Cell-based Therapy For Myocardial Regeneration

Cell-based Therapy For Myocardial Regeneration ABSTRACT Myocardial infarction is one of the main cause of mortality in many countries. Therefore, an effective therapy for myocardial infarction is required. Reperfusion and other conventional therapy have been the mainstay therapy for myocardial infarction. However, many patients remain refractory to this therapy. Cell-based therapy is considered a novel therapy, in which stem cells are used for cardiac repair. Stem cells are potential therapeutic and promising option that could be the alternative solution for salvaging damaged cardiomyocyte. Based on current studies, stem cells are a promising therapeutic approach for myocardial infarction. However, some challenges need to be answered by future studies before this novel therapy can be widely applied. This essay provides an overview of the progress in stem cell therapy for myocardial infarction. INTRODUCTION The robust potential of stem cells were still a mystery, but today, we are constantly getting new information on this particular topic. One of the prospects of stem cell therapy is to treat damaged cardiomyocyte (Fischer, et.al, 2009; Beltrami, 2003).Acute myocardial infarction is one of the main causes of mortality and morbidity in many countries. Not only this disease causes a massive socio-economic burden, but also reduces the quality of live for patients who survive the attack (Hamm, 2016). Currently, one of the mainstay therapy for myocardial infarction is rapid revascularization to limit ischaemic damage. Reperfusion and other conventional therapy have undoubtedly saved so many lives, yet there are patients remained refractory to this therapy and left with no other treatment options. In addition to that, many patients who have underwent reperfusion strategy and survived, often left with significant impairment of left ventricular systolic function. One big question remain unansw ered. Is there any other treatment option for these patients? Medical therapeutic approach to reduce damaged cardiomyocyte and generate new functioning muscle is the current unmeet need. Stem cells emerge as the novel procedure to restore damaged cardiomyocytes, and this procedure is popularly known as cellular cardiomyoplasty (Pendyala, et.al, 2008; Reinlib, 2000). Many preclinical and clinical trials have documented the potential use of stem cells to generate viable cardiomyocyte and improve cardiac function (Bergmann, et.al, 2009). To date, there are many different types of adult stem cells and progenitor cells used for this procedure, some of which are bone marrow derived stem cells, hematopoietic stem cells, mesenchymal stem cells and so on. Since the advance of stem cells technology is faster than ever before, this essay aimed to give an evidence based update on stem cells use for myocardial infarction, what we have achieved so far, and what does the future hold for this breakthrough. CELL-BASED THERAPY FOR MYOCARDIAL REGENERATION After an ischaemic attack due to occluded coronary vessels, heart muscle usually left damaged and nonfunctioning. However, recent evidence suggested that the cardiac muscle could actually undergo a limited amount of renewal. A prospect of inducing muscle cell to undergo division for cardiomyocyte replacement, or generating new muscle by stem cells are certainly intriguing (Roell, et.al, 2002; Santoso, et.al, 2011). Stem cells are capable to proliferate in the same state (self-renewal) and differentiate into multiple cell lineages. On the other hand, progenitor cells are more specific and have limited differentiation potential. Mechanism on how stem cells work are as follows: firstly, these stem cells need to be extracted from the source (eg. bone marrow), after that these stem cells need to be delivered to the injured area. These cells are implanted in the myocardium, and due to the nature of these cells, they would grow and differentiate/transdifferentiate into cardiomyocyte. To achieve the goal of cardiac repair, these cells should also have the ability to fuse with the surrounding tissues that their harmonious contraction increases the heart contraction. Furthermore, these newly-formed cardiomyocyte should also express the appropriate electromechanical properties required for contraction to yield a synchronous contraction (Templin, et.al, 2011; Makino, et.al, 1999). Many clinical studies have documented the feasibility and safety of cellular cardiomyoplasty in patients with coronary artery disease (Makino, et.al, 1999; Strauer, et.al, 2002). To date, there are some different types of adult stem cells and progenitor cells used for this procedure, some of which are bone marrow derived stem cells, hematopoietic stem cells, mesenchymal stem cells and many others (Jackson, et.al, et.al, 2001; Kamihata, et.al, 2001; Bolli, et.al, 2011) POTENTIAL SOURCE AND TYPE OF STEM CELLS Bone Marrow Derived Stem Cells Bone marrow derived stem cells (BMCs) are the most widely studied type of stem cells. Orlic et al. (2001) first describe the ability of bone marrow cells to regenerate infarcted myocardium in mouse models. The transplanted cells showed transdifferentiation into cardiomyocyte which eventually lead to improved left ventricular ejection fraction (Orlic, 2001). The three types of stem cells derived from bone marrow are hematopoietic stem cells (HSCs), mesenchymal stem cells (MSCs), and endothelial progenitor cells (EPCs) (Orlic, 2001; Piao, et.al, 2005; Badorff, et.al, 2003). The role of BMCs for acute myocardial infacrtion has been reported to improve left ventricular ejection fraction (LVEF), both in REPAIR-AMI and BOOST trial (Meyer, et.al, 2006; Schachinger, et.al, 2006).BOOST trial demonstrate an acceleration of LVEF after intracoronary BMCs transfer (ejection fraction increased by 6.7% in the BMCs group as compared to 0.7% in the control group), and significant result was sustained until 18 months (Meyer, et.al, 2006). While in REPAIR AMI trial, improvement of LVEF, infarct size and wall thickening of infarcted segments were reported at two years follow up. At two years, the cumulative end point of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (hazard ratio, 0.58; 95% CI, 0.36 to 0.94; P=0.025) (Assmus, et.al, 2010; Perin, et.al, 2012). Skeletal Myoblast Skeletal muscle has the ability to regenerate under certain circumstances. Skeletal resident stem cells are usually known as satellite cells, and these cells would differentiate to new myocytes in response to injury. However, whether this ability can be translated to a different condition, as in cardiomyocyte repair, should be further studied (Taylor, 198; Reinecke, et.al, 2002). MAGIC trial, a randomized controlled phase II trial, showed no significant changes in terms of global and regional LV function in skeletal myoblast- treated patients (Mensche, et.al, 2008). Another study performed by Dib et al.