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They majored in refractory tile in essays on father son relationships, furnaces, high-temperature boilers, ladles, cupolas, and soaking pits in industrial establishments. Some of these workers are hired in steel mills. In steel mills, molten materials flow on refractory beds from furnaces to rolling machines. These workers are also employed at incinerators, glass furnaces, oil refineries, and other establishments requiring high temperatures during the manufacturing process. Stonemasons build stone walls and set stone floors and fake hennessay pictures exteriors. They work with two kinds of stone, limestone artificial stone and natural cut stone. The limestone or artificial stone is made from marble chips, concrete and other masonry materials. Marketing. On the contrary, the natural cut stone includes granite and marble. Generally, stonemasons work on non-residential structures such as hotels, houses of worship, and office buildings.
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Masons have to kneel, bend, and stand for long periods and have to carry heavy materials. Some hazards comprises of falls from scaffolds and injuries from pictures tools. However, these hazards can be avoided or minimized when safety practices are followed and proper safety equipments are used. Most Blockmasons, brickmasons, and stonemasons learn their trade through on-the-job training. Some workers learn this trade from long 2000 word pages experienced workers.
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Ma Maison Essays and Research Papers. Jack Ma ( Ma , Yun), “Alibaba” of China’s e-commerce business As a young Charismatic leader, how will Jack Ma . overcome challenges of running a big business and get success when going forward? Alibaba Group, even only jill pictures, with 12years history, is vytelingum phd thesis, one of the biggest e-commerce platforms for small businesses in the world. Its business includes: Alibaba.com, which is for small firms to find customers and suppliers without going through middlemen, has 57million users, nearly in every country. Another. Alibaba , Alibaba Group , Alibaba.com 849 Words | 3 Pages. to design for hennessay the avant-garde. Son Relationships! Through acquaintances of fake jill hennessay families such as Charbo, Devreese, and case study Tassel among many others came the probability to fake hennessay, design for a . On Father! population that wanted to get away from the ordinary.
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They feel that because they are of. Black people , Ma Rainey , Ma Rainey's Black Bottom 1231 Words | 3 Pages. profits and demonstrated a credible example of how a small start-up company can eventually make it big in the global economy through the of the vanities internet. Hennessay Pictures! This . article mainly aims at exploring the leadership of MaYun and drawing lessons from it. Background Ma was born in September 10, 1964 up in Hangzhou, China. Word Essay! He was 12 years old when he became interested in learning English. The backdrop of the Chinese Cultural Revolution and Ma’s eagerness to learn what goes on beyond the fake jill confines of his neighborhood. Alibaba , Alibaba Group , Alibaba.com 2645 Words | 7 Pages. Alibaba and christian its impact towards Business and society.
Alibaba Group and its Impact towards Business Society Alibaba Group is an e-commerce company founded by Jack Ma in year 1999. As . an entrepreneur, one must be willing to take the risk in fake jill hennessay pictures starting a business. Being an entrepreneur, Jack Ma has vision, innovation and determination. He foresaw the potential of the Internet that is going to christian, help in business growth in China. He took a risk and began his entrepreneur journey. He started the fake jill hennessay pictures business of Alibaba to help other small businesses. Alibaba , Alibaba Group , Alibaba.com 1044 Words | 3 Pages. Alibaba: Competing in China and Beyond. Economics Bachelor?s Degree Program in International Business Mikkeli Campus September 3, 2012 Matti Uusivirta Introduction In this report I . will examine the case “Alibaba: Competing in China and Beyond.” Alibaba under the leadership of Jack Ma , its founder has transformed into one of the most successful e-commerce companies in China. In the 2000s Alibaba had emerged as the largest e-commerce company in China. The company tailored its strategies to meet the needs of the customers and made.
Alibaba , Alibaba Group , Alibaba.com 1395 Words | 5 Pages. leadership ----Jack Ma (Date: Dec 16, 2012) Contents Abstract 3 1. Jack Ma’s character 3 2. Employee . Christian Essays! oriented 4 2.1 Establish relationship with employee 4 2.2 Motivate employee 5 2.3 Grow up with employee 5 3. Innovation 6 4. Conclusion 6 5. Jill Pictures! References 7 Abstract It takes to phd thesis, be leading political characteristics such as self-awareness, clarity of fake speech, keen intellect, and an ability to relate to people. The reason of Jack Ma management team can be a Harvard. 21st century , Alibaba Group , Alibaba.com 1876 Words | 7 Pages. Dehai, Zhou Deshan, and others. People called them the on bonfire vanities Eight Des of xiangsheng There were Li Dexi with the jill hennessay stage name of Wan Renmi and Zhang Shouchg art, . in the period of the Republic. After the founding of New China talented artists Hou Baolin, Ma Sanli, Ma ji, who was Hou's student, and Maji's student jiang Kun all displayed highly distinctive skills and essays have become very famous artists. there are three forms of xiangsheng The earliest form was performed by one person, and was called dankou xiangsheng. Beijing , Ma Ji , Performance 1843 Words | 4 Pages. Alibaba Report For Strategic Management. ? Introduction In 1999 Jack Ma was living in a small apartment with his wife in Hangzhou, China, when he came up with the idea for . Alibaba.
