Capstone Project

Schizophrenia and Physical Activity Grand Canyon University MRS.-441 V-230 Professional Capstone Project January 9, 2014 Research shows that implementing physical activity into a lifestyle is a vital part of being healthy and encouraged for the general population. The importance of physical activity is a knowledge deficit for the person living with schizophrenia as the education and support needed from the treating psychiatrist and nurse is not consistently provided. An emphasis is placed on medication adherence, treatment compliance and reduction in hospital admissions.Research also shows that a person living with schizophrenia has a higher mortality and morbidity rate. This population often has chronic illnesses such as diabetes, hypertension and cardiovascular disease which often is the cause for premature death. Therefore prescriptive physical activity prescribed by the psychiatrist with support from the assigned nurse to provide much needed education and program structured to su pport this change in lifestyle is a much needed service provided in the current psychiatric outpatient clinic setting.Physical activity for patients should be seen as integrative care and art of the common practice for mental health nursing. (Happens, Plantain-Phone, and Scott 2011). Keywords: schizophrenia, physical activity, serious mental illness Capstone Project A problem frequently found in the outpatient mental health clinic, inpatient facilities and within the community is the lack of importance placed on physical activity being part of the schizophrenic patient's life.There needs to be a shift to encourage the mental health nurse, the treating psychiatrist and the clinical team to take the time to educate the patients diagnosed with schizophrenia on the importance of incorporating physical activity into their daily routines. The benefits of becoming physically active should be described in detail to the patient as an effort to show them how this would improve their quality o f life.For many suffering from schizophrenia it may be difficult for many reasons not to be physically active but for others it is the simple lack of understanding of how being active can impact their lives in a positive way as well as having support within the clinical team. Much education of the schizophrenic patient lies with the busy mental health nurse who fete fails to realize that this type of education is Just as important as the education given to the patient on medication compliance for management of their symptoms and treatment adherence for long term stability.There is a need for greater access to physical activity information, opportunities, and professional standards for staff in mental health care (Wand & Murray 2008). The World Health Organization (WHO) finds that physical activity, ranging from daily walking to structured exercise regimens, is internationally recognized as a key prevention and health management strategy (2007). If physical activity is a health prior ity for the general population why should it not be Just as important for the schizophrenic patient?Physical health in this group is often poor and individuals tend to die early with life expectancy reduced by up to ten years compared to the general population (Philae 2001). It is common knowledge to the nurse and psychiatrist that regular physical activity can improve several common physical ailments such as hypertension, hyperglycemia, and hyperventilation's as well as reduce the risk for developing cardiovascular disease, diabetes and cancer. In adult schizophrenic patients does implementing physical activity versus not implementing physical activity improve overall health in 1 year?There are many factors that should be addressed in order to solve this problem. The education of the mental health nurse, treating psychiatrist and clinical team on the importance of taking the time to educate these patients with this information is a very important part of providing care. The identif ication of the barriers for which patients who receive this education and do not implement physical activity to their current lifestyles is also important. There is also a need for immunity based physical activities or places where a patient with schizophrenia will feel welcomed and supported.The likelihood and reality of these patients to be accepted in general population venues for physical activities is often low due to the stigma and lack of education within society of the mentally ill. Review of Literature Education and Barriers In reviewing the articles similarities were found in a few of the articles. The importance of physical activity within all the articles was identified for the Schizophrenia patient. Each article stressed the fact that this patient population has high morbidity and mortality rate.One that with incorporating physical activity can reduce risk factors that contribute to premature death. Physical activity is determined to be an important factor in improving the quality of life as well as quantity of life for these patients. The main point in my research was to show how the mental health nurse can influence the patient's perspective of physical health as well as support it by promoting the physical activity and assisting the patient in identifying ways to incorporate physical health in their daily routines.In the first article the argument is made on how the mental health nurse should provide leadership in promoting physical activity even if the mental health nurse is not educationally prepared to perform this role. It also concluded that mental health nurses can provide directions in understanding physical activity for their patients by using evidence-based research and mainstream physical activity in the mental health clinic. Physical activity for patients should be seen as integrative care and part of the common practice for mental health nursing. Happens, Plantain-Phone, and Scott 2011). Two of the articles were studies that identif ied barriers for why patients with schizophrenia do not engage in physical activity. It is has been found that these patients self-report up to a 47% that they are sedentary but without any physical limitations. The first study included 27 patients from four community clinics that were interviewed individually using a structured questionnaire. This study used the recommended American College of Sports Medicine guidelines for weekly activity levels.The data showed that two-thirds of the participants were inactive and almost a third of the participants minimally active. Only two participants met the criteria of active which is described as having moderate intensity activity or walking for at least 30 minutes for 5 days per week. The study identified four barriers: limited experience of physical activity, impact of illness and the medication, effects of anxiety and the influence of support networks. It concluded that physical activity may need to be more individualized with case manage ment approaches by health care providers.The development of physical activity programs should include professional and peer support which would facilitate physical activity and program adherence. Moonstone, Nicola, Donated, and Laurie, 2009). The second study explored the perceived barriers and benefits to physical activity in people with serious mental illness. A total of four focus groups were held with a total of 34 patients from two program sites which included 16 men and 18 women. The data showed that barriers to physical activity were identified as mental illness symptoms, medications, and weight gain from medications, fear of discrimination and safety concerns.The benefits were identified as the program offered a feeling of belonging, program offered comfort and support, physical activity was viewed costively, they were able to link being active to improved health. The conclusion of this study was that these patients did value physical activity and were aware of its health be nefits. The report of fear of discrimination and relying on the staff to plan and initiate physical activities also contributed to their inactivity.The recommendation is that any program implemented should include independent initiation of activity as a method of improving one's health as this would assist the serious mentally ill patients in becoming more active and increase program compliance. McDermott, Snyder, Miller and Wilbur 2006). Lifestyle Factors and Activity Five articles, two of which were randomized studies that emphasized the importance of physical activity in relation to mortality rate, quality of life and identified activity interventions for the Schizophrenia patient. They also identified the importance of lifestyle factors such as diet, alcohol consumption and smoking.All of the studies in this section supported the fact that a poor diet can be identified in this population and should be correlated with chronic illnesses such as Diabetes and Cardiovascular disease. The first study identified a lack of physical activity participation and impaired functional exercise capacity compared to healthy controls contributed to health related quality of life. Patients diagnosed with Schizophrenia (n=60) and health controls (n=40) completed the SF-36 Bake Physical Activity Questionnaire and performed a 6 minute walk test.The results were significantly lower in patients with Schizophrenia compared to those of matched healthy controls. The activity scores indicated that patients with schizophrenia were significantly less' active during their leisure time and less involved in sports activities. The participants walked a shorter distance on the 6 minute walk test (19. 3%) and reported more symptoms of despise after the 6 minute walk test (28. 