Relationship Between Service Quality and Client Satisfaction

Relationship Between Service Quality and Client Satisfaction Clients: Satisfaction with the Service and Organizational Justice Researchers consider that the service quality theory is based on the literature of client satisfaction and product quality (Brady Cronin, 2001). Liljander and Strandvik (1995) observed that client satisfaction is determined by the overall perception of the service quality. This overall picture about service quality of the organization is reached easily if a client regularly uses service of the organization (Liljander Strandvik, 1995). Lagace, Dahlstrom, and Gassenheimer (1991) found that by including â€Å"ethics† as component of the quality of the relationship between pharmaceutical buyers and sellers, ethical behavior led to higher levels of relationship quality and ethical behavior has been positively associated with client satisfaction (Lagace, et.al., 1991). Also, the research conducted in bank sector by Emari, Iranzadeh and Bakhshayesh (2011) found a significant relationship between perceived quality and client satisfaction, and testing Gronroos three dimensions model – which consists from technical, functional and image, the research revealed that general perceptions of the service quality is influenced by the technical quality, in other words it is influenced by outcomes what one receives (Straiter, 2005). According to above mentioned, service quality evaluated by the client can be considered as related to their satisfaction level. Similarly, when considering the service quality gap between employees and clients, we assume that, service quality gap decreases the level of client satisfaction with the organization. We want to reveal the service quality gap relationship with client satisfaction with intellectual disability care centers: H2a: Higher is the gap in service quality evaluation lower is the relatives’ satisfaction with the organization (fig I). The relationship between service quality and client satisfaction has been reported to be different in terms of strength between industries as well as between contexts (Ame, 2005, 2009; Sureshchandar et.al. 2002). Accordingly, researchers consider that some factors must be responsible in influencing this relationship. These include, but not limited to, the type of industry studied, nature of service, income levels of client, management culture, client social culture, gender, etc, (Ame, 2005). The various empirical findings on studies about service quality and client satisfaction have suggested that relationships on these variables may be moderated by some factors. Client perceived justice is one of the popular factors among researches in the field of service. Liao (2007) confirmed client perceived justice mediation effects on client satisfaction and service recovery performance. Also the study conducted to determine the influence of emotions on justice for client satisfaction conducted by Ellyawati, Purwanto and Dharmmesta (2012) found that clients’ perceived justice impacts on clients’ satisfaction. According to the one of the Justice theories Equity Theory, the inequality can be observed when person perceives that he/she is putting more and is getting less value, and satisfaction much depends on how one perceives the justice, injustice can lead to dissatisfaction and anger (Adams, 1965). Clients’ perceptions of the input and output, and their perception about the fair distribution of resources, information etc. is expected to have a moderator role for their satisfaction. Accordingly we expect that organizational justic e perceived by the relatives of PIDs can moderate the relationship of service quality gap and relatives’ satisfaction with the center: H2b: Relatives perception of organizational justice moderates relationship between service quality gap and relatives satisfaction with the organization (fig I). We discussed the problems of ethic in service quality from the side of the employees and from the side of the client (relatives). However, the situation is getting more complex and critical especially when considering the primary goal of the organization oriented on mental health care: to increase the quality of life of people with intellectual disabilities (PIDs). We review this aspect in the next section. PIDs: Quality of Life and Service Quality Evaluation The World Health Organization (WHO) defines Quality of Life (QoL) as â€Å"individuals’ perceptions of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns† (The World Health Organization Quality of Life Assessment WHOQOL, 1997, p. 1). We can say that QoL exists when one perceives that lives with dignity, feels that dreams and ideas are respected, and is an active handler and responsible of own life (Tamarit, 2002). QoL as usually includes subjective evaluations of positive and negative aspects of life (World Health Organization Quality of Life Assessment 1998). Generally it includes health perceptions at physical and mental level and their relations—including conditions, social support, etc. (Kindig, Booske Remington, 2010). Organizations that provide services to people with intellectual disabilities (PIDs) also contribute to developing their QoL (FEAPS, 2010), and are designed to care the QoL of individuals with intellectual disabilities (Martinez-Tur, Peirà ³, Moliner, Potocnik, 2010). These organizations are the basic sources of QoL for people with intellectual disabilities (Moliner, Gracia, Lorente, Martinez-Tur, 2013). Since QoL of PIDs is directly derived from service quality that is provided for them, we suppose that it can be affected by the ethical challenges in services; service provided from professionals includes dilemma: to whom it must be ethical – to PIDs or to relatives? As we mentioned above service quality perceived by relatives and service provided by employees is related to challenges since they have different standards about how service should be provided. Usually for the mental healthcare service organizations a relevant source of information is the relative of the PIDs; QoL of Persons with Intellectual Disabilities can be evaluated from professionals/employees or from relatives. Since information which comes from external subject is more objective it is more relevant to use family member as the main evaluators to assess QoL of PIDs (Moliner, et. al., 2013). When there is a gap in service quality and QoL is evaluated by the relatives we argue that it can have influence on th e level of QoL of PID. Therefore in order to improve quality for future development in mental care related services the assessment of QoL is an important tool (Moliner, et. al., 2013). Our next hypothesis aims to find out this relationship among gap and QoL: H3a: Higher is the gap in service quality evaluation lower is the quality of life of PIDs’ perceived by their relatives (fig I). Any attempt to judge the service quality provided by mental healthcare services would be less complete not considering the experiences of people who use the product and receiving the service. By finding out what service users think, important information can be obtained which can have impact on other factors (National Institute for Health Clinical Excellence, 2012). National Institute for health and care excellence (NICE) claims that past years are characterized with more initiatives highlighting the importance of considering the service user’s experience about the service quality. E.g. Lord Darzi’s report on High Quality Care for All (2008) focuses on the importance of the entire service user experience to ensure that they are in a safe and well-managed environment (Darzi, 2008). To understand how center is operating to deliver high service quality to direct users (PIDs) it is important to understand what users think about their care and treatment. Our last hypothesis stresses on the effect of PIDs perceived service quality that can moderate the service quality gap effect on their QoL: H3b: PIDs’ service quality evaluation moderates the relationship between service quality gap and PIDs’ quality of life perceived by their relatives (fig I). With the almost universal increase the involvement and support for mental healthcare services more concerns are about the responsibility of the agencies and professionals who provide such assistance (Roth, Fonagy, Parry, 1996), the QoL of people with intellectual disabilities becomes a very important question nowadays. Specifically, social, educational and health services are focusing on providing services to people with intellectual disabilities, and establishing this subject as a specific goal of the organizational in order to find new ways of developing a QoL in the future (Schalock Verdugo, 2007). These questions and hypothesis give opportunities to orient organizations’ activities in order to improve the service quality, mental health, satisfaction and QoL at the centers for intellectual disabilities.

