Diagnosis and Pathophysiology
The diagnosis is asthma. The main etiologic factor is a genetic predisposition to type 1 hypersensitivity. This results in acute inflammation which eventually leads to chronic inflammation of the airways and hyper responsiveness of the bronchial mucosa to various stimuli (Mims, 2015). Airway inflammation involves various inflammatory cells and inflammatory mediators, but type 2 T helper cells play a significant role in causing asthma. There is an excessive type 2 T helper cell reaction directed against various environmental antigens. These cells produce cytokines, especially interleukin-4 that stimulates the production of IgE, interleukin-5 that activates eosinophils, and interleukin-13 that stimulates the production of mucus and contributes to the stimulation of the production of IgE by B cells. Once these mast cells are exposed to specific allergens, they release the contents of their granules, leading to two types of reactions: early and late phase reactions.
An early reaction is characterized by vasodilation of various degrees, bronchoconstriction, and increased production of mucus. Bronchoconstriction results from stimulation of vagal receptors located below the epithelium by the monoamines released from mast cell granules. A late reaction is characterized by inflammation mediated by activated T cells, eosinophils, and neutrophils. Repeated episodes of inflammation lead to airway remodeling characterized by structural changes in the walls of the bronchi. These changes are increased vascularity, hypertrophy of bronchial mucus glands and smooth muscle, and deposition of collagen below the epithelium. These changes lead to increased resistance to the passage of air within the bronchial tree resulting in the characteristic features of asthma such as difficulty in breathing and wheezing.
Non-Pharmacologic and Pharmacologic Interventions
Non-Pharmacologic Interventions
The best non-pharmacologic intervention that will prevent asthma attacks and exacerbations is the avoidance of allergens. These could be certain foods, animal fur, pollen, or dust mites. Once the trigger is identified, modifications are made to the patient’s environment, especially the home, to reduce the concentration of the trigger (Milligan, Matsui, & Sharma, 2016). Modifications include removing items that trap dust such as rugs and upholstered furniture, cleaning floors with a damp cloth, regular changing and cleaning of bedding, and use of mite-resistant mattress covers.
Physical activity is essential for patients with asthma. It improves both lung and heart function. However, sometimes physical exertion may trigger asthmatic attacks. Therefore, the physician must work with the patient and her caregiver to select activities that are appropriate for her levels of fitness.
Pharmacological Interventions
Pharmacologic management of asthma is composed of short-term relief of symptoms and long-term control (Wang et al., 2017). The short-term relief is given using drugs that cause relaxation of bronchial smooth muscles and reduction of the secretions produced by the epithelium. Beta-adrenoceptor agonists are most effective for this. Others are anti muscarinic agents. Long-term control is attained using anti-inflammatory agents like inhaled corticosteroids.
Inhaled beta-adrenoceptor agonists such as albuterol act on beta 2 receptors on the respiratory smooth muscle causing relaxation. They also inhibit the release of inflammatory mediators from effector cells. The inhaled route is preferred because beta-adrenoceptor agonists have other systemic effects such as causing skeletal muscle tremors and tachycardia. This is because beta receptors are also present on cardiac muscle fibers and skeletal muscle. They have weak protein binding and low oral bioavailability. Also, they have a high renal clearance. Their short half-lives imply they can only be used for rapid, short-term relief of the symptoms.
Antimuscarinic agents competitively inhibit the action of acetylcholine at its receptors. Acetylcholine is released by vagal nerves causing increased secretion of mucus and smooth muscle contraction (Blake & Raissy, 2018). Antimuscarinic agents such as ipratropium bromide prevent this response and therefore cause bronchodilation and decreased secretions. Inhalation prevents the central nervous and gastrointestinal adverse effects of antimuscarinic agents. They have a longer half-life than beta-agonists hence they are given in combination or monotherapy when there is hypersensitivity to the agonists. It has a longer duration of action. Ipratropium is poorly absorbed across the pulmonary membranes, thus limiting its systemic effects.
Inhaled corticosteroids prevent the occurrence of the late phase inflammatory reaction by inhibiting chemotaxis. This is specifically through the inhibition of the release of leukotriene B4. The drugs are usually composed of small particles. They have a high affinity for the receptor and a long pulmonary residence time. These prolong its effects. They may be given as a prodrug which is activated by esterases in the pulmonary system. Activation in the lungs limits oral bioavailability and thus systemic effects. They are also rapidly cleared to prevent unwanted events. They should have a high plasma protein binding to prevent diffusion into other body tissues. Inhaled corticosteroids with hydroxyl moieties at the 21 position can bind to fatty acids present in the pulmonary system. These conjugates cannot be absorbed into the body thus potentiating their local action.