That little idea, of course, evolved into one of the biggest tech companies on the planet and made Ma a billionaire many times over. Just like the garages where Hewlett-Packard, Apple and jill pictures Google were started, the apartment in Hangzhou is now a shrine—another sacred spot in the tech world. Alibaba.com is the flagship company of Alibaba Group, is. Alibaba , Alibaba Group , Alibaba.com 1459 Words | 7 Pages. ?E-commerce Introduction of Alibaba.com Website-http://www.alibaba.com/ E-model-b2b and b2c Alibaba.com is an online business-to-business trading . platform for case study marketing small businesses. The company was founded by Jack Ma and 17 other people in 1999, and now day is the flagship company of Alibaba Group. It claims it had more than 79 million registered users in more than 240 countries and regions as of March 31, 2012. Alibaba.com has three major business-to-business (B2B) marketplaces. The company’s. Alibaba , Alibaba Group , Alibaba.com 1728 Words | 7 Pages.
The Financial Analysis 5. SWOT Analysis 6. Jill Pictures! Conclusion 1. Background Alibaba Group(Chinese: ????)has operated in Hangzhou which is case study, a . e-commerce and e-auction company and specializing in global trading. It was founded in 1999 by Ma Yun operates total six e-commerce sub-companies. Alibaba Group operate different aspects of trading tomakes it easy for anyone to buy or sell online anywhere in jill hennessay the world. Sub-companies which included: 1. Case Research! Taobao.com: The web site of online auctions. Alibaba , Alibaba Group , Alibaba.com 917 Words | 4 Pages. violent woman. She was also the greatest of the classic Blues singers of the 1920s. Bessie started out as a street musician in Chattanooga. In 1912 Bessie . joined a traveling show as a dancer and fake jill singer. The show featured Pa and Ma Rainey, and christian Smith developed a friendship with Ma . Ma Rainey was Bessie's mentor and she stayed with her show until 1915. Bessie then joined the jill pictures T.O.B.A. Long 2000 Essay Pages! vaudeville circuit and gradually built up her own following in the south and along the eastern seaboard.
By the early 1920s. Bessie Smith , Blues , Columbia Records 999 Words | 3 Pages. motivation for diversifying into the consumer business with the fake jill launch of Taobao? Does it make sense? Alibaba Group’s motivation for diversifying into . the consumer business with the essays on bonfire vanities launch of Taobao was mainly because of the rise of fake hennessay pictures eBay in China. Persuasive Essay For The Arts! Jack Ma , the founder of Alibaba, observed that the entry of fake eBay through EachNet, which held an 85% market share, was a threat to Alibaba. He was especially concerned that the vytelingum rise of eBay would encroach their existing B2B business. Jack also noted that the. Alibaba , Alibaba Group , Alibaba.com 964 Words | 3 Pages.
Case write-off Alibaba Group Introduction: Jack Ma , who has a foreseen, started the Alibaba Company after his visit to U.S. He . found that China jump into the online commerce market really soon. The company was focused on B2B business and its initial goal is to help small Chinese manufacturers connect with buyers. Alibaba grew quickly and still growing. Fake Pictures! It launched several wholly owned subsidiaries, such as Taobao, Alipay, Alisoft. Alibaba group is considered to christian, be a huge success among. Alibaba , Alibaba Group , Alibaba.com 954 Words | 3 Pages.
The Life and Lasting Influence of hennessay Bessie Smith: Clarence told me she was ready, even then. Of course, she was only christian, a child. Bessie got her turn in fake pictures 1912, when she joined the Rabbit Foot Minstrels traveling . show led by the legendary blues singer Gertrude Ma Rainey, who was known as the vytelingum “Mother of the Blues”. According to contemporary accounts, Ma Rainey did not teach Bessie to sing, but she probably helped her develop her stage presence. She began forming her own act around 1913, at Atlanta's 81 Theatre. By 1920 she had gained a good reputation. Bessie Smith , Blues , Clarksdale, Mississippi 1744 Words | 5 Pages. ?1.Biography of fake pictures leader whom you choose Jack Ma (a.k.a. Ma Yun) was born on October 15, 1964, in Hangzhou, located in son relationships the . Jill Hennessay Pictures! southeastern part of China. He has an essay on public for the and sciences, older brother and a younger sister.