(2005) showed an increased in LV ejection fraction in the group treated with transepicardial injection of autologous SMs. Mesenchymal Stem Cells Mesenchymal stem cells (MSCs) are another potential option for cellular cardiomyoplasty. Mesenchymal stem cells can be found in various tissue, such as bone marrow and adipose tissue (Pittenger, 2004). One interesting mechanism by which MSCs mediate cardiac function improvement is the paracrine effect. MSCs may secrete soluble cytokines and growth factors that would eventually influence adjacent cardiomyocyte (Gharaibeh, et.al, 2011). Hare JM et al. (2009) studied the efficacy of intravenous allogenic human mesenchymal stem cells in patients with myocardial infarction. According to this study, intravenous MSCs were safe as showed by the similar adverse event rates in both intervention and control group. MSCs injection favorably affected patient functional capacity, quality of life and LV remodeling (Hare, et.al, 2012). Endothelial Progenitor Cells Endothelial progenitor cells (EPCs) have been linked with neovascularization in ischemic tissue. This interesting finding lead to the use of EPCs for another therapeutic purpose like cellular cardiomyoplasty (Isner, et.al, 1999). The human peripheral blood-derived EPCs would be a potential approach because those cells can be easily isolated without the need of major surgical intervention (Lin, et. Al, 2000). This assumption was later confirmed by Badorff et al. In this study, Badorff et al. (2003) reported that EPCs from healthy volunteers and Coronary Artery Disease (CAD) patients can transdifferentiate into functionally active cardiomyocytes when co-cultivated with rat cardiomyocytes. However, this finding was later opposed by Gruh I et al. According to this study, there was no significant evidence of transdifferentiation of human EPCs into cardiomyocyte (Gruh, et.al, 2006). Resident Cardiac Stem Cells Until recently, we believe that heart is a fully mature organ with no capability of self-renewal. However, the adult heart is not a terminally   differentiated organ, but harbors stem cell with regenerative capacity, namely resident cardiac stem cells (CSCs). Although the origins of CSCs are yet unclear, they can be isolated from heart tissue and expanded ex vivo for use as a cell-based therapy. There were many types of CSCs have been described in previous studies, like: epicardium-derived cells, cardiosphere-derived cardiac cells, and cardiac Sca-1+ cells. These resident stem cells have the potential to differentiate into different types of cells like vascular smooth muscle and myocardial cells (Tang, et.al, 2013; Tang, et.al, 2006; Fazel, et.al, 2006). Embryonic Stem Cells and Induced Pluripotent Stem Cells (iPS) Embryonic stem cells (ESC) are derived from the blastocyst (inner cell mass) of human embryo prior to implantation. ESCs are pluripotent cells, which means they have the capability to differentiate into any cells, one of which is cardiac myocytes. Due to the source of these cells, there are ethical issues regarding the use of ESC (Kofidis, 2005).The huge potential of ESC comes with a price. The pluripotency of ESC made these cells predisposes to tumor formation including teratomas. Amariglio N et al. (2009) documented the occurence of a human brain tumour following neural stem cell therapy. A boy with telangiectasia was treated with intracerebellar and intrathecal injection of human fetal neural stem cells. Four years later, he was diagnosed with a multifocal brain tumour. After thorough analysis, the tumor was of nonhost origin, indicating it was derived from the transplanted neural stem cells (Amariglio, 2009). To date, due to the scarcity of studies on ESC and negative experiences of previous studies, the significance of ESC as cell-based therapy for myocardial infaction remains elusive. The above-mentioned limitation would hopefully be elucidated in future research. Human Umbilical Cord Blood Cells Human umbilical blood cells (hUCB) contains a large number of non-hematopoietic stem cells which rarely express human leukocyte antigen (HLA) class II antigens, thus reducing the risk of rejection. Many studies have reported the efficacy and safety of hUCB administration in acute myocardial infarction model, with conflicting result (Henning, 2004; Moelker, 2007).According to Henning RJ et al. (2004) hUCB administration reduce infarction size and improve ventricular function in rats without requirements for immunosuppression (Henning, 2004). Similar positive finding were documented by Kim et al. Circulating Blood-derived Progenitor cells Circulating blood-derived progenitor cells (CPCs) are similar to BMCs, which mainly composed of EPCs. Santoso T et al. (2011) studied the safety and feasibility of combined granulocyte colony stimulating factor (G-CSF) and erythropoetin (EPO) based-stem cell therapy using intracoronary infusion of peripheral blood stem cells in patients with recent anterior myocardial infarction. G-CSF is used to mobilized stem cells to the injured area, inhibits cardiomyocyte apoptosis, promotes neovascularization, and increase the production of nitric oxide. While EPO, that is originally thought to be a hematopoietic hormone only, also may inhibited apoptosis and induced angiogenesis. This phase I study concluded that this procedure is safe and resulted in improved endpoints for LV ejection fraction and cardiac viability (Santoso, 2011). Cardiopoietic Stem Cells Cardiopoietic stem cells are not a distinct type of stem cells but refer to the novel way of processing stem cells in order to get a lineage specification. Cardiopoietic stem cells are harvested stem cells that are treated with a protein cocktail to replicate