3%). This data suggests that patients with higher IBM might also be limited in completing daily life activities such as walking as a sedentary lifestyle correlates with a higher IBM.This study recommends that patients s hould be made aware that increased body weight and physical inactivity are modifiable risk factors. Educational programs should focus on these risk factors as they are key for both treatment and prevention of disease. Bancroft, Probes, Eschews, Marriages, Sewers, Knap, and De Here, 2011). The second study evaluated evidence of physical activity with or without having diet counseling on creditability parameters in people with schizophrenia.It is well documented that people with schizophrenia have a reduced life expectancy of 20-25 years in comparison to the general population related to premature cardiovascular disease. They also have twice the normal risk of dying from cardiovascular disease. This study reviewed 13 articles that addressed physical activity with or without diet counseling. The conclusion was that physical activity with or without diet counseling is effective in reducing weight and improving creditability risk factors in people with Schizophrenia.It is recommended tha t clinicians assess and monitor cardiovascular risk factors as well as refer patients to a physical health programs. It was noted in the study that without the support of clinicians, people with schizophrenia exercised sporadically and dropout rates were at 90% after 6 months. (Bancroft, Knap, De Cert., Van Winkle, Deck, Marriages, Puddles, Simons and Probes 2009). The third article focused on the impact of poor hysterical health in relation to the mortality rate of patients with schizophrenia.This study summarized lifestyle factors such as poor diet, low rates of physical activity, increased weight, smoking, lack of dental care, social isolation, limited to no family involvement and unemployment which can all be considered underlying causes of increased mortality in this population. This article found patients with schizophrenia have the inability to provide self-care which also places this population at greater risk for premature death. This article emphasis the need for health ed ucation that retrofires physical health as an effort to improve mortality and morbidity of people with serious mental illness.These health education strategies would include education of lifestyle factors to intervene before a serious health problem is established. As well as secondary interventions which include health screenings to aid in the early detection and management of high risk factors for diabetes and cardiovascular disease. (Pack 2009). The fourth article was also study that was based on assessment of the metabolic profile for individuals with schizophrenia in relation to dietary and physical activity habits.This study interviewed 130 patients diagnosed with schizophrenia from the outpatient clinic. The data from these 130 patients and another 250 participants of the 2005-2008 ENHANCES were analyzed by using SPAS version 17. 0 for Windows. The data showed that less than half of the sample reported moderate physical activity and few individuals reported any vigorous physi cal activity. The controlled group showed a higher frequency of moderate physical activity but no difference in vigorous activity.Previous studies have found that 40% of patients with Schizophrenia report no moderate physical activity and 75% port no vigorous physical activity. This study found that household income did correlate with moderate activity and did impair participation in physical activity for those patients who had a lower income. The conclusion of this study is that interventions should combine education and physical activity as a form of outreach that would be more appropriate for the serious mentally ill patient who has limited knowledge of the benefits of exercise.Health care providers should offer increased opportunities for physical activity for patients with Schizophrenia as this may improve treatment outcomes and ease the burden of disease. Rattail, Palmers, Returnee, Lisbon, Grill, Take 2012). The objective of the fifth and final study was to evaluate the assoc iation between a sedentary lifestyle and psychiatric symptoms in obese and overweight adults with schizophrenia or specification disorders. This was a randomized study which included weight assessment and intervention in schizophrenia treatment.The data was collected during 2005-2008 in an outpatient setting and included 55 patients. Sedentary behavior has been shown to be an independent risk factor for mortality in the general population and may be a factor hat is increasing the risk of common co-morbidity's in adults with schizophrenia or specification disorder. This study found in regards to physical activity that patients who were monitored spent 13 hours per day practicing sedentary behaviors and that physical activity was very limited.Physical activity was primarily light physical activities 17% of the monitoring time and moderate to vigorous activity was 2% of the monitoring time. Self-reported sedentary behavior was found to be associated with psychiatric symptoms such as ne gative symptoms, depression, cognitive symptoms ND extramarital side effects to psychotropic medications. This study suggests that public health campaigns and mental health providers should focus on decreasing sedentary behaviors as an effort to reduce the risk of co-morbidity's which are often experienced by adults with schizophrenia or specification disorder. Ann., Gauguin, Richardson, Hellman, Tang, Caules, and Karakas 2013). There is much evidence to support the fact that the mental health nurse should spend time educating, promoting and possibly even facilitating the programs within the clinic that support the schizophrenia patient with the lifestyle change to incorporate physical activity into their lives to increase their quality and quantity of life. It would be realistic to set a goal for the patient to be able to incorporate 30 minutes of physical activity into their routines at least three times per week.Physical activity teaching and support should include topics that de al with barriers to physical activity, poor diet and their influence as factors that contribute to the development of Diabetes and Cardiovascular disease. Implementation Plan In the current outpatient clinic setting such as Partner's In Recovery decisions about NY change that will affect the patients care are made not only at the administrative level but the patient level as well. There is an identified Advisory Council which is made up of volunteers which consists of patients, clergy and community members.Prior to any proposal for change or new program within the clinic to be brought before administration the information must be presented to the Advisory Council at one of their monthly meetings. Once approval is obtained from the council then the information would be presented to the patients for their input and approval. Moving onto administration will be the tough part. The presentation will have to include physician approval, URN endorsement and willingness to adapt teaching to their current practice, patient testimony on the importance of having physical activity ordered by the physician as part of their treatment plan.As well as the patients currently participating in a walking program for 30 minute intervals two to three times per week. This presentation would be given by the URN with self-identified patients who would help facilitate and share their personal experiences. In order for administration to be on board with a change the buy in would have to be monstrance at the patient level with a few patients willing to go the extra mile and advocate for this change to happen. A presentation for the patients would be developed and presented to the patients in the current onsite classes.This presentation would highlight the high risk behaviors that can be modified to avoid the development of chronic illnesses such as diabetes, cardiovascular disease and cancer. It would also include the high morbidity and mortality rates found within this population which i s also attributed to schizophrenia and the lack of physical activity. A healthy snack would be served to them during the presentation. Patients that were self-identified as wanting to participate in this process would be called to additional Once the patients were on board and actively walking we would move meeting. Onto the physicians and nurses. This presentation would have the same information and would be presented to them during one of the monthly clinical staff meetings with arrangements made for lunch to be served since it is normally held during their lunch hour. This presentation would focus on the importance of physical activity being prescriptive by the physician. Reinforced, supported and taught by the URN who is assigned to that patient for continuity and adherence.It is recognized among the medical staff that serious mentally ill patients across the spectrum of diagnosis suffer from a sedentary lifestyle. Physical activity may need to be more individualized with case m anagement approaches by health care providers. The development of physical activity programs should include professional and peer support which would facilitate physical activity and program adherence Moonstone, Nicola, Donated, Laurie 2009). This presentation would be adaptable to the audience for future reservations.For the physicians and nurses it would have statistical data to support the change and show the positive outcome for reinforcing a lifestyle change for many of their patients. For administration it would have data to support that the quality of life would be greater and the quantity of years of life extended with the patient who is being supported to be physically active. The cost may be increased for the mental health system as the SIMI patients diagnosed with Schizophrenia will live a longer life related to implementing this change.This small change may motivate the patient to incorporate more healthy behaviors such as quitting smoking, eating healthy and seeing thei r primary care physician regularly to manage their chronic illness such as diabetes and hypertension which will in turn lead to healthier more productive lives. For some, patients possibly even the opportunity to reach full recovery in