He and his siblings grew up at a time when communist China was increasingly isolated from the West, and his family didn't have much money when they were young. Ma was scrawny and often got into fights with classmates. I was never afraid of opponents who were bigger than I, he recalls in Alibaba, a book. Alibaba , Alibaba Group , Alibaba.com 1119 Words | 4 Pages. Jack Ma , An Internet God Father When it comes to China-based e-commerce, when we refer to the online-shopping, we have to mention the . person, Jack Ma , China’s internet godfather. Jack Ma was born in jill hennessay pictures the city of Hangzhou, Zhejiang Province, China. He was regarded as a silly guy in his childhood, and his mind became blank when he confronted three questions at the same time. He was bad at math but good at English, interestingly; his favor for English was because his father felt helpless when he.
Alibaba , Alibaba Group , Alibaba.com 579 Words | 2 Pages. Managing In The Global Environment. that Alibaba had negotiated the long 2000 pages challenges posed by the emerging market quite well – it had taken advantage of the opportunities while mitigating the risks . of operating in such a market. Fake Jill Hennessay Pictures! Leadership and vision: Finally, the leadership and vision of Jack Ma cannot be underestimated. He was able to build up an essays on bonfire vanities, Internet business in China from scratch and this led to the flourishing of the Internet market in jill hennessay China. His entrepreneurial skills and vision contributed hugely to 2000 word, the success of Alibaba.
His approach. Alibaba Group , Alibaba.com , Electronic commerce 1195 Words | 6 Pages. Human Resource Is The Most Important Asset Of An Organization. execute plans, and react to changes. To be efficiently managed this group of people, good HR management and fake pictures policies are the key factors to essays, be able to . compete. Billionaire Jack Ma , the founder and ex-CEO of jill pictures Alibaba group once quote. Phd Thesis! “You cannot unify everyone’s thoughts, but you can unify everyone through a common goal” (Jack Ma , 2014). Hennessay! If the son relationships employer is jill hennessay, able to unite the organization under a common goal rather than uniting the company around a particular person, it is a lot easier to push for essays of the a company. Alibaba Group , Employment , Jack Ma 1019 Words | 3 Pages. Alibaba Organizational Structure changes for its IPO.
Holding ltd. to conduct some organizational considerations before being listed on the New York Stock Exchange last September. Jill Pictures! Alibaba is essays on father son relationships, a Chinese e-commerce . company founded in 1999 by Jack Ma , who successfully created a B2B website and portal connecting Chinese manufacturers with thousands of hennessay overseas buyers. Ma eventually managed to attract foreigners to son relationships, run the company since, during that time, people in China had very little management expertise. Fake Hennessay! This decision, together with the significant Internet. Alibaba , Alibaba Group , Alibaba.com 824 Words | 3 Pages.
to learn to sing and dance. After Clarence had joined the Moses Stokes Minstrel Show, Bessie got auditions. Bessie's career began when she was 'discovered' . by none other than Ma Rainey when Ma's revue, the essays Rabbit Foot Minstrels, was passing through Chattanooga around 1912 and hennessay pictures she had the essays of the occasion to fake jill hennessay pictures, hear young Bessie sing. Ma took Bessie on the road with the show and communicated, consciously or not, the subtleties and long word intricacies of an ancient and still emerging art form. (Snow). Fake! . Bessie Smith , Blues , Blues Hall of Fame 952 Words | 3 Pages. While traveling with the christian essays Moses Stokes Traveling Show, Smith met Ma Rainey, one of the most famous blues singers at hennessay pictures that time. . Ma Rainey's vocal style was similar to Bessie Simth's–full-throated, with sophisticated phrases–but Smith's style was already firmly established by the time she met Rainey. Phd Thesis! Rainey took young Bessie under her care and nurtured her as a mother nurtures her child. Pictures! The relationship between Bessie Smith and Ma Rainey was more personal than stylistic. Bessie soon became a part. Alberta Hunter , Bessie Smith , Black people 2193 Words | 6 Pages. Using Three Examples, Comment on and Discuss the Development of French Domestic Architecture in the 17th Century. moved away from the simplicity and elegance of classical architecture.
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Alibaba , Alibaba Group , Alibaba.com 2929 Words | 12 Pages. ALI FARHOOMAND rP os t HKU776 ALIBABA.COM op yo China is vytelingum, a place where miracles are made. - Jack Ma , founder and chairman of Alibaba . Hennessay Pictures! Group1 tC On 6 November 2007, Alibaba.com debuted on the Hong Kong Stock Exchange, raising US$1.5 billion to become the world’s biggest internet offering since Google’s initial public offering (“IPO”) in 2004. A frenzied purchase of the stock pushed prices up by 193% on mcdonalds case study research, the first trading day, making it the fourth-largest first-day gain in fake jill pictures Hong Kong’s stock exchange. Alibaba , Alibaba Group , Alibaba.com 6794 Words | 73 Pages. . 10 1 1. Introduction 1.1. Alibaba Group Alibaba (SEHK: 1688) (Chinese: ? ? ? ? ; pinyin: a li ba ba) is a Hangzhou-based . e-commerce/e-auction company, specializing in global trading. It was founded in 1999 by Ma Yun (Jack Ma ), and operates five e-commerce sub-companies which operate different aspects of vytelingum trading. 1.2.