natural cues to heart development, before being injected into the patients heart. The C-CURE trial studied the efficacy of bone marrow derived-mesenchymal stem cells in chronic heart failure. The isolated mesenchymal stem cells were exposed to a cardiogenic cocktail that trigger expression and nuclear translocation of cardiac transcription factors, before being injected to the patients heart. After six months follow up, patients in the treatment group significantly improved in terms of LVEF and fitness capacity. There was no evidence of increased cardiac or systemic toxicity induced by cardiopoietic cell therapy (Bartunek, 2013). Unfortunately, data comparing the efficacy and safety between cardiopoietic stem cells and ordinary stem cells without cocktail-based priming is still lacking. DELIVERY METHODS In order to make these stem cells reach the heart, a reliable delivery method need to be employed. The ideal method should be able to safely and efficiently deliver an optimal number of stem cells to the target tissue. Beside the high efficacy, this delivery method should be as minimally invasive as possible for the sake of patients comfort. There are some delivery methods worthy to know. Intracoronary Infusion As the name implies, intracoronary infusion is a process of delivering stem cells through coronary artery, usually through intracoronary catheterization. Stem cells are infused under pressure via a ballon catheter. The ballon was inflated in order to prevent anterogade blood flow that would compromize stem cells delivery. Catheter guided cell transfer has its unique advantage of safety under local anesthesia, and a part of routine cardiac catheterization. The intracoronary method provide a maximum number of cells to the target area, with good blood supply which is crucial for cell survival. Multiple studies have reported the use of intracoronary infusion for stem cells delivery (Strauer, 2002; Schachinger, 2006). Intravenous Peripheral Infusion Intravenous stem cells administration is one of the easiest method to be employed. Intravenous administration is possible through homing phenomenon of stem cells to the injured heart. Unfortunately, intravenous peripheral infusion comes with some disadvantages. First, only 3% of normal cardiac output will flow per minute through the left ventricle. This low amount of blood would limit the amount of stem cells delivered. Secondly, due to the passing of venous blood in the lung, many cells would trap in lung vasculature that eventually lead to stem cells reduction (Grieve et.al, 2012). Intramyocardial, Transendoccardial and Transpericardial Route As mentioned earlier, the downside of intravenous administration is the passing of the blood in certain organs that would entraped some of the stem cells. Unlike intravenous route, intramyocardial method is undoubtly provide direct access to the injured cardiomyocyte bypassing the need for mobilization, homing and any risk of cells entrapment in other organ, thus provide a more effective way to deliver abundant stem cells to the injured area. However, this method comes with its own expense of a more invasive method, not to mention the risk of ventricular perforation in the already damaged cardiomyocyte. Intramyocardial delivery usually performed during an open heart surgery or needle-tipped delivery catheter (Strauer, 2003; Forrester, 2003). Nelson et al.(2009) documented that intamyocardial delivery of iPS originating from reprogrammed fiobroblast, yielded progeny that properly engrafted and resulted in restored contractile performance, increased ventricular wall thickness, and elec tric stability (Nelson, et.al, 2009). STUDIES USING STEM CELLS IN MYOCARDIAL INFARCTION Many studies have been carried out to investigate the efficacy and safety of stem cell therapy in patients with myocardial infarction. Each of these studies investigated different kind of stem cells with different delivery methods. The ultimate goal of these studies is to answer whether stem cell therapy could be a feasible therapeutic approach for patients with myocardial infarction. The result of these studies were not always positive, even some of the studies did not document any beneficial effect of stem cell therapy. However, this conflicting result need to be intepreted with caution due to the different study method, different type of stem cells used, and different delivery methods employed. Three meta- analysis on the efficacy of BMCs therapy for myocardial infarction have been published. In a meta-analysis by Delewi R et al, intracoronary BMCs infusion is associated with improvement of LV function and remodelling in patients after ST-segment elevation myocardial infarction. The benefit in terms of LVEF improvement was more pronounced in patients with a worse baseline LVEF (LVEF cut off: 40%) and younger age (age cut off: 55 years) (Delewi, et.al, 2013).   In a second meta-analysis by Clifford DM et al. (2012) which include thirty-three RCTs, there was no significant difference in hard end point like mortality and morbidity in the BMCs treated group. However global heart function, as represented by LVEF and infarct size, was improved significantly and was sustained long term (12 to 61 months) in the BMCs group (Clifford, et.al, 2012). The third meta-analysis by Long C et al. (2013) further confirmed the beneficial effect of intracoronary BMCs in patients with acute my ocardial infraction. According to this meta-analysis, BMCs therapy significantly improved LVEF, while mildly but not significantly reduced left ventricular end-systolic volume and left ventricular end-diastolic volume (Lond, et.al, 2013). These three meta-analysis synonymously agree that BMCs therapy is beneficial in terms of improved heart function and reduced infarct size. CHALLENGES AND THE FUTURE We have just entered the new era of stem cell therapy. When advanced therapy like primary PCI and thrombolytic showed more limited beneficial for patients with myocardial infarction, the concept of cell-based therapy is definitely appealing. This new approach could be the answer that have been waited for sometime. As we have discussed previously, there are many issues on stem cell therapy that need to be addressed in future studies. Firstly, what is considered to be the best stem cells to replace