which they would no longer need to be part of the mental health system. The problem at hand is that physical health in this group is often poor and individuals tend to die early with life expectancy reduced by up to ten years compared to the general population Philae et al. 001). It is common knowledge to the nurse and psychiatrist that regular physical activity can improve several common physical ailments such as hypertension, hyperglycemia, and hyperventilation's as well as reduce the risk for developing cardiovascular disease, diabetes and cancer. At the outpatient clinic level much of the patient education is provided by the busy Mental Health Nurse. Time constraints, patients in crisis needed to be triages or hospital discharges often take preced ence to teaching or reinforcement of physical activity.There is a need for rater access to physical activity information, opportunities, and professional standards for staff in mental health care (Wand & Murray 2008). The World Health Organization (WHO) finds that physical activity, ranging from daily walking to structured exercise regimens, is internationally recognized as a key prevention and health management strategy (2007). In the additional meeting these patients would be given more specifics about what their participation will mean to move this change forward to Administration for final approval to be implemented for all the patients diagnosed with Schizophrenia.A detailed explanation of the commitment being made to themselves in become physically active. Patients would receive a pre-test and a plan would be set for implementing walking for 30 minute intervals two to three times per week as well as a log to track their participation. Patients would receive a pedometer if they were interested in seeing their walking translated into steps. Patients would return weekly to report their progress, enjoy a health snack, receive additional support and reinforcement from their assigned Nurse as well as planning the following weeks activity.A room within the clinic would be designated or this meeting. The cost for implementing this walking program for the patients would be minimal as the clinic receives donations of food and water on a weekly basis. Often time staff is also willing to support activities such as this with donations of fruit or vegetable trays. The cost on the other hand maybe viewed differently from Administration as this program would take time from a designated URN to meet with the patients on a weekly basis which in turn would take away from clinical hours and billable patient care. The average URN at PRI makes $28-$32 per hour.Considering one our for the patient meeting time, prep time and possible phone call allotment time may come out to thr ee to four hours per week which would average $112-$128 per week. Not being privileged to the average billing rate for a visit with an URN for one hour in the clinic a weekly average of the loss in unable to be determined. There would also be a cost incurred with paper, ink and printing of materials. If this program was to be implemented as identified above with the physician prescribing the physical activity to the patient diagnosed with schizophrenia and the support given by the URN the outcome would be phenomenal.Mental health nurses can provide directions in understanding physical activity for their patients by using evidence-based research and mainstream physical activity in the mental health common practice for mental health nursing. (Happens, Plantain-Phone, Scott 2011). Resources that would be needed for this program to be implemented would include the meeting room, healthy snacks, power point presentation or printed handouts, pre-test for the patients, a nurse to run weekly meetings, weekly tracking log, pedometers and a post-test to measure the increase in awareness and knowledge.A elaboration or recognition of some sort for the patients who continue to practice this lifestyle change after a pre-set timeshare. This patient group would be followed by the assigned URN for one year and their progress would be reported to the Physicians, Nurses, Advisory Council, Administration and other patients suffering from serious mental illness at each quarter through the year. Another resource that may be necessary after the initial year would be to continue this program with new patients.In the clinic setting peer support is a big deal, maybe the patients who have been successful, faced challenges and are now practicing this new lifestyle may be the ones facilitating the weekly meetings with the URN present for additional support and reinforcement. How much more effective would it be to see and hear it from your peer and your nurse to get you motivated to actuall y give physical activity a try? Theory There are two theories that will address the issue of increased physical activity in the Schizophrenia patient population.The first is the Health Belief model in which the key concepts are based on the patient's perception of the threat, benefit and barriers. In this model in order for the patient to adopt the new behavior such as physical activity, their perception of the threat for chronic long-term illness, the severity of those identified illnesses and the benefits of their participation in physical activity must outweigh their perceived barriers to incorporating this activity. This theory would be one that is easy to implement and incorporate into a visit with the nurse or psychiatrist without needing additional time scheduled.The use of this theory would facilitate the education much needed by this patient population in regards to deeding physical activity as part of their treatment plan. It is the hope that once the patient is given this information by a nurse or psychiatrist their interest in physical activity will be increased. Once there is motivation behind the interest then the patient can implement the physical activity. The second theory is the Theoretically model which entails the stages of change. In this model it is believed that a person (patient) shift in a progression though five levels related to their readiness to make a change.The first stage is pre-contemplation in which the patient maybe thinking bout making this change. The second is contemplation in which the patient maybe more serious about making this decision. The third is preparation in which the patient is now taking steps to be able to make the change. The fourth is action in which the patient is actually doing the activity or incorporating the change into their routine. The fifth and final stage is maintenance in which the patient is implementing the activity into their routine and doing other activities to support their new lifestyle cha nge.This theory would be easy to include into a support group or class setting. This theory can aid in facilitating the class structure. With this theory each patient will be able to identify what stage they are in, identify what is needed to make the change and even set a date to incorporate change into their current lifestyle. This theory can be beneficial in addressing physical activity as a healthy lifestyle change that is much needed in this patient population as an effort to prolong their lifespan.The hope is that with a class structure the patient can be supported as he/she incorporates physical activity into their current lifestyle. Evaluation The methods used to evaluate the progress of implementing a walking program will be a pre and post-test (Appendix A). This walking program will be implemented as part of a Wellness program that entails enhanced patient education and consists of group walking 3 days a week for 30 minutes with the self-identified patients being treated f or Schizophrenia at an outpatient psychiatric clinic.The identified variables that will be measured throughout the year of this program will be an increase in knowledge of the participants about the importance of physical activity, increase in he amount of physician referred or prescriptive physical activity, increase in amount of referrals to the walking program (Appendix C). A long term outcome worth measuring would be the decrease in IBM, cholesterol and triglycerides in the patients who participate in the walking program for one full year (Appendix B). Dissemination Results would be disseminated first of all with Administration and the Advisory Committee in one of the quarterly meetings.A power point presentation would outline the Journey of the implementation of the walking program as well as the outcomes. It would include the amount of physician and nurse educational sessions, physical activity weekly nurse run classes, amount of participants actively walking, amount of referr als via physician referral or self-identified participants, measurable changes in lab results for cholesterol and triglycerides, changes in IBM tracked for 1 year. Posters would be printed in colorful themes displaying the outcomes which were tracked over the year.These posters and the power point presentation would then be shared with the referring physicians and nurses during Grand Round. Results would be shared with the patients and staff with these posters by placing them on the walls throughout the clinic. It would be the hope that these posters would build motivation and interest of other patients to encourage them to follow and start exercising. Results would be shared with all clinical staff, case managers, family and peer mentors in the monthly staff meetings with the power point presentation.Each time the power point presentation is presented it will be given by a patient who has completed or is currently actively walking and has some personal experience with the outcomes of decrease in IBM, lower cholesterol or triglycerides so that they may share their story during this time as well. These results and personal accolades will be shared with the Arizona Department of Health Services, Behavioral Health Services Division for Mauricio County as an effort to provide education to other outpatient clinics with the same patient population.