Business profile The English-language web site alibaba.com specializes in business-to-business trades, especially for international buyers trying. Alibaba Group , Alibaba.com , Business-to-business 3166 Words | 12 Pages. Kong Stock Exchange (Symbol: 1688). The parent company is owned by Yahoo (39%), Softbank - a Japanese telecommunications company (31%) while the remaining . shares are held by jill hennessay, the Chairman, Jack Ma and case other founders. Exhibit 1 outlines the subsidiaries of the fake Group. Alibaba.com was set up in 1999 by Jack Ma along with 17 other founders. The company has four marketplaces or trading platforms: * www.alibaba.com: International platform * www.1688.com: Chinese platform * www.alibaba. Alibaba , Alibaba Group , Alibaba.com 4622 Words | 15 Pages.
and one of her mentors, Gertrude Ma Rainey, seemed to have created the genre. They also became models of how African-American women could . 2000 Word Essay Pages! become economically independent in a culture that had not previously allowed it. Both Smith and fake Rainey composed, assembled, and managed their own road bands. Coming from the poor and working-class communities they easily influenced and related to mcdonalds case study research, people of similar backgrounds which quickly moved them into success. Bessie and Ma Rainey both addressed controversial. African American , Bessie Smith , Blues 420 Words | 2 Pages.
Alibaba's Juhuasuan Overseas Platform for Consumers in Hong Kong and Taiwan. Chief representative of jill hennessay NASDAQ China segment met Alibaba senior executives and discussed the christian essays possibility of launching the IPO in the US and invited Alibaba . to jill hennessay, the meeting and met the person in essay pages charge of the company's IPO, but the company's founder Jack Ma and executive director Cai Chongxin were not present. According to fake jill, Sinocast, The Stock Exchange of Hong Kong has not responded about 2000 word essay pages Alibaba’s finance, the spokesperson of Alibaba declined to fake jill hennessay pictures, comment, and NASDAQ also refuses to remark on on public funding for the arts and sciences, the reply of. Alibaba , Alibaba Group , Hong Kong 539 Words | 2 Pages. ?1. How does Alibaba create a competitive advantage?
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Cleft Lip and Palate and its Effect on fake hennessay pictures Speech Essay. Introduction on Speech and Phonetics. Phonetics and phonology are concerned with speech – with the ways in which human produce and hear speech. Talking and listening to each other are so much part of normal life that they often seem unremarkable. Yet, as in any scientific field, the curious investigator finds rich complexity beneath the son relationships surface. Fake Jill! Even the simplest of conversations – an exchange of son relationships, short greetings, for example – presupposes that the speaker and hearer make sense to each other and understand each other. Their ability to communicate in fake, this way depends in turn on proper bodily functioning (of brain, lungs, larynx, ears and so on), on recognizing each other’s pronunciation a bewildering jumble of unpronounceable and unintelligible noise only underlines the extent of our organization and control of talking and listening within particular social and linguistic conventions. Once we make a decision to start with an examination of speech, we can come up to it on a range of steps. At one step, speech is an issue of anatomy and physiology where we can examine the organs of speech such as tongue and larynx and of the vanities their role in the creation of speech. Fake Pictures! Taking another perspective, we can focus on the speech sounds produced by these organs – the case study marketing units that we commonly try to identify by letters such as a ‘b-sound’ or an ‘m-sound’.
But speech is transmitted as sound waves themselves. Jill Hennessay Pictures! Taking yet another approach, the term ‘sounds’ is a prompt that speech is proposed to be heard or supposed that it is then probable to concentrate on the manner in which a listener understands and process a sound wave (Clark, Yallop, Fletcher, 2006). Phonetics is the study of the sounds of natural language. The use of sounds in speech involves three distinct phases: 1) the production of sounds by the speaker, 2) the transmission of sounds between the speaker and the hearer, and 3) the mcdonalds study marketing reception of the sounds by jill hennessay pictures, the hearer. Each of these phases especially 1) and 3), which clearly involve the human brain, is an extremely complicated process, each needs to be understood if we wish to essays on father have full understanding of the workings of jill hennessay, human speech, and each requires its own methods of study. The science of phonetics thus consists of three main branches, each devoted to the study of one of the persuasive funding and sciences phases of speech. Articulatory phonetics is the study of the jill way in which speech sounds are produced or ‘articulated’ by the speaker. It includes a description of the organs of speech, such as the vocal cords, the tongue and the palate, and how they are used to vytelingum phd thesis produce sounds. The description of speech in articulatory terms has a long history, going back to ancient times, and is still considered the most useful type of description for jill pictures language teaching purposes.
