With You Until The End Essay -- Oscar Wilde The Devoted Friend Essays

With You Until The End 1. The story, The Devoted Friend, is an exercise to be educated. It shows how one can control just as how one can be controlled. It likewise shows exactly how far certain individuals will go for a companion. For this situation, Hans quit any pretense of dealing with his nursery to enable a to valid companion and kicked the bucket doing as such. Creator Oscar Wilde gives great detail of the characters and sets up clashes inside the plot to underline on the subject, a committed companion is one that is with you, and will do anything for you, until the end. 2. In the initial scene of the story a couple of minor characters are presented, including the storyteller, the Green Linnet, a little flying creature with small wings. The storyteller recounts to this story to a water-rodent, an old rodent with brilliant, beady eyes and solid dim hairs. He felt it related to the rodent in view of how basic the rodent was being of the unadulterated white mother duck that had splendid red legs. All she was attempting to do was show her kids, who resembled minimal yellow canaries, how to fit into society and the rodent was offering inconsiderate remarks. 3. As the Linnet recounted to the story, he told about Hans, a little man with a clever, round, pleasant face. Hans had an exceptionally kind heart and was an incredibly given companion. This was demonstrated all through the story in him dismissing his nursery to help his dearest companion, Hugh the Miller. The Miller was a major man who was genuinely wealthy, he had a hundred sacks of flour, six dairy animals, and a herd of sheep. He exploited Hans since Hans accepted they were closest companions and the Miller frequently helped him to remember that. The Miller utilized blame to control Hans for doing whatever he required done, while never giving back in kind. 4. The tone all through the story is ... ...t have Hans getting things done for him, he was taking from Hans’ garden his most lovely blossoms and best organic products. 10. The second most clear clash in the story was Thought versus Action. Hans was continually thinking how much consideration his nursery required and by helping the Miller he would disregard his nursery, yet he generally did precisely what the Miller asked of him decisively. The Miller additionally knew precisely how to control Hans by utilizing blame, and he put that enthusiastically every time he required something accomplished for him. 11. The Devoted Friend was an ideal case of how much kinship intends to a few and how little it intends to other people. It demonstrated that it was so natural to control others and be controlled by others. Be that as it may, the most significant thing it indicated was exactly how far an individual would go to enable a companion to despite the fact that it implies relinquishing numerous things.

Introduction for Currys Essay Example for Free

Presentation for Currys Essay For this task I am exploring Currys and I will get data about my examination from the client care of Currys, yet to do this I should realize likewise a smidgen about the clients profiles and what the clients consider Currys items and administrations that they give. Foundation: Currys is the main decision for families purchasing electrical gadgets for the home and different organizations. Currys additionally conveys their products to their clients seven days every week to family units and organizations all through the UK. While conveying new items the Group gathers 750,000 parts of the bargains merchandise apparatuses, ice chests, coolers, cookers, PCs, printers, radios, TVs, telephones and clothes washers, from clients homes every year, of which, until November, around 300,000 were ice chests. Until November 2001 these were reused or renovated by a system of temporary workers, assuaging Local Authorities, who might some way or another be obliged to gather or get these items, of a huge weight. Numerous units were repaired and exchanged requiring little to no effort, giving modest items to families on low salary (counting through make, a Dixons upheld task to re-train long haul jobless individuals as architects). Others were sent out for additional utilization and the rest of and discarded following CFC gas extraction fulfilling natural guidelines. Essentially Dixons Group gave a sans cost channel to the removal of this local waste and one which limited the age of additional excursions by householders or neighborhood authority gatherers and is in this way more naturally satisfactory. This shows the amount Dixons bunch has been acting morally. Administrations that Currys gives and serious foundation: For my task, it is critical to comprehend why retailers offer such administrations. Electrical retailing is profoundly serious, as: Currys, Comet, John Lewis, Debenhams, House of Fraser, Argos, Powerhouse, Dixons and a huge number of little autonomous retailers all vie for exchange what numerous clients see as an item showcase. Low edges exhibit the offer and that is the serious idea of the business. Since this is a serious market, value pressure is extraordinary and retailers will ordinarily attempt to offer the least cost in the market. So the client becomes acclimated to the possibility that costs will be comparative in many outlets. Along these lines there is an exacting strain to make diverse either by offering elite items or by exceeding expectations on administration. That is the reason all retailers will offer serious assistance offers including appropriate conveyance and after deals. No retailer will need to chance for a really long time a contender having the option to offer another help perceived. Up 'til now the leaving of reclaim has had inadequate things on deals; anyway one of the two principle tops for deals, the sweltering summer months and this is the time of deals and a period that organizations hope to expand their deals. Clients profile: Most of clients of Currys are from a blended gathering old enough, sexual orientation and races. The vast majority of clients that I for one observe going to the store of Currys in Chadwel heath are guardians or just grown-ups who can buy items by Mastercards or some other methods of installments. There are likewise different clients of Currys who are of a normal age like young people who can pay melodic things or games. Currys doesn't have any land clients in light of the fact that their clients are more often than not locally. A few clients have their data put away into Currys framework because of their clients devotion and due to Currys advertise investigates. Currys provides for its clients an assurance of buying things from their stores in the event that that the client isn't happy with the items or administrations that Currys gives to them, at that point the client can take the items back and get a substitution or if conceivable get the client can recover his/her cash back yet this depends with the case. A few times if Currys can't sift through the issue that the client has with the items, they generally provide for the client the telephone number of the organization or the maker of that specific item for additional data or directions about the use of the item.