Charity Essay

Charity is supposed to be a selfless act done by people who expect nothing in return for their help except for the feeling of having helped someone in need. Charity has changed from an act of nobility or kindness to a way of looking good in front of other people or to receive some type of material reward or to receive some type of tax reduction as done by big companies who prefer †Donating† $100,000 and then save $300,000 in tax reductions for helping out a such noble cause.Charity should be what it used to be a SELFLESS cause period, not just a â€Å"win-win situation† in which both parties â€Å"benefit† from it, it should be done because you want to do it out of the kindness of your heart not because it will get you a C- on the class you’re failing or, because you want to look good in front of someone, it should be done because you want to help the people in need. For example my five year old cousin Jerry, at his age you would expect him to blow al l of his money on games, toys or other things kids like, but no he doesn’t.He saves up all his allowance for months at the time and then one he feels he has an amount that seems big enough to help someone he will goes online to see what charities convince him to donate his money on them, so far he has donated over fifth teen hundred dollars to over ten different charities that vary from animals in danger of extinction to research for AIDS and even Cancer, and he started doing it all by himself, not because someone expected it from him, not because he wanted to look good in front of other people he did it because he wanted to make help people in need, people who don’t have as much as we do, people who have had the â€Å"bitter side of life† as my little cousin would say.One time he went on and went asking door by door all over town until he had knocked on every single door in his town (with his moms supervision of course) and gathered up a good nine hundred dolla rs he could donate to a research on way to prevent miscarriages, and in my opinion more people should be like my cousin and walk that extra mile to help people without the need to receive a â€Å"reward† in order to do what he feels is right. Charity should be a selfless act, and not this sempiternal cycle in which people expect a reward for everything they do.