Acoustic phonetics is the study of the transmission of speech sounds through the air in the form of air waves. Precise studies of the vytelingum phd thesis transmission stage of speech rely heavily on electronic equipment which has only been available since the 1930s and 1940s, but in the relatively short space of time since then great strides have been made in our understanding of the transmission of speech sounds. Acoustic phonetics is not as important in hennessay, pronunciation teaching as articulatory phonetics, but it can be of valuable assistance in certain areas such as the description of vowel sounds or intonations, which are not easily described in articulatory terms. Auditory phonetics , finally, studies the processes in essay on public for the, the ear, auditory nerve and brain which lead to the perception of sounds by the hearer (Hall, 2003). The first essential for the student of Phonetics is to have a clear idea of the jill structure and functions of the various parts of the organs of speech. The term organs of speech is used to refer to parts of the body in the larynx and the vocal tract that are involved in the production of speech. It is a misleading term in that it suggests that we have special physical organs for speaking.
This is word pages not so: all our so-called ‘organs of speech’ have primary biological functions relating to our respiratory system and the processing of food (Gussenhoven Jacobs, 1998). The organs of speech are all bodily structure composed of a variety of tissue types (such as bone, cartilage and skin) which are specific to fake jill hennessay pictures their biological (rather than linguistic) function. Bodily organs are generally grouped into systems which have particular functions in the life of the organism. These include the mcdonalds case respiratory system, the digestive system, and the reproductive system and so on. Pictures! While it can be argued that the of the vanities organs of hennessay, speech form a system, they do not contribute to life support in the same way as other systems, and they are generally not thought of as performing their primary biological function when they are used in speech production (Clark et al., 2006). Nature of Speech Defects. Speech is a motor act that requires little concentration once it is learned. Essays Vanities! The energy source for speech is fake jill pictures air. The diaphragm is the primary muscle of essays on father, respiration and fake pictures air is inhaled and essays exhaled through the jill vocal tract, the diaphragm contracts and flattens; this enlarges the thoracic cavity by displacing the abdominal contents downward and expanding the thoracic volume. The external intercostals assist the diaphragm in increasing the size of the thoracic capacity. If these movements are not coordinated, the supply and control of mcdonalds marketing, air may be reduced.
Lack of coordination occurs during inhalation when the abdominal muscles contract simultaneously with the diaphragm and push the abdominal contents upward. This upward movement decreases the size of the jill pictures thoracic cavity, which reduced the amount of air available for the production of speech. Restriction of the air supply may lead to essays reduced loudness, illogical breath groups, limited pitch range, decreased intelligibility and increased expiratory effort. Respiration for speech should be effortless and coordinated with phonation and resonation. Adduction of the vocal folds in a stream of fake, air produces phonation.
During quiet respiration, the vocal folds are abducted to an intermediate position by the poster cricoarytenoid muscles. Changes in the vibration pattern may result in altered voice quality, pitch, and loudness and decreased speech intelligibility. Communication is a closed loop system. When individuals speak, others hear them and respond to essay arts and sciences their speech. In addition, individuals hear themselves speak and monitor their speech production. If speech production does not match the specific intention, then speech os modified.
When speakers have a speech disorder, they may compensate for the impaired speech production by hennessay, changing their respiration, phonation, and articulation. If this compensation is carried out in an effortful way, the compensation may be counterproductive and essays may worsen the symptoms (Brin, Comella, Jankovic, 2004). Speech assessments proper are established from the age of fake jill hennessay, 4 years and allow objective evaluation to take place over a long period. The articulation of long 2000 essay, phonemes is routinely evaluated during sessions of repetition as well as free speech. The speech-language pathologist (SLP) will also evaluate the child’s speech production and some of the aspects of phonology. The SLP will ask the child to say various syllables or words and evaluate the “correctness” of what the fake jill hennessay pictures child says. Christian Essays! The SLP is trained to listen and compare all aspects of speech to a criterion of correct production. Hennessay Pictures! The SLP will comment on the child’s voice quality.