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Song's Copyright - Assignment Example For musicians, copyrights are designed to protect their songs from unauthorized reproduction or copying of the work (Atkinson, 2011). Consumers can purchase songs for use in their homes only. When they want to use certain songs for public performance or advertising, they need to gain the rights to do so. To gain the rights, consumers can enter into rights-managed contracts, where they pay royalties based on the number of times they want to use a particular song or several songs. The payable royalty fee is also determined by the number of people who will hear it and the location in which will be played (Berne, 1975). Copyrights laws in Canada extend to both the nationals of Canada and foreign nationals. The foreign nationals are limited to the members of Berne conventional countries. Substantial amendments were made in Canada to the copyright Act in 2012. The amendments were aimed at modernization of the Canadian copyright law. The United states also have their copyrights laws which have several similarities and differences with the Canadian copyrights laws. Both countries confer protection to artistic work based on the concept of originality (Bogsch, 1986). The Canadian Act recognizes artistic works, musical, dramatic, and original literacy. The U.S Act protects and recognizes ‘works of authorship’ as a general name for artistic works. There are no requirements for registration of copyright in Canada. The registration confers particular presumptive benefits in the country. Lack of copyright registration in the U.S limits some available remedies. Canada prohibits the sale and use of technological designs to circumvent protection measures technological wise. In the U.S the law on technological designs is similar to the one in Canada (Buckingam, 1836). Internet service providers are protected by the Canadian copyrights Act. They are protected when they are