Descartes The Existence Of God - 1682 Words

Descartes’ attempt to prove the existence of God begins with the Trademark argument. He reasons that by having an idea of an infinite being with a certain degree of â€Å"objective reality†, â€Å"there must be at least as much reality in the efficient and total cause in the effect of that cause† (40). Descartes’ idea of God has more objective reality of any of his ideas. Therefore, God must be the cause of his idea as a result of his existence. In what follows I will explain these terms and why the premises seemed true to him. It is important to mention that Descartes distinguishes two types of realities of ideas, the objective (representational) and the formal (actual) reality, for which the formal reality seems to possess more reality than the objective reality. By formal reality, Descartes is referring to the actual existence of an idea and by objective reality, he means the object contained in an idea. What is being introduced here is the notion of degrees of reality. Descartes classifies three levels of formal reality from the highest to the lowest level of reality: infinite substances, finite substances and modes. An infinite substance (God) consists of a higher level of formal reality and exists independently from everything else, whereas finite substances (human) exists independently of everything but God, followed by modes which consists of even less formal reality. After classifying the ideas and distinguishing the two types of realities, Descartes can makeShow MoreRelatedDescartes and the Existence of God751 Words   |  3 Pagesï » ¿Descartes: The existence of God Over the course of his treatise Discourse on the Method, the philosopher Rene Descartes attempts to refute radical skepticism, or the idea that we can know nothing with the mind, because what we consider reality may simply be a delusion or a dream. Descartes begins, however, by taking a posture of doubting everything, and then attempting to discern what could be known for certain. 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The truth about the nature of God, proof of God’s existence, and the nature of corporeal objects are considered, among others, after Descartes proves his existence. Descartes’ principal task in the Meditations was to devise a system that would bring him to the truth. He wanted to build a foundation from which all further philosophicalRead MoreDescartes Proof Of The Existence Of God1609 Words   |  7 PagesOne of the most important ideas upon which Descartes’s proof of the existence of God rests is that rational minds face constraints. While God is the absolute infinite, humans and other beings exist with limitations on their actions. One of these limitations is human intellect, which Descartes names as one component of the cause of our tendency toward error as humans. 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Even though ontological arguments have lost popularity with modern philosophers there has been some recent attempts to revive them. Descartes formulation is regarded as being one of the best because it is straight forward and relativelyRead MoreDescartes Ontological Argument For The Existence Of God1302 Words   |  6 Pages10/30/2014 Descartes’ Ontological Argument for the Existence of God The Ontological Argument for the existence of God is an a priori argument that aims to demonstrate that God’s real-world existence follows necessarily from the concept of God. In Meditation V of Discourse on Methods and Meditations on First Philosophy, Descartes presents his version of the Ontological Argument for the existence of God. In this essay, I will argue that this argument fails because necessary existence for a concept

Cosmology A Creation Myth - 1227 Words

At the infrastructure of nearly every culture is a creation myth that explains how Earth in its entity came to be. Cosmology is defined as being all of the assumptions we make about how the universe is arranged. Modern society has developed possible assumptions in regards as to how the universe came to be and in similar so did ancient cultures. These myths have an immense influence on people’s framework of reference. They all come from one early source and are divergent only because time and local cultural circumstances have exaggerated or modified them. Despite being separated by numerous geographical barriers, many cultures before and after Genesis have developed creation myths that share common aspects that are fundamentally derived†¦show more content†¦And on the seventh day God ended his work which he had made; and he rested on the seventh day from all his work which he had made†¦Ã¢â‚¬  (Gen. 2.4). In the second story, creation takes one day, man is created first, then proceeds the creation of all the plants and animals, and in the end, the woman is created. To further reiterate what some people believe Genesis One and Two are no doubt contradictions based on the descriptions others have the intuition that Genesis One is the account of the creation of the universe and life on planet Earth as it happened in chronological order. Genesis Two is simply an expanded explanation of the events that occurred at the end of the sixth and creation day-when God created human beings. Indian myth is confronted by the imaginative riot of Vedic, Hindu, Buddhist, and Jainic deities that gives rise to the God-given creation as seen in Genesis. In the early myths of the Rig Veda it was said: â€Å"who verily knows and can declare whence came this creation? He, the first origin of this creation, whose eye in the highest heaven controls this world, whether he did or did not form it all, he verily knows it, or perhaps he knows it not† (Harrison 516). Edward Harrison articulates in his article â€Å"Creation of the Universe† that according to the Hindu