Semester Reflections

Semester Reflections This past semester has been different than any of our other semesters at MIT (and even any of our years in K-12), in that we only took ONE class together! Not all twins are like this, but we just happened to always have very similar academic interests, and so weve always taken the same classes (often the timing of our schedules were different, but our courses were always the same). Having similar academic interests is not what changed this semester though. At MIT, combined with cross-registering, there are just so many freaking cool classes! Plus our major (Humanities and Engineering) is extremely flexible! So as opposed to in K-12, when there were only sooo many classes that we found interesting and that met requirements, we now have the option to BOTH have schedules we enjoy and that are different. Granted, we’ve had this option for the past three semesters and have taken advantage of it to an extent in freshman spring and sophomore fall. But after three semesters, we finally felt that we were getting the hang of MIT enough to really step out of our comfort zone. So, this past semester, we just decided to take much more deliberate advantage of this option, as kind of an experiment, to see how it would be like to take mostly different classes. These were our schedules: Danny: 6.009 Fundamentals of Programming ES.1803 Differential Equations 21M.601 Drawing for Designers CMS.339 Hacking VR: VR and Immersive Media CHANI1 Character Animation (taken at MassArt) Allan: 6.009 Fundamentals of Programming 6.163 Strobe Project Lab CMS.S60 Crafting Comics DTB2 Digital Toolbox 2 (taken at MassArt) The one class we decided to take together was our hardest one, so we can struggle through it together. But even with this class, the coding assignments had to be done individually. No one could really work together that much, since you really just needed to code your own solution. Obviously, we still did some things together this semester, like making these very blogs and helping run some clubs that we are both involved in. But in general, this past semester has been the first semester we’ve conquered mainly individually! So here are some reflections from a semester spent mostly apart: 1) This semester, the ratio of us meeting people as individuals to us meeting people as twins was a lot higher than in the past. Weve never minded meeting people together, but often times, our first conversation with those persons would end up being about how we are twins, and we assume this translates to their first impression of us as being part of a set, as the twins. Regardless if that assumption is accurate, we kind of embraced that perception we call ourselves “da twins” on these blogs, for example. But with that said, it definitely was cool to meet people on a regular basis this past semester, without right away revealing our now secret identities (muh ha ha ha ha) as twins. 2) Following this thought, it was also fascinating to see the reactions of people when they did learn we are twins. Two instances stand out. Allan: One person on my strobe lab team tried saying hi to Danny, who he thought was me, in the infinite, only to get ignored. In our next lab session, he asked me, confused and hesitantly, “would you happen to be a twin?” I replied, also confused (thinking how my teammate guessed), “yeeeessss?” He then explained how he tried waving at Danny, and thought I was rude (for not waving back) for about 5 seconds before coming up with this theory. My teammate then revealed that he, himself, is also a twin! Go figure! Danny: As I was walking out of my VR class with one of my teammates, Allan bumped into us (I think he was leaving from 6.009 office hours), and my teammate was so shocked to find out that I have a twin that she wanted to get a picture with us. It was an amusing experience, since this was the first time weve taken a selfie with someone solely because were twins. 3) Eating dinner alone is a thing. We were kind of scared to eat dinner alone in freshman year, because of social awkwardness. This was usually not a problem though because we would sit with our wing from Next House, or if we went down to dining too late, we’d just eat together. This semester, however, with our schedules so different and office hours consuming our lives, we rarely ate dinner with our wing at Next House or together. We usually had to stay on campus until 10pm every single day, because of either office hours or club meetings or whatever else. Sometimes we’d be able to coordinate dinner together, but mostly, we would separately eat dinner in McCormick (which is closer to campus than Next House is, and is also the best dining hall in our opinions).    Sometimes, we would sit with friends we’d bump into at McCormick, but usually we would each eat dinner by ourselves. And it’s actually not at all scary as freshman-we thought! It is kind of more productive if anythi ng, because you just focus on eating and then leave. This was actually very necessary many times during the rough spots of the semester, when every second had to be used at maximum productivity. 4) Recapping days. We have done this before, telling each other interesting snippets of things we did not both experience. Allan was on RingComm, we had different CMS.100 sections, Danny was in a club Allan wasn’t in, we’ve taken classes separately before, and have been on separate teams for project-based classes weve both taken, so there has been plenty content to share. But this semester, we regularly would spend entire days not experiencing things together, and thus was the first semester we regularly recapped entire days to each other. 5) A byproduct of number 4 is that this semester was the first time we deliberately kept things out of our recaps. In other words, we kept secrets from each other :0. Not with malicious intent of course there was just one situation where a piece of information had to be kept hidden from Allan for about a month. Any other semester, we would just have had too many interactions for a secret to be kept that long or even at all. 6) Studying by ourselves. We’ve done this before, but not to the extent that we did this semester, where basically everything we studied for was different and we could not rely on each other for academic support or being study buddies. This ended up being totally fine, because office hours. 7) Clothes became slightly more complicated. As children, we wanted to be exactlyyyyyy the same. We were  the  twins that wore the same outfit every day. We grew out of this towards the end of elementary school, but still kind of cringe at our past image. (Sidenote: This is not to say that there is anything wrong with twins who wear similar or the same clothes. We, personally, just do not like to anymore). So in recent years, we have been making deliberate efforts to wear different outfits. Usually that just means making sure that we’re not both wearing the same article of school gear or pieces of clothing that look really similar. But this semester, because of our separate schedules, we would wake up at different times and couldn’t coordinate our outfits to be different. By chance, it worked out that, mostly, our outfits were different enough. But likewise, by chance, there was one cursed day when we wore literally, exactly, the same outfit: the same MIT 2020 sweatshirt, the sam e style jacket, and very similarly colored pants. And because we are extra and over-react, we mutually refused to eat lunch together that day haha. This did make us question why we find it important for us to wear different clothes. When curating our individual images, we do not put that much thought into what our clothes say about us. We usually just wear comfortable things, and things we think fit us well. But when curating our image as twins, we do care about our clothes, in so much that they are just different from each other. As much as our identities are centered around being twins and as much as we like working together on random projects and as much as we like twin-blogging, we also each have our own sense-of-self and value the differences in our personalities and ways of thinking. And we want our clothes to be different to show that orrrrrrr, maybe we are just still embarrassed by our childhood pictures? or maybe both! Hhhmmmmmm That’s about all the reflections we can think of now. Post Tagged #6.009 #Course 21E - Humanities and Engineering #cross-registration #dining #Next House