Comparative Analysis of Tesco PLC and Primarks Capacity Management Essay

Comparative Analysis of Tesco PLC and Primarks Capacity Management - Essay Example n demand, retail service providing companies are faced with a challenge of managing, expanding and planning their capacity to meet increased demand for retail products. In this pursuit of retail capacity management, two main options have been considered by the retailers across the UK. The first option is the expansion of retail floor space by opening up new retail outlets and the second option has been to go online and make use of the omnipresent advantage. Tesco PLC and Primark, both of which are retailing companies, have catered this increase in demand and the challenge of capacity management by focusing on these options. However, it is pertinent to note here that both companies have different challenges to face; Tesco PLC has a large and mature customer segment which needs to be catered, managed and facilitated through conventional and unconventional means. On the other hand, with a comparatively small customer segment, Primark’s aim to build capacity is aimed at increasing customer base, rather than managing or facilitating it. Having taken into consideration the increase in retail customers’ demand, Tesco has considered a paradigm shift in its capacity planning and management. As per the interim report published by the company in company for the year 2012 – 13, the management is focusing more on online retailing rather than increasing physical retail outlets. The possible outcome of this strategy to increase capacity can be the catering of increased demand of the customers and to have a wider reach by nullifying the impact of constraints associated with physical outlets (Tesco PLC, 2012). Having considered the fact that the customers of the company increased significantly, Tesco PLC required a solution for increasing its capacity to manage growing customer... This esay sresses that Tesco PLC has a large and mature customer segment which needs to be catered, managed and facilitated through conventional and unconventional means. On the other hand, with a comparatively small customer segment, Primark’s aim to build capacity is aimed at increasing customer base, rather than managing or facilitating it. Having considered the fact that the customers of the company increased significantly, Tesco PLC required a solution for increasing its capacity to manage growing customer base. Having taken into consideration the increase in retail customers’ demand, Tesco has considered a paradigm shift in its capacity planning and management. This paper makes a conclusion that keeping in view the comparative analysis of Tesco PLC and Primark in this report with regard to their capacity management and initiatives taken in this respect by both of them, it is evident that there is a marked difference between the strategies of both companies. Tesco PLC, having a strong physical presence and large retail floor space in the UK, has been focusing on going online to target a greater customer base. In fact, the management at Tesco PLC is considering reducing its retail space, which will ultimately benefit the company in reducing its operating costs. On the other hand, Primark has persisted with its strategy of increasing retail floor space in the UK and has also planned to carry it forward in the future too.

Materialism and Domination in Ben Jonson's Volpone Research Paper

Materialism and Domination in Ben Jonson's Volpone - Research Paper Example The concept materialism is many times associated with political nature where, agents of politics are seen as materialist. Marxist provided us with knowledge of how the society works and thus, poets and philosophers can predict how the society will behave over time (Friedman, 1974). When you look at Marxist versus historical materialism the idea of a society developing from one stage to another can be seen although such transition is characterized by several conflicts that arise between social relations and productive forces. Marxist believed that a change in ideas could not change the society because dominant ideas that the reformers use to bring change to the society are embedded in material conditions. In the play â€Å"Volpone† various characters portray acts of materialism and dominance among and against each other. In this play, two characters by the name Volpone and Moscow play the servant master relationship, for an individual to employ a servant, he must possess some m aterial things such as money, physical comforts which can be seen by the way a person spends his jewelry, his clothes and behavior around other people. Servants normally would be submissive to their master and follow their masters’ instructions to the letter. ... For example, in the capitalist exploitation of labor is a common phenomenon as portrayed by Marxist. In the play a similar behavior is seen in Volpone, he wants to exploit the likes of Voltore, Corbaccio and Corvino. Because he possesses a significant amount of vast wealth with no heir and he knows that several people would fall prey in his trap in the quest to be named the beneficiary of his wealth or at least be given a portion of the wealth. Volpone thinks that because he owns material wealth he can easily dominate over peoples thoughts. This is evident in the actions of the three characters, Voltore, Corbaccio and Corvino, who bring him gift after gift hoping their generosity to the sick man will be repaid in tenfold. It is so ironic that even though Volpone’s servant has no wealth he is able to manipulate him contrary to his expectation. Mosca plots a lot of schemes for his master and the other three individuals, Voltore, Corvino, and Corbaccio, portraying his desire to d ominate above everyone. The desire for wealth is a common phenomenon in this play, Volpone, Mosca, Corvino Corbaccio and Voltore all desire wealth. In their pursuit to achieve this goal, they seek to outdo each other in the different plots they come up with. Volpone and Mosca seek to cheat the lawyer, the merchant and the old miser who is also on the verge of dying, on the other hand, Mosca is encouraging the three to continue bringing gifts to his master, he does this intentionally because he has a plan that will benefit him. Volpone has a great desire to accumulate as much gold as he can, he says to his servant â€Å"I long to have possession of my new present†, his servant uses

Art analyze Assignment Example | Topics and Well Written Essays - 500 words

Art analyze - Assignment Example The old building has a large door and a fleet of staircase heading to the large door, which suggests a warehouse. In addition, the "Lane with Poplar Trees" by Van Gogh depicts the image of a man standing on a lane with Poplar trees at sunset. The poplar trees are seemingly handy with no leaves, which suggest drought or a dry season. The poplar trees line the lane in a defined pattern heading to a far distance, which manifest the unending tribulations of the dry season. Moreover, the man stands in the middle of the lane in a desperate posture, which depicts the hopelessness at the time. The trees and the grass on the sides are standing still showing the stagnant nature of life in this season. Denotative description refers to the translation of an image to its literal meaning (Bedford, 2014). On the other hand, a connotative description is a symbolic translation of an image to its implied meaning (Bedford, 2014). In this context, we seek to give the denotative and connotative meaning of the Royal Media advertisement image. The denotative description of the Royal Media advertisement image is the word LEGO enclosed in a brown board. The letters are in white and the boundary of word is in black. The brown board propels in the sky. On the other hand, the connotative description of the Royal Media advertisement image, LEGO is a dominant line of construction toys manufactured by The Lego Group. Notably, the LEGO is a private company with its headquarters in Billund, Denmark. An icon may refer to an image that represents an exclusive object, a sacred Christian personage, or a religious piece of art. An icon stands for an object that relates to religious, economic, cultural, or political setting. I think the image below is an icon representing a religious personage, which has a symbolic meaning to many people (Sturken & Cartwright, 2001). The Russian icon of Holy Trinity, which Russian painter Andrei Rublev