cardiomyocyte. Secondly, the right delivery method of these stem cells need to be determined. Whether different type of stem cells required certain delivery methods also need to be further elucidated. Another question is the right timing of delivery (acute, sub-acute or chronic), whether it contributes to the fate of stem cells. Fourth, the concentration of stem cells, dose-effect relationship and safety of stem cell therapy need to be further investigated. One particular topic in regard to stem cell safety is the tumorigenicity of ESC. We need to disentangle a way to reprogram these cells so they can differentiate into functional cells, but lack the ability to form tumours. Finally, novel diagnostic tools are required to detect and evaluate stem cells therapy. Future studies would hopefully provide s olid proof on hard end-points (eg. mortality), instead of surrogate markers like LVEF or infarct size. CONCLUSION Tremendous progresses were made in cell-based therapy, and future advances would further lead us to a new solution for ischaemic heart disease. Stem cells own robust potential in medicine, one of which is to replace damaged cardiomyocyte. More evidents are needed in advance to widely use of this modality. REFERENCES Amariglio N, Hirshberg A, Scheithauer BW, et al. (2009). Donor-derived brain tumor following neural stem cell transplantation in an ataxia telangiectasia patient. Assmus B, Rolf A, Erbs S, et al. (2010). Clinical outcome 2 years after intracoronary administration of bone marrow-derived progenitor cells in acute myocardial infarction. Circ Heart Fail, 3, pp.89-96. Assmus B, Schachinger V, Teupe C, et al. 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Mental Models About a Person’s World Essay

INTRODUCTION: Meeting a person for the first time, can either be a positive or negative experience and the way someone interacts with this person can also show both positive and negative behaviours. So the question is, how can mental models about a person’s world, both aid them and also limit their perceptions when meeting a person for the first time. Through exploring how and why these perceptions can be assisted and limited, we can start to question the reasoning behind our mental models. MENTAL MODELS Throughout the years, academic literature has defined a mental model in many ways, however the best way to understand what a mental model is, is the deeply imbedded ways of thinking or even certain images, that trigger assumptions and generalisations, ultimately affecting the way a person responds too or behaves in the world, be it towards a person or a life situation (Senge 2006). A good example of a mental model is, the generalization that only rich people live in the eastern suburbs of Sydney. This generalisation may be true in some cases, but in other cases, other people may live there because they have lived their all their lives, and so, we can see this particular generalisation or â€Å"mental model† has not be thought through. Not questioning mental models, can often lead to false generalisations, this situation can also arise when meeting a person for the first time. When meeting a person for the first time, our mental models can help us both understand and ultimately get along with the person or they can limit our perceptions, meaning we make assumptions or generalisations that eventually alter our perceptions about this person or how we act towards them. Very often, we see that we are not consciously aware of our mental models and the affects that they can have on our behaviour (Chermack 2003), this in turn, restricts our perceptions. Mental models are often vague, incomplete and imprecisely expressed (Karp 2005) however, once believed, mental models are extremely difficult to change (Chermack 2003). This is highly due to the  fact that people are unaware of their own mental models, and the only way for a person to change their mental model, is for them to acknowledge that they have one to start with. Mental models can be useful as they can help us to process information and make decisions quickly (Unknown 1997) and they can also be imperative foundations for building knowledge about the world we live in (Karp 2005). For instance, when an individual has a mental model that all take away food is bad for their health and wellbeing, when given the option of either having take away food or a healthy meal at home, the individuals mental model will therefore lead them to quickly decide to eat a healthy meal at home. However, very strong mental models can hinder active thinking and the acceptance of new ideas (Unknown 1997), and often arise problems when they are tacit, meaning that they are below the level of awareness (Senge 1992). Using the example of the Detroit auto maker, not recognising that they had the mental model that all that customers cared about was styling, believing that â€Å"all people care about is styling†, evidently shows us that their mental model had become tacit. This mental model continued to be unexamined, and because this mental model remained unexamined, the model remained unchanged, and thus as the world changed the gap grew between the mental model of this Detroit automaker and the world (Senge 1992). Clearly, mental models can perform as filters that screen incoming information that come to us, limiting our ways of thinking and also our perceptions (Unknown 1997). An individual’s mental model represents their view on the world, it also provides them with the context in which they view and interpret new material and also new people in which they meet for the first time (Kim 1993). It not only helps us to make sense of what is going on around us, but it can also restrict our understanding of a certain situation. For example, when someone has been labeled as not a nice person, with never questioning the validity of it, people create a mental model that, that person is not nice, and so when they do or say something nice it goes unnoticed, and therefore, the behaviour does not fit with the mental model people have towards this  certain individual. These untested assumptions or mental models can eventually cause conflict and misunderstandings between people. Developing skills in reflection and inquiry can aid us in realising our mental models and also with dealing with others. When we use skills of