Lean Body Mass in Children with Asthma Controlled by Steroid Therapy A Cross-Sectional Study - Free Essay Example

Sample details Pages: 2 Words: 678 Downloads: 5 Date added: 2019/08/08 Category Health Essay Level High school Tags: Asthma Essay Did you like this example? Childhood asthma is markedly increasing in developing countries. The first line of management according to national asthma guidelines is inhaled corticosteroids (ICS). Accurate body composition analysis with persisted asthma controlled by steroid therapy is essential at childhood, as the potential effects of the long-term treatment are still a matter of concern. Don’t waste time! Our writers will create an original "Lean Body Mass in Children with Asthma Controlled by Steroid Therapy A Cross-Sectional Study" essay for you Create order Aim: The purpose of this study was to assess the total and segmental body composition especially the lean body mass in Egyptian children with asthma receiving inhaled steroid therapy. Methods: Lean body mass was measured by the gold standard, dual-energy X-ray absorptiometry (DEXA) in a cross-section study of 130 Egyptian pre-pubertal school-aged children (4-12 years); 50 asthmatic children with long-term steroid therapy (for two years) and results were compared with lean body mass values of 50 healthy children. Also, 30 asthmatic children with short-term steroid therapy (less than 6 months) were examined to rule of the duration therapy effect. Results: Asthmatic children received long-term steroid therapy had significantly higher chest lean mass than healthy children, which had highly significant association with weight, height, body mass index (BMI), total lean mass and total fat mass. However, no statistical significance is detected with short-term steroid therapy. Also, there is no significant sex difference. Conclusion: The lean chest mass is increased in children with asthma controlled by long-term steroid therapy, evaluation of those children using DEXA provides an accurate analysis of both total and segmental body composition. Keywords: lean body mass, DEXA, asthma, steroids Introduction Childhood asthma is the most common chronic inflammatory disease of lung [1, 2]. It is characterized by inflammation of airway with episodes of coughing, wheezing and shortness of breath [3]. Proper diagnosis of asthma is essential for the management; to detect accurate treatment and its dose [4]. Asthma cannot be cured, but it can be controlled by medications to reduce symptoms during acute attacks [5]. Inhaled corticosteroids (ICSs) are used as long-term controllers to reduce asthma-related morbidity and mortality and improve quality of life. National guidelines recommend corticosteroid therapy as a standard treatment for long-term control of childhood a sthma [6, 7]. Hence, the effects of long-term ICS therapy on asthmatic children must be clearly defined. Analysis of body composition is essential for clinical and research settings [8]. The majority of studies on asthma had concentrated on obesity and used body mass index (BMI) as a fat indicator, its results reflect limitation to predict body fatness and health risks in children; BMI cannot differentiate between muscle and fat mass as well as bone mineral content (BMC), also it cannot measure fat distribution but only indicate fatness in the whole body [9-12]. Alternatively, measurement of body composition by dual energy x-ray absorptiometry (DEXA) provides an accurate assessment of the tissue level [8]. Careful consideration of the body composition changes and differentiation between fat and lean body mass may be an important factor in examining the lung functions in asthmatic children [13, 14]. The aim of this study was to assess the total and segmental body composition especially the lean body mass in Egyptian children with asthma receiving inhaled steroid therapy. Cross section data were collected and reported in this manuscript. Results The present study includes three groups: children with asthma controlled by long-term steroid therapy (32 males and 18 females), healthy children (26 males and 24 females) and children with asthma used short-term steroid therapy (9 males and 21 females). Their mean age of both groups is 8.5 ? ± 3.0 SD. Regarding the frequency distribution of BMI; the asthmatic group of long-term steroid therapy included (42 of normal weight and 8 overweight and obese), while the asthmatic group of short-term steroid therapy included (24 of normal weight and 6 overweight and obese) and the healthy group included (43 normal weight and 7 overweight and obese). The means and standard deviations (SD) of the anthropometric measurements and significant body co mpositions values (lean mass and fat mass) of asthmatic with long-term steroid therapy and the healthy group showed in (Table 1), while between asthmatic with long-term versus short-term steroid therapy shown in (Table 2). These data indicated that weight and BMI were significantly higher in