMC which is highlighted by many studies from developing countries (Ali, 2009; Boo, 2007; Charpak, 2001; Ramanthan, 2001). Infants discharged 7.4 days earlier than control group (Ramanthan, 2001). Similarly, Boo found difference of nine days (Boo, 2007). This major impact is further contributing to cost-effective management. Parents of LBW and preterm infants face dual burden of complication of prematurity as well as economic constraints. Thus, KMC could be an appropriate cost-effective intervention for this population. However, it has not been explored in Pakistan to our knowledge. Therefore, keeping in mind the efficacy of KMC there is a need to implement such trial in Pakistan to fill the gap. Conclusion The literature review suggests KMC as an effective intervention to achieve thermal stability and breast feeding among LBW and preterm infants. Complications such as infections can be minimized by the help of protective environment of mothers skin contact and breastfeeding component. Thus countries with scarce resources like Pakistan can benefit from this intervention to promote the health of high risk newborns. Aziz, N., Akhtar, S., Kaleem, R. Newborn Care Practices Regarding Thermal Protection Among Slum Dwellers in Rachna Town, Lahore, Punjab. Annals of King Edward Medical University, 16(1 SI). Bergman, N. J., Linley, L. L., Fawcus, S. R. (2004). Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns. Acta Paediatr, 93(6), 779-785. Byaruhanga, R. N., BergstrÃÆ' ¶m, A., Tibemanya, J., Nakitto, C., Okong, P. (2008). Perceptions among post-delivery mothers of skin-to-skin contact and newborn baby care in a periurban hospital in Uganda. Midwifery, 24(2), 183-189. Bystrova, K., Matthiesen, A. S., Vorontsov, I., WidstrÃÆ' ¶m, A. M., RansjÃÆ' ¶Ãƒ ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ Arvidson, A. B., UvnÃÆ' ¤sà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ Moberg, K. (2007). Maternal axillar and breast temperature after giving birth: effects of delivery ward practices and relation to infant temperature. Birth, 34(4), 291-300. Charpak, N., Ruiz-Pelaez, J. G. (2001). A randomized, controlled trial of kangaroo mother care: results of follow-up at 1 year of corrected age. Pediatrics, 108(5), 1072. Heinig, M. J. (2001). Host defense benefits of breastfeeding for the infant: effect of breastfeeding duration and exclusivity. Pediatric Clinics of North America, 48(1), 105-123. Lawn, J. E., Mwansa-Kambafwile, J., Horta, B. L., Barros, F. C., Cousens, S. Kangaroo mother careto prevent neonatal deaths due to preterm birth complications. International journal of epidemiology, 39(suppl 1), i144. Matthiesen, A. S., Ransjà ¶ Arvidson, A. B., Nissen, E., Uvnà ¤s Moberg, K. (2001). Postpartum maternal oxytocin release by newborns: effects of infant hand massage and sucking. Birth, 28(1), 13-19. McGuire, W., Anthony, M. Y. (2003). Donor human milk versus formula for preventing necrotising enterocolitis in preterm infants: systematic review. Archives of Disease in Childhood-Fetal and Neonatal Edition, 88(1), F11-F14. Pattinson, R., Woods, D., Greenfield, D., Velaphi, S. (2005). Improving survival rates of newborn infants in South Africa. Reproductive Health, 2(1), 1-8. Ramanathan, K., Paul, V., Deorari, A., Taneja, U., George, G. (2001). Kangaroo mother care in very low birth weight infants. Indian Journal of Pediatrics, 68(11), 1019-1023.

