Introductory paragraph and online worksheet Essay Example for Free

Introductory paragraph and online worksheet Essay I am number three of four children in the family line up, the first and only to go to college. My parents always have been supportive of my going back to school because they did not even finish elementary school. My career plan is to become an Elementary School Teacher or a Marriage and Family Therapist. I am currently working on getting my bachelor’s degree in psychology, possibly a master’s degree in education or counseling. University of Phoenix was one of my first school choices, I loved that I could focus on one class at a time and be able to work full time. The tools available to a University of Phoenix student are amazing; build a career plan, do job market research, online library, personality tests, and much more. My competencies helped me to see what my strengths and weaknesses are such as innovating, writing, adapting to change, and coping with pressure. Once I completed the career interest profiler, I was not surprised to see that my results encouraged me to be a teacher or a therapist because I am interested in that.

Bergers Disease: IgA Nephropathy

Bergers Disease: IgA Nephropathy Sarah A. Poorman IgA nephropathy, or Bergers disease, is one of the most prevalent, primary, and chronic glomerular disease and an imperative cause of renal failure (Mayo Clinic, 2017). IgAN is one of the most common renal diseases present in todays world. It can occur at any age, perceiving first evidence of renal disease when people are in their teens to late 30s (Wyatt and Julian, 2013). It is twice more likely to appear in men than women, being the most common amongst Asian and Caucasian populations (Wyatt and Julian, 2013). Early stages of Bergers Disease may not have symptoms. It can be silent for years, sometimes even decades before a single symptom shows. The most common symptom witnessed is hematuria, or bloody urine (NIDDK, 2015). This is a definite sign of a damaged glomeruli. Usually, the tint of urine will become a hue of pink or resemble the color of tea or cola (National Kidney Foundation, 2016). Another common symptom to arise is albuminuria. This is when urine contains an overabundance or albumin. Albumin is a protein, typically found in the blood, which maintains fluid balance throughout the human body (Nephcure, 2016). Blood loses its capacity to absorb fluid from the body once albumin leaks into the urine. Due to the lost blood supply, low blood albumin levels will occur. Too much fluid will let to edema, or swelling, of various body parts. The most common body parts to experience edema are the legs, feet, and ankles, leaving the face and hands to be the least commonly affected (NIDDK, 2015). Foamy urine is a signal of albuminuria. The least common symptoms associated with IgAN are high blood pressure and high cholesterol levels (NIDDK, 2015). Glomerulus is a system of capillaries situated at the beginning of a nephron in the kidney (Wyatt and Julian, 2013). Its focal objective is to assist as the first phase of the filtration process of the blood, which is carried out by the nephron in the creation of urine (Mayo Clinic, 2017). IgA nephropathy, or IgAN, is considered an autoimmune disease that affects the glomeruli of the kidneys. Glomeruli are tiny filtering units where the blood is cleared. As the IgA deposits build up in the glomeruli, it causes the kidneys to leak blood and protein into the urine. Human IgA antibodies have two subclasses, IgA1 and IgA2, while IgA1 constitutes 85% of the total IgA in the circulation, starting in the bone marrow (Wyatt and Julian, 2013). Predominantly, these deposits consist of IgA, but they can also exhibit IgG and IgM antibodies by themselves or combined. As the IgA deposits build up in the glomeruli, it causes the kidneys to leak blood and protein into the urine. IgA in the glomerular deposits are exclusively of the IgA1 subclass and are in the polymeric form (Wyatt and Julian, 2013). IgA1 exhibits galactose deficiency in the O-linked glycans in the hinge region of the heavy chain (Suzuki et al, 2011). Going all the way back to basic chemistry, galactose, or Gal, is a monosaccharide sugar that is composed of the same element as glucose, but has a different arrangement of atoms (Maillard et al, 2015). The Fc receptor will blind the GD-IgA1 to create immune complexes that leads to the complement activation. The transcription of IgG and IgM trigger the pathways of complement activation, containing immune complexes (Maillard et al, 2015). Eventually, over time, the massive discharge of ctyokines, components of the ext racellular matrix, and oxidants that disrupt the function of the glomerular basement membrane will induce apoptosis (the product of TGF-B and IL-6) and glomerular scarring (Maillard et al, 2015). This creates the destruction of the kidneys which leads to the major development of end-stage renal disease. To put it simply, T cell-dependent activation of B Cells is initiated by APCs, which processes the antigen, and creates peptides to present, in MHC 11, to CD4+ T cells. This results in the production of T Helper cells. With the interaction of B and T cells, the expression of CD40L, a protein apart of the TNF (tumor necrosis factor) family, begins. Isotype switching of naà ¯ve B cells towards IgA1 and IgA2 producing plasma cells takes place. The B cells carry the antigens to the surface of the cell by Ig expression. They present this to MHC II, which aids in the recruitment of T cells. With the expression of CD40L and cytokines and signals from APCs will begin the regulation of production for IgA the IgA immunoglobulin will typically bind oneself to an antigen or infection found in the body. This will result in the activation of an immune response, which will find a way to rid the body of the infection. People with IgAN have an augmented blood result of IgA that signifies less galactose than what is considered normal. This galactose-deficient IgA, or GD-IgA1, in the blood, is recognized as foreign by the other antibodies circulating the blood. But, when an individual has IgAN, a flawed arrangement of IgA antibodies attach their selves to another IgA antibody, as an alternative of an infection or antigen, resulting in the creation of immune complexes. These immune complexes turn out to be jammed in the kidneys glomeruli, causing damage to the filters. Inflammation takes place, which causes blood and proteins to leak out of the kidneys and into the urine. Eventually, this will lead to end-stage renal disease (ESRD) and total kidney failure, resulting in death or the dire need of a kidney transplantation. Currently, there is no known cure for IgA nephropathy, with no ultimate way of knowing what path the ailment will take. Once the kidneys are scarred, they cannot be repaired. Therefore, the vital goal of IgA nephropathy treatment is to inhibit or delay the inevitable, end-stage renal disease. Some people experience complete remission and others live normal lives with low-grade blood or protein in their urine. Treatment with numerous of medications can slow the progress of the disease and help manage symptoms such as high blood pressure, protein in the urine, and swelling. Some of the medications that are currently being used to treat IgAN are as follows: 1) Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) which lowers blood pressure and reduces the amount of albumin in the urine. 2) Omega 3 Fatty acids, which aid in the reduction of inflammation throughout the body, in this case the glomeruli, leaving no harmful side effects. 3) Immunosuppressants such as corticosteroids medication (prednisone) will suppress the immune system response, allowing to protect kidney function. However, these can cause serious side effects such as high blood pressure and high blood sugar. 4) Statin therapy are cholesterol lowering medications that are known to help slow the damage to the kidneys. 5) Mycophenolate mofetil, or CellCept, has been successfully used in some pati ents who have had persistent protein in the urine, however, most studies so far have failed to show the benefit for using this medication. There are no sources in the current document.   Ã‚  