Resources Available in Tampa, Florida
The state of Florida has asthma-friendly child care centers. They are approved by the Florida Asthma Coalition. However, Hillsborough County does not have such a center. Instead, it has a mentor, Mary Martinasek from the University of Tampa, who may help child care centers to become certified by the Florida Asthma Coalition. She is also in charge of the Tampa Bay Asthma Coalition which provides outreach and community education. Shriners Hospital for Children and St Joseph’s Children’s Hospital are recognized asthma-friendly hospitals in Tampa by the Florida Asthma coalition.
Communication Plan
Involving children in their treatment and also effective communication with them has significant effects on their adherence to treatment (Klok, Kaptein, & Brand, 2015). In chronic conditions such as asthma, children need to take charge of taking their medication and thus must be guided appropriately.
Communication to the child involves a simplified description of the condition with the assurance that it is manageable. The child is encouraged to play an active role in their treatment. She will be taught to recognize triggers that cause exacerbations and how to avoid them. She will also be taught how to recognize an attack, what medication to take, and how to take it. Since in most cases an inhaler is given, the child will be taught to correctly activate and use an inhaler and also detect when the medication is almost finished to get a timely replacement. The child will also be educated on behavior modification such as increased hygienic vigilance and anticipation of attacks.
The mother will be encouraged to create a partnership with the patient. She will play a more supporting role while allowing the child to take charge of management. The mother will be responsible for the home and environment modification. She will be required to take the child along when collecting replacement medication so that the child can receive counseling from the community pharmacist. The mother will also be responsible for booking and keeping regular check-up appointments for the child. Finally, she will be the child’s emergency contact and the first responder in case of attack; therefore, the training on selection and use of medication will involve both the mother and the child.
References
- Blake, K., & Raissy, H. (2018). Asthma guidelines from the National Asthma Education and Prevention Program: Where are we now? Pediatric Allergy, Immunology, And Pulmonology, 31(1), 37-39. doi: 10.1089/ped.2018.0878
- Klok, T., Kaptein, A., & Brand, P. (2015). Non-adherence in children with asthma reviewed: The need for improvement of asthma care and medical education. Pediatric Allergy and Immunology, 26(3), 197-205. doi: 10.1111/pai.12362
- Milligan, K., Matsui, E., & Sharma, H. (2016). Asthma in urban children: Epidemiology, environmental risk factors, and the public health domain. Current Allergy and Asthma Reports, 16(4). doi: 10.1007/s11882-016-0609-6
- Mims, J. (2015). Asthma: Definitions and pathophysiology. International Forum of Allergy & Rhinology, 5(S1), S2-S6. doi: 10.1002/alr.21609
- Wang, G., Zhang, X., Zhang, H., Wang, L., Kang, D., Barnes, P., & Wang, G. (2017). Corticosteroid plus β2-agonist in a single inhaler as reliever therapy in intermittent and mild asthma: A proof-of-concept systematic review and meta-analysis. Respiratory Research, 18(1). doi: 10.1186/s12931-017-0687-6
New Approaches In Teaching To Enhance Teaching
Contemporary education places biases in terms of the efficacy of testing because of the increased pressure on teachers. Testing restricts creative and innovative approaches to delivering knowledge to students. Therefore, “teaching to the test” excludes improvements in teaching approaches. To eliminate a test focus approach, an opposite strategy is introduced to make sense of the reading process. Using an alternative approach provides the teacher with a possibility to engage children with disabilities in better learning and widening children’s creative and analytical thinking skills.
The problem of modern teaching lies in associating the learning process with standardized testing, which reduces the role of teaching and imposes pressure on teachers. It also contradicts the actual purpose of learning aimed at making sense and gaining experiences from theoretical knowledge.
As an alternative, two options have been proposed. The first one is confined to widening educational choices for children with disabilities based on the No Child Left Behind program. The second option relates to implementing a person-oriented approach which acquires greater popularity nowadays. There is a greater chance to introduce effective learning techniques about student diversity.
The outlined ‘meaning-making policy’ requires a closer interaction between a teacher and a student and provides students satisfaction with the learning process. In contrast, the standardized test approach provides an objective evaluation of students’ performance and less pressure imposed on teachers.
Introducing less teaching to the test can increase students’ interest in a learning process and enhance their reading comprehension skills. Promoting child-centered instruction can also contribute to intensifying the connection between students and reading texts. Such a strategy can take advantage of standardized testing because of the benefits of gaining educational experience.
Adopting the new approach requires the active participation of both parents and teachers in teaching children to diminish the pressure. Teachers should pay closer attention to individuals rather than group discussions as a whole. The proposed decision to standardize testing can be a combination of both meaning-making and teaching to the test approaches.
About the established problems, criteria, and alternatives, the police report seems to be well-grounded because of the consistency of options to be implemented.