reflection we slow down our ways of thinking and acknowledge how our mental models are formed and how they affect our behaviour. Where as skills of inquiry, is concerned with how we operate in face-to-face situations with others, especially when we are dealing with complex and conflictual issues (Senge 2006). Together with the tools and methods used to develop these skills these constitute the core of the discipline of mental models, which consists of; the distinctions between espoused theories and theories-in-use, recognising â€Å"leaps of abstraction†, exposing the â€Å"left-hand column† and balancing inquiry and advocacy (Senge 2006). When an individual says that they value or desire something, that is known as espoused theory, however, what they actually say or do, is known as theories-in-use (Bocham 2010). Acknowledging the gaps between what we say and what we do, can be seen as an effective reflective skill in becoming more aware of our mental models. Someone may profess their view (espoused theory) that people generally are trustworthy, but their actions (theories-in-use) show differently, as they never lend out money and keep their possessions to themselves (Senge 2006). As evident in the example above, there is a gap between the individual’s espoused theory and their theory-in-use. By recognising the gap between espoused theory and the theory-in-use, learning can occur, as we as individuals question whether or not we really value our espoused theory (Senge 2006). When we meet a person for the first time, we can quickly jump into generalisations as we never think to question them. For example, when we meet a person and they say that they are a doctor, we automatically assume that they are smart, as it is a generalization that all doctors are smart we never seem to question this mental model. These are known as â€Å"leaps of abstraction†. â€Å"Leaps of abstraction† occur when we move from direct observations to generalisations without questioning them, this ultimately  impedes learning because it becomes axiomatic, as what was once an assumption is now treated as a fact (Senge 2006). Therefore, this becomes another limitation, in which mental models can have on our perceptions when we meet people for the first time. However, these â€Å"leaps of abstraction† can easily be identified when people ask what their generalisation is based-on and whether or not the generalisation is inaccurate or misleading (Senge 2006) Senge (2006) identifies the â€Å"left-hand column† as a powerful technique whereby individuals begin to see how their mental models operate in differing situations. This exercise can show individuals that they indeed have mental models and show them how those models play an active part in sometimes negative interactions with people, not only do these people become aware of their mental models, but they begin to acknowledge why dealing with these assumptions is imperative (Senge 2006). In order for good communication between individuals to arise, people need to recognise that in order for the communication process to be effective, mental models must be managed properly, this is done by balancing advocacy and inquiry (Peggy & Bronn 2003). Advocacy is the process of communicating an individual’s ways of thinking and reasoning in a manner that makes it clear for others (Peggy & Bronn 2003). When there is advocacy without inquiry, it only leads to more advocacy, and therefore leads to two individuals stating their ways of reasoning and thinking, they both are keen to here the others views, but do not inquire into what they are saying because they believe that what they are saying is ultimately the best way of thinking. A way to tackle this, is through the process of inquiry. Inquiry engages two individuals into the communication process in a joint learning process (Peggy & Bronn 2003). Here the objective is to understand the reasoning and thinking of the other individual, this can be done by asking them questions in order for them to determine the origin for their conclusions and statements (Peggy & Bronn 2003). Individuals can do this by asking questions such as; â€Å"What is it that leads you to that position?† and â€Å"can you illustrate your point for me?† (Senge 2006). Thus, it is evident  that grasping the skill of balancing advocacy and inquiry, is highly advantageous in interacting with other individuals, especially those you meet for the first time. CONCLUSION: Therefore, it is imperative and highly advantageous for us to question our mental models in everyday situations, such as meeting people for the first time, as it will deter us from automatically making assumptions and making generalisations. Through acknowledging ‘leaps of abstraction†, using the â€Å"left-hand column† technique and also personally mastering the skill of balancing advocacy and inquiry, we can learn to question these mental models, and thus questioning whether or not they really do hold their value in our world. Thus, when we meet a person for the first time, before we make assumptions and generalisations, we may need to recognise our imbedded mental models and learn to question them, therefore aiding the process of communication to be a positive experience. REFERENCE LIST: Bochman, DJ & Kroth, M. 2010, â€Å"Immunity to transformational learning and change†, _The Learning Organization,_ vol. 17, no. 4, pp. 328-342. Chermack, TJ 2003, â€Å"Mental models in decision making and implications for human resource development†, _Advances in Developing Human Resources,_ vol. 5, no. 4, pp. 408-422. Karp, T 2005, â€Å"Unpacking the Mysteries of Change: Mental Modelling†, _Journal of Change Management,_ vol. 5, no. 1, pp. 87-96. Kim, DH 1993, â€Å"The Link Between Individual and Organizational Learning†, _Sloan management review,_ vol. 35, no. 1, pp. 37-37. Peggy, SB & Bronn, C 2003, â€Å"A reflective stakeholder approach: Co-orientation as a basis for communication learning†, _Journal of Communication Management,_ vol. 7, no. 4, pp. 291-303. Senge, P 2006, â€Å"Mental Models†, _The fifth discipline: the art and practice of learning organizations,_ rev. edn, Doubleday, New York, pp. 163-190. Senge, PM 1992, â€Å"Mental Models†, _Planning Review,_ vol. 20, no. 2, pp. 4-4. Unknown 1997, â€Å"What are Mental Models?†, _Sloan management review,_ vol. 38, no. 3, p. 13.