Treatment of Acute Renal Colic: Rectal Diclofenac Sodium

Treatment of Acute Renal Colic: Rectal Diclofenac Sodium Therapeutic Effects of Rectal Diclofenac Sodium and Intramuscular Pethidine Injection  in The Treatment of Acute Renal Colic: A randomized Clinical Trial Mohammad Mehdi Hosseini, Abdoul-Rasoul Ebrahimi Abstract Renal colic is a type of abdominal pain commonly caused by obstructive stones. The aims of this study were to evaluate safety and efficacy of rectal diclofenac sodium ( RD ) in acute renal colic and compare it with intramuscular pethidine (IMP) injection. In an interventional prospective double blind randomized control trial with 541 patients, which referred to Emergency Department due to acute renal colic, RD and IMP were administrated to 266 patient (as group I) and 275 patients (as group II), respectively. Pain relief was measured through asking the patient by the physician at 10, 20 and 30 min after using of respective drugs in each group. In group I, analgesic effects of RD were appeared in 121 patients (45.5%) after 10 min, 191 patients (71.9%) after 20 min and 233 patients (87.5%) after 30 min. 33 patients (12.5%) had no response to RDS . In group II, analgesic effects of IMP were appeared in 123 patients (44.7%) after 10 min, 191 patients (69.5%) after 20 min and 254 patients (92.3%) after 30 min. 21 patients (7.7%) had no response to IMP. Our results demonstrated that although, there were no significant differences in analgesic effects between two drugs (P=0.06), but, due to availability, cheapness, safety and self administration properties, use of sodium diclofenac in suppository form is highly recommended in renal colic. Keywords: Renal colic; diclofenac sodium; pethidine; analgesia. Introduction Renal colic is a common urological emergency at the emergency department, often caused by the movement of ureteral stones and characterized by severe pain. Patients describe this pain as the most severe and excruciating situation ever experienced (Ay et al. 2013). This condition afflicts 5à ¢Ã¢â€š ¬Ã‚ 12% of the population in industrial societies at least once in their life time and its recurrence rate is approximately 50% (Esmailian and Keshavarz 2014). The pain is usually attributed to contraction of ureter soft muscles in response to the presence of stone (Holdgate and Pollock 2004). Therefore, the most important consideration in the emergency management of renal colics is pain control/relief (Esmailian and Keshavarz 2014). Both parenteral opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to provide relief from renal colic (Bektas et al. 2009). For relieving this pain, morphine and pethidine in the traditional approach were used, but, due to their side effects such as addictive effects, constipation, respiratory depression, and mental changes,, using of them is reduced and replaced by NSAIDs (Kalb et al. 2010; Muslumanoglu and Tepeler 2008). Experimental works suggest that prostaglandins (PGs) play an important role in producing pain in renal colic and therefore, antiprostaglandins can eliminate or diminish this type of pain (Hetherington and Philp 1986; Thompson et al. 1989). Diclofenac, 2-(2-(2,6-dichlorophenylamino)phenyl)acetic acid, is an NSAID taken or applied to reduce inflammation and as an analgesic reducing pain in certain conditions such as renal colic. The exact mechanism of action is not entirely known, but the primary mechanism responsible for its analgesic action is thought to be inhibition of PG synthesis by inhibition of cyclooxygenase, one of the basic enzymes in the PG synthesis pathway (Dutta et al. 2000). On the other hand, pethidine is a once popular synthetic opioid analgesic of the phenylpiperidine class (MacPherson and Duguid 2008). The specific adverse event of vomiting showed a clear association with opioids, in particular pethidine. Although no studies reported serious adverse events, the short follow-up period and failure to specifically record renal dysfunction and gastrointestinal bleeding means these results should be interpreted cautiously (Holdgate and Pollock 2004). Given these findings, when a single bolus of analgesia i s used, an NSAID rather than an opioids was recommended. However, in some condition such as severe pain using of opioids is inevitable. Therefore, in this study, we compared the efficacy of analgesic therapy of rectal diclofenac sodium (RD) and intramuscular pethidine (IMP), commonly preferred in emergency departments in our country in patients with renal colic. Participants and Methods A. Patients and study design An interventional prospective multicenter double blind randomized control trial (RCT) with five hundred forty one eligible patients which had renal colic and referred to Motahhary and Peymanieh Hospitals of Jahrom and Faghihi and Nemazee Hospitals of Shiraz between Dec 2005 to Apr 2007 was done. The study protocol and informed consent were approved by the Ethics Committee at Jahrom University of Medical Sciences. All patients who enrolled in this study, were read, accepted and signed the consent form. Participant, with age between 17 to 52 years, randomly allocated in two parallel groups, RD (single dose of 100 mg) and IMP (single dose of 50 mg) in the approximately ratio of 1:1 (266 and 275 patients, respectively). Randomization was performed using a computer-generated random permuted block method. Patients with history of allergy to NSAIDs, hemorrhoids and anal fissures, peptic ulcers, coagulopathy, inflammatory bowel disease, pregnancy, ischemic coronary diseases, chronic obstruct ive pulmonary disease, and liver or renal failure were excluded from the study. B. Method of measurement Subjects reported pain and its decline at 10, 20 and 30 min after drug receiving and according to significant decrease in pain intensity at each time (decrease in pain intensity more than 50%), the patient was placed in the respected groups. Subjects were blind to their previous reports. Our outcome measure was the change in pain intensity at 10, 20, 30 and more than 30 min. The participants that enrolled in group 3 (significant decrease in pain after 30 min) were composed from patient in group 1 (significant decrease in pain after 10 min) and 2 (significant decrease in pain after 20 min) and there was similar pattern between group 2 and 1. C. Statistical analysis SPSS for Windows version 16 package program was used for statistical analysis of the data. t test and analysis of variance were used for analysis of variables. Results were expressed as n (number of patients), and percentage (%). According to the results, a P value 0.05). Distribution of patients according to time of responding to analgesic effects of RD and IMP is displayed in Figure 2. According to these data, the percentage of patients that showed defined decline in pain at 10 and 20 min after using of drug in RD was higher than IMP. However these differences were not significant (P=0.06). Discussion In this study, the analgesic efficacy of rectal sodium diclofenac and intramuscular pethidine administration in patients which suffered from renal colic were evaluated. Our results demonstrated that although, the percent of patients with diminished pain in 10 and 20 min after using of RD was higher than IMP but, this difference was not significant. Therefore, the efficacy of these two drugs is similar. However, due to availability, cheapness, safety and self administration properties, use of RD is highly