The Crime Of The Criminal Justice System - 3025 Words

The criminal justice system we have today was formed by the trial and error of our society. From no rights to African Americans to equal rights to all, we no longer hold public hangings for spectacles but we as a society are still characterized for our hyper obsession with law and order. We pour billions into our police and judicial system in a hope to curb crime and this has led to the creation of a prison solution. This solution is simple when someone breaks the law you lock them away, when that doesn’t work you lock them away for a longer period. Over the decades this method combined with the so called drug war has led to the overcrowding of the prison system. As Ernest Drucker wrote there are over 7.3 million people under the control†¦show more content†¦Those who go to prison are again those that have committed crimes seen as so severe or heinous that they garner a sentence over a year such as armed robbery, rape or murder. This seems like a sensible solution, th at these people deserve to be punished for their actions. But what happens when truly criminalize minor actions such as petty drug crimes, enact mandatory sentencing or even three strike laws? This would mean that for a certain crime such as possession of marijuana you receive a year in prison. The number of people eligible for prison skyrockets and then if there is a three strike law and any of these offenders is caught three times they are shipped off for life. And what happens is society sends more people off to prison and these buildings designed to house hard criminals become overcrowded with a mix of all walks of crime. From those unlucky enough to be in the wrong place at the wrong time to those who have committed petty drug crimes three times too many and are sentenced to life in a prison. This leads again to overcrowding but it also means breaking up communities as drugs aren’t typically found equally in every part or society, they are usually concentrated in smaller sections typically the poorer ones. This factor holds the police and the criminal justice system target the poor society