Linking Human Capital Development To Financial Performance Business Essay - Free Essay Example

Sample details Pages: 11 Words: 3412 Downloads: 3 Date added: 2017/06/26 Category Management Essay Type Narrative essay Did you like this example? In this paper, I will explain human capital within organizations and how they are used to maximize business profit and if used properly, retain its employees to keep continuity. Personally, I believe with human capital it is about educating your employees and bringing out the best in them to achieve the overall organizational goal and give people sense of accomplishment. Some things that can help maximize each individuals potential is proper time management, education, incorporating value added HR, quality recruiting and evaluation performance. Recent surveys reveal that although business executives firmly believe that people are the most important asset, most executives are at a loss to prove that investments in people lead to improved business results. Common metrics like economic value added and return on investment shed little light on how organizations human assets are performing. The question rises What needs to be measured? Through interviews with senior HR executives, CFOs and financial analysts all refer back to the common theme of human capital. This reflects the way managers want to create value in their organization. Second measures need to be useful from an investment perspective. Executives and top management of organizations what to know what they should be investing in for the future both in terms of skills that their employees will need to achieve the organizations goals and the types of human resource capabilities that will need to develop and retain employees with those necessary skills. A way for organizations to do this would be to minimize risk associated with new technology, markets and acquisition. The challenge of effectively linking human capital development to financial performance is three-fold. It measures must capture direct and indirect effects, be simple and compile results so that future planning and forecasts can be built from them. There are outside agencies that you can hire to come to your organizat ion and evaluate the human capital practices. Their assessment includes variables that influence the relationship between a companys human capital assets and its financial performance. Evaluating Performance In the Article Removing Performance Appraisal and Merit Pay in the Name of Quality, An Empirical Study of employees reaction goes on to explain the management trends across the American industry, specifically the banking industry placing high emphasis on excelling in customer service and embedding continuous improvement into all bank processes. (Waite, 2000) The role of a companys human resources department will be able to help facilitate the goal of the organization by ensuring quality control, recruiting qualified candidates, evaluating the performance appraisal programs in place, with more emphasis on that particular category, because it is the determinant of the employees job performance and gives them direct feedback if done properly to give them an idea of where they stand professionally in the organization, and given ways to improve. An interesting point made in the article was how performance appraisals can be criticized for stifling teamwork. When it comes time for performance appraisals, it is done on an individual basis, giving some people the thought of undermining group efforts and working as an individual and not looking out for the needs of the whole team. Being a team player is a part of individual performance, but does not have a major part in an individual assessment. After a study done after several years to determine the effectiveness of comprehensive performance appraisals process, special attention was focused on the interview between the subordinate and his or her manager, because this is the discussion which is supposed to motivate them to improve performance, and found that criticism has a negative effect on achievement of goals, praise has little effect, performance improves when specific goals are established, defensiven ess resulting from critical appraisal produces inferior performance, coaching should be a day-to-day not once a year activity and participation by the employee in the goal setting procedure helps produce favorable results. (Herbet H. Meyer) To measure the true effectiveness of an appraisal program at the workplace, appraisals should be based on job responsibilities rather than on personal characteristics of the individual. Setting up an intensive training program by managers to help them in the appraisal process should be implemented and given techniques to help them establish rapport with their employees instead of just evaluating them once a year, but make it an ongoing process to give effective communication and feedback. An effective performance appraisal is designed to serve two major purposes. The first is to justify recommended salary action, and the second was to present an opportunity for the manager to review a subordinates performance and promote discussion on needed i mprovements by drawing up a specific plans and goals for the subordinate to help improve their job performance and hopefully qualify them for future promotion. (Herbet H. Meyer) Every ten years or so, a management innovation comes along that gives new ideas to organizations and ways to boost the organization. Three hundred sixty degree feedback has been the most notable innovation for management since the 1990s. (David A. Waldman, 1998) According to the research in the article, it says that every individual has received some written form of feedback from sources that were once nontraditional or unheard of. These sources include subordinates, peers, and internal and external customers. The goal of this type of feedback was to increase the individuals awareness of themselves and they can improve in performance. I have learned that 360 feedback is not only for subordinates or employees, but today an estimated 20-25 percent of organizations actually ask followers, peers, and our cust omers to rate managers for developmental and learning purposes. (David A. Waldman, 1998) This process is similar to a former rating process called upward feedback, where feedback is gained from subordinates to rate superiors but does not include peers or customers. When it comes time to give yourself a performance rating, research shows that individuals do not evaluate themselves accurately or at least not in line with how others view them, because of unreliability and bias and are inaccurate when compared with ratings provided by others or with other objective measures. (Herbet H. Meyer) Negative feedback is usually discounted or not mentioned, but on the other hand positive feedback is generally more accepted and is the most accurate than the negative feedback. When negative feedback is in the form of an anonymous message, it is difficult to discount or deny what was said, so it is more likely to be accepted. Personality plays a big part in this, and alters an individuals reality of self perception. (Herbet H. Meyer) The intent of an effective performance evaluation to me is to modify my actions at work to get in line with the goals of the organization and making sure that I am doing my part to the best of my ability to uphold my weight at work. In the military, I have seen more than one type of evaluation being done and is very effective. Early on in my career, I was introduced to 360 degree feedback that was anonymous and was done after working with some peers after several weeks and sometimes results can be surprising or can be a wakeup call for some. The people you work with, and not the ones you work for often give you a more accurate assessment because they are with you every day and know your strengths and weaknesses. The objective of performance evaluations in the military is to weed out the weak and to promote the strong. Every time I start a new job, I am given an initial counseling outlining my goals, objectives, expectations and professional d evelopment. After the initial counseling, feedback is given to me verbally along the way, and then quarterly, I will sit with my supervisor and receive a formal evaluation letting me know if I have been meeting