recommended in renal colic in compare to IMP. In two previously studies, the efficacy of using of sodium diclofenac versus pethidine in acute renal colic were evaluated and reported. In the study of Hetherington and Philp (1986) on 58 renal colic patients, it has been concluded that 75 mg of sodium diclofenac, IM, was more effective than 100 mg of Pethdine, IM, in the management of acute renal colic and has fewer side effects (Hetherington and Philp 1986). Also, Thompson et al (1989) reported that diclofenac suppositories provided potent, specific analgesia in renal colic. They also concluded that, diclofenac is superior to pethidine, because its effect starting at a similar time but lasting longer (Thompson et al. 1989). On the other hand, this fact that diclofenac can be self administered and is not an opiate makes it a useful drug in general practice, especially for patients with recurrent renal colic. Pethidine as a synthetic opioids, is about one tenth as potent as morphine and due to having more lipid solubility than morphine, elimination half life of two to four hours and duration of action of only two to three hours were considered for it (Foley 1985). At 2000, in a double blind RCT, analgesic efficacy, patient satisfaction and side effects of morphine and pethidine in patients with clinically suspected renal colic were evaluated. Although, their data demonstrated that there was no significant difference between morphine and pethidine with respect to any of the parameters measured, but they concluded that because of the well known adverse effects that may be associated with pethidine use, morphine should be the preferred agent in suspected renal colic, when an opioid analgesic is to be used (O 'Connor et al. 2000). In addition, it has been reported that norpethidine, the predominant metabolite of pethidine, is potentially toxic and causing central nervous system excitability such as tremors, myoclonus or seizures. Also, accumulation of norpethidine has also been seen in patients with normal kidneys, particularly with large doses or frequent dosing intervals (Marinella 1997). Finally, due to adverse effects of pethidine and its metabolite, norpethidine and also due to possibility of pethidine addiction, we believe that diclofenac suppositories should be considered as the first line treatment of renal colic, both in hospital and in general practice. Acknowledgment The authors thank the staff physians and nursing team of the Emergency Department of the Motahhary and Peymanieh Hospitals of Jahrom and Faghihi and Nemazee Hospitals of Shiraz and all other people who help in this study. References Ay MO, Sebe A, Kozaci N, Satar S, Acikalin A, Gulen M, Acehan S (2013) Comparison of the Analgesic Efficacy of Dexketoprofen Trometamol and Meperidine HCl in the Relief of Renal Colic. American Journal of Therapeutics. doi:10.1097/MJT.0b013e318274db78 Bektas F, Eken C, KaradenÄ ±z O, Goksu E, Cubuk M, Cete Y (2009) Intravenous paracetamol or morphine for the treatment of renal colic: a randomized, placebo-controlled trial. Annals of Emergency Medicine 54 (4):568-574 Dutta NK, Annadurai S, Mazumdar K, Dastidar SG, Kristiansen JE, Molnar J, Martins M, Amaral L (2000) The anti-bacterial action of diclofenac shown by inhibition of DNA synthesis. International Journal of Antimicrobial Agents 14 (3):249-251 Esmailian M, Keshavarz M (2014) Synergistic Effects of Citalopram and Morphine in the Renal Colic Pain Relief; a Randomized Clinical Trial. Emergency 1 (2):26-29 Foley KM (1985) The treatment of cancer pain. New England Journal of Medicine 313:84-95 Hetherington JW, Philp NH (1986) Diclofenac sodium versus pethidine in acute renal colic. British Medical Journal 292 (6515):237-238 Holdgate A, Pollock T (2004) Nonsteroidal anti-inflammatory drugs (NSAIDs) versus opioids for acute renal colic. Cochrane Database Syst Rev 1:1-54 Kalb B, Sharma P, Salman K, Ogan K, Pattaras JG, Martin DR (2010) Acute abdominal pain: is there a potential role for MRI in the setting of the emergency department in a patient with renal calculi? Journal of Magnetic Resonance Imaging 32 (5):1012-1023 MacPherson RD, Duguid MD (2008) Strategy to Eliminate Pethidine Use in Hospitals. Journal of Pharmacy Practice and Research 38 (2):88-89 Marinella MA (1997) Meperidine-induced generalized seizures with normal renal function. South Medical Journal 90:556-558 Muslumanoglu AY, Tepeler A (2008) Renal kolik tani ve tedavisi. Marmara Med J 21:187-192 O'Connor A, Schug SA, Cardwell H (2000) A comparison of the efficacy and safety of morphine and pethidine as analgesia for suspected renal colic in the emergency setting. Journal of Accident and Emergency Medicine 17 (4):261-264 Thompson JF, Pike JM, Chumas PD, Rundle JS (1989) Rectal diclofenac compared with pethidine injection in acute renal colic. British Medical Journal 299 (6708):1140-1141 Figure 1. Number and percentage of patients which response/non response to rectal sodium diclofenac and intramuscular pethidine. Figure 2. Comparison on the efficacy of rectal sodium diclofenac and intramuscular pethidine in attenuating of renal colic pain.

A Timeline of Major Events in the American Civil Rights Movement :: American Civil Rights Movement

Civil Rights Movement: 1890-1900 1890: The state of Mississippi adopts poll taxes and literacy tests to discourage black voters. 1895: Booker T. Washington delivers his Atlanta Exposition speech, which accepts segregation of the races. 1896: The Supreme Court rules in Plessy v. Ferguson the separate but equal treatment of the races is constitutional. 1900-1910 1900-1915: Over one thousand blacks are lynched in the states of the former Confederacy. 1905: The Niagara Movement is founded by W.E.B. du Bois and other black leaders to urge more direct action to achieve black civil rights. 1910-1920 1910: National Urban League is founded to help the conditions of urban African Americans. 1920-1930 1925: Black nationalist leader Marcus Garvey is convicted of mail fraud. 1928: For the first time in the 20th century an African American is elected to Congress. 1930-1940 1931: Farrad Muhammad establishes in Detroit what will become the Black Muslim Movement. 1933: The NAACP files -and loses- its firs suit against segregation and discrimination in education. 1938: The Supreme Court orders the admission of a black applicant to the University of Missouri Law School 1941: A. Philip Randoph threatens a massive march on Washington unless the Roosevelt administration takes measures to ensure black employment in defense industries; Roosevelt agrees to establish Fair Employment Practices Committee (FEPC). 1942: The congress of Racial Equality (CORE) is organized in Chicago. 1943: Race riots in Detroit and Harlem cause black leaders to ask their followers to be less demanding in asserting their commitment to civil rights; A. Philip Randolph breaks ranks to call for civil disobedience against Jim Crow schools and railroads. 1946: The Supreme Court, in Morgan v. The Commonwealth of Virginia, rules that state laws requiring racial segregation on buses violates the Constitution when applied to interstate passengers. 1947: Jackie Robinson breaks the color line in major league baseball. 1947: To Secure These Rights, the report by the President’s Committee on Civil Rights, is released; the commission, appointed by President Harry S. Truman, recommends government action to secure civil rights for all Americans. 1948: President Harry S. Truman issues an executive order desegregating the armed services. 1950-1960 1950: The NAACP decides to make its legal strategy a full-scale attack on educational segregation. 1954: First White Citizens Council meeting is held in Mississippi. 1954: School year begins with the integration of 150 formerly segregated school districts in eight states; many other school districts remain segregated.