Childhood Obesity In United States Education Essay Free Essays

The coveted subject of pick is childhood fleshiness in United States. Obesity has become a major factor with the immature coevals and continues to turn. Childhood fleshiness needs to be solved or our kids ‘s lives will be filled with unneeded diseases and wellness complications due to hapless wellness and eating wonts. We will write a custom essay sample on Childhood Obesity In United States Education Essay or any similar topic only for you Order Now Obesity plays a immense portion in the lifting population worldwide. Harmonizing to the Center of Diseases Control and Prevention childhood fleshiness has more than tripled in the last 30 old ages. ( Center of Disease Control and Prevention, 2012 ) Fleshiness can take to shorter life span, depression, figure of diseases and other physical and psychological jobs. There can be many factors are involved that can act upon childhood fleshiness. Cultures, environmental factors, life style ‘s picks can all play in the function of raising the population of childhood fleshiness in United States. It is of import to halt the tendency and give the following coevals of kids a healthy start in life. Who can the universe bend to educate our society in the right nutrients to eat, and physical activities so that the job of childhood fleshiness is corrected? It is true that kids in the United States are in problem in many ways. Of class, there are a batch of dissensions of precisely what all the jobs are, and even more dissension on how to work out the jobs of childhood fleshiness in United States. Many parents in United States do n’t cognize what nutrient to function their kids, and physical activities for their kids. Because the parent does n’t cognize what nutrient is healthiest, they provided their kids with nutrient that are non healthy for them. Who is precisely the incrimination for childhood fleshiness in United States? Parents must larn the right nutrients, and physical activities to assist cut down childhood fleshiness. Parents can act upon what their kids eat. Everyone is born with a sweet tooth and a salty one, but they must larn to bask other gustatory sensations. If parents are to protect their kids from fleshiness, they must look beyond the place, and their kids ‘s schools. When kids are introduced nutr itionary nutrients early in their lives, they tend to larn to eat smart. That ‘s why it is of import for kids to larn how to take nutrients before come ining school. Childhood fleshiness has become a turning epidemic and some may believe that the parents are the incrimination. Lee Haney stated, â€Å" More than of all time, we as parents, and a state must make something about the growing of fleshiness in our kids. â€Å" ( Haney ) Environmental factors, civilization, and life can play a immense portion in the lifting population of fleshiness worldwide. Obesity leads to a figure of diseases, shortens life span, depression, and a figure of other physical and psychological jobs. It is of import that grownups halt the tendency and give the following coevals of kids a healthier start in life. This is an issue that is non merely for persons, but it a job that affects society. The inquiry in who is the incrimination? Fleshiness is non-discriminating among male childs and misss and occurs in all ages, races, and cultural groups. Harmonizing to the Institute of Medicine, parents ( defined loosely to include primary health professionals ) have a profound influence on kids by advancing certain values and attitudes, by honoring or reenforcing specific behaviours, and by functioning as function theoretical accounts. These values start during the first hear of life, and can advance healthy life styles for kids if implemented right by parents. ( 2004 ) . Some blame genetic sciences for childhood fleshiness in United States. Children are more likely to go fleshy if their parents are corpulent. It is contributed through cistrons or household life styles and behaviours? Children are either feed excessively much nutrient, or non plenty nutrient? Is it possible that dietetic factors during the babyhood phases of kid development set the phase for future fleshiness? Birch states that fat cells ( adipose tissue ) develop in an baby during gestation and are distributed during childhood. Additionally, he states that one time the adipose tissue develops in the organic structure, it remains there for life. ( Birch, 2006 ) A kid ‘s eating wont is a combination of the nutrient and parts ‘ sizes that the kids are offered. Children depend on their parents and health professionals to supply their day-to-day nutrient consumption. With this being said, it is clip for parents and health professionals to get down going a positive function theoretical account in the kids ‘s life. It is clip now for parents and health professionals to be responsible for what and how much is being feed to kids. There are many more on the job parents working now than in the yesteryear, this has cause many parent s to turn to fast nutrients. A kid is exposed to over 40,000 fast nutrient advertizements yearly. These advertizements influence the nutrient picks of kids and striplings, and the nutrient is likely position while watching telecasting. Consumptions of fast