asthmatic patients with long-term steroid therapy compared to healthy group. Therefore, the chest lean mass had significantly higher in the asthmatic group with long-term steroid therapy (P 0.008) comparing to the healthy group, however no statistically significant was detected with short-term steroid therapy. The fat mass had no statistically significant between groups. Also, a comparison between asthmatic with short-term steroid therapy and the healthy group was done with no statistically significant detected. In spite of the absence of significant sex difference, we conducted several additional analyses to find the association between body composition (lean mass especially chest and fat mass) with each other as well as with anthropometric measurements that shown in Table (3), using Pearson's correlations. These data indicated that lean chest, total lean and total fat masses had highly association with weight, height, BMI as well as with each other. Correlation is significant at the 0.01 level (p-value). Discussion Asthma and obesity represent serious complex chronic health conditions with high prevalence that have been studied in many studies and systematic reviews, reported a significant association between them [16-19]. Obesity considers a significant risk factor of asthma as more frequent symptoms with severe exacerbations could be detected in obsessing child, reduced response to medications as well [20- 25]. The excess fat and lean masses increasing risk of asthma [5]. Careful consideration of the body composition changes during growth and development of a child is essential for prediction of obesity and other health risks latterly in life. Although body mass index (BMI) is used as a fat indicator at many studies, although its limitation to predict body composition and health risks in children; as BMI cannot differentiate between lean and fat masses as well as bone mineral content (BMC), also it cannot measure fat distribut ion but only indicate fatness in the whole body [10-13]. Dual-energy X-ray absorptiometry (DEXA) is used to analyze body composition based on a three-compartment model; fat mass, lean mass and the bone mass. Every compartment has a unique density and attenuates different energy beams; allowing an accurate quantification of each tissue with a convenient analysis of the whole and segmental body composition [14, 26]. Differences of body composition are detected among sex (males and females) at all ages; the included children in this study were selected in a pre-pubertal school-age period to avoid the obvious differences in body composition which emerge at adolescence with greater fat mass within females, while lean mass more prominent within males [27]. Few studies assessed the lean mass; total and regional distribution in children [14, 28, 29]. Some researches indicated the importance of studying thoracic adiposity in asthmatic adults [10, 24]. In this study, the lean chest mass withi n Egyptian asthmatic children was increased, who received long-term inhaled corticosteroids therapy, as steroids had anabolic action on protein metabolism by increasing synthesis and inhibition of breakdown, causing muscle growth. Moreover, the present study revealed a highly positive association between lean mass with weight, height and BMI, this agrees with Granell et al., (2014) that found the increased lean mass and fat mass in high risk asthma in mid-childhood, which persisted to age 15 years in birth cohort study [5]. Jensen et al., in (2014) have assessed the association between lean mass in obese Australia children aged (8-17 years) by DEXA. It was suggested that lean mass may be more important than fat mass in relation to the respiratory function of asthmatic children [14]. Findings of this study showed no significant difference in the fat mass between healthy and asthmatic children received short or long-term inhaled steroid therapy. Consistent results were found in a previous study concluded that short-term treatment with inhaled corticosteroids does not provoke growth alteration and fat accumulation [30]. Studies on obesity with respiratory disorders reported that in addition to the amount of fat m ass is contributing to impaired pulmonary function; fat distribution plays a role as well [22]. Abdominal fat was increased with decreased respiratory functions in asthmatic children [31, 32]. Therefore, it was suggested that children with long-term therapy of asthma accumulate more adipose tissue on the trunk [33, 34]. In conclusion, this cross-sectional study is based on an accurate body composition analysis by (DEXA) that allowing the evaluation of total and segmental body composition in relation to the duration of steroid therapy. The lean chest mass is increased in asthmatic children controlled by long-term steroid therapy. Conflict of interest No conflict of interest associated with this manuscript. Acknowledgments Authors are grateful to all children participated in this study and their parents.