Media Essay - Advertisements for Body Enhancement Supplements

Advertisements for Body Enhancement Supplements There is evidence that shows that at least one scientist reported 100 years ago that testosterone is the cause of masculine features in males. But 100 years ago this was yet to be proven. That is approximately how long the idea of a product which aids in the enhancement of mass and strength for people was around. However, when the actual development of the product came around, the advertisements designed to aid in the sales and production of the product left a lot to be desired compared to what is available. Today, that is only to be expected due to the fact that we live in a more advanced civilization. Over time, the physical description of what was depicted to be the ideal muscular physique has changed as eras passed. The reasoning for this change in muscle physique dates back to the development of the product which technically started it all, Steroids. The actual development of anabolic steroids took place during the 1930's which was during the decline of the United States industrial society courtesy of the Great Depression. Researchers developing steroids used dogs to test out their theories. Through their test, they discovered that the usage of anabolic steroids increased muscle mass in the dogs, causing a leaner, more muscular looking physique. In the 40's, the anabolic steroids were given to POW's and those that were suffering from malnutrition. In the 50's, anabolic steroids were given a new purpose that was strictly for strength gains. Athletes in Europe and Russia were using steroids just for that purpose. Ster... ...that deemed steroids to be lethal took place in the late 1970's and early 1980s during Olympic games. In the "Golden Era", the side effects were unaware of and steroids seemed to be safe so no restraints were brought upon for its usage and distribution. Even with the knowledge of possessing side effects, there is a select few of who still purchase and use Steroids over the black market. In most cases, the method which fascinated those back then for instant muscle is still use today, but on different products. "Hard Bodies", "Ripped Pecs", "Six- Packs", are all part of the "Total Package" method use for people to buy body and muscle enhancing products. Works Cited Associate Press "Mind & Muscle POWER" General Media Communications Inc September 1999 Phillips "The Steroid World" www.http://www.steroidworld.com/ (C) 1999-2000

Immunization: Health Care Delivery

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO). Nowadays, this is one of the global issues that experts are trying to solve on how they can help each individual to attain this stage, which in the end they across of finding ways on how an individual will be able to achieve this goal. That is through immunization. Immunizations are used to protect the human body against preventable diseases. Immunizations are usually given in the form of a shot or vaccine.When one gets immunized, the body develops the ability to fight off a given disease. Immunizations safeguard the body from illnesses and death caused by certain infectious diseases. Some immunizations are given to prevent a single disease, while others will take care of two or three diseases. Immunizations help control infectious diseases that were once common. They have reduced, and in many cases, eliminated, diseases that routinely killed or harmed infant s, children, and adults.However, the viruses and bacteria that cause vaccine-preventable disease and death still exist and can be passed on to people who are not immunized. Children need immunizations to protect them from dangerous childhood diseases. How can this be possible for everybody? That was answered by World Health Organization, when they initiated the Expanded Program on Immunization in May 1974 with the objective to vaccinate children throughout the world.Ten years later, in 1984, the WHO established a standardized vaccination schedule for the original EPI vaccines: Bacillus Calmette-Guerin (BCG), diphtheria-tetanus-pertussis (DPT), oral polio, and measles. Increased knowledge of the immunologic factors of disease led to new vaccines being developed and added to the EPI’s list of recommended vaccines: Hepatitis B (HepB), yellow fever in countries endemic for the disease, and Haemophilus influenzae meningitis (Hib) conjugate vaccine in countries with high burden of disease.In 1999, the Global Alliance for Vaccines and Immunization (GAVI) was created with the sole purpose of improving child health in the poorest countries by extending the reach of the EPI. The GAVI brought together a grand coalition, including the UN agencies and institutions (WHO, UNICEF, the World Bank), public health institutes, donor and implementing countries, the Bill and Melinda Gates Foundation and The Rockefeller Foundation, the vaccine industry, non-governmental organizations (NGOs) and many more.The creation of the GAVI has helped to renew interest and maintain the importance of immunizations in battling the world’s large burden of infectious diseases. The current goals of the EPI are: to ensure full immunization of children under one year of age in every district, to globally eradicate poliomyelitis, to reduce maternal and neonatal tetanus to an incidence rate of less than one case per 1,000 births by 2005, to cut in half the number of measles-related deaths that occurred in 1999, and to extend all new vaccine and preventive health interventions to children in all districts in the world.In addition, the GAVI has set up specific milestones to achieve the EPI goals: that by 2010 all countries have routine immunization coverage of 90% of their child population, that HepB be introduced in 80% of all countries by 2007 and that 50% of the poorest countries have Hib vaccine by 2005. In each of the United Nations’ member states, the individual national governments create and implement their own policies for vaccination programs following the guidelines set by the EPI.Setting up an immunization program is multifaceted and contains many complex components including a reliable cold chain system, transport for the delivery of the vaccines, maintenance of vaccine stocks, training and monitoring of health workers, outreach educational programs to inform the public, and a means of documenting and recording which child receives which vaccines.At the local level, implementation of the health care delivery system has been given greater responsibility to the local government Unit (LGU) by virtue of the Local Government Code of 1991, the Magna Carta for health workers for Republic Act 7305 in 1992, and the barangay health workers benefits in Incentives Act of 1995. The latter act provides for training volunteer workers as well as minimal incentives to convince them to help run barangay health station or centers. This volunteer will assist in clerical tasks and minor health procedures, such as weighing and measuring patients and malnutrition mitigating activities.However, this workers do it in this context that the study was conceptualize the results of the study may provide an assessment of the status of the health care delivery system and immunization status of children whose ages are 0 to 12 months old in Barangay San Juan- San Ramon of Municipality of Camaligan, Camarines Sur. The research finding can be a basis and inputs to the Local Government Units of Camaligan and Barangay San Juan- San Ramon in planning and implementation of barangay health care delivery system.Furthermore, allocation of Local Government Units (LGUs) budget or expenditure priority can also be guided towards a more responsive allocation level of health services. Results of the study may also contribute towards awareness building and educating the barangay residence about preventive health care. In terms of capacity building, the Local Government Unit (LGU) and the National Government will be given one basis for their technical support and training program for the health care workers to better improved the capacity to perform their jobs.After all, an empowered and well trained social health care work force will improved the delivery of community health care and reduce the number of children from preventable illnesses such as measles, malaria, diarrhea, malnutrition, and acute respiratory infection. Providing care for the children is really important. They will live to grow into adulthood and eventually become the future adult citizens. To ensure a productive future for these children, they