Toyota hybrid cars Assignment Example | Topics and Well Written Essays - 2750 words

Toyota hybrid cars - Assignment Example Various advanced technologies that are utilized by hybrids include regenerative braking which is characterised by the electric motor applying resistance to the drivetrain consequently forcing the wheels to slow down (Fuhs, 2009, p. 73). In response, the energy form the wheels will turn the motor that acts as a generator which converts energy that usually goes to waste during braking into electricity and battery is used for storing the electricity until when it will be required by the motor (Lagunoff, 2008, p. 156). Another technology that is used by the hybrid vehicles is the electric motor assist where the electric motor avails more power to help the engine during acceleration, overtaking or going up a hill. Therefore, a smaller and more efficient engine can be used while in some of the cars, only the motor avails power needed for driving in low speed conditions where internal combustion engines are not very effective. They also employ automatic start and shut off that shuts of the engine spontaneously when the car pulls to a halt and starts it again it when the motorist presses on the accelerator. The automatic start and shut off is important in preventing wastage of energy from idling. Toyota is a leading corporation in manufacturing, assembling as well as supply of cars all over the globe. One of the key reasons for the company’s good performance is the efficient management system that it employs (Czinkota and Ronkainen, 2013, p. 535). There are several other striking attributes that have enabled the company to achieve its place as a market leader. The type of market structure that the company functions in cannot be defined clearly and in some cases, it is considered to be a monopoly. The dominance of the company in the market is what makes the company to be seen as operating a monopoly. The company’s differentiation approach has enabled it to have a monopolistic existence particularly in the emerging nations. Conversely, the