Abraham Lincoln and the Telegraph

President Abraham Lincoln used the telegraph extensively during the Civil War, and was known to spend many hours in a small telegraph office set up in the War Department building near the White House. Lincolns telegrams to generals in the field were a turning point in military history, as they marked the first time a commander in chief could communicate, practically in real time, with his commanders. And as Lincoln was always a skillful politician, he recognized the great value of the telegraph in spreading information from the army in the field to the public in the North. In at least one instance, Lincoln personally interceded to make sure a newspaperman had access to telegraph lines so a dispatch about action in Virginia could appear in the New York Tribune. Besides having an immediate influence on the actions of the Union Army, the telegrams sent by Lincoln also provide a fascinating record of his wartime leadership. The texts of his telegrams, some of which he wrote out for the transmitting clerks, still exist in the National Archives and have been used by researchers and historians. Lincoln's Interest in Techology Lincoln was self-educated and always highly inquisitive, and, like many people of his era, he had a keen interest in emerging technology. He followed the news of new inventions. And he was the only American president to obtain a patent, for a device he designed to assist riverboats to cross sandbars. When the telegraph changed communication in America in the 1840s, Lincoln would certainly have read about those advances. Its likely he knew about the wonders of the telegraph from newspaper articles he read in Illinois before any telegraph wires had reached that far west. When the telegraph started to become common through the settled parts of the nation, including his native Illinois, Lincoln would have had some contact with the technology. As a lawyer working for railroad companies, Lincoln would have been a sender and receiver of telegraph messages. One of the men who would serve as a government telegraph operator during the Civil War, Charles Tinker, had done the same job in civilian life at  a hotel in Pekin, Illinois. He later recalled that in the spring of 1857 he chanced to meet  Lincoln, who was in town on business related to his legal practice. Tinker recalled that Lincoln had watched him sending messages by tapping the telegraph key and writing down incoming messages he converted from Morse code. Lincoln asked him to explain how the apparatus worked. Tinker recalled going into considerable detail, describing even the batteries and electrical coils as Lincoln listened intently. During the campaign of 1860, Lincoln learned he had won the Republican nomination and later the presidency via telegraph messages which arrived in his hometown of Springfield, Illinois. So by the time he moved to Washington to take up residence in the White House he was not only aware of how the telegraph worked, but he recognized its great usefulness as a communication tool. The Military Telegraph System Four telegraph operators were recruited for government service in late April 1861, soon after the attack on Fort Sumter. The men had been employees of the Pennsylvania Railroad, and were enlisted because Andrew Carnegie, the future industrialist, was an executive of the railroad who had been pressed into government service and ordered to create a military telegraph network. One of the young telegraph operators, David Homer Bates, wrote a fascinating memoir, Lincoln In the Telegraph Office, decades later. Lincoln In the Telegraph Office For the first year of the Civil War, Lincoln was barely involved with the militarys telegraph office. But in the late spring of 1862 he began to use the telegraph to give orders to his officers. The Army of the Potomac was becoming bogged down during General George McClellans Peninsula Campaign in Virginia, Lincolns frustration with his commander may have moved him to establish faster communication with the front. During the summer of 1862 Lincoln took up the habit he followed for the rest of the war: he would often visit the War Department telegraph office, spending long hours sending dispatches and waiting for responses. Lincoln developed a warm rapport with the young telegraph operators. And he found the telegraph office a useful retreat from the much busier White House. One of his constant complaints about the White House was that job seekers and various political figures wanting favors would descend upon him. In the telegraph office he could hide away and concentrate on the serious business of conducting the war. According to David Homer Bates, Lincoln wrote the original draft of the Emancipation Proclamation at a desk in the telegraph office in 1862. The relatively secluded space gave him solitude to gather his thoughts. He would spend entire afternoons drafting one of  the most historic documents of his presidency. The Telegraph Influenced Lincoln's Style of Command While Lincoln was able to communicate fairly quickly with his generals, his use of communication was not always a happy experience. He began to feel that General George McClellan was not always being open and honest with him. And the nature of McClellans telegrams may have led to the crisis of confidence that led Lincoln to relieve him of command following the Battle of Antietam. By contrast, Lincoln seemed to have a good rapport via telegram with General Ulysses S. Grant. Once Grant was in command of the army, Lincoln communicated with him extensively via telegraph. Lincoln trusted Grants messages, and he found that orders sent to Grant were followed. The Civil War had to be won, of course, on the battlefield. But the telegraph, especially the way it was used by President Lincoln, did have an effect on the outcome.

Postpartum Depression On The Mother And Parenting

For this research paper, I decided to focus on postpartum depression. While being a listening ear, I was introduced to the reality that not every mother has the attachment to her child that almost every movie in Hollywood portrays. After hearing the story and not sure if it was a real thing, I began to search the web for information, stories, and news coverage related to the rarely-discussed category of depressed known as Postpartum Depression (PPD). I wanted to find solid proof that this was an actual diagnosis and what the long-term effects would be, as well as what was being done to reduce the amount of women that suffer from this. This research should allow me to better understand the causes and effects of postpartum depression on the†¦show more content†¦Problems such as breastfeeding, marital or relationship issues, feeling inadequate, and not having the social support can all add to the stress factors that could potentially lead and contribute to postpartum depression (Postpartum Depression, 357). Primary Care Physicians are ultimately more likely to make the diagnosis of PPD over their obstetrician since they usually have a more solid foundation and trust built up after being seen there more frequently. A test is given to women around eight to twelve weeks postpartum in order to determine the likelihood of postpartum depression and overall health of the mother (Postpartum Depression, 358-359). Another scholarly journal I found was Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae by Marinus H van Ijzendoorn, Carlo Schuengel, and Marian J. Bakermans-Kranenburg published by Cambridge University. The journal describes how a mother’s postpartum depression affects the mental development of the child as well as their own attachment issues that can result in educational delays as well as behavioral issues (Development and Psychopathology, 228). Children develop attachments with anyone who gives them steady care, disregarding the quality of that care. The effect on infants whose mother went through postpartum depression (PPD) can impact the development and quality of life that child will have (Child Development, Feb 1993). A long-term effectShow MoreRelatedThe Effects Of Postpartum Depression On A Woman s Mood1307 Words   |  6 PagesMedlinePlus, the exact causes of postpartum depression are unknown. Changes in hormone levels during and after pregnancy may affect a woman’s mood. Many non-hormonal factors may also affect mood during this period; Change in your body from pregnancy and delivery, changes in work and social relationships, having less time and freedom for yourself, lack of sleep, and worries about your ability to be a good mother (Postpartum depression, n.d.)