must be protected from heavy childhood diseases which can be prevented through immunization.Presidential Decree No. 996 stated about â€Å"providing for compulsory basic immunization for infants and children below 8 years of age†. Immunization is one of the most important preventive management that should be done and given to infants in the first few months of his life. Estimates reveal that diphtheria, pertussis, tetanus, poliomyelitis, tuberculosis, and measles are responsible for the deaths of about 5 million children every year in developing countries.These diseases are preventable through immunization with a handful of vaccines that can be given within the first year of a child’s life. Immunization has been recognized and accepted as one of the most important components in the prevention and control of c ommunicable diseases. Immunization is a basic health service; therefore it is integrated into the healthcare delivery service of the ministry of health. With the assistance of UN children’s fund and WHO, the ministry of ealth launches the expanded program on immunization objective of reducing the morbidity and mortality rates of the EPI mentioned by increasing the proportion of fully immunized children in their first year of life. The researchers are fully aware and knowledgeable about the immunization that will provide maximal immunity to Expanded Program on Immunization diseases before a child’s first birthday. The respondents are well exposed to immunization activities for they have volunteered and participated in the community’s activity program. Thus, they can well undertake the study.

Learning Organization Essay

The evolution of â€Å"Organizational Learning† has started in 1938 when John Dewey, in his book â€Å"Experience and Education†, publicized the concept of experiential learning as an ongoing cycle of activity. But, how did this concept emerge? Or, what does it really mean for the businesses? In order to understand this, we have to analyze the problems and needs. The core idea behind â€Å"learning organization† is that organizations of all kinds will not survive, let alone thrive, if they do not acquire an ability to adapt continuously to an increasingly unpredictable future. Or in other words, in order to survive and succeed for businesses, it is essential to establish or build stronger relationships with customers, where there are rapidly changing, turbulent and/or highly competitive market. Through learning, organizations may be better equipped to meet the challenges caused by continuous environmental turbulence. In addition, where products and processes can rapidly be copied, according to Arie de Geus, head of strategic planning department of Royal/Dutch Shell, the only real source of competitive advantage is to stimulate learning by employees. This may allow these individuals to identify new ways of working more closely with customers, which in turn permits the organization to differentiate itself from competition. However, the style of learning has to reflect the operational needs of the organization. For instance, a manufacturer which has adopted a transactional marketing style would probably choose to operate in a relatively stable market, produce standard components and focus primarily on offering adequate quality goods at a competitive price. In such circumstances, assuming that the organizational systems are based around repetition of routine procedures, the firm would probably be well advised to focus upon creating a single-loop learning environment as the most appropriate way fur sustaining employee development aimed at organizational efficiency. 2 On the other hand, in market situations where firms face periods of significant, discontinuous change and/or there is a desire to differentiate  the firm from competition through the adoption of a relationship marketing style, then possibly an incremental, more adaptive learning style, which is called double-loop learning may be more appropriate, so to involve the exploitation of new knowledge to evolve new practices, perspectives and operational frameworks. Figure 1: Single- vs. double-loop learning. II. DEFINITION OF LEARNING ORGANIZATIONS Keeping in mind what we have so far discussed, now let us check some definitions of the Learning Organizations. Peter M. Senge, who is also named as the father of this concept, describes learning organizations as organizations where people can continuously expand their capacity to create results which they truly desire. In such organizations, new and expansive patterns of thinking are nurtured, and collective aspiration is set free. Individuals learn to learn together. He declares â€Å"Deep down, we are all learners. It is not only our nature to learn, but we love to learn. â€Å" Chris Argyris and Donald Schon defined the concept of learning organizations through the help of the definition of organizational learning: where the process of â€Å"detection and correction of errors† rules. 3 Moreover, how de Geus defined learning organizations is very remarkable: â€Å"Forget your tired old ideas about leadership. The most successful corporation of the 1990s will be something called a learning organization? The ability to learn faster than your competitors, may be the only sustainable competitive advantage. â€Å" One last definition might be the one of Kim, D., â€Å"a learning organization is one that consciously manages its learning process through an inquiry-driven orientation among all its members†. III. FIVE DISCIPLINES OF SENGE I have already mentioned that Senge was called as the father of the concept of â€Å"Learning Organizations†. When he first published his book The Fifth Discipline: The Art & Practice of The Learning Organization in 1990, he caught a significant attention from academics and the business world. Peter M. Senge (1947- ) was named a ? Strategist of the Century’ by the Journal of Business Strategy, one of 24 men and women who have ? had the greatest impact on the way we conduct business today’. Moreover, Senge has founded the Center for Organizational Learning at Massachusetts Institute of Technology (MIT) in 1991 while he is also the founding chairperson of the â€Å"Society for Organizational Learning† (SoL) and a senior lecturer at MIT. Being maybe the most important, namely the person having the most influence in Learning Organizations I will study his so called five disciplines in my project. 4 3. 1 PERSONAL MASTERY 3. 1. 1 Introduction to Personal Mastery  Senge says, â€Å"Organizations learn only through individuals who learn. Individual learning does not guarantee organizational learning. But without it no organizational learning occurs. † The people are the main active force in every aspect of the business. Since, people have their own will and mind, and their own way of thinking; it is essential that they be sufficiently motivated to challenge the goals of growth and complexity. In today’s practices, the manager should not be willing to dominate controlling, planning and organizing the workers activities. Instead they should be enabling the people in the business have their own enriching lives through establishing and maintaining the conditions needed. One should be living his own life from a creative viewpoint, so as to turn the life into a creative work. Personal Mastery is the phrase Senge and his colleagues use for the discipline of personal growth and learning. People with high levels of personal mastery are continually expanding their ability to create the results in life they truly seek. From their quest for continual learning comes the spirit of the learning organization. 3. 1. 1. 1 Mastery and Proficiency. There are two main underlying movements when personal mastery becomes a discipline, one of which is always continually making clear what is important for oneself, whereas the other movement is to continually learn how to see the current reality more clearly. It is vital to know where you are now in moving toward a desired destination. People with a high level of personal mastery share several basic characteristics, one of which is that they have a special sense of purpose that lies behind their visions and goals. 5 For such a person, a vision is an aspiration rather than simply a good idea. One other characteristic is that they live in a continual learning mode, where they never â€Å"arrive†. They know that personal mastery is not something one possesses, but is a process, a lifelong discipline. Those with a high level of personal mastery are acutely aware of their ignorance, their incompetence; and they know, or better to say truly believe that the journey itself is the reward. 