Foreign market entry strategies Essay Example for Free

Foreign market entry strategies Essay â€Å"Firms which participate in the business system as partners complement the company and its suppliers, thereby increasing the value to customers†. Explain your understanding of this view and provide examples to reinforce your arguments. For a company, entering new foreign markets may be achieved in a variety of ways. Each of these ways places its unique demands on the company in terms of organizational and financial resources. Most of the times, entering international markets is not a matter of choice but of necessity to remain competitive in new or established markets by meeting the consumer’ needs and values. The decision to go international represents an important commitment, to go into a new line of activity, this being the reason why it should be taken step by step: obtaining information, analyzing them, formulating alternative action plans, (Tookey, 1975) and of course find the right partners that match the company brand image and values. The international business system model is focused on the advantages determined by the internationalisation process and less on the development process of the internationalisation of companies. The main scope obtained by applying the Uppsala Model is predicting the company’s evolution on foreign markets. Two elements are at the basis of the model: the notion of essentiality attributed to the process and the notion of physical distance. The internationalisation of a multinational company takes place step by step, according to the Uppsala Model, which minimises the risks regarding the new market (Johanson; Wiedersheim-Paul, 1975). Therefore, the company is being involved gradually (investments, control and profit), getting to the point of creating a production subsidiary which ensures also the selling of the products on the new market. The stages of the internationalisation process are presented in Appendix 1. The concept of physical distance, the second element the Uppsala Model is based upon determines the companies to select, in a first stage, the neighbour countries in order to reduce the cultural, economical, political differences. According to this approach, the bigger the physical distance, the bigger is the incertitude about the new market and bigger the risks associated to this market. In the view of the globalisation phenomena, there are numerous criticisms about the â€Å"physical distance† notion. Many papers have developed the subject of the company’s internationalisation; a special place holds J. Birkinshaw who analysed the problems regarding the role of the subsidiaries and the evolution of the mandated in the internationalisation process at the multinational’s level. Therefore, Birkinshaw and Hoods (1998) have shown that creating a subsidiary can be explained on the basis of the interactions between the decisions of the mother-company, the initiatives o f the subsidiary and the specific conditions existing on the new market. The model developed by Birkinshaw (1997) is based on three variables: The relation headquarters – subsidiary; the subsidiary’s initiatives and the local environment. Regarding the internationalisation process, the company has more options (see Appendix 2) The first choice is represented by the development of the existing markets and it is being used by companies that are acting on highly competitive markets; the second choice – the company can choose to develop its activity on new markets, similar to the ones they are already acting on – in this case, they are usually choosing to export their products; the third strategy is developing a new line of products similar to the ones they already have and which will be sold on similar markets- in this case the company can choose between strategic alliances: creating a joint venture or licensing. . Management’s involvement in export operations is different, as we talk about passive exporters (when selling abroad is induced by the demand existing on the foreign market, meaning that the business is initiated by the importer) or active exporters (when the operation is initiated by the seller, which has an export strategy and a suitable business plan (Popa, 2006) From the operational point of view, exporters can be indirect exporters(with the participation of trading houses), when it isn’t necessary to create an organizational structure specific to the export activity or direct exporters, which is made by the producer, which is creating services or departments for international business. The determinants of export behaviour are experience and uncertainty effects; behavioural and firm-specific influences and strategic influences. 1. Experience and uncertainty effects Knowledge and learning regarding the exporting activity may be possessed or accumulated by the company in time. Experience has a key role, as firm’s involvement in international markets is most of the time a gradual process. During the early stages of exporting, firms have a more concentrated foreign market focus, while increased involvement in foreign market encourages diversification to a wider range of markets. As a firm’s knowledge of an export market increases, the uncertainty factor diminishes. This knowledge allows the identification of concrete opportunities, as distinct from theoretical that may be apparent from objective knowledge. 2. Behavioural and firm-specific influences Recent theories of exporting are strongly influenced by the behavioural theory of the firm, which stresses decision-maker characteristics, organizational dynamics and constraints, ignorance and uncertainty as key variables in decision making. Exporting has been described as a development process based on a learning sequence involving six stages Bilkey and Tesar, 1977): Stage 1: the firm is not interested in exporting Stage 2: the firm supplies unsolicited business, doesn’t examine the feasibility of active exporting Stage 3: the firm examines the feasibility of exporting in an active way Stage 4: experimental exports on neighbour countries Stage 5: the firm becomes an experienced exporter Stage 6: the firm explores the feasibility of exporting to additional countries of greater business distance. According to Welch (1982), the export commitment is influenced by four groups of factors (see figure 4): pre-export activities, direct export stimuli, latent influences on the firm and the role of the decision-maker. 3. Strategic influences The opinion among researchers and managers is divided on the issue of the relation between the firm size and export success. Still, the importance of a positive managerial attitude to exporting and the necessity of committing managerial and financial resources to the internationalization process are crucial to the success of the firm, irrespective of size. As a mode of international market entry, strategic alliances allow the firm (Bradley, 2002): †¢ Access to assets not readily available in the market †¢ Access to technology and markets †¢ The smaller firms can have access to technology and new products †¢ The larger firms can have access to markets †¢ Synergetic effects in the partner firms. Choosing the way to enter a foreign market represents an important part of the foreign direct investment strategy. The companies should select the new market, decide upon the types of operations that are about to be developed on these markets and decide the type of entry –green field investments, acquisitions, joint ventures. Choosing the way to enter a foreign market was also explained through cultural and national factors. Many studies have been concerned about this topic: †¢ Kogut and Singh (1988) after researches have concluded that a big cultural distance between the country of origin and the host country have as a result choosing joint ventures or green field investments. †¢ Gatignon and Anderson (1988) have shown that an important socio-cultural distance, measured with the help of the Index developed by Ronen and Shenkar (1985) goes to the partial propriety right. †¢ Gatignon and Anderson (1988) have concluded that multinational companies avoid having 100% owned subsidiaries in high risk countries. †¢ Cho and Radmanabhan (1995) have shown that companies from Japan are not willing to make acquisitions in developing countries. Choosing the joint venture as a mechanism to enter new markets (especially the developing countries and the ones with centralised economy) is usually a sec ond-best option for the companies from developed countries. Still, the companies show through this the major interest for the local market; the participation in the joint-venture could be qualified as a foreign direct investment. Many times, this mechanism represents the only way to be present on a certain market. Licensing in international markets: License is the purchase or sale by contract of product pr process technology, design and marketing expertise (Bradley, 2002). It involves the market contracting of knowledge and know-how. International licensing takes place when a company provides, for a certain fee-royalty, a technology needed by another company in order to operate a business in a foreign market. Licensing of this firm involves one or more of these elements: †¢ a brand name †¢ operations expertise †¢ manufacturing process technology †¢ access to patents †¢ trade secrets. Licensing may be attractive when host countries restrict imports or foreign direct investment, or when the market is small and when the prospects of technology feedback are high. Franchising to enter international markets: Franchising is a derivative of licensing. In franchising a business format is licensed, not a product or a technology. Trademarks, trade names, copyright, designs, patents, trade secrets and know-how may all be involved in different mixtures in the „package† to be licensed. Franchising is a form of marketing and distribution in which the franchisor grants an individual or company, the franchisee, the right to do business in a prescribed manner over a certain period of time, in a specified place (Ayling, 1986). A franchise is, according to International Franchise Association (IFA), the agreement or license between two legally independent parties which gives: †¢ a person or group of people (franchisee) the right to market a product or service using the trademark or trade name of another business (franchisor) †¢ the franchisee the right to market a product or service using the operating methods of the franchisor †¢ t he franchisee the obligation to pay the franchisor fees for These rights †¢ the franchisor has the obligation to provide rights and support to franchisees. Types of Franchises There are two main types of franchises: product distribution and business format. Product distribution franchises simply sell the franchisor’s products and are supplier-dealer relationships. In product distribution franchising, the franchisor licenses its trademark and logo to the franchisees but typically does not provide them with an entire system for running their business. The industries where you most often find this type of franchising are soft drink distributors, automobile dealers and gas stations. Some familiar product distribution franchises include: Pepsi, Exxon, Ford Motor Company. Although product distribution franchising represents the largest percentage of total retail sales, most franchises available today are business format opportunities. Business format franchises, on the other hand, not only use a franchisor’s product, service and trademark, but also the complete method to conduct the business itself, such as the marketing plan and operations manuals. Business format franchises are the most common type of franchise. The United States, today reported that the 10 most popular franchising opportunities are in these industries: fast food, retail, service, automotive, restaurants, maintenance, building and construction, retail—food, business services, lodging. The many advantages and disadvantages of owning a franchise should be carefully evaluated before deciding to purchase one. Throughout all these different foreign market entry strategies, by understanding every characteristic detailed we can conclude that partnership can be at the core of international marketing decisions and enable possibilities of internationalisation. Partnerships can be structured in various ways depending on their purpose. Wholly foreign-owned enterprises, non-equity/contractual/co-operative strategic alliances, equity strategic alliances/joint ventures, and franchises, are basic types of formal partnerships. There are numerous other types of informal partnerships including; joint marketing promotion, joint selling or distribution, technology licensing, R D contracts, design collaboration, production agreements, and other synergies. Consequently, the ideal partner in a business partnership is one that has resources, skills and assets and values which complement the company. The partnership has to work financially and contractually, but it is also essential that a partner’s areas of strength and weakness are known and that an assessment is made of what actions would be needed to achieve an appropriate level of operational fit between the cultures of the two organisations. To meet the market needs effectively and in a sustained way, the business partnership must be based on a systematic and transparent agreement between the client and the partners (common values). That agreement provides the basis for a partnership deal and has to be sufficiently strong to engage the sustained commitment of both parties but also sufficiently flexible to enable the partnership to be responsive to changes in market needs and conditions. Being at the forefront partners are an extension of the company capability, image and valu es perceived by the consumer, therefore, complement the company by increasing the value to customers. For instance, Sony is an international and reputed company for its high standards range of TVs. Today, within the UK market, Sony position itself as a seller of durable and high end products by practicing a selective distribution. Their products are mostly found at Sony Centres (Sony own shop) or PC Currys World, exclusive partner (distributor) chosen by Sony well known in the market and sharing similar values such as expertise in the audiovisual area or guarantee of quality products and services. It reflects well a relevant and consistent image of the values conveyed by both organisations to the customers.