†. Romm states that becoming a mother can be overwhelming, and fewRead MorePostpartum Depression : Symptoms And Treatments Essay1101 Words   |  5 PagesDepression Postpartum in United States According to Merriam Webster Dictionary, depression is â€Å"a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies.† According to the definition of the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), postpartum depressionRead MoreIs Abortion Morally Wrong?867 Words   |  4 Pagesopportunity to have an abortion rather than giving birth, and raising your child. An abortion can happen in practically two ways, the pill, which deteriorates the non-living fetus, or the physical way where doctors pull out the fetus with medical tongs. Parenting is having the child and raising them as your own till they are a legal adult at eighteen years old. The United States is quite divided on the topic, and choice of abortion. Nearly half think a bortion is utterly wrong and should not be a choice atRead MorePostpartum Depression : A Mental Health Disorder1414 Words   |  6 Pages Postpartum depression, or PPD, is a mental health disorder that occurs in women prior to the birth of a newborn infant. PPD is caused by a dramatic shift in hormones occurring anywhere from a month to a year after childbirth. Because of the hormonal changes, women may feel that pregnancy is a time of happiness, fear, excitement, exhaustion, and even sadness. Expecting mothers may also feel a multitude of emotions after delivery as well. Postpartum depression in new mothers is a debilitating illnessRead MoreMaternal Depression And Its Impact On Infant Health1144 Words   |  5 PagesMaternal Depression and its’ Impact on Infant Health â€Å"Maternal Depression† is a term that includes a range of depressive conditions, which impact mothers while pregnant and up to 12 months after delivery (NIHCM). Such depressive conditions include prenatal depression, postpartum depression and postpartum psychosis (NIHCM). In this paper, current literature that examines both prenatal depression and postpartum depression in relation to infant health will be reviewed. Prenatal depression includesRead MorePathophysiology And Effects Of Postpartum Depression1528 Words   |  7 PagesRhetoric Professor Jaffe The Pathophysiology Effects of Postpartum Depression After childbirth, around 85% of women experience some sort of mood change. For most, the symptoms, following childbirth are minor and brief, otherwise known as the baby blues. Though, 10 to 15% of a woman’s baby blues manifests and develops into postpartum depression and in extreme circumstances, psychosis (Zonana, J., Gorman, J., 2005). Postpartum depression is a multifaceted phenomenon with various components. ThisRead MoreMother Infant Dyads Completed All Aspects Of The Study Essay2058 Words   |  9 PagesMethod Twenty-four mother-infant dyads completed all aspects of the study. Of those 24, 18 were Caucasian, 22 were married, eight of them had an annual family income of $50,000 to $74,999, and seven had an annual family income of over $100,000. Also 16 of the participating mothers had a graduate degree. Not only is the sample size very small, but the demographics of the mothers is greatly disproportionate. With the majority of mothers being caucasian, educated, middle class, married women, the sampleRead MoreLiterature Review : Postpartum Depression Essay1652 Words   |  7 PagesLiterature Review Postpartum Depression Mothers who have brought into this world a blessing have been preparing themselves for a big change in their life. They have been learning and educating themselves about how to be a good mother. Many mothers find it really hard to transition from being an independent woman without children to becoming a mother (Corrigan, Kwasky, Groh, 2015). Adapting to motherhood can be a drastic change, and usually creates challenges that lead to feeling overwhelmed (LegerRead MoreMaternal Depression : A Standard ( New York State Department Of Health1048 Words   |  5 PagesDespite widespread recognition of the problem of maternal depression and the potential benefits of screening, screening for maternal depression is not a standard (New York State Department Of Health, 2016). This policy brief was written for healthcare providers who treat expectant and new mothers with goals to improve the screening and to increase the number of women receiving appropriate treatment in our community. The rec ommendations address measures to improve early identification of the conditionRead MoreEssay On Fight For Women Health863 Words   |  4 Pageswoman can act, think, or feel. For some, one of those symptoms could be depression. Antenatal depression is a form of depression that can affect a woman during her pregnancy. In an article, Pregnancy Blues Can Be Crippling, it states that â€Å"one in seven women experience depression during pregnancy or within 12 months of delivery.† Many women suffer through this and they can never really tell if its serious depression or just their hormones acting up. The inability to control emotions could

Six Sigma for Pizza Free Essays

Hong Kong Baptist University Professional Diploma in Quality Management Six Sigma and Quality Tools Group Assignment Report of Six Sigma Project For Yum Yum Pizza Group Group Members: CHIU Chi Cheong, Ricky CHOI Kam Tong, Danny CHUNG King, Carmen FONG Luk Chi, Brian LEE Lai Fun, Fanny Wong Ming Chung, Victor DQM03I2-004 DQM03I3-004 DQM03I3-021 DQM03I3-008 DQM03I3-022 DQM03I3-018 Report of SiX Sigma Project, Yum Yum Pizza Group Page 1 of 23 Contents 1. Introduction 2. Define Phase 3. We will write a custom essay sample on Six Sigma for Pizza or any similar topic only for you Order Now Measure Phase 4. Analysis Phase 5. Improve Phase 6. Control Phase 7. Conclusion Report of SiX Sigma Project, Yum Yum Pizza Group Page 2 of 23 Introduction Yum Yum Pizza group comprises of 10 pizza shops scattering in different areas in Hong Kong Island, Kowloon and New Territory as shown on the map below. Staff in each shop are basically organized with order receptionist, baker and delivery worker. On top of these 10 pizza shops, the leadership and management works are responsible by a management team. The core business is to produce pizza of various styles and deliver to their customers according to address of the order by phone. Of course, there are also self-pick up pizza available to the customers. However, this is merely involved about 10% of the overall business. Pizza Group Shops Location P P P P P P P P P P P : Shop Location Starting from early 2003, there were occasional customer feedbacks and complaints which were mainly involved unpunctual delivery of pizza. Since 90% of the business required our pizza delivery, the management began to pay attention on these feedbacks. During the half year review in June 2003, it was discovered about 3% loss of customers and about 5% drop in pizza sales in the same period. We immediately communicated the finding with the Management. Subsequently, a project team was set up to investigate the causes and seek for improvement on the situation. After the first Report of SiX Sigma Project, Yum Yum Pizza Group Page 3 of 23 project team meeting, it was agreed that the team would adopt Six Sigma strategy to determine the cause of the problem and implement the solution. Purpose of this report is to present the results of the pizza group’s problem-solving process and explain the solution adopted. As Six Sigma problem-solving includes statistical and measurement methods, by using the stools , we focused the efforts on understanding the variations in the business process and the defects that results: Customer satisfaction Revenue Quality Impact to employees Growth of business Competitive advantages. This report also presents a detailed explanation of steps on how we used the six sigma problem-solving strategy ( i. e define, measure analysis, improve and control ) to determine