The Availability Of Fast Food Essay - 1210 Words

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Instead of people just buying them once a week people are buying them 3 to 4 times a week and it’s causing their diets to be unhealthy. In Cambridge and Hamilton there are healthy o ptions available these can include Subway, Kebabs, and local bakeries that sell sandwiches etc. Question 2: Gather evidence for and against different points of views? The professionals say that policies should be put in so that they cannot advertise junk foods so that kids do not go out and buy it. There has been 3000 institutions of professionals whoShow MoreRelatedObesity Is A Serious Public Concern862 Words   |  4 PagesObesity has increased rapidly in the U.S. since the 1970s. At the same time, the number of fast food restaurants more than doubled over the same time period. 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Similarities Between 1984 And Gattaca - 976 Words

In the dystopian worlds created by the film director Andrew Niccol and renowned author George Orwell, notions of control and freedom are explored. Both worlds contain an overarching power that governs the rest of the population and restricts freedom of individuals, these powers also aid in the progression of technology, which further act to control individuals. The characterisations of the protagonists of each text portray the lack of freedom from the perspective of those that are affected. Both authors use a variety of techniques to portray themes of control and freedom in their texts. Both Gattaca and 1984, explore notions of control over individual freedom exhibited by the dogma’s present in both worlds. Within both dystopian worlds,†¦show more content†¦Ultimately, the doctrines within both worlds constrict the freedom of individuals. Both texts explore how advancements in technology impact the freedom of individuals. In Gattaca, advancements in science – mainly in genetic engineering – leading to discrimination, in 1984, technological advancements such as the development of telescreens impacts the freedom people have as they are constantly watched. Within Gattaca, the genetic discrimination leads to a loss in freedom as â€Å"invalids† are denied jobs since â€Å"[the] real resume is in [their] cells.† The telescreens in 1984 constantly patrol individuals for any signs of rebellion against the party, even â€Å"a couple of seconds during which the expression in [their] eyes might conceivably [betray them]† to the party as a â€Å"thought criminal†. Within Gattaca, the world is portrayed as sterile and mechanical, everything is perfect – including the people – harshly juxtaposing with the imperfect world of nature. Similarly, in 1984, the party’s ideal set up was â€Å"a world of steel and concrete, of monstrous machines and terrifying weapons – a nation of warriors†¦marching forward in perfect unity†¦the reality was decaying, dingy cities where underfed people shuffled to and fro.† Both worlds wish for perfection and a loss of identity, this, however, is impossible. In Gattaca, someone will always have more superior genetics than others, leading to a constant inequality betweenShow MoreRelatedGattaca and 1984 Insight968 Words   |  4 PagesStephanie Sadaka Mr. Sisti April 26th, 2010 ENG 4U1 Literary Insight Paper After reading the novel 1984 and watching the movie Gattaca, I was able to perceive many concepts and similarities and differences between both pieces of art. Gattaca, directed by Andrew Niccol, shows a story of a society where life is controlled by genetics, rather than education or experiences. Based on your DNA, society determines where you belong, and your future. This allows no room for people to gain experiences

Silent Languages and the Business Culture Adopted by an...