Does the child’s voice sound like a typical child’s should at that age? Is it too high-pitched, strained, or too nasal? The SLP will comment on fluency, or the relative ease with which the child talks. Does the child stutter or stammer? The SLP will also perform oral-motor exam . In this exam, the SLP asks the child to do some movements incorporating his tongue, lips, teeth, cheeks, soft palate, and jaw. These movements are checked to see if the child has any weakness or coordination problems with the muscles and essay on public arts structures of the mouth that would influence the child’s ability to produce the speech sounds correctly. The SLP will also do an articulation test. In this test the SLP asks the child to say a group of syllables or words that contain all the sounds of English. The SLP makes a judgment about how correctly the child produced the sound. Jill Pictures! Sometimes the SLP marks whether the error was an omission (the child did not say the sound at all), a substitution (the child substituted one sound for another; for example the phd thesis child said “pish” instead of “fish”), or a distortion (the child said a sound that was not the correct speech sound and did not sound like another sound).
The SLP will list which sounds were produced incorrectly and make suggestions for follow-up therapy (Easterbrooks Estes, 2007). It is the term applied to a fissure in the roof of the mouth (palate) and/or the lip which is fake hennessay pictures present at birth. It is found in varying degrees of severity in about 1 in 700 children. Modern plastic surgery can greatly improve the son relationships appearance of the jill hennessay baby and essays of the often further cosmetic surgery later will not be necessary. The parent of the child who has cleft lip and/or palate will be given detailed advice specific to his case. In general the team of specialists involved are the pediatrician, plastic surgeon, dentist or orthodontic specialist, and speech therapist (Havard, 1990). The deficiencies associated with cleft palate depend on the location of the defect in the palate. In the normal palate, the tensor veli palatine and fake levator palatine muscles within the soft palate insert into an aponeurosis at on public funding and sciences, the midline raphe. In the cleft palate, the muscle fibers follow the medial margin of the cleft and hennessay insert into the medial cleft edges and the posterior edge of the mcdonalds study research lateral bony hard palate.
Clefts involving the jill pictures alveolus can disrupt normal dental development, eruption, and retention. The subject of normal human facial growth is extremely complex and incompletely understood; and superimposing a cleft defect complicates an already complex process. Essays Of The Vanities! Many children with clefts will develop collapse of the alveolar arches, midface retrusion, and resultant malocclusion as they approach their teenage years. The underlying cleft deformity itself, as well as the surgical procedures performed to correct the defect, has been implicated as possible contributing causes of these developments. Currently, controversy exists regarding the relationship between surgical procedures and maxillary growth in terms of the sequencing of the jill hennessay surgical procedures, the timing of the cleft repair; whether or not the cleft repair itself has an effect on maxillofacial growth, and the various surgical techniques of lip and palate repair. Phd Thesis! Of interest, it is jill hennessay common in nonsyndromic older children whose cleft is phd thesis unrepaired to have relatively normal midfacial projection and occlusion (Bailey, Johnson, Newlands, 2006).
The Effects on Speech and Resonance. Dental problems in children with cleft lip and palate or craniofacial syndromes can be quite complex. These problems frequently require dental specialists to coordinate treatment with other health care providers in order to properly manage the patient. The specialists involved usually include a pediatric dentist, an fake jill pictures, orthodontist, an oral maxillofacial surgeon, and a prosthodontist. Together, they monitor and treat problems of the developing dentition, occlusion, and facial growth of the cleft lip/palate patient. As dental professionals reconstruct the oral environment, the speech pathologist leads to a more holistic management of the structural and functional effects of dental and on father son relationships speech abnormalities (Kumme, 2000).
Speech may be difficult to understand and have a muffled nasal quality, the greatest difficulty being in the pronunciation of consonants. This type of inadequate closure leads to the diagnosis of ‘cleft-palate’ speech, even though the palate is anatomically closed. In some cases adenoid tissue helps to close the space, so its removal by surgery or its decrease at the time of adolescence leads to jill further deterioration of speech. There may be associated, non-specific neurological symptoms (Baird Gordon, 1983). The reasons for cleft palate repair are improved feeding, speech development and protection of the Eustachian tube, and effect on the growth of the middle third of the face. Not enough attention was paid to the hearing in on father, cleft palate patients and, in the earlier years, the speech was also not given important consideration. All the attention was focused on the growth of the middle third of the face but if one misses the hearing and the speech, the damage is irreversible.
The timing of jill hennessay, cleft palate repair has always been governed by geographical location. In the European Centers, the repair is delayed for considerably longer, even up to six to case marketing research seven years. In the English speaking countries, the fake repair is done around one year of age, but why leave these repairs till so late as speech usually develops by christian essays, seven months? Physiologically, it is better to repair the palate before speech starts developing, so that postoperative edema and scarring settles down, it is then better to operate in the cleft palate at four months. Traditionally, the treatment of cleft lip and palate was to repair the cleft lip and anterior palate (single layer closure) between six to 12 weeks of age and repair the palate at about 18 months (Desai, 1997). Currently, the majority of surgeons around the jill hennessay pictures world who treat many of these children prefer to operate around 3 months of on bonfire of the, age for physiological and technical reasons. A 0.25mm error in alignment in a 1-day-old- child will show noticeable 1 to 2mm malalignment by age 1 year. Jill Hennessay Pictures! The cleft palate is repaired best at around age 12 months. 2000 Essay! This is a compromise. Earlier repair may be an advantage for speech, but it is fake hennessay pictures a disadvantage to subsequent facial growth.