the cause of losing customer , decreasing of pizza sales and to establish method in rectifying the faulty steps in our operation process. Lastly, with implementation of the fine-tuned process, reoccurrence of the defects can be minimized in order to maintain and enhance a sound pizza business operation. Define Phase To the current practice, the time required for delivery of a pizza to customer was one hour on average. With concern on the customer complaints on unpunctual delivery, sales decreasing and number of customers was found reducing in the 6-months financial review in June 2003, undoubtedly, the pizza group had to take action to rectify the situation. At the beginning, we did not know what particular problem being existed in the business. A project team was therefore set up, by using six sigma strategy to tackle and rectify the problem. After the first project team meeting, a project team charter was formulated based on the management concern and displayed as below: Report of SiX Sigma Project, Yum Yum Pizza Group Page 4 of 23 Project Team Charter – Delivery performance of pizza Business Case Opportunity Statement Current average delivery time is one hour for each We currently have an average delivery of pizza / pizzas to customer. Management delivery cycle of one hour. requires the pizza to be delivered within one hours as declared by same scales competitors in this trade of Our customers expect the business. pizza can be delivered Yum Yum Pizza group have been losing 3% of punctually within +/- 5 min. customers base per month within the past 6 months variation review, the sales have dropped in 5% (HKD135K per month) for the same period. By improving the accurate delivery time we anticipate loss of customer would be merely 1% drop and the sale would also be return to about 2% drop. With continuous implementation, the pizza sales would have 3% to 5% further increase monthly (i. e. $81K/month – $135K/month increase ) in the coming one or two years. Goal Statement -To deliver pizza from order to customer within one hour punctually – To achieve pizza delivery time within +/- 5 min. – Since this is the first six sigma project in Yum Yum Pizza Group, the current sigma process level is unknown which have to be identified and improved as the target of the project team. Activity Define Measure Analyze Improve Control Track Benefit Project Plan Start End 6/1 6/14 6/10 6/30 7/4 8/1 9/12 10/13 10/13 11/13 11/14 12/15 Project Scope Main objective – to review and improve order processing – Start – Order received from customers – End – Pizza in customer’s hand Team Selection Bob Black Belt Charles Group Manager Apple Order Receptionist Donald Baker Edward Deliveryman The project team charter submitted to management and was approved in mid May 2003. Right immediately, a brainstorming session conducted to review the business Report of SiX Sigma Project, Yum Yum Pizza Group Page 5 of 23 rocess on a high level steps. SIPOC diagram was also established with identification on Supplier, Inputs, Process, Outputs Customers for showing the current situation of the business process and is now as below : Report of SiX Sigma Project, Yum Yum Pizza Group Page 6 of 23 SIPOC Diagram – Pizza Delivery Company Supplier Inputs Process Outputs Customers Requirements †¢ Ingredients for Pizza †¢ Packaging material supplier †¢ †¢ Supplier for motorcycle †¢ Printing Company Process †¢ Ingredients †¢ Packaging materials †¢ Staff †¢ Motor cycles †¢ Order form See below †¢ †¢ Pizza Office customers Household customers Delicious †¢ Good taste †¢ †¢ †¢ †¢ †¢ †¢ Punctual delivery Step 1 Receive Order (by phone) Step 2 Production Packaging Step 3 Motorcycle Delivery Step 4 Park arrive delivery point Step 5 Hand in pizza to Customer receive money Report of SiX Sigma Project, Yum Yum Pizza Group Page 7 of 23 Besides, customer surveys was also conducted to collect the impression and feedback from customers. With these â€Å"Voice Of Customers† (VOC ), we firstly developed a list of key customer issues. On the further steps, we also formulated a list of critical customer requirement as listed on the table: Voice of Customer to Critical Customer Requirement ( VOC to CCR ) Critical Customer Requirement maintain pizza at temperature 40 degree C when passing to customer inform arrival time and price in advance Key Customer Issue pizza delivered to customer should be at reasonable temperature on time delivery packing arrangement concern on price Voice of Customer Cool pizza, tasted no good Late delivery Long deliver lead time Poor packaging outlook Poor packaging spoil pizza unexpected high price impolite delivery manner ragged deliver worker – – – keep arrival time variation less than 5 min. tandard pizza package standard greeting and manner delivery worker in uniform need polite manner when passing pizza to customer reasonable worker outlook – Measure Phase To investigate and realize further improvement for fulfilling the most important requirement from customers, it was anticipated operational definition would be essential to clearly point out the criteria to our operational performance. Based on the current operation process and the established operational definition, we conducted surveys and interviews with our customer and staff to collect data on how we performed currently. Below is the table showing our data measurement plan which was designed to collect the feedbacks and opinions. As indicated, the data were collected from various sources, that included the direct feedback from customer, and we anticipated the right moment to collect these data should be right after the telephone order from customers, which was the most simple and direct method to collect the first hand information.. Report of SiX Sigma Project, Yum Yum Pizza Group Page 9 of 23 Data Measurement Plan Performance Measure Operational Definition Data Source and Location -measure the failure rate in maintaining pizza temperature not less than 40 degree -maintain pizza in standard cartoon Sample Size Who will collect the Data When will data be collected? How will data be selected? Other data that should be collected at the same time? -feedback from customer,-feedback from delivery worker, 15% of delivered pizza 1June to 30 June Randomly Pizza quality,, Bob, Black Belt -telephone ,survey / questionnaire ox with thermal indicator and ensure the temperature is not less than 40 degree C on the indicator -estimate delivery time and price of pizza, then inform customer on the arrival time right after telephone order -ride motorcycle for pizza delivery and arrive on time -packaging pizza with standard cartoon box -greeting to customer with wording -delivery worker must be wearing clean and tidy uniform standard C when passing to customer -measure the failure rate in informing arrival time an d price in advance to customer -measure the failure rate in keeping arrival time variation less than 5 min. measure the failure rate in packaging pizza in standard package -measure the failure rate of delivery worker greeting to customer by saying standard greeting and manner -measure the failure rate of delivery worker wearing uniform selected Weather situation, Traffic situation Report of SiX Sigma Project, Yum Yum Pizza Group Page 10 of 23 Pizza Ordering Sequence ( By Phone ) Customer Order Receptionist Baker Deliver Order by phone standard greeting, listen customer’s order details produce and bake pizza as ordered confirm order details and customer address lan delivery route confirm delivery time, payment package pizza in delivery box collect packaged pizza, or other food items plan for production schedule put pizza and other items into delivery box of motorcycle drive to customer address get to the door of the address, ring the bell and say standard greeting check accept ance and pay confirm delivery of pizza and other food items receive payment and customer signature on receipt, say standard goodbye and leave business case completed Report of SiX Sigma Project, Yum Yum Pizza Group Page 11 of 23 According to the established operation definition and sequence above, survey forms and questionnaires were formulated. It was also decided to perform the 500 surveys to customers randomly starting from 1 June. 2003, that involved about 15% of the pizza business during the moment. In addition to the questions devised from operation definitions, some general questions liked â€Å"Do you think choice of the pizzas is sufficient to you â€Å" and â€Å"Can you find your favorite taste among the existing available choice of pizzas â€Å" were also included in the questionnaires and survey questions to customers. Below is the table summarizing the survey results: Summary of operation defects as identified in June 2003 survey Satisfactory Defect item Operation description level Frequency not acceptable 1 maintain pizza not less than 40 degree C not acceptable 2 advise pizza arrival time not acceptable 3 variation of pizza arrival time within 5 min. cceptable 4 acceptable pizza package acceptable 5 delivery worker wearing uniform 6 acceptable greeting words fromdelivery worker acceptable 7 Do you think choice of the pizzas is sufficient to yougood Can you find your favor us taste among the existing 8 available choice of pizzas very good good 9 waiting time during telephone order for pizza 10 clear telephone communication with order receptionivery good 11 overall impression during making telephone order good %in Overall Defect 21 21. 