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Professional Environment Ethical Business Dilemma

Question: Discuss about the Professional Environment for Ethical Business Dilemma. Answer: 1: An ethical dilemma is quite common in a workplace. In case of ethical dilemma, an employee or an employer encounters a very complex and confusing situation, whereby it becomes challenging for the worker to take a firm decision, as the choice of one decision leads to the transgression of the other (Natale and Doran 2012). In the present case study, it has been observed that Alice, an employee of the organization named ACE, has utilized her professional skills and expertise for the purpose of creating and inventing her own security system, that owing to its unique, innovative and highly advanced qualities was capable of offering better protection to any kind of threat to the Information and Technology system of an organization. However, when Alice introduced the program to the manager of ACE, Ted, Ted absolutely refused to use it, owing to the absence of sufficient confidence in the capabilities of Alice. However, when Alices program was rejected by her own organization, she started continuing with her job, while at the same time focusing sufficient time, on the development of her program as well, and soon produced the same I the market under the pseudo name of Locksmith. . However, as and when the program became popular among the masses, and Ted discovered that Locksmith was none else but Alice herself, he immediately terminated her (Weiss 2014). Now, Teds manager Sheila Silk who was supposed to re-examine and review the whole thing, before terminating the service of an employee, relied blindly on the decision of Ted, and worked solely based on her prejudiced opinion towards Alice. The problem emerged when Busta, the owner of ACE, came to know about Locksmith, and asked Sheila to hire her, who was very well-aware about the actual identity of Locksmith. Here, the ethical dilemma emerges in the mind of Sheila silk, as to what she is supposed to do, as she is left with two conditions: Sheila will not hire back Alice. Sheila should hire Alice, as she has the necessary professional expertise required to take the organization a few steps ahead in a highly competitive market. It can be understood from the case study, that Alice was being terminated from her job without any justified grounds. Alice did not indulge in any kind of illegal activity, as she did not violate any privacy law of the business organization. A programmer can be sued and her service can be terminated, if he fails to follow the ethical guidelines such as giving proper credit for intellectual property, or honoring the confidentiality of his work or projects (Daft and Marcic 2016). In case of Alice, she has violated none of the ethical guidelines, and yet her service was being terminated on ground of the fact that she has hidden her identity, and has produced products in the market, instead of devoting her service solely to the development of the organization she has been working in, for the last 5 years. Alice has not behaved unprofessionally, and she has merely used her own professional skills, a part of which she has acquired from the training programs at ACE, to create her own progra m. Sheila, the senior manager of the organization must have reviewed and re-assessed the whole situation, to find out if it was an example of wrongful termination (Kruppe et al. 2016). It is noteworthy here that Sheila worked out of her biased opinion towards Alice, and it is evident that she has not gone through the positive performance reviews of Alice. Now, although she has been asked by the owner to hire Locksmith, she knowing the real identity, is unable to decide if she should hire back Alice, as it would also interrogate her and the managements decision in terminating the service of a highly skillful employee. It should be noted that each organization has a set of rules pertaining to the employment practices, and hence neglecting any of these rules, can lead to the accusation of breach of duty of good faith and fair dealing (Deaking and Morris 2012). The ground of termination of the service of Alice, is unjust and more importantly Sheilas decision to support and give consent to the decision of Ted, is in itself so wrong and devious that it can bring legal charges against her. Even if an employee is terminated due to the negligence of duty, she is supposed to be given a warning, something which was also denied to Alice. Now that Alice has proved her expertise and skills in the market, Sheila is confronting an ethical dilemma, regarding the fact whether she should hire the employee fired on unjust ground by the organization, or should the organization lose the working skills of a highly resourceful expert (Walsh 2015). 