Global Orientation Essay

Global marketing has the potential to bring a company to its proverbial next level. In order to understand how to thrive in global marketing one must first understand the conditions leading to the development and sustainment of global market. The need and environment for a global market stemmed from a number of factors. One factor is the rapid technological advances in equipment, communications, and transportation, which are all major drivers of both the ability and the desire of companies to expand globally. Advances in production equipment allows companies to create larger volumes of product which, when paired with the expanded customer base of a global market, can generate greater profits which can be reinvested into research and development efforts. These increases in product volume and profit are aided by faster communication and transportation, which serve to shrink the global marketplace and provide less costly methods for companies to distribute products, information, and financial flows. Another factor is the international system, which includes the development of the International Monetary Framework, trading blocs, General Agreements on Tariffs and Trade (GATT), and other such formations of international agreements facilitated by the spread of global peace. One final factor is the spread of awareness in disparate markets of different products and processes. In the process of forming international infrastructures, global experiences have served to change attitudes and behaviors of entire segments of domestic markets. Being exposed to ideas from around the world has affected these market segments’ tastes and professed needs, eventually leading to a convergence of world markets to global markets sharing common tastes and needs across geographical boundaries. From a more conceptual angle, global markets derived from the Bretton Woods system of global free trade and are able to thrive under the policies of a hegemon, or dominant world power. The Bretton Woods Agreement established a method enabling currencies to be convertible for trade, by pegging currencies to gold, and formed the International Monetary Fund and the International Bank for Reconstruction and Development. The system established by the Bretton Woods Agreement was validated due to the United States’ economic dominance and manufacturing base. Through the uses of diplomacy, finance, and military force, the United States has ensured openness in the Bretton Woods system, a concept defined by the Greek word hegemony. It has been theorized that international systems are best able to maintain stability when managed by a single dominant world power. According to the theory of hegemonic stability, the downfall of the reigning hegemon causes the global market to suffer instability until another rises into power. Furthermore, the tastes and needs of global markets will change to reflect that of the hegemon, which explains the current spread of western culture. The convergence of world markets has created the need for companies to approach all country markets within their scope of operations as a single global market, identifying market segments with similar demands that can be satisfied with the same product, standardizing what components of the marketing mix that they can, and adapting the marketing mix to accommodate for significant cultural differences when necessary – an approach called global orientation. Factors that must be considered for a company to achieve global awareness and succeed in global orientation include objectivity, tolerance toward cultural differences, and a solid knowledge base. The first factor, objectivity, involves being objective in the assessment and handling of opportunities, risks, and issues associated with prospective investments. The second, tolerance, requires an understanding of and willingness to work with different cultures that exhibit behaviors unlike one’s own. The final factor to achieving global awareness is becoming knowledgeable about the changes occurring throughout the world, the global economy, social trends, world market potentials, world history, and individual cultures. A company’s success in the three aforementioned factors will determine the level of global awareness they will be able to achieve, their success in a transition to global orientation, and ultimately their success in the global marketing environment. Once a company has achieved global marketing success, it must establish a competitive advantage in order to thrive. Competitive advantages can be typified by a company’s competitive strategy coupled with their emphasis on new product-market growth. Table 1 depicts Mullins and Walker’s (2013) typologies of business level competitive strategies. An example of how a company may fit into this typology is that of Samsung. Samsung gauges whether they are on the right track in the global market through the use of data collection and studies including revenue measurements, profitability measurements, average price indices (API), brand attitude studies (BAS), and dealer attitude studies (DAS), which would place them in the position of analyzer using both competitive strategies of differentiation and cost leadership. Table 1: Combined Typology of Business-Level Competitive Strategies Emphasis on new product-market growth Heavy Emphasis No Emphasis prospectorAnalyzerDefenderReactor Competitive strategyDifferetiationUnits primarily concerned with attaining growth through aggressive pursuitof new product-market opportunitiesUnits with strong core business; actively seeking to expand into related product-markets with differentiated offeringsUnits primarily concerned with maintaining a differentiated position in mature marketsUnits with no clearly defined product-market development or competitive strategy Cost leadershipUnits with strong core business; actively seeking to expand into related product-markets with low-cost offeringsUnits primarily concerned with maintaining a low-cost position in mature markets In conclusion, global markets have evolved from increased international cooperation and interaction. In order for companies to continue to grow and thrive, they must become globally oriented in their operations and implement a competitive strategy for the global environment. Globalization has opened up many opportunities for worldwide development and is strengthened by the participation of companies in the global market and by strong leadership by a world power. References Cooper, R. N. , Eichengreen, B. , Holtham, G. , Putnam, R. D. , & Henning, C. R. (1989). Can Nations Agree? Issues in International Economic Cooperation. Washington D. C. : The Brookings Institution. pp. 255-298. Mazlish, B. (2012). Three Factors of Globalization: Multinational Corporations, Non-Governmental Organizations, and Global Consciousness. Globality Studies Journal. Retrieved from http://globality. cc. stonybrook. edu/? p=239 Mullins, J. W. , Walker, O. C. (2013). Business Strategies and Marketing Decisions. McGraw Hill Education. Retrieved from http://answers. mheducation. com/business/marketing/marketing-strategy/business-strategies-and-marketing-decisions