the intent or not. If this process is done correctly in any organization, it will force people to be more responsible and hold them accountable for their actions. To me, the most harm you can do to an individual is fail to give them evaluations, fair evaluations in particular, because if this is one, you are only setting them up for failure and they have the false sense of success, and most of the time not meeting organizational standards and practices. The only thing that differs from performance evaluations in the military and ones done in the civilian sector, is that in the military, you will get a pay increase every year in January, and also get one at least every two years in your career whether you advance in rank or not. There are time requirements for rank, but goo d performance evaluations can help you accelerate on time or sometimes faster than usual. I believe 360 degree feedback is the most effective system to measure individual performance, and gives managers a good idea of who is a good team player and who only works well with management supervision. It is nearly impossible for a manager of a large company to effectively evaluate each employee and give an accurate account of their work performance. The use of supervisors and peers help to facilitate and provide details and usually is more accurate when coming from someone in the same position as you. Companies began to use 360 feedback from customers to improve business practices and stay competitive. Performance evaluations for some people can be a wake-up call, and takes a good manager to have the ability to evaluate someone fairly and be able to let them know if they are just not doing what they are supposed to. Professionally developing the individuals in your organization will be key to overall success and making the goals of your company. Information technology uses Information is defined as all forms of technology used to create, store, exchange and utilize information in its various forms including business data, conversations, still images, motion pictures and multimedia presentations according to https://www.entrepreneur.com. Understanding your business needs and intent will help you to identify what type of equipment you will need and how you will use it once you receive it. No matter what business venture you plan to go into or analyze, information technology has taken its place among businesses and is growing rapidly. When we think of information technology, it is not just the development of computers, but it is the use of technology to allow you to maximize productivity more efficiently and effectively. The impact that it has, is that in order to be effective, you have to be able to educate yourself and keep up with changes in technology. Rel ating from this weeks article entry, information technology has to be adopted and embraced by managers. Effective communication is key to success in any organization, and if done properly, you will keep employees and other members of management informed on your goals and vision. In the article, Information Technology and Business Process Redesign, the author builds a link to help those aspiring to improve the way work is done and how to apply the capabilities of information technology to redesign business process. Business process design and information technology are natural partners, and their relationship today is still never utilized to their maximum capabilities, leaving managers scared to adopt it into their organizations. The businesses that have used information technology have benefited from it enormously. Information technology deals with expanding the capabilities offered by computers, software applications and telecommunications. The business process design analyzes t he work flow and processes within the organization as well as between other organizations. This is the link that researchers are still trying to figure out, and encourage other top decision makers in business to adopt some form of relationship between the two. The objectives of information technology and business process redesign, is to reduce cost, reduce time by allowing computers and software to process more data and streamline data to cut employee labor , and in return saving the company on payroll expenses. A major benefit that I can see about information technology is that it can help you to easily track the output quality and results can be measurable over a period of time. Managers can take this data and be able to see if the change in information technology was as useful. One of the major unseen benefits would be the quality of worklife, allowing control over output of products and enables employees to control productivity potential. In Forbes magazine, an interesting point that Steve Cakebread brought up in regards to implementing information technology into your business to take your business to the clouds, should be done one step at a time, being careful to not loose continuity while preparing your business for an I.T. breakthrough. One key thing as a manager is to sometimes sick back and see how the software and hardware is working for companies that are local or have the same background as yours before permanently changing over. A vendor and partners must also have a working knowledge of the new equipment you will be using, so that if you have issues, it can be resolved quickly and not cause a pause in business operations. In my career, information technology is so widespread, it will be nearly impossible to go without it. Daily, we have software updates, new hardware, and new ideas to improve efficiency. After reading the article for this week, I can tie in how information technology can be easily resisted by those who have to work with it on a daily basis. Your business will have its own unique set of equipment needs that probably differ from those of the company next door and have a different amount of money to spend. At my job, the use of spreadsheets, word documents, presentations and audio/visual equipment is a daily need, and we spend millions every year for updates and supplements that we think will allow us to complete missions faster, and help manage the resources that we are allocated to its fullest extent. Depending on what you use your business for and the size of your business, the amount of technology you need will differ but the concept will remain the same. While researching some job opportunities, your knowledge of computers and software play a big part in the growing age of information technology. What I have noticed is that the younger generation adults and teenagers and becoming more efficient at operating computers and the latest technology, versus an older adult with working experience. Co mpanies seek out the younger generation because of their understanding of technology and help them to take their companies to the next level with minimal training required. Time management Time management is a necessary skill if you want to be able to experience success in all areas of your life.   Living a full and enjoyable life does not mean that you should be spending 60 hours a week or more at work,   even if you are making really good money.   What would be the point of making an enjoyable amount of money if you did not have time to enjoy it? People who are used to work hard continuously without a break. After that they are too tired to do anything at all. people who are procrastinating all the time people who are tired all the time Also,   we all know that there are many things in life that are more important than work and dollars.   Family, friends,  and hobbies are all part of having a complete and full life.   So,   you have to be able to effectively manage your time so that you can experience life in all of its different aspects and not just work and business. A lot of people do not like the idea of scheduling their time because it may feel like they are losing their freedom,   but you can actually experience much more free time if you can put together a schedule that makes the best use of your time and your skills.   And there are many people who spend so much time at their business or job because they are unable to let go of the control and trust that their employees may be able to do just as good of a job. Remember,  that we all want to experience success because we want to enjoy our lives.   