2: Four Step Ethical Analysis and Decision Making Process: Situation: Relevant Facts: In the present case study, it has been observed that Alice, the programmer working at ACE, develops her own program that owing to the unique and highly innovative features becomes an immediate success once it is launched in the market. However, as she has already approached her manager, who rejected the possibility of the sale of the program at a discounted or even free cost, the manager Ted on discovering the fact that Alice is using a pseudo name for continuing her business in the market, terminates her from her job. Ethical Issues: The main ethical issue that has emerged out of the situation is that Alices service was being terminated without any practical or justified ground. It is to be noted here that the case study suggests that she is an efficient worker of the organization, who has gained sufficient skill and knowledge about her work, by participating in a variety of trainings. Although she has initiated her private business, she cannot be accused of having neglected her official duty for the purpose of self-advancement (Bagenstos 2013). The case study clearly states that she worked in her own time, that did not intervene with the official work. The potential harm caused as a result of this ethical issue, is that an employee was being terminated without any justified ground. This resulted in the loss of Alices job that would not only affect her financial stability and dignity, but might also affect her family who might be dependent on her income. The next ethical issue that arose here is that Sheila, the senior manager must have cross checked and verified the entire situation, before terminating the service of an employee, and yet her decision was absolutely governed by her prejudiced opinion about Alice (Mamorsky 2015). The harm caused as a result of this ethical issue, is that that the organization lost the skill and expertise of a highly efficient and talented employee. Alice herself had also made an ethically wrong decision, when she chose to hide her real identity, and employ the pseudo name Locksmith, for conducting private business. Non-disclosure of private information is an ethical issue, and affects the reputation of the organization, in case the employee is engaged in an immoral act. This ethical issue might not affect the organization as a whole. However, if as an employee Locksmiths real identity would have been disclosed later, not only Alice would have been penalized, but the reputation of ACE might also get tarnished as well. Stakeholders Involved: Employee (Alice) Manager 1 (Ted) Manager 2 (Sheila) Shareholders (Jennings 2012). Government Step 2: Isolate the Major Ethical Dilemma: The major ethical dilemma that arises here is that whether Alice should be called back to work, or the organization should respect the decision taken by the manager of the organization, Ted. In case Alice is being called back to work she may sue the manager, Ted for having terminated her service without any valid or just grounds. Besides, her disclosure of unfair treatment to the other employees may create a negative impression in the minds of the employees, regarding the senior management system. Alice could also try to seek vengeance for the unlawful action taken against her, and may potentially harm the resources of ACE. However, if Alice s not being called back, the organization may lose efficient expertise of Alice, and may consequently be outrivaled by other organizations. In both the cases, the organization will be harmed; however, not hiring Alice would cause lesser harm to the organization. In case Alice is again hired, Alice will benefit, given the greater amount of financi al compensation, and incentive she can gain, while in case Alice is not being re-appointed, other rival organizations may benefit. However, choosing the second alternative that is not hiring Alice will be the most beneficial alternative (Shapiro and Stefkovich 2016). Step 3: Consequentialism: If Alice is being called back to work, then the reputation of the organization might get harmed. Since, Alice was being fired by the management authority of ACE, she might seek vengeance by harming the organization and its brand reputation, after re-joining the organization. If Alice is not being called back to work at ACE, then the organization might be harmed to a considerable extent. This is because, Alice has proved her skill, expertise and efficiency in program development, and in case she is employed by a rival organization, that organization will have a competitive advantage over ACE. Not hiring Alice back, is the alterative that will cause the least harm to the organization. If Alice is being hired back, Alice will be benefitted, though it should be remembered that she has already benefitted as the product introduced by her was an immediate success in the market, and as such she would gain enough recognition, to be able to earn sufficient amount of money. Hence, the organization would be benefitted by hiring a resourceful employee like Alice. If Alice is not being called back, the organization might be benefitted, as there would be less threat to the security system of the organization. Not hiring Alice will always result in maximum benefit, as though the organization might not be benefitted by the appointment of a talented employee, it would not have to suffer from a possible threat coming from an ex-employee. Consequentialism Comments: Not hiring Alice back, is the alterative that will cause the least harm to the organization. In case Alice is not being hired, another organization may temporarily gain a competitive