3. 1. 1. 2 Why We Want It We want it because people with high levels of personal mastery are more committed, take more initiative, have a broader and deeper sense of responsibility in their work, and learn faster. Kazou Inamori, founder and chairman emeritus of Kyocera Corporation and president of the Inamori Foundation, who holds a bachelor of sciences in applied chemistry, says that â€Å"Our employees agreed to live in a community in which they would not exploit each other, but rather help each other so that we may each live our life fully. † 3. 1. 1. 3 Resistance One of the issues against the personal mastery is the resistance, which in turn is a valid fear for companies in which the managers couldn’t build a shared vision along with shared mental models. It is useless to have personal mastery as solely without other disciplines of the organizational learning. That’s why we always have to keep in mind that personal mastery must go together with a shared vision and the other disciplines. 6 3. 1. 2 The Discipline of Personal Mastery 3. 1. 2. 1 Personal Vision Most adults have goals and objectives, but these are not visions. Thus, we can say that most have little sense of real vision. When asked what they want, many adults will say what they want to get rid of, as if they delineate themselves as given-ups, rather than grown-ups. Senge points that â€Å"The ability to focus on ultimate intrinsic desires, not only on secondary goals, is a cornerstone of personal mastery. † Vision is different from purpose, since purpose is similar to a direction, a general heading, whereas vision is a specific destination, a picture of a desired future. Vision is the image of your desired future. It shouldn’t be confused with competition; it shouldn’t be isolated from the idea of one’s purpose. It is something which has personal aspects along with material aspects, such as where we want to live and how much of savings we want, or issues like health or freedom contribute, relatively. 3. 1. 2. 2 Holding Creative Tension One testimony of Senge says that there is something called the creative tension which is the source of energy derived from the gap between one’s vision and where it stands in reality. This gap can push someone forward to get closer to the vision; however it might also discourage some other people, so as to leading to feelings and emotions associated with anxiety. Imagine a rubber band, stretched between your vision and the current reality. When stretched, the rubber band creates tension, representing the tension between vision and current reality. What does tension seek? Resolution or release. There 7 are two possible ways for the tension to resolve itself: pull reality toward the vision or pull the vision toward reality. Which occurs will depend on whether we hold steady to the vision. Figure 3: Creative Tension Negative emotions caused by anxiety of the creative tension, shouldn’t be realized as the creative tension itself. What Senge argues, is that after some time what we call emotional tension will arise due to the negative emotions. In such cases, we feel deeply discouraged about a vision that is not happening and tend to lower the vision as an immediate so called remedy. It is clear that escaping emotional tension is easy; but what we really pay against is giving up something what we profoundly want, our vision. In the context of organizations we can say that goals are slowly lowered because of low tolerance for emotional tension. What we have to do is to understand thoroughly what the creative tension is and allow it to operate without lowering our vision; only then the vision becomes an active force in personal mastery. The gap in between should be used to generate energy for change. 8 Mastery of creative tension transforms the way we judge failure. It is simply an opportunity for learning. 3. 1. 2. 3 â€Å"Structural Conflict†: The Power of your Powerlessness A research done by Robert Fritz has shown that practically all of us have a â€Å"dominant belief that we are not able to fulfill our desires†. This in turn, is an obstacle one should get rid off. These beliefs, which are mandatory as a child to survive, were taught us so that we learnt our limitations. Most of us hold one of two contradictory beliefs that intrinsically limit our ability to create what so called we really want. The more common belief is in our powerlessness, namely our inability to bring into being all the things we really care about, whereas the other belief focuses on unworthiness, that we do not deserve to have what we truly desire. Fritz uses a metaphor to describe how contradictory underlying beliefs work as a system, which he calls the â€Å"structural conflict†, the metaphor counter to achieving our goals, through symbolizing the concept by another rubber band example. Figure 4: Effect of â€Å"structural conflict† to the creative tension. Later on, he identifies three generic so called strategies to cope with the forces of structural conflict, each of which has its own limitations. Accordingly, one is letting 9 our vision to erode. This strategy will lead to the sacrifice of what we truly want as discussed earlier. The second strategy is to â€Å"conflict manipulation† which is actually the strategy of people who mostly worry about failure. What they do is to focus on avoiding what they do not want to happen. This strategy makes one to spend his/her life in worry and fear. For those following this strategy, which is also called the â€Å"negative vision†, there is little joy in their life, even when they achieve their goals because this time they immediately tend to begin worrying about losing what they have gained. The last and most favorable strategy is defined as the willpower, where we simply â€Å"psyche ourselves up† to overpower all forms of resistance to achieving our goals. Simply saying, motivating through heightened will. In the next section, we will discuss Senge’s strategy for dealing with structural conflict: telling the truth. 3. 1. 2. 4 Commitment to the Truth People often want a technique that they can apply to solve the problem of structural conflict. But, in fact, being committed to the truth is far more powerful than any technique. So, what does it actually mean? It means a relentless willingness to root out the ways we limit or deceive ourselves from seeing what is, and to continually challenge our theories of why things are the way they are. The first critical task in dealing with structural conflicts is to recognize them, and the resulting behavior, when they are operating. This helps us to develop so called internal 10  warning signals, such as when we find ourselves blaming something or someone for our problems. What Senge suggests in this context is that we have to work on developing skills to discuss such situations with the people involved without producing defensiveness. We shouldn’t always act in a manner where we always think of what others have done in the situation, rather we have to concentrate on what we can do. This in other words, relates to the fact that we have to understand, or better to say, realize the situation, the current reality in which we are, so to use this as a generative force. This has even been concluded in religions like Hinduism, Christianity, Islam, Jewish, Buddhism. One example might be the statement of â€Å"The truth shall set you free. † 3. 1. 2. 5 Using the Subconscious One of the most fascinating aspects of people with high levels of personal mastery is their ability to accomplish extraordinarily complex tasks with grace and ease. But, how does this come to happen? It is through the subconscious that all of us deal with complexity. What distinguishes people with high levels of personal mastery is they have developed a higher level of understanding between their normal awareness and their subconscious. Even the daily activities of us like walking, talking, eating or putting on your shoes are enormously complex tasks, for which we have learned the required skills of the tasks, which in turn led that the whole activity gradually shifts from conscious attention to subconscious control. People with high levels of personal mastery focus on the desired result itself, not the process or the means they assume necessary to achieve that result. This allows the person in focusing on the artistry of the result as well. 11 In other words, we can say that we must work at learning how to differentiate what we truly want, from what we think we need to do in order to achieve it. In order to develop a subconscious understanding it is also important to commit to the truth, because when not telling the truth, most people create some level of internal stress. The principle of creative tension recognizes that the subconscious operates most effectively when it is focused clearly on our vision and our current reality. One effective way to focus the subconscious is through imagery and visualization. For instance, world-class swimmers have found that by imagining their hands to be twice their actual size and their feet to be webbed, they actually swim faster. Mental practicing of complex tasks has become a routine psychological training for professional performers from different areas of interest. A strict reliance on only conscious learning could never have achieved this level of artistry, even if there was all the willpower in the world present. Contradictorily, it had to depend on a high level of subconscious understanding. 