Unilever Case Study: Marketing Strategy Of The Products
Introduction
Unilever is a global company that deals with manufacture of consumer products. The company manufactures a wide range of products ranging from food to personal and home categories. The company’s engagement in production of different commodities has largely contributed to its growth in most parts of the world. The success of Unilever company relies on the ability to market its products and strategies to penetrate the market. This mainly involves proper marketing research and the need to meet customers’ requirements. Various aspects that contribute to the growth of Unilever as a consumer product company are discussed in the paper.
Strengths and Opportunities
The growth of Unilever entirely depends on both the company’s internal and external analysis. The company’s prevalence in the consumer products market owes credit to the internal strengths and ability to utilize the opportunities in the outside environment. One of the major strengths for Unilever’s penetration in the global market is diversification of consumer products in markets all over the world. Diversification is the production of several varieties of goods with the aim of expansion to enjoy the market share of most product consumers in different regions (Graham, 2007).
The idea of diversification entitled the products managers in different regions with powers to make decisions on the marketing strategy of the products. This enabled proper distribution of products since the managers on the ground knew the most consumed products hence increasing its supplies in the regions. An additional strength of the company dwells in Unilever’s capability to foresee customers’ ways of product purchase and consumption of goods. This enables them to supply products according to market demand and needs of customers.
The ready market for consumer product purchase all over the world offers a great opportunity for Unilever company products. According to Fletcher (2010), new markets provide greater potential for an immense growth in product sales. Therefore, the introduction of Unilever products in new markets provides the opportunity for potential growth in sales. Such opportunities offer the advantages of enjoying the global market share of the product before other companies in the same category.
Keys to success in the consumer product manufacturing industry
The success in consumer products industry owes credit to well planned marketing strategies, proper coordination between the internal and external factors of the company in the market share. Since the industry is very competitive, customer relationship also accounts for the growth and expansion in this industry. Consumer research is a vital subject for success in this industry. For the case of Unilever, extensive research is done to enable innovation of fresh products and improvement of existing products to fit the consumers’ needs. This involves rebranding and getting to customers in both local and international markets by smooth relations between the company and its customers. To achieve this, the company has to implement appropriate customer relationship management strategies (Waarts, 2005).
Implementation of culture difference strategy is another important factor towards success in consumer product industry. Unilever applies this strategy to penetrate into local markets. This contributes to expansion in different markets at a faster rate than companies that do not apply the strategy. The company combines this strategy with building correct leadership behavior to produce competent employees and managers. These produce responsible staff which engages in socio-cultural promotional programs in order to win the customers hence consumption of their products. Moreover, success in this industry requires efficient transformation in information technology (Hoskinsson, 2009). With the fast changing technology, companies need to keep track in order to apply e-commerce which enhances efficient and quick transactions between the consumers and the organization.
Unilever’s strategies for competition in global markets
The main important strategy used by Unilever to compete for the market share in the industry is the global strategy. The strategy involves marketing of brands in local environments and maintaining the supply of similar products in these regions. The company also applies this strategy to produce new brands for marketing in different regions all over the world. This strategy is of benefit to the company since it improves the uniformity in the marketing operations at the same time building the product’s brand equity.
Unilever employs the cross- market strategy to succeed in getting customers from their competitors. This is done by providing their products in the market at a subsidized price which is normally lower than that of other competing companies. These strategies work for Unilever because most companies find it difficult to offer these services while maintaining high quality of products (Jones, 2002).
Lessons learnt from Unilever case study
From the case study, it is observed that Unilever is a multinational company in production of consumer commodities. The ability of Unilever to use its strengths such as involvement in variety of products enables the company to utilize the available opportunities in expansion to international markets. Further more, the company’s strategies in market entry show that for success in such a business, one needs to use appropriate and effective marketing strategies in order to succeed in a competitive market (Fletcher, 2010). Therefore, it is important to plan well and carefully follow the appropriate strategies for success in the industry.
Conclusion
The success of Unilever in this category is based on the company’s marketing strategies. The ability of the company to introduce its commodities in new and emerging markets give it an advantage to grow in most parts of the world. The growth of the company is also observed as a result of its engagement in manufacture of different products. These strategies teach us the importance of well planned market strategies and the importance of diversification in brand marketing.
References
Fletcher, C. (2010). Unilever’s volume beats estimates, aided by Europe. Business Week, 6. Web.
Graham, J. L., & Cateora, R. P. (2007). International marketing. London: McGraw-Hill.
Hoskinsson, R. E., Ireland, D. R., & Hitt, A. M. (2009). Strategic management: competitiveness and globalization: Concepts & cases. Cambridge: Cengage Learning.
Jones, G. (2002). Control, performance, and knowledge transfers in large multinationals: Unilever in the United States. Business History Review, 76 (43-45).
Waarts, E. (2005). Competition as an inspirational marketing tool. European Business Forum,12,(3-6).
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