88 18 18. 75 45 46. 88 6 6. 25 3 3. 13 3 3. 13 N. A. N. A. N. A. N. A. N. A. ( Satisfactory Level : very good; good; acceptable; not acceptable; poor ) Report of SiX Sigma Project, Yum Yum Pizza Group Page 12 of 23 Before tackling the results, we also formulated the data in Pareto Chart and calculated the process sigma for more understanding on the business situation of the pizza group. Operation Defect Rates in Pareto Chart O cc u ran n a ce F req u e n cy 100 90 80 70 60 50 40 30 20 10 P a re to C h a rt – O p e ra tio n D e fe c t a s id e n tifie d in J u n e 2 0 0 3 % in O v e ra ll D e fe c t 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% s a y i n g st a n d a r d g r e e ti n g k e e p a rri v al ti m e v a riati o n i n f o r m a rri v a l ti m e a n d sta n d ard p a c k a g e aintain te m p erature p a c kin g piz z a in w it h p o lit e m a n n e r p ric e in a d v a n c e w e arin g u nif o r m at 4 0 d e g re e C Calculated Sigma Value of the overall process ( as in June 2003 ) less th a n 5 m in. O p e r a tio nD e fe c ts 1 2 3 4 5 6 O v e ra ll Y e ild = 21 18 45 6 3 3 = U n its 500 500 500 500 500 500 DPU 0 . 0 4 2 0 . 0 3 6 0 . 0 9 0 . 0 1 2 0 . 0 0 6 0 . 0 0 6 T h r o u g h tp u C u m . Y ie ld t Y ie ld 0 . 9 5 9 0 . 9 5 9 0 . 9 6 5 0 . 9 2 5 0 . 9 1 4 0 . 8 4 5 0 . 9 8 8 0 . 8 3 5 0 . 9 9 4 0 . 8 3 0 0 . 9 9 4 0 . 8 2 5 ( Y (1 ) x Y (2 ) x Y (3 ) x Y (4 ) x Y (5 ) x Y (6 ) 0 . 8 2 5 a ro u n d 0 . 0 6 sig m a ) Report of SiX Sigma Project, Yum Yum Pizza Group Page 13 of 23 Analysis Phase In analysis phase, we had studied why all the pizza delivery to customer could not be achieved steadily within one hour. The failure rates is the highest of 46. 88% among all defects identified and it happened 45 times during the survey period with sample size of 500 survey. With further investigation on the finding, we found the traffic condition, weather condition, and the familiarity of the delivery worker to the customer address would highly affected the overall delivery time and therefore giving an â€Å" Not Punctual Impression† to customer. In addition, such delay would also caused the pizza temperature dropped below the designed 40 degree C. As the result, the number of customer decreased and pizza sales dropped. Below was the Cause-and-Effect diagram utilized for analyzing causes leading to delayed delivery. Cause-and-effect Diagram – Pizza Delivery People poor communication Machines Telephone Traffic Condition Traffic Jam Pizza Oven deliver not familar with customer’s address Road excavation Motorcycle Operation process Not Punctual Pizza Delivery Typhoon kill of baking by Pizza Oven Driving Skill on Motorcycle Raining delivery box on motorcycle Cartoon box for packing pizza Methods Weather Materials For the pizza temperature, we investigated the delivery box on motorcycles and cartoon boxes currently used in packaging pizzas for delivery. No major problem was found in keeping pizza exist oven temperature. Actually, the material for keeping warm, that included delivery boxes on motorcycles and cartoon boxes, all these equipment and facilities were at an acceptable quality standard and in a sound condition. Report of SiX Sigma Project, Yum Yum Pizza Group Page 14 of 23 Cause-and-effect Diagram – Pizza Temperature People poor communication Machines Telephone Pizza Oven deliver not familar with customer’s address Motorcycle kill of baking by Pizza Oven driving skill of Motorcycle delivery box on motorcycle Cartoon box for packing pizza Pizza Temperature below 40 degree C Methods Materials Analysis on other issues were also conducted, which mainly carried out with reference on the operation process, starting from customer order to the payment received from customer. Report of SiX Sigma Project, Yum Yum Pizza Group Page 15 of 23 In addition to the analysis on the collected data, FMEA was also a tool to study on recommended improvement action. The project team had also formulated a FMEA table below for showing the analyzed risk priority and recommended action. Ite m a n d F u n c tio n p la n d e liv e ry ro u te P o te n ia l F a ilu re M ode p la n b a s e d w ro n g o r o n w ro n g d e la y in fo r m a tio n d e liv e ry P o te n ia l E ffe c t(s ) of F a ilu re F M E A P ro c e ss P o te n tia l C a u se(s) o f F a ilu re A c tio n re s u lts C u rre n t C o n tro ls R e c o m m e n d e d R e s p o n s ib ility A c tio a n d T a rg e t A c tio n n c o m p le tio n D a te Severity e Occurrenc Detection RPN Severity e Detection Occurrenc RPN T aken o lle c t a n d p u t p iz z a in d e liv e ry box of m o to rc y c le d riv e to th e c u s to m e r ad d ress g e t to th e ad d ress an d rin g d o o r b e ll p iz z a d ro p p e d d u rin g c o lle c tio n need re p la c e m e n t, lo s e o f p iz z a 7 w ro n g in fo rm a tio n fro m o rd e r re c e p tio n is t o r w ro n g p la n n in g o f 9 c a re le s s o f d e liv e r 2 p la n b a s e d 5 on m ap and e x p e rie n c e 3 1 ta k e c a re in p u ttin g th e p iz z a 7 0 a s th e re a re to ta lly 1 0 s h o p s , s u g g e s t to s e rv e th e c u s to m e rs based on s p e c ific a re a o f 2 7 ta k e c a re in d e liv e ry o n tin u . b y o rd e r re c e ip tio n is ts , N ov. 03 e ffe c tiv e b y d e liv e ry w o rk e rs, N o v . 0 3 e ffe c tiv e b y d e liv e ry w o rk e rs, N o v . 0 3 e ffe c tiv e b y d e liv e ry w o rk e rs, N o v . 0 3 e ffe c tiv e b y d e liv e ry w o rk e rs, N o v . 0 3 e ffe c tiv e c o n tin u . 4 2 3 24 9 1 3 27 f a ilu re o f d e la y in m o to rc y c le , d e liv e ry tra ffic ja m d e la y d e liv e ry d e liv e r n o t f a m ilia r w ith th e p la c e o f a d d re ss c o n f irm d ro p th e d e liv e ry p iz z a w h ile a n d re c e iv e p a s s in g to paym ent c u s to m e r u n p re d ic te d tra ffic o r w e a th e r s itu a tio n 6 n o t fa m ilia r w ith th e a r e a o f c u s to m e r ad d ress 8 c a re le s s o f b o th c u s to m e r a n d d e liv e r 4 n o s p e c ific c o n tro l 6 1 6 8 lis te n to ro a d re p o rt fro m ra d io 1 0 8 a rra n g e e x p e rie n c e d e liv e r fo r s e rv in g th e a re a 3 2 b e c a re fu ll in h a n d lin g p iz z a c o n tin u . 4 3 4 48 3 n e e d m o re 6 c o n tin u . 2 2 4 16 need re p la c e m e n t, lo s e o f p iz z a tim e to p re p a re d e liv e ry p la n 1 b e c a re fu ll in h a n d lin g p iz z a c o n tin u . 