advantage over ACE, and yet it should be noted that ACE can still use the product produced by Alice, and utilize the same for the organizations benefit. However, if Alice is hired back, she will gain sufficient knowledge about the security system of the organization, and may exploit the same for harming the information security system of the organization. In case Alice is not being hired, the organization will be benefitting the most under the given situation. This is because although the organization may not lose a potential and highly resourceful employee like Alice, they would at least not have to suffer from the fear of information hacking, and information theft, because of the presence of an agitated ex-employee. Rights and Duties: The rights and the duties violated here are as follows: The firing of Alice was illegal and as such the basic employment right was violated here, which clearly states that if an employee would be terminated, he/she should be terminated on properly justified grounds. Further, it is the duty of the employer to cite sufficient cause, as well as to provide a warrant before terminating the service of a employee. Again, the basic duty was also being violated when Sheila refused to review ad re-examine the whole situation, before providing consent to Teds decision of terminating the service of an employee, Alice. Another breach of duty, no less than an offence, was being conducted when Alice used a fake identity, for selling her program in private, while working as a program developer at ACE. Rights and Duties Comments: It can be seen from the above discussion that not only the management authority had violated the basic laws about fundamental rights and duties of the nation, but as a employee Alice can also be accused of identity theft. Kants Categorical Imperative: If Alice is being hired back, Ted as a manager as well as Sheila as a senior manager would be disrespected. If Alice is not being hired back, not only Alice would be disrespected, but the owner Busta Bigwig would also be disrespected. The alternative of not hiring back Alice is preferable. If Alice would be called back, then Ted ad Sheila would be treated unlike others. If Alice is not being called back, Busta will be treated unlike others. The alternative of not hiring back Alice is preferable. If Alice is being hired back, the organization might benefit from her professional expertise. If nobody agrees with the decision of hiring back, the benefit would be the company would be able to save itself from the fear of information theft. The alternative of not hiring back Alice would be the most preferable. Discussion: It has been understood that although Alice has perpetrated an action, that cannot be regarded as absolutely ethical, when she chose to conduct private business, without disclosing her identity to her own organization, or to the world, she did not deserve termination of her service. It should be remembered that if Alice chooses, she can sue the managers, Ted and Sheila, for having terminated her without any warning, and more importantly without a systematic approach to the situation as her performance history was neither reviewed nor was considered in the process (Oliver 2014). Decision: Finally, it can be concluded that the organization, as for now, should not hire Alice back, as her unfair treatment and poor experience in the organization may tempt her to cause serious harm to the information security system of the organization. It is advisable here that the organization creates a set of stringent ethical guidelines that must be followed by the employees as well as the managers, while appointing or terminating an employee. The management authority of ACE may also consider writing an apology letter to Alice, apologizing for the treatment meted out to her, while congratulating her on her success at the same time. Reference List: Bagenstos, S.R., 2013. Employment Law and Social Equality.Mich. L. Rev.,112, p.225. Daft, R. and Marcic, D., 2016.Understanding management. Nelson Education. Deakin, S.F. and Morris, G.S., 2012.Labour law. Hart publishing. Frericks, P., Jensen, P.H. and Pfau-Effinger, B., 2014. Social rights and employment rights related to family care: Family care regimes in Europe.Journal of aging studies,29, pp.66-77. Jennings, M.M., 2014.Business: Its legal, ethical, and global environment. Nelson Education. Kruppe, T., Rogowski, R. and Schmann, K., 2013.Labour market efficiency in the European Union: Employment protection and fixed term contracts. Routledge. Mamorsky, J.D., 2015.Employee Benefits Law: ERISA and Beyond. Law Journal Press. Natale, S.M. and Doran, C., 2012. Marketization of education: An ethical dilemma.Journal of business ethics,105(2), pp.187-196. Oliver, L., 2014. Linda Dickens (ed.), Making Employment Rights Effective: Issues of Enforcement and Compliance.Work, Employment Society,28(1), pp.139-141. Shapiro, J.P. and Stefkovich, J.A., 2016.Ethical leadership and decision making in education: Applying theoretical perspectives to complex dilemmas. Routledge. Walsh, D.J., 2015.Employment law for human resource practice. Nelson Education. Weiss, J.W., 2014.Business ethics: A stakeholder and issues management approach. Berrett-Koehler Publishers.