3. 2 MENTAL MODELS 3. 2. 1 Introduction to Mental Models  Mental models can be described as the views and assumptions we hold in our minds about how things are and how things work. A mental model is like one’s way of looking at what’s happening in the world. In other words, it determines how we think and act. Mental models depend on the past experiences, and the perception as a result of those experiences, and observations. In the introduction I had introduced the experiential learning, which was the style of learning through past experience and some other elements 12 like concrete experience, observation and reflection, and forming abstract concepts. Accordingly, a child without knowing that it might cut his hand might take a knife in his hand and try to push it in his hand. This in fact, will hurt him a lot. However, grown ups already know how to deal with a knife, so they won’t do the same mistake as the child does. All the experiences learnt are added up so to form or build up the mental models. 3. 2. 1. 1 Why the Best Ideas Fail? From the business point of view, one thing which is known by all managers is that many of the best ideas never get put into practice. Even brilliant strategies fail to get translated into action. New insights fail to get put into practice because they conflict with deeply held internal images of how the world works, images that limit us to familiar ways of thinking and acting. That is why the discipline of managing mental models ? surfacing, testing, and improving our internal pictures of how the world works- promises to be a major breakthrough for building learning organizations. Our mental models determine not only how we make sense of the world, but how we take action, namely they shape how we act which puts them into an active sense. But, why are mental models so powerful in affecting what we do? In part, because they affect what we see. As psychologists say, human beings observe selectively. Mental models also exist in the organizations, and also in management. Mental models could cause big losses in the business world as it can also prevent us from seeing the current situation. Loosing America’s car market share to German and Japanese countries was a result of the mental models of the management, where they are prevented to see the situation because of their models in mind, and perceptions. 13 The problems with mental models lie not in whether they are right or wrong-by definition, all models are simplifications. The problems with mental models arise when the models are tacit-when they exist below the level of awareness. 3. 2. 1. 2. Overcoming â€Å"The Basic Diseases of the Hierarchy† In the traditional authoritarian organization, the dogma was managing, organizing, and controlling, whereas in the learning organization, the new dogma will be vision, values, and mental models. In addition, in traditional organizations, merit means doing what the boss wants, openness means telling the boss what he wants to hear, and localness means doing the dirty stuff that the boss doesn’t want to do. However, in learning organizations these concepts will get new understandings. 3. 2. 2. The Discipline of Mental Models Developing an organization’s capacity to work with mental models involves both learning new skills and implementing institutional innovations that help bring these skills into regular practice. 3. 2. 2. 1 Managing Mental Models Throughout An Organization A concept of scenarios should be adapted in pursuit of mental models, so to force managers to consider how they would manage under different alternative paths into the future. This offsets the tendency for managers to implicitly assume a single future. When groups of managers share a range of alternative futures in their mental models, they become more responsive to those changes. 14 Mental modeling should be implemented as a philosophy. It is important to note that the goal in mental modeling is not agreement or congruency. Many mental models can exist at once. What is important is that we have to consider all of them and test against situations that we confront. Only after the process works it leads to congruency. 3. 2. 2. 2 Managing Mental Models At Personal and Interpersonal Levels The learning skills of â€Å"action science† practitioners such as Chris Argyris fall into two broad classes: skills of reflection and skills of inquiry. Where skills of reflection concern slowing down our own thinking process so that we can become more aware of how we form our mental models and the ways they influence our actions, inquiry skills concern how we operate in face-to-face interactions with others, especially in dealing with complex and conflictual issues. Reflection skills start with recognizing â€Å"leaps of abstraction†, which mean that our minds move at lightning speeds. Ironically, this often slows our learning, because we immediately â€Å"leap† to generalizations so quickly that we never think to test them. Namely, leaps of abstraction occur when we move from direct observations to generalization without testing. Here it is important to distinguish direct observation from generalizations inferred from the observation itself. To distinguish it, explicitly separate it from the data which led to it. A second technique from action science is the left-hand column, which in turn is a powerful tool for beginning to see how our mental models operate in particular situations. It reveals ways that we manipulate situations to avoid dealing with how we actually think and feel, and thereby prevent a counterproductive situation from improving. The most important lesson that comes from seeing â€Å"our left-hand columns† is how we undermine opportunities for learning in conflictual situations. Here, a process called â€Å"balancing inquiry and advocacy† comes into action. 15 Managers are mostly trained to be advocates. In many companies, being a competent manager means, being able to solve problems, figuring out what needs to be done, and enlisting whatever support is needed to get it done. In such organizations, employees are rewarded according to their ability to debate forcefully, and influence others, where the inquiry skills are unrecognized. Those rewards unfortunately can bring the employees to managerial positions, where they suddenly face the fact that they do not learn while they should learn. Advocacy without inquiry between two people can end up in vicious circle. The more vehemently one argues, the more it creates a threat to the other’s position, so that the latter argues vehemently, which causes a threat to the first one’s position, therefore, the first one argues even more vehemently. This reinforcing advocacy can be stopped by inquiring. Then it gives a chance for the both parts to understand each other’s conflicts, and reasoning. When in pure advocacy, people do not want to show the weak parts of their reasoning, and discard them. Definitely it does not bring any learning to us. Instead it brings polarization within the group. When operating in pure advocacy, the goal is to win the argument; however, when inquiry and advocacy are combined the goal is no longer â€Å"to win the argument† but to find the best argument out of all. This combination allows us to discover completely new views. What we have to keep in mind is that practicing inquiry and advocacy means being willing to expose the limitations in your own thinking, namely the willingness to be wrong. 16 3. 3 SHARED VISION 3. 3. 1 Introduction to Shared Vision 3. 3. 1. 