Late repair has an opposite essays effect. It is subsequently easier today to correct an underdeveloped midface in the 10% to 20% of fake, patients in whom it may occur, rather than trying to son relationships correct bad speech in nearly all patients so treated by jill hennessay, late palate closure. Cleft lip and palate need no longer be devastating deformity that it was 30 years ago, if untreated by an experienced team (which needs to see at least 40 new patients a year), the phd thesis child should be expected to have normal speech, a symmetrical lip with a fine scar, a nose close to hennessay pictures normal in appearance, and a full set of well-fitting teeth. To achieve this requires good patient and parent cooperation. Phd Thesis! In most cases, further surgery will be required by age 5 years to jill hennessay improve the nose shape. The wearing of orthodontic braces is almost inevitable but should be limited to 1 session in early adolescence. With good psychosocial support and good parenting, such children should grow into normal well-adjusted adults.
However, if the quality of the surgery is bad and repeated operations are carried out, the speech and hearing are ignored and the teeth are not treated, then a very different psychological outcome will be present. Unfortunately, this still occurs even in the most advanced countries, if children are treated by either inexperienced or inadequately trained people, or without the essays benefits of a team approach, or where the team does not have a big enough population load to maintain its expertise (Eder, 1995). Surgical Management of the Primary Deformity. If the hennessay child presents with a very wide cleft lip and a palate, it may be advantageous to “help” the cleft to essays on father son relationships become narrower, thereby facilitating the surgical outcome of the cleft lip repair. Fake Hennessay Pictures! Most commonly, presurgical orthopedic molding of the wide cleft palate and study research lip can be accomplished with a process called “taping.” In taping, a strip of hypoallergenic tape is applied with tension across the cleft and secured to the child’s cheeks. The tape is worn 24 hours a day and reapplied as needed. Taping causes molding of the bony tissues by applying gentle pressure onto the protruding bony portions of the maxilla.
This simple technique can be extremely effective in jill hennessay pictures, reducing the width of the cleft in christian, a nonsurgical manner. When taping a ineffective or not tolerated by hennessay, the infant, a lip adhesion can be considered. The goal of a lip adhesion is to surgically convert a complete cleft lip into an incomplete cleft lip, allowing the definitive lip repair to be performed with less tension. The lip adhesion also orthopedically molds and improves the alignment of the underlying maxillary segments before definitive lip repair. Lip adhesion, if indicated, is the initial procedure and it is performed at 2 to 4 weeks of age. Definitive lip repair follows the on bonfire of the adhesion at 4-6 months of age, which allows the fake hennessay scar to mature. The following criteria are used to determine if lip adhesion is needed (following failure of the taping technique):
Wide, unilateral complete cleft lip and palate where closure with conventional lip repair might produce excessive tension on the incision Symmetric, wide bilateral complete cleft lip with a very protruding premaxilla Introduction of symmetry to an asymmetric bilateral cleft lip. A disadvantage of lip adhesion is the phd thesis introduction of scar tissue, which can occasionally interfere with the definitive lip repair; although not usually a major concern, this has prompted some surgeons to limit its use. If no medical contraindications exist, and a lip adhesion has not been performed previously, definite lip repair is jill pictures accomplished at case marketing research, 8 to 12 weeks of age. In the United States most surgeons follow the “rule of fake jill hennessay, tens”: lip repair is performed when the infant is at least 10 weeks old, weighs 10 pounds, and has hemoglobin of 10 g. Cleft Palate Restoration. Historically, the exact timing of surgical closure of the cleft palate has been controversial. The desire to facilitate velopharyngeal competence for adequate speech favors relatively early closure of the palate, whereas the possible negative influence on maxillofacial growth and occlusion favors relatively late closure. Anatomic factors to consider when evaluating the palate include the extent and on father width of the cleft (between both the fake jill hennessay alveolar ridge and palatal shelves); position of the maxillary segments; and, in the bilateral cleft, the size, position, and degree of protrusion of the premaxilla and prolabium. In both unilateral and bilateral complete cleft palate, collapse of the lateral maxillary segment can occur following the lip repair. In some cases, preoperative orthopedics can be used to realign the persuasive essay for the arts maxillary segments in a more normal position before the palate is repaired.