Managerial Decision Making Entrepreneurship Theory

Question: Discuss about theManagerial Decision Makingfor Entrepreneurship Theory. Answer: Introduction Herbert Alexander Simon, a political scientist, psychologist and sociologist, researched within a large range of subjects, unified by the researches of decision making (Zsambok Klein, 2014). The capacity of human mind for formulating and solving complex problems is very small compared with the size of problems whose solution is required for objectively rational behavior in the real world or even for a reasonable approximation to such objective rationality this quote of Simon will be analyzed in this essay based on four concept of Simon that defines the bias in decision making in the workplace. This theory is also known as the concept of bounded rationality. It is beyond doubt that Simon has been a pioneer of the concepts of bounded rationality. These concepts discussed here, can be used in order to explain bias and rationality in the decision making process on the basis of explaining the concepts here. The concepts are Judgment and decision making process, Bounded rationality, Judg ment heuristics and biases that are responsible for a biased managerial judgment in the organization. These concepts define the diverse influence on the though process of an individual while making an important decision. Judgment and Decision Making Process Any kind of decision making aims to solve problem and in order to do that the procedure involves three basic activities, selecting the agendas, setting up the goals, and designing the actions; after the problem solving evaluating and choosing is generally called decision making (Ford Richardson, 2013). Simon as a researcher focused on the understanding of human behavior and particularly the decision making. In discussing the judgment and decision making process, Simon had addressed two approaches. The first approach concerns the cognitive process in practice, not the theoretical approach to the economic theories that states decision makers have access to all the required information and unlimited time. The second goal is to prescribe how to make the good decisions. In other words, it can be said that Simon has investigated whether any competence in the decision making exists or not. This approach of Simon towards the process of decision making gives rise to another concept, biased r ationality. Researchers have agreed with Simon on the economic agents not being rational, but not exactly with the concept of bounded rationality theory (Clarke, Horst Roberts, 2015). It was found in the later researches that several times people diverge systematically from the expected outcome, decided in many theories. Bounded Rationality The concept of bounded rationality refers to the economic actors maximizing the utility; it also says that, in order to do it, the actors need to be rational and perfect agents. This also means that the final outcome of their taken decisions will be same if logical rules are used properly or a full cost benefit analysis is done with all the available options (Hasan, Shamsuddin Aziati, 2013). Simon came with this concept where he defined the decision making as a search process that is guided by several aspiration levels. Aspiration levels are defined as the value of the aim variable that much be surpassed by the satisfactory decision substitute. In other words, the concept of bound rationality refers to the rational theories underlying the adaptive behavior of people. In other words, it is the idea that when the individuals make decisions their sense of rationality is limited by the decision problem, the cognitive restriction of the mind and the available time for taking the decision (Chrisman, Memili Misra, 2014). The given quote clearly refers to the concept of bounded rationality. It refers that the decision makers act as the perfect agents who seeks a solution that is satisfactory than the optimal one. Simon proposed this theory as the alternative of the mathematical expression of decision making and the model views the decision making process as a entirely rational one of finding the optimal choice from the available information. Simon had utilized the analogy of scissors and represented one blade as the cognitive limitation of an individual and the other one as the structure of the environment. This example illustrated the process how the minds compensate for the limited resources by utilizing the known structural reliability of the environment. Simon pointed out that in most cases people are partly rational and mostly irrational in the rest part. He also states that the bounded rational agents experience several limits in solving and planning the comple x problems and also in processing the information. There are several dimensions that come along with the classic model of rationality that are more realistic than the real one, while sticking within the fair formalization; those are, limiting the utility function types, distinguishing the collecting and processing the information and the possibility of having the vector utility function (Tang, Huang Shang, 2015). In this model, Simon stated that the economic agents utilize the heuristics for making the decisions than any strict regulation of optimization. The agents are bound to act like this because of the complex situation and their incapability of processing, also work out the predictable utility of the alternate action. This gives rise to another theory of Simon in managerial decision making, Judgment Heuristics. Judgment Heuristics In the sphere of psychology, heuristics are considered as the simple rules that are often used by people in order to form the judgment or make significant decisions. These are considered to be the shortcuts in the mental level, which are involved to focus on a specific aspect of a complex problem ignoring the rest (Betsch Haberstroh, 2014). On the basis of the concept