8 1 4 32 T o ta l R is k P rio rity N u m b e r R e s u ltin g R is k P rio rity N u m b e r Report of SiX Sigma Project, Yum Yum Pizza Group Page 16 of 23 After analyzing the survey data and cause of operation defects, we had also analysed the relationship of the customer requirement against our group available technical and internal resources , that included analysis on communication tools, listening skill, baking skill, packaging devices, delivery equipment and even the manner of delivery workers etc. The purpose was to had a thorough understanding on the internal strength and weakness of Yum Yum Pizza Group. Below was the quality function deployment matrix utilized for the analysis. As indicated on the diagram, the highest score of 27 was found on â€Å" Keep arrival time variation less than 5 minutes â€Å". That meant it should be the first issue to be resolved for improving the pizza business Quality Function deployment Matrix VS : Very strong relationship w w Thermal sensing tape w w Good knowledge of road condition and driving skill S : Strong relationship W : Weak relationship VS Well equipped pizza bakery Communication tools Manner training Cartoon pizza box Good baking skill Technical requirement Good conditioned motorcycle Accurate watch Tidy uniform CCR Pizza at temperature 40 degree to customer Inform arrival time price in advance Keep arrival time variation less than 5 minutes Standard pizza package Standard greeting and polite manner Proper dressed delivery worker Low pizza price Delicious Score 24 18 9 9 9 9 9 9 9 3 3 27 10 9 9 9 9 1 9 1 1 1 3 1 1 9 1 9 5 22 Report of SiX Sigma Project, Yum Yum Pizza Group Page 18 of 23 Improve Phase Based on the analyzed information, the project team understood that the methodology, facilities and including the operation behavior of staff are at acceptable level. The most serious and uncontrollable factor is the traffic or road condition and weather situation, which was mostly serious item affecting the arrival time of pizza to customer. To minimize this factor, the Project Team recommended the entire services areas of the Pizza Group to be separated into 10 services zones. And each shop would response to serve the pizza customers’ within the defined zone. Should there was any order outside the their responsible zone, the order receptionist had to refer the orders to the responsible shop to produce and deliver the pizza by their own resources. However, whenever there was any order outside all the 10 service zone as shown on the map of responsible zone, the receptionist had to estimate the delivery time and immediately explain to the customer for the estimated time required. Even the delivery time would exceed the pre-designed one hour delivery period, with this clarification the customer would understand the situation without wrong expectation on the pizza delivery. As such, complaint on unpunctual pizza delivery should be kept to the minimal. Below were the modified operation process chart with the changes marked in brown and the map showing the responsible service zones of the 10 pizza shop for reference. Responsible Zones of Pizza Shops P Hou se Hou se P P Hou se P Hou se P Hou se P Hou se P Hou se P Hou se P Hou se P Hou se P Responsible Service Zone Report of SiX Sigma Project, Yum Yum Pizza Group Page 19 of 23 Pizza Ordering Sequence, after process restructuring ( By Phone ) Customer Order Receptionist Order Receptionist of responsible area Baker Deliver Order by phone standard greeting, listen customer’s order details confirm order details and customer address confirm delivery time, payment Plan for production schedule produce and bake pizza as ordered plan delivery route pack pizza in delivery box collect packed pizza, or other food items Review for production area put pizza and other items into delivery box of motorcycle continue pizza production locally drive to customer address get to the door of the address, ring the bell and say standard greeting check acceptance and pay confirm delivery of pizza and other food items receive payment and customer signature on receipt, say standard goodbye and leave business case completed Report of SiX Sigma Project, Yum Yum Pizza Group Page 20 of 23 Control Phase For monitoring operation performance, control chart was utilized to collect operation data. The chart could distinguish the process variation resulting from common causes or special causes. It was aware that variation in the pizza operation was unavoidable. Number of factors including material, machines, methods, environment and operators were the major elements causing variation. For easily reflecting and controlling the overall performance of the pizza delivery, X-bar R chart was selected for the monitoring and controlling purpose. Measures Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10 No. ( min. ) ( min. ) ( min. ) ( min. ) ( min. ) ( min. ) ( min. ) ( min. ) ( min. ) ( min. 1 56 57 58 55 55 60 54 58 54 59 2 59 49 53 52 59 57 52 57 58 56 3 58 57 54 52 49 55 52 54 55 53 4 50 52 49 54 53 68 63 51 56 59 5 52 53 52 52 49 56 52 53 47 52 6 52 54 53 54 59 64 63 53 56 53 7 58 57 48 57 59 57 64 59 51 53 8 56 54 57 59 52 52 55 54 52 59 9 57 51 63 51 51 59 51 59 51 53 10 53 50 50 57 63 53 54 56 54 59 11 49 56 52 53 64 62 48 54 48 54 12 59 49 59 53 56 57 52 58 52 57 13 59 57 62 59 64 52 70 52 53 52 14 52 52 55 54 52 59 54 53 54 53 15 51 59 51 49 51 53 57 57 57 58 16 55 53 54 55 54 60 47 55 54 57 17 57 54 49 56 52 53 47 52 59 57 18 52 49 59 49 49 53 56 53 52 52 19 53 52 59 57 49 59 51 54 53 59 20 54 53 52 52 55 54 52 57 55 53 21 57 57 51 59 51 70 51 52 60 56 22 64 52 64 53 54 69 54 53 53 52 23 65 53 62 54 49 56 52 53 62 53 24 63 54 52 49 59 69 59 53 56 49 25 59 53 50 54 53 54 53 55 57 55 Average Range == X == R __ UCL X __ LCL X 56 16 53. 48 10 54. 72 16 53. 96 10 54. 44 15 58. 44 18 54. 52 23 54. 6 8 54. 36 15 54. 92 10 = 54. 944 ( min. ) = = = 14. 1 ( min. ) 57. 1013 ( min. ) 52. 7867 ( min. ) __ UCLR __ LCLR = = 21. 7281 6. 4719 Report of SiX Sigma Project, Yum Yum Pizza Group Page 21 of 23 Average 63 62 61 60 59 58 57 56 55 54 53 52 51 50 1 2 3 4 5 Day 6 7 Performance Requirement Min. __ UCLX __ X __ LCLX 8 9 10 Range 40 35 30 25 20 15 10 5 0 1 2 3 4 5 Day 6 7 8 __ R UCL __ R Min. __ LCLR 9 10 Report of SiX Sigma Project, Yum Yum Pizza Group Page 22 of 23 The above data was collected within 10 operation days from mid Oct. o mid Nov. It was obvious that the operation on a heavy rainy, day 6 was the worst. There were totally 4 deliveries required more than 65 minutes to complete, which exceeded the operation definition. This was still out of our control. With comparison with the performance before the project improvement, it was found that the defect rate was great ly improved as summarized below : Summary of Operation Defects Comparsion between June 2003 / Dec. 2003 June 2003 Dec. 2003 Frequenc % in Overall Frequenc % in Overall y Defect y Defect 21 21. 88 7 20. 59 18 18. 75 5 14. 71 45 46. 88 10 29. 41 6 6. 25 6 17. 65 3 3. 13 3 8. 82 3 3. 13 3 8. 82 item 1 2 3 4 5 6 Operation description maintain pizza not less than 40 degree C advise pizza arrival time variation of pizza arrival time within 5 min. acceptable pizza package delivery worker wearing uniform acceptable greeting words from delivery worker Conclusion Even though it was not 100% rectified all the operation defects, with the great improvement on the pizza delivery, the defect rate on pizza temperature was also improved. The sigma value on the overall pizza delivery of the group was greatly improved to 1. 5 sigma and the pizza sales as reviewed in end Dec. 2003, 5% increased was identified in comparing with the sales figure six months before. Sigma level after implement of new operation process: OperationDefects Units DPU Throughtpu Cum. Yield t Yield 1 7 500 0. 014 0. 986 0. 986 2 5 500 0. 01 0. 990 0. 976 3 10 500 0. 02 0. 980 0. 957 4 6 500 0. 012 0. 988 0. 946 5 3 500 0. 006 0. 994 0. 940 6 3 500 0. 006 0. 994 0. 934 Overall Yeild = = Y(1) x Y(2) x Y(3) x Y(4) x Y(5) x Y(6) 0. 934 ( around 1. 502 sigma ) It was concluded, implementation of the improved operation process was essential to the business. With the continuation implementation of the improved process and current good taste of pizza with variety choice to customer, the pizza sales was expected gradually increased with number of customer increased as well. Report of SiX Sigma Project, Yum Yum Pizza Group Page 23 of 23 How to cite Six Sigma for Pizza, Papers

Major Depressive Disorder (MDD)