nutrient among kids and striplings increased significantly from 1998-2001. ( Bowman, S.A, Gortmaker, S.L. , Ebbeling, C.B. , Pereira, M.A. , A ; Ludwig, D.S. , 2004 ) Parents and child care givers are responsible for the nutrients that are selected to given at meal clip, and at snack clip. Many old ages ago more grownups turn to cooking a nutritionary repast daily. Timess have truly changed. Unfortunately many parents today face many challenges, such as non holding adequate clip to fix, and storage infinite many grownup non being able to supply healthy formulas, which makes it difficult to cook homemade repasts of old ages ago. With these jobs, no admiration many parents are trusting on fast nutrients, procedure nutrients and frozen nutrients. Parents and child care givers are responsible for the nutrients that are selected to be given at meal clip, and at snack clip. Many old ages ago, more grownups turned to cook a nutritionary repast daily. Timess have truly changed. Unfortunately, many parents today face many challenges, such as non holding adequate clip to fix, and storage infinite many grownups non being able to supply healthy formulas, which makes it difficult to cook homemade repasts of old ages ago. With these jobs, no admiration, many parents are trusting on fast nutrients, procedure nutrients and frozen nutrients. Many grownups depend on the readily available fast nutrient to feed their kids. Yes, it is easier to merely run by the thrust in eating house on your manner place from work, but it is more educational and alimentary to do the same meat at place. Children must larn about utilizing good nutrient picks. Food provider ‘s gives people what they want. In certain vicinities, fast nutrient is more accessible than healthier nutrient. Sometimes populating in a vicinity where fast-food eating houses are more accessible than food market shops straight affects how the kids eat. Peoples who live in nutrient piece of lands with greater handiness to fast-food eating houses than food market shops had higher rates of diet -related decease. ( Gallagher, 2006 ) One may experience that school tiffin plans are an of import beginning of day-to-day nutriment. This is particularly of import for kids that come from a low income place, where there are jobs with nutrient. Most schools provide kids with two repasts a twenty-four hours. These repasts are breakfast, and tiffin. Some kids are in drawn-out twenty-four hours plans where they are offered a bite, and sometimes supper. These schools are have bound Calories and saturated fats in the school tiffins, more that approximately 80 per centum of schools autumn to me these ordinances. Are these plans the cause of childhood fleshiness? It is difficult to state. Is it the peddling machines and competitory nutrient higher class schools? Some higher-grade schools offer school tiffin, every bit good as different nutrients on a separate nutrient line, and peddling machines. With the usage of these machines, or buying nutrient from the competitory line of nutrient this nutrient, pupils can buy extra nutrient to eat so the needed sum that each pupil is provided. Possibly these are the nutrients that are doing fleshiness? Could it be that there is excessively small physical instruction offered for the kids day-to-day life? Schools in United States offer physical instruction. Each kid is provided physical instruction at least one time a hebdomad. Each kid besides has physical instruction provide daily through the deferral, better known as kid ‘s drama. Each kid has limited deferral chances. Parent can seek to alter some of the things, to assist extinguish childhood fleshiness. It is really tough to learn a immature adolescent to listen to their organic structures, to eat when they are hungry. Lasting behavior alterations can non be done from the exterior. This is a alteration that has to be done internal. This can go a long-time conflict. This is why it ‘s really of import to larn the nutrients to eat, and the right physical exercising that can be usage to extinguish childhood fleshiness. There is a great demand to rectify childhood fleshiness. It is non every bit simple as inquiring, who is the incrimination for childhood fleshiness? There are many factors involved. What we need is instruction and information. United States is filled with people who are over worked, over scheduled, of activates. This is the sort of job that can non be solved nightlong. It is of import to derive control of the issue of childhood fleshiness ; this is non an person job, but a job that affects many people in United States. Who is the incrimination, everyone in United States plays a portion in the incrimination? Everyone must pull off their consumption and supervise the nutrient that enters the organic structure. The epidemic of childhood fleshiness is planetary. The effects can be long-run or even life threatening. If United States looked at the issue of childhood fleshiness, and seek to undertake it on as a society, instead than looking at it as who is the incrimination, we can if non extinguish, set a great large dent in the turning population of childhood fleshiness in United States. It can be solved. So, allow ‘s move. How to cite Childhood Obesity In United States Education Essay, Essay examples