In bilateral cleft, presurgical orthopedic treatment consists of molding the nasoalveolar process with progressively modified splints, and achieving lengthening of the deficient and short columella tissue, leading to an improved nasal appearance with a single stage procedure. Other groups favor techniques that allow for intranasal correction of the hennessay deformity and malposition during the lip repair. Although insufficient space exist to essays on bonfire of the vanities describe all the commonly used techniques, the principles of bilateral lip repair are common among them, including creation of the philtrum from the prolabium and midline tubercle from the lateral vermilion. Fake Hennessay! A symmetric, bilateral complete cleft lip and palate with an adequate and moderately protruding prolabium and premaxilla are used as an example. Asymmetric, bilateral cleft lips and christian those with a rotated premaxilla can be treated with a one or two-stage closure (using the lip adhesion as the first stage). For children with an extremely protruding premaxilla, presurgical orthopedics may be required before definitive lip repair to move the premaxilla posteriorly, either surgically or via molding with appliances or tape (Bailey et al., 2006). Daily use of folic acid before conception decreases the risk for isolated (not associated with another genetic or congenital malformation) cleft lip or palate by jill, up to 25%. Women of childbearing age should be encouraged to take a daily multivitamin containing folic acid until menopause or until they’re no longer fertile (Kumme, 2000). Use of a contoured speech bulb attached to the posterior of a denture to occlude the nasopharynx helps the child develop intelligible speech when a wide horseshoe defect makes surgery impossible. Special nipples and on bonfire vanities other feeding devices are available to improve feeding patterns and promote nutrition in infants with a cleft lip or palate (Eder, 1995).
There is no comparable series of routine cleft lip repair in newborn within 48 hours over a long period using the same technique; it is extremely difficult to fulfill such requirements as the temptation to alter the technique or timing is so great. Every now and then, ideas about the treatment and techniques are reported in the literature or at conferences. There was considerable opposition to, and hennessay pictures criticism of, our work at every level, nationally as well as internationally. If one contemplates surgery in the newborn, then a proper team should be assembled. A surgeon should only undertake such a project if he feels it will help the child, not to impress other surgeons.
A time will come when there will be fewer surgeons undertaking the treatment of these children in specialized centers. It is a safe procedure in mcdonalds study marketing, the hands of fake jill pictures, dedicated clinicians and essays of the surgeons. Pediatricians and fake jill pictures the anesthesiologist should have a final say in on father, the decision for surgery. It is fake hennessay possible to do a formal repair. The scar revision in unilateral cleft is comparable to any other series. In bilateral clefts the plan is to lengthen the columella, repair the orbicularis and on father son relationships narrow the philtrum at the same time at about four or five years of age. It may be worth looking at the technique of palate repair. One has to find a way to fake pictures achieve repair early on mcdonalds case study research in order to maintain hearing and speech results while achieving excellent maxillary alignment (Desai, 1997). Bailey, B. J., Johnson, J. Pictures! T., Newlands, S. D. (2006).
Head Neck Surgery–otolaryngology (4th ed. Vol. 1). Tokyo: Lippincott Williams Wilkins. Baird, H. W., Gordon, E. C. (1983). Neurological Evaluation of on public for the arts and sciences, Infants and Children . London: Cambridge University Press. Brin, M. F., Comella, C. L., Jankovic, J. J. (2004).
Dystonia: Etiology, Clinical Features, and hennessay Treatment . New York: Lippincott Williams Wilkins. Clark, J., Yallop, C., Fletcher, J. (2006). An Introduction to Phonetics and Phonology . Victoria, AU: Blackwell Publishing. Desai, S. N. (1997). Neonatal Surgery of the persuasive on public funding arts and sciences Cleft Lip and Palate . Hongkong: World Scientific.
Easterbrooks, S. R., Estes, E. L. (2007). Helping Deaf and Hard of Hearing Students to Use Spoken Language . Thousand Oaks, CA: Sage Publications Inc. Eder, R. A. Jill Hennessay Pictures! (1995). Craniofacial Anomalies: Psychological Perspectives . New York: Springer. Gussenhoven, C., Jacobs, H. (1998). Long Word Essay Pages! Understanding Phonology . London: Oxford University Press US. Hall, C. (2003). Modern German Pronunciation: An Introduction for Speakers of English . New York USA: Manchester University Press. Havard, C. W. H. (1990). Black’s Medical Dictionary . Savage, Maryland: Rowman Littlefield.
Kumme, A. W. Jill Hennessay Pictures! (2000). Cleft Palate and Craniofacial Anomalies: The Effects on Speech and Resonance . San Diego, Canada: Thomson Delmar Learning. University/College: University of Arkansas System. Type of paper: Thesis/Dissertation Chapter. Date: 26 February 2017. Let us write you a custom essay sample on Cleft Lip and Palate and its Effect on Speech. for only $16.38 $13.9/page.
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