1 A Common Caring A shared vision is not an idea, it is rather a force in people’s hearts, a force of impressive power. It may be inspired by an idea, but once it goes further ? if it is compelling enough to acquire support of more than one person? then it is no longer an abstraction. It is tangible. People begin to see it as if it exists. Few forces in human affairs are as powerful as shared visions. At its simplest level, a shared vision is the answer to the question, â€Å"What do we want to create? † Just as personal visions are pictures or images people carry in their heads and hearts, so too are shared visions pictures that people throughout an organization carry. When people truly share a vision they are connected, bound together by a common aspiration. Shared vision is one of the vital fundamentals of learning organizations, because it provides energy and also focus for learning. People should have something that really matters to them, something that makes them excited. A shared vision is not one dictated by that top management; it only exists when people are personally committed, since it is their personal vision. 3. 3. 1. 2 Why Shared Visions Matter? In an organization, a shared vision changes people’s relationship with the company. What they so far called as â€Å"their company†, becomes â€Å"our company†. It helps to create a common identity. Only this way, a learning organization can really succeed. You cannot have a learning organization without shared vision. 17 How can a commitment to the long term be fostered is the key question in efforts to develop systems thinking in management. People do not focus on the long term because they have to, but only because they want to. 3. 3. 2 The Discipline of Building Shared Vision Shared visions emerge from personal visions. This is how they derive their energy and how they foster commitment. The management should encourage individuals so as to let them create their own visions, as was told earlier in this project. However, these visions are not the shared vision itself. This is needed so that it will be easier for the individuals to accept visions of others and work in the same manner. In this way, the synergy which will be established is needed for the organization indeed. The shared vision shouldn’t be written and taught to employees because this will establish a fear. Instead, everyone should adopt this vision and commit itself to the whole vision of the organization. 3. 3. 2. 1 From Personal Visions to Shared Visions To make it clearer, let’s imagine a picture of a landscape. When you cut this picture into smaller parts, you will not be able to see the whole sight. However, if you have a picture of an ocean in which all the organisms, like fish, plants, etc. live, and you cut it into pieces, you will still be able to see the whole sight because the vision of the ocean is the same in that part. It’s like the shared vision. When you take the shared vision person by person into consideration you’ll see that they match each other and reflect the whole image. 18 So, it is the fact that when more people come to share a common vision, the vision may not change fundamentally. But it becomes more alive, more real in the sense of a mental reality that people can truly imagine achieving. Writing a vision statement, which is often a one-shot vision, can be a first step in building shared vision but, alone, it rarely makes a vision come alive within an organization. Another problem with the so called one-shot vision that was prepared by the top management is that the resulting vision does not build on people’s personal visions. Contrarily, it only reflects the personal vision of one or two people at the top. The last problem might be explained in the manner as the vision is not a solution to a problem. Building a shared vision must be seen as a central element of the daily work of leaders. It is ongoing and never-ending. It is not truly a shared vision until it connects with the personal visions of people throughout the organization. Moreover, visions that are truly shared take time to emerge. They grow as a by-product of interactions of individual visions. Experience suggests that visions that are genuinely shared require ongoing conversation where individuals not only feel free to express their dreams, but also learn how to listen to each others’ dreams. 3. 3. 2. 2 Spreading Visions: Enrollment, Commitment, and Compliance There is a big difference between compliance and commitment. The committed person brings energy, passion and excitement, which in turn brings the synergy; he does not play by the rules of the game, instead feels responsible for the game, and will not hesitate to change the rules of the game if they stand in the way of achieving vision. On the other hand compliant followers only accept the vision, but do not have a personal desire. They may want it in order to keep their job, or to get a promotion etc. , but they know that it’s not their vision at all. For an organization to survive, it must ensure that a shared vision with the commitment of the individuals is established. 19 However, there are the types of genuine compliant followers, which may often be mistaken for enrollment or commitment. What then is the difference between being genuinely compliant and enrolled and committed? The answer is deceptively simple. People who are enrolled or committed truly want the vision, where genuinely compliant people accept the vision. They may want it in order to keep their job, or to get a promotion etc. , but they know that it’s not their vision at all. 3. 4 TEAM LEARNING 3. 4. 1 Introduction to Team Learning 3. 4. 1. 1 The Potential Wisdom Teams In order to understand team learning, it is important to understand what teams are. The word â€Å"team† can be traced back to the Indo-European word â€Å"deuk† (to pull); it has always included a meaning of â€Å"pulling together†. (The modern sense of team, â€Å"a group of people acting together†, emerged in the sixteenth century) We define â€Å"teams† as any group of people who need each other to accomplish a result. This definition is derived from a statement made by former Royal Dutch/Shell Group Planning coordinator, Arie de Geus: â€Å"The only relevant learning in a company is the learning done by those people who have the power to take action†. Team learning is a process of aligning and developing the capacity of a team to create the results its members truly desire. It builds on the discipline of developing shared vision. It also builds on developing personal mastery, for talented teams are made up of talented individuals. But shared vision and talent are not enough. The world is full of teams of talented individuals who share a vision for a while, yet fail to learn. 20 Here we can discuss the terms unaligned and aligned teams. The fundamental characteristic of the relatively unaligned team is wasted energy. Individuals may work extraordinarily hard, but their efforts do not efficiently translate to team effort. By contrast, when a team becomes more aligned, a commonality of direction emerges, and individuals’ energies harmonize. There is less wasted energy. In fact, a resonance or synergy develops, like the coherent light of a laser rather than the incoherent and scattered light of a light bulb. There is commonality of purpose, a shared vision, and understanding of how to complement one another’s efforts. Individuals do not sacrifice their personal interests to the larger team vision; rather, the shared vision becomes an extension of their personal visions. In fact, alignment is the necessary condition before empowering the individual will empower the whole team. Team learning is possible in every area, sports, business, performing arts, science, etc. It can even have extra ordinary results where the teams can be coordinated and even intelligence of the team can exceed the intelligence of its members totaling. In such an environment, team members can also show a rapid growth, than they could gain individually, namely constructing the synergy. With the changes in the organizations, team learning has never been that important. No matter if it’s a product development team, management team or cross-functional task forces. As they are teams, they are the people who need one another to act. The three critical dimensions of Team Learning can be described as; 1. Insightful thinking is necessary for complex issues. Teams must learn to end up with one more intelligent solution when compared to each of the participants’ solutions. 2. Innovative and coordinated action is vital.