Bachelor of Nursing Students for Cognitive -myassignmenthelp

Question: Discuss about theBachelor of Nursing Studentsfor Cognitive Development. Answer: Introduction The selected case study for this assignment is scenario topic 2: bachelor of nursing students. The paper will explore the importance of aspects of social and cognitive development that occur in children aged between two and five years with a focus on the selected case study. Also, it will discuss the factors that influence this development. The assignment will refer to the Piagets theory of cognitive development and Eriksons theory of social development. The last part will discuss why the developmental stage between the ages of two and five years is relevant to nursing and midwifery practice. Examples of cognitive development Cognitive Development is the normal or systematic development of intellectual and thought processes including reasoning, imagination, problem-solving and perception. This kind of development can be seen by observing how children develop and learn new perceptions and skills. Different cognitive developmental milestones mark the growth of a child. The two examples of cognitive development between two and five years are the ability to learn colours and search for hidden things. Based on Piagets theory of cognitive development, between the age of two and seven years, a child is in a preoperational stage (Asokan, Surendran, Asokan, Nuvvula, 2014). This stage can be subdivided into intuitive development and symbolic function development. During the symbolic development, it is when the child learns colours. The childs ability to understand and remember picture objects increases. Due to symbolic development, a child can remember colours, objects and numbers without seeing them. This aspect of development helps children to produce clear imagery. The other aspect of cognitive development that can be drawn from Piagets theory is intuitive thought development. A child starts to propose the questions how come? and why? Their thinking ability is starting to expand and start viewing the world from different perspectives. The childs thoughts are broader, bigger, dynamic, less rational and less systematic compared to those of the older children (Al-Shidhani Arora, 2012). These developmental milestones occur alongside the ability to speak. According to the case study, Jacks speech has not developed fully and can only speak one-to-two words. Thus, Jack might have problems in counting numbers, which is a key cognitive developmental milestone at this stage. Examples of social development Social development involves intrapersonal and interpersonal processes. This development entails childs experiences, expression and the management of emotions. Social development is a fundamental aspect of childhood since it guides the childs integration into the society. The examples of social development are playing games with other children and toileting independently. Between the age of two and five years children tends to express more independence and excitement when with others. The Eriksons psychosocial development theory notes that children aged between three and six years are in an initiative vs guilt stage (Kail Cavanaugh, 2015). At this developmental stage, the child tends to interact with others at school. A key aspect at this stage is playing because it offers children the opportunity to advance their interpersonal skills by initiating activities. Evidently, the child starts to plan activities and create games with other children. The child also tends to copy the actions of the other children. On the other hand, if the childs sense of control and feelings are suppressed through criticism or discouragement, they might develop a sense of guilt (Sun Shek, 2012). Also, the child may develop guilt if they are unable to control their feelings such as toileting like the other children. A child might feel like a nuisance to others and thus, lack self-initiative. As guilt increases, the child limits their interaction with other children, and their creativity might be inhibited. As explained in the case study, Jack has not yet learnt toileting skills. Hence, he might develop guilt and fail to interact with other children in school. However, some level of guilt is necessary because it enables the child to exercise self-control. Examples of factors which influence cognitive and social development The cognitive development might be influenced by nutrition while the child-rearing environment may influence social development. Cognitive development: nutrition At the age of 3 years, the childs brain develops rapidly through the generation of synaptogenesis, axonal and neurons. There is also synaptic pruning and dendric growth at this age (Ali, 2013). Lack of nutrients or under-nutrition can have persistent impacts on the brains structure as well as socio-emotional development. In case a child experiences under-nutrition, macronutrients and micronutrients, their cognitive development might be affected (Burrows, et al., 2014). Specifically, under-nutrition retards the cognitive growth and increases the risks of disease and infection, which might further increase the probability of malnourishment. Additionally, under-nutrition impacts motor development and compromises educational attainment (Nyaradi, Li, Hickling, Foster, Oddy, 2013). Social development: child-rearing environment The child-rearing environment has a great influence on social development. This factor can be explained through contingency and attachment. Attachment is a biological tendency of young children to seek proximity to their parents at times of stress. Also, the attachment can be viewed as the relation that enables a securely attached child to use their parents to re-introduce a sense of well-being after experiencing stress. If the attachment is insecure, the child might have social development problems. In the early stages of development, a child progresses appropriately when they have an adult caregiver who pays attention to their verbal as well as nonverbal cues and responds accordingly. Contingent responses to gestures develop the groundwork for social development in children (Kliegman, BF, JW, NF, Behrman, 2012). If the rearing environment does not offer such conditions, the child might have social developmental problems. Significance of understanding this life stage to nursing and midwifery practice Normal social and cognitive development shows that the child has good health. Thus, this life stage is relevant to nursing and midwifery practice because it helps to predict the health of the child. Ideally, monitoring and tracking growth disturbances are important to a childs health care (Haymond, Kappelgaard, Czernichow, Biller, Takano, Kiess, 2013). An understating of this stage is important towards addressing developmental issues. Early brain development is important in the later stages of life. Thus, early detection of developmental problems will result in the adoption of appropriate interventions and consequently lead to better developmental outcomes. Further, understanding this life stage to nursing and midwifery practice will guide the creation of growth assessment criteria. In pediatric health surveillance, growth assessment is vital since most problems within social, interpersonal and physiologic domains can negatively impact growth. This aspect is supported by the fact that development is multidetermined and varies as a function of nutrition, biomedical status, social and cultural status (Ali, 2013). It is evident that the social and cognitive development of a child is important aspects of life that should be closely monitored. The focus, in this case, should thus be the presence of growth disorders and growth disturbances (Scherdel, et al., 2013). Conclusion This assignment has highlighted some key examples of social and cognitive development. The examples have been linked to two authoritative theories of growth and development which are Piagets theory and Eriksons theory. Based on the Piagets theory of cognitive development, Jack is in the preoperational stage. He should thus exhibit the ability to learn colours and search for hidden things. The Eriksons theory of social development will categorise Jack under the initiative vs guilt stage. As discussed in this paper, cognitive development and social development is affected by nutrition and rearing environment respectively. Understanding this life stage is important to nursing and midwifery practice because it will result in the adoption of interventions that will lead to better outcomes. References Ali, S. (2013). A brief review of risk-factors for growth and developmental delay among preschool children in developing countries. Advanced biomedical research, , 2 (1), 91. Al-Shidhani, T., Arora, V. (2012). Understanding dyslexia in children through human development theories. Sultan Qaboos University Medical Journal , 12 (3), 286-294. Asokan, S., Surendran, S., Asokan, S., Nuvvula, S. (2014). Relevance of Piaget's cognitive principles among 4-7 years old children: A descriptive cross-sectional study. 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