Table of Contents Introduction Literature Studies Management of MDD Conclusion References Introduction MDD is a cluster of syndromes that comprises a mental disorder, which is marked by declined moods, followed by a decline in self-esteem and not being interested in pleasurable tasks. Its features involve a clinical course, marked by major depressive periods. These take like a fortnight, marked by low moods and displeasure. The condition is also referred to as major depression, unipolar depression and clinical depression.Advertising We will write a custom research paper sample on Major Depressive Disorder (MDD) specifically for you for only $16.05 $11/page Learn More The disorder is disabling and comprises an individual’s lifestyle and family, loss of appetite and sleep distractions, which compromises one’s health (Greden, 2001). The patients of this medical condition end up committing suicide. The reason as to why I chose the topic is because it affects my life and many people around me in school and at home. Having the condition has affected my lifestyle, school work, social life and has compromised my career since I lose pleasure in all activities. I even devalue life as I find my self contemplating on suicide during the phases of depression. MDD affects people differently with different symptoms such as weight loss, pessimism, feeling guilty, loss of concentration, insomnia or hypersomnia, sleeping disorders, fatigue, hopelessness, irritability, loss of self-worth, disinterest in life and in severe cases, delusions and hallucinations may result. The disorder affects more of females as compared to males (Deb Bhattacharjee, 2009). The occurrence of the disorder may be linked to other medical close to 20.0 % to 25.0% of patients with conditions related to cancer, prolonged pain, diabetes, stroke, hypothyroidism, medications e.g. sedatives as well as myocardial infarction, which worsens these conditions (Deb Bha ttacharjee, 2009). Health conditions that accompany MDD include drug abuse, panic, anxiety, obsessive-compulsive disorder, anorexia nervosa, Bulimia Nervosa and borderline personality disorder (Deb Bhattacharjee, 2009). Literature Studies According to one study dubbed the ‘epidemiology of Major Depressive Disorder’ aimed at determining the prevalence of MDD. The study design used face to face research in 48 homes in the U.S by interviewing individuals over eighteen years. From the study, the MDD prevalence for a lifetime was 16.2% and that over one year was 6.6% and stated to be â€Å"10.4% mild, 38.6% moderate, 38.0% severe, and 12.9% very severe† (Kessler et al, 2003).Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Role impairment showed 59.3% over a year where 51.6% of the cases sought medical attention and were being treated for MDD. Treatment proved enough f or 41.9% of the cases, adding up to 21.7% MDD treatment annually. The study concludes that MDD was a common condition with its distribution being extensive in the population. It is linked to severe symptoms and role impairment. There has been a rise in treating MDD, which offers hope for its management although lack of enough treatment is still a critical issue. The study maintains that â€Å"Emphasis on screening and expansion of treatment needs to be accompanied by a parallel emphasis on treatment quality improvement† (Kessler et al, 2003) Another study regarding MDD on 3,258 adults is presented. According to the study, â€Å"MDD was found to affect women more than men by a ratio of nearly 2 to 1. The lifetime prevalence rate for both sexes combined was 8.6%. The period prevalence rates for both sexes combined were 3.2% and 4.6%, for 6 mo and 1 yr, respectively. The age of onset for MDD showed a wide range, with over 75% of cases having an onset prior to age 30 yrs. The pr esence of a recurrent MDD was associated with an increased risk of substance abuse, panic disorder, and dysthymia, whereas a single MDD episode was not associated with increased comorbidity† (Spaner et al, 1994). The prevalence of MDD according to Culture, sex and age is obvious. Culture for instance affects the communication and experiences regarding MDD where it is mostly experienced as somatic in nature and not by guilt of low moods. Some complain of nerves as well as headaches particularly for Latinos as well as those from Mediterranean origin. Others complain of weakness or fatigue especially the Chinese and Asian people while other talk of heart problems such as those in the Middle East to refer to the depressive feeling. MDD occurs twice as many times as in adolescents and mature women as compared to adolescents and mature males (Deb Bhattacharjee, 2009). The prevalence of MDD is high for individuals aged 25 to 44 years of all genders and lower for those aged 65 and ab ove. Its onset may be at any age but is mostly notable during mid twenties.Advertising We will write a custom research paper sample on Major Depressive Disorder (MDD) specifically for you for only $16.05 $11/page Learn More Studies related to MDD have shown a broad rage of outcomes for the population assessment of the condition. The lifetime risk for MDD in population samples vary from 10.0% to 25.0% for males while the point prevalence of MDD in adult population samples varies from 2.0 to 3.0 % for males. MDD is 1.5 to 3 times greater for 1st degree relatives of patients with MDD as compared to the general population. Besides, it has been indicated that alcohol dependence is high in mature 1st degree relatives as well as a higher rate of hyperactivity disorder for children of patients with MDD (Deb Bhattacharjee, 2009). MDD has been attributed to various fatalities where approximately fifteen percent of patients end up committing suicide. Epidemiologi cal studies points that the fatalities of those aged over fifty five years with MDD have risen by four times in the recent years. Management of MDD Treatment of MDD may involve use of antidepressants such as Selective serotonin re-uptake inhibitors (SSRIs) or Serotonin norepinephrine reuptake inhibitors (SNRIs). Antipsychotic medications are recommended for the ones with severe psychotic symptoms. These drugs needs to be taken for an extensive period and may be combined with supplements like Lithium thyroid hormone for their efficiency of antidepressants, to prevent recurrence of the condition and avoid situations of treatment-resistant depression (Herrman, 2009). Additionally, talk therapy is very efficient and may involve counseling on one’s thoughts and behaviors. Cognitive Behavioral Therapy is one such procedure, which utilize the modeling of thoughts and feelings as reflected in the behavior of an individual. This method repels negative thoughts. Psychotherapy is essen tial in the understanding of the causes of the problem in relation to their behavior, thinking and feelings. Patients may also be put under Electroconvulsive therapy (ECT) especially ones contemplating suicide in order to enhance their moods, for ones with treatment-resistant depression and ones those with psychotic symptoms. Besides, Transcranial magnetic stimulation (TMS) utilizes magnetic pulses directed towards affected brain sections and may be done after carrying out an ECT (Greden, 2001). Conclusion The cause of MDD is not proven though many studies indicate it could result from chemical instability in the brain. This may be as a result of genetic predisposition and interaction with the environment. The factors that are known to trigger MDD include drug use, socio-economic constrains and medical conditions.Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More MDD is known to result to several fatalities and therefore it requires to be managed through pharmacological or talk therapies. Open communication is also essential for patients to gain assistance before the disorder destroys a person completely. Such patients needs to be well monitored without being left alone, else they contemplate of suicide. References Deb, S. and Bhattacharjee, A. (2009). Mental Depression: The Silent Killer. New Delhi: Concept Publishing Company. Greden, J. F. (2001). Treatment of Recurrent Depression, Volume 20, Issue 5. Washington, DC: American Psychiatric Publishing, Inc. Herrman, H., Maj, M, and Sartorius, N. (2009). Depressive Disorders. New York: John Wiley and Sons. Kessler, C. R. et al. (2003). â€Å"The epidemiology of Major Depressive Disorder: Results from Comorbidity Survey Replication (NCS-R).† The Journal of the American Medical Association, 289(23):3095-3105. doi: 10.1001/jama.289.23.3095. Retrieved from https://jamanetwork.com/journals/j ama/fullarticle/196765 Spaner, D., Bland, R. C. and Newman, S. C. (1994). â€Å"Major Depressive Disorder.† Acta Psychiatrica Scandinavica, Vol 89(376, Suppl), 7-15. doi: 10.1111/j.16000447.1994.tb05786.x. Retrieved from https://psycnet.apa.org/record/1994-25582-001 This research paper on Major Depressive Disorder (MDD) was written and submitted by user Noelle W. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.