of bounded rationality by Simon, psychologists Tversky and Kahneman exhibited that there are three heuristics, which underlie the intuitive judgments. The three heuristics are representativeness, availability and anchoring and adjustment. The availability heuristic refers to the ease which brings the exact idea in the mind. If an individual estimates the frequency of the event based on the availability, the availability heuristics is used (Kappesser Williams, 2013). For instance, people overestimate the death in the dramatic events, whereas the usual deaths are not that much overestimated at all. This happens because people use the heuristics of availability and overestimate the less available one. The next heuristics, representativeness refers to the usage of categories, for instance at the time of deciding whether an individual is a good person or not. People categorize others on the basis of things with high representativeness (Harrison, Mason Smith, 2015). In addition to that, when people are categorizing based on the representative heuristics, the representative means two different things, the sample used for the comparison and also the relation between the sample and the thing they are categorizing. This heuristic is also an instance of the clarification that how people use cause and effect method in judgment and decision making. The third heuristics anchoring and adjustment refers to the heuristic used in several situations when people tend to estimate any number. According to the original definition of Tversky and Kahneman, this involve the start from the available number, which works a s the anchor and any kind of shift from this, up or down, reach the final answer. It has been seen in several experiments that the anchor value can be random and extreme as well, although it still contaminate the estimates (Glimcher Fehr, 2013). These heuristics along with many others impact on almost most of the decisions taken by an individual. Biases Several factors have a significant impact on the decision making such as biases. Bias can entirely change the final outcome of the decision, or it might influence the decision to some extent as well. Among the different kinds of biases, conformation bias is the tendency of interpreting or favoring the information in such a way that confirms the preexisted value of the individual, while they give less consideration to the other alternate possibilities (Heath et al. 2013). This is also a type of cognitive bias and people are seen to have this kind of bias while they try to gather selective information and interpret them in a biased way. Another kind of bias is anchoring bias, which refers to the general tendency of an individual of relying on the initially available information or the anchor (Toplak, West Stanovich, 2014). While making a decision, if the individual sets the anchor as the first information available to him, the other decisions are made by adjusting with the help of the anchor. For instance, if someone likes the first dress offered to him and sets it to be the final one on the mental level, he will get biased judging the other dresses offered to him. Conclusion In the light of the quote by Simon, it can be seen that there are several factors that can be responsible for the final decision and in a business organization it is highly effective. Making decision is a cognitive process and it results in selection of the course of action among many other alternative options. The above four concepts show that how a decision making can be influenced by several factors in the organization. The quote by Simon clearly shows how the decision making process can be influenced by the available time and the complexity of the issue. However, effective rational decision can result in profit in the organization. Reference List Betsch, T. Haberstroh, S. eds., (2014).The routines of decision making. Psychology Press. Chrisman, J.J., Memili, E. Misra, K., (2014). Nonfamily managers, family firms, and the winner's curse: The influence of noneconomic goals and bounded rationality.Entrepreneurship Theory and Practice,38(5), pp.1103-1127. Clarke, H.F., Horst, N.K. Roberts, A.C., (2015). Regional inactivations of primate ventral prefrontal cortex reveal two distinct mechanisms underlying negative bias in decision making.Proceedings of the National Academy of Sciences,112(13), pp.4176-4181. Ford, R.C. Richardson, W.D., (2013). Ethical decision making: A review of the empirical literature. InCitation classics from the Journal of Business Ethics(pp. 19-44). Springer Netherlands. Glimcher, P.W. Fehr, E. eds., (2013).Neuroeconomics: Decision making and the brain. Academic Press. Harrison, R.T., Mason, C. Smith, D., (2015). Heuristics, learning and the business angel investment decision-making process.Entrepreneurship Regional Development,27(9-10), pp.527-554. Hasan, Y., Shamsuddin, A. Aziati, N., (2013). The impact of management information systems adoption in managerial decision making: A review.The International Scientific Journal of Management Information Systems,8(4), pp.010-017. Heath, L., Tindale, R.S., Edwards, J., Posavac, E.J., Bryant, F.B., Henderson-King, E., Suarez-Balcazar, Y. Myers, J. eds., (2013).Applications of heuristics and biases to social issues(Vol. 3). Springer Science Business Media. Kappesser, J. C Williams, A.C., (2013). Clinical judgement heuristics: Methods and models.European Journal of Pain,17(10), pp.1423-1424. Tang, T.Q., Huang, H.J. Shang, H.Y., (2015). Influences of the drivers bounded rationality on micro driving behavior, fuel consumption and emissions.Transportation Research Part D: Transport and Environment,41, pp.423-432. Toplak, M.E., West, R.F. Stanovich, K.E., (2014). Rational thinking and cognitive sophistication: Development, cognitive abilities, and thinking dispositions.Developmental psychology,50(4), p.1037. Zsambok, C.E. Klein, G., (2014).Naturalistic decision making. Psychology Press.