But,  we cannot enjoy them fully if we do not schedule our tasks so that we have as much free time as possible. Value Added HR Over the years, there has been tremendous emphasis placed on HR practitioners becoming strategic business partners and being a v alue added source within organizations.   Traditionally, HR professionals could talk generally and conceptually about employee morale, turnover, and employee commitment being outcomes of HR efforts.   Furthermore, the HR function is often viewed as an expense-generator and an administrative function and not as a value added partner. Human resources today is under extreme pressure to keep up with changing technology and industry. The role of HR is to develop innovative people strategies to ensure business success. Today, there are still numerous companies that still use the traditional HR model, and restrict the role of the HR department to administrative providers. This is not added value, and HR is viewed as necessary but not very valuable. The role of HR is to draft up company policies, employment laws, and assist in maintaining company profits. In simple terms, human resource management focuses on the companys mission, and assist in the planning process of getting t o that goal. HR is an essential department to every manager, and can either make or break a business. Some things that a company can do to create value added to their human resource department is to first come up with a plan that is aligned with the companys overall vision and mission. When implementing new plans, you want to start small and depending on the size of your company, implement policies and procedures that will allow you to take it slow and monitor the progress. Communication is an important and crucial area. All information and changes should reflect the companys image, and communicated to personnel at all levels that is easy to understand. Increasingly, an organizations ability to respond and adapt quickly while providing increased stability in the midst of change is a great leverage point for achieving sustainable competitive advantage. But this is not about predicting or riding trends; change needs to be a lot more than that. Organizations can get caught in pendul um swings from one trend to another. Sometimes Human Resources professionals are responsible for flavor-of-the-month initiatives; other times they may be trapped by flawed strategies advanced by senior executives. In todays business environment, organizations need to be constantly evaluating their internal and external environment for challenges and opportunities to remain competitive and to sustain growth.   Political, economic, social, and even psychological changes within our societies create significant impact on organizations.   Given any significant change or event, how ready are we as an organization to react in order to remain competitive? Â  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚  Ãƒâ€šÃ‚   Many factors are driving changes in organizations today including the use of technology, globalization, changes in workforce demographics, eliminating the bureaucracies in organizational structures, an d balancing work-family issues.   Understanding the potential of an organizations resources and optimizing the output of such resources given the changes, provides the impetus for HR being the key source of creating the competitive advantage for the organization.   Many change efforts follow a predictable pattern likely to lead organizations down paths filled with frustration, resistance, and ultimately preservation of the status quo. After compelling arguments are developed as to why change is needed, a plan for getting from where you are now to where you want to be is viewed as the solution, with implementing the strategy seen as the last step. However, if your vision of the future the where you want to be is a shift from one pole of a polarity to the other, your efforts are guaranteed to generate amazing resistance. Resistance in the work place Is not always a bad thing. Resistance sometimes can mean that people are just afraid of change or when people get wrap ped up into managing the business like they have always done, they limit their earning and growth potential. Today, you will notice that companies are recruiting young, energetic people who have the drive and bring new ideas to organizations to help it get to new levels. As a manager, you always have to remember that there is always going to be resistance in any decision that you make. Don’t waste time! Our writers will create an original "Linking Human Capital Development To Financial Performance Business Essay" essay for you Create order

The Four Roman Gods of the Wind

The Romans personified the four winds, corresponding with cardinal relationships as gods, as did the Greeks. Both peoples gave the winds individual names and roles in mythology.   Gettin Windy With It Here are the winds, according to their domains. They are called the  Venti, the winds, in Latin, and the  Anemoi  in Greek. Boreas (Greek)/Septentrio, a.k.a. Aquilo  (Latin) - North WindNotos (Greek)/Auster  (Latin) - South WindEurus (Greek)/Subsolanus (Latin) - East WindZephyr (Greek)/Favonius (Latin) - West Wind Whats Up With the Winds? The winds pop up all over Roman texts. Vitruvius identifies a whole lot of winds. Ovid  Ã¢â‚¬â€¹Ã¢â‚¬â€¹recounts how the winds came to be:  The world’s maker did not allow these, either, to possess the air indiscriminately; as it is they are scarcely prevented from tearing the world apart, each with its blasts steering a separate course. The brothers were kept apart, each with his own job.   Eurus/Subsolanus went back to the east, the realms of dawn, also known as Nabataea, Persia, and the heights under the morning light. Zephyr/Favonius hung out with Evening, and the coasts that cool in the setting sun. Boreas/Septentrio seized Scythia  and the seven stars of the Plough [Ursa Major], while Notos/Auster drenches the lands opposite [the northern lands of Boreas, a.k.a. the south] with incessant clouds and rain. According to Hesiod in his  Theogony, And from Typhoeus come boisterous winds which blow damply, except Notus and Boreas and clear  Zephyr. In Catulluss Carmina, the poet talks about his friend Furiuss villa. He recites, The blasts of Auster, Furius, miss your villa. Favonius, Apeliotes (a minor god of the southeast wind), Boreas skirt the estate†¦ That mustve been a really good spot for a house! Poor Zephyr didnt merit a mention here, although he was involved in the love affairs of the god Apollo. Both guys fell in love with the hunky youth Hyacinthus, and, angry at Hyacinthus favoring his other suitor, Zephyros caused the discus the hottie was throwing to hit him in the head and kill him.​ Bad Boy Boreas In Greek myth, Boreas is perhaps best known as the rapist and abductor of the Athenian princess Oreithyia. He kidnapped her while she was playing by the riverside. Oreithyia bore her husband daughters, Cleopatra and Chione, and winged sons, Zetes and Calais, ​according to Pseudo-Apollodorus. The boys ended up becoming heroes in their own right as sailors on the Argo  with Jason (and, eventually, Medea). Cleopatra married the Thracian king Phineus  and had two sons with him, whom their father blinded when their eventual stepmother accused  them of hitting on her. Others say that Phineuss in-laws, Zetes and Calais, saved him from the Harpies stealing his food. Chione had an affair with Poseidon and gave birth a son, Eumolpus; so her father  wouldnt find out, Chione dumped him into the ocean. Poseidon raised him and gave him to his own half-sister, his daughter, to raise. Eumolpus ended up marrying one of his guardians daughters, but he tried to get with his sister-in-law. Eventually, when war broke out between Eumolpuss allies, the Eleusinians, and his grandmothers people, the Athenians, the king of Athens, Erechtheus, Oreithyias father, ended up killing Eumolpus, his great-grandson. Boreas kept up his kinship with the Athenians. According to Herodotus in his  Histories, during wartime, the Athenians asked their windy in-law to blow the enemys ships to pieces. It worked! Writes Herodotus, I cannot say whether this was the cause of  Boreas  falling upon the barbarians as they lay at anchor, but the Athenians say that he had come to their aid before and that he was the agent this time.