Social Responsibility And Its Impact On Society - 1579 Words

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In view of this, this paper will discuss and define the concept of social responsibility of a business to its workers, stakeholders, and society; how the perspectives align with that of Drucker; comparing Cohen’s opinion with that of Friedman and finally determines which of the two individual’s opinion best aligns with the current business climate promoting a green environment. Concept of social responsibility Read MoreCorporate Social Responsibility Definition1011 Words   |  5 PagesThis research study is about what the Corporate Social Responsibility (CSR) is, how people define and how I understand this term? According to my research and observations, CSR does not have only one and constant definition. I have read a lot of definitions of CSR and in fact, they are similar but not the same. Briefly, definition and understanding of CSR depends on person to person. Thus, I am going to talk about definitions of the CSR and I will define my own perspective about the CSR.

Basics of the Central Business District

The CBD, or Central Business District, is the  focal point of a city. It is the commercial, office, retail, and cultural center of the city and usually, it is the center point for transportation networks. The History of the CBD The CBD developed as the market square in ancient cities. On market days, farmers, merchants, and consumers would gather in the center of the city to exchange, buy, and sell goods. This ancient market is the forerunner to the CBD. As cities grew and developed, CBDs became a fixed location where retail and commerce took place. The CBD is typically at or near the oldest part of the city and is often near a major transportation route that provided the site for the citys location, such as a river, railroad, or highway. Over time, the CBD developed into a center of finance and control for government as well as for office space. In the early 1900s, European and American cities had CBDs that featured primarily retail and commercial cores. In the mid-20th century, the CBD expanded to include office space and commercial businesses, while retail took a back seat. The growth of the skyscraper occurred in CBDs, making them denser. The Modern CBD By the beginning of the 21st century, the CBD had become a diverse region of the metropolitan area and included residential, retail, commercial, universities, entertainment, government, financial institutions, medical centers, and culture. The experts of the city are often located at workplaces or institutions in the CBD. This includes lawyers, doctors, academics, government officials and bureaucrats, entertainers, directors, and financiers. In recent decades, the combination of gentrification (residential expansion) and the development of shopping malls as entertainment centers have given the CBD a new life. In addition to housing, CBDs have mega-malls, theaters, museums, and stadiums. San Diegos Horton Plaza is an example of a downtown area as an entertainment and shopping district. Pedestrian malls are also common today in CBDs in an effort to make the CBD a 24-hour destination for not only those who work in the CBD but also to bring in people to live and to play in the CBD. Without entertainment and cultural opportunities, the CBD is often far more populated during the day than at night, as relatively few workers live in the CBD and most commute. The Peak Land Value Intersection The CBD is home to the Peak Land Value Intersection in the city. The Peak Land Value Intersection is the intersection with the most valuable real estate in the city. This intersection is the core of the CBD and thus the core of the metropolitan area. One would not typically find a vacant lot at the Peak Land Value Intersection, but instead one would typically find one of the citys tallest and most valuable skyscrapers. The CBD is often the center of a metropolitan areas transportation system. Public transit, as well as highways, converge on the CBD, making it very accessible to those who live throughout the metropolitan area. On the other hand, the convergence of road networks in the CBD often creates overwhelming traffic jams as commuters from the suburbs attempt to converge on the CBD in the morning and return home at the end of the workday. Edge Cities In recent decades, edge cities have begun to develop as suburban CBDs in major metropolitan areas. In some instances, these edge cities have become a larger magnet to the metropolitan area than the original CBD. Defining the CBD There are no boundaries to the CBD. The CBD is essentially about perception. It is usually the postcard image one has of a particular city. There have been various attempts at delineating the boundaries of the CBD but, for the most part, one can visually or instinctively know when the CBD starts and ends, as it is the core and contains a plethora of tall buildings, high density, a lack of parking, transportation nodes, a large number of pedestrians on the street, and generally just a lot of activity during the daytime. The bottom line is that the CBD is what people think of when they think of a citys downtown area.