Accreditation Process Essay Example for Free

Accreditation Process Essay Accreditation refers to the recognition given to institutions which have fully met specific standards of educational quality by an agency or an association. In the US, the relevant agencies undertake a review of education quality at all levels including elementary, secondary, colleges and universities. The agencies set basic standards reflecting the qualities of sound educational programs (Hasley et al, 1986 pp 66). They then develop procedures aimed at determining whether the institutions and programs meet the set standards. Many other countries lack accreditation systems like those used in the US and instead rely mainly on government agencies to check their education quality and standards. In Canada, provincial government authorities work closely with private educational associations in periodically assessing the quality of universities, colleges and schools. Accreditation offers standards of excellence that help in encouraging educational institutions in improving their programs. It also provides accountability for institutions’ educational policy, and creates criteria for certifying professions like medicine and law.   Furthermore, it helps prospective students to identify quality institutions, while facilitating student transfer from an institution to another. Accreditation is also among the factors used in determining the institutions and programs eligible for receiving federal and private funds. The accreditation procedure for any agency entails five fundamental stages, each of which has many other subtasks under it. First, the agency must establish the criteria or standards of academic excellence in consultation with the educational institution being accredited. The second stage involves development of procedures enabling institutions to evaluate themselves deeply, to help in determining if they meet the set accreditation standards or not. In case they do not meet the established standards, the institutions must go back to the drawing board and make the necessary adjustments and improvements to satisfy the required demands. Depending on the level of compliance, this may require the institution to invest some more time and resources and resources into it. Thirdly, the agency performs an evaluation aimed at determining first-hand if the institution really meets the set standards. This involves examining the institution’s facilities as well as its resources, both physical and human. This is done until the agency is fully convinced that the institution meets its minimum requirements. The evaluation is done by the agencies’ experts, who are usually armed with specific requirements for accreditation. Fourthly, the agency then grants the accreditation to the institution after it is convinced that the necessary requirements have been met. It then publishes a list of institutions that have met similar requirements and have been awarded accreditation by the agency, including the time of the accreditation. Finally, the agency periodically reviews these institutions to find out if they still maintain educational quality standards. This is done to ensure the institutions do not compromise on the quality of educational standards. All accreditation agencies utilize these steps even though inspection procedures and specific criteria differ depending on the agency. Current issues in the accreditation process Problems of the Law School Accreditation Process For the past ten or so years, the American Bar Association’s accrediting arm has faced a lot of criticism with regard to its standards. The association has been accused of having poorly monitored standards that are not related to law school quality (Marty et al, 1991). Critics are of the view that ABA’s accreditation standards lack correlation with professional competence and institutional quality. The accreditation process puts emphasis on high cost inputs; like requirements for physical facilities, library collections and the number of professors available. Moreover, it considers test scores at law school admission, which has been criticized as not being related to professional skills and academic achievement. The association has also been accused of restricting low income students and minorities by putting too much emphasis on standardized tests as well as raising tuition fees (Luebchow, 2007). The critics have accused the ABA of being inconsistent and using secret rules, which are not made public or disclosed to schools, to make accreditation decisions. The Department of Education has also complained about ABA’s failure in abiding by the department’s specific requirements (Hagan, 2004 pp201). The Congress has also raised concerns about the association’s accreditation. Both the federal officials and law schools have often disapproved ABA’s accreditation process from the early 1990s. The Massachusetts School of Law, which has itself not been accredited, has for long strongly criticized the association. In 1993 the school sued ABA citing violation of antitrust law because it functioned as a cartel and set unfair standards that only raised costs, yet were not connected to law school quality. The Justice Department filed a similar suit in 1994, leading to a ten year consent decree, which is now defunct (Hagan, 2004). The Education Department has also crossed heads with the association over its failure to comply with the department’s criteria for recognition since the 1990s. These deficiencies led to the limiting of the association’s recognition to just three years in 1997. Later in 1998, the Education Department’s staff recommended the limiting, suspending or terminating the association’s recognition as nationally recognized accreditation agency (Luebchow, 2007).

Challenges in Caring for Dementia Patients

Challenges in Caring for Dementia Patients INTRODUCTION Dementia consists of a lot of symptoms that include lowering ability to do routine or familiar tasks, impairment of the memory, reasoning and judgment, behavior and mood changes. However, treatments are not yet available for the progressive, irreversible, dementias in which nerve cells in the brain become sick and eventually die. People experiencing dementia have been entitled the right to enjoy the highest possible quality of care and quality of life by engaging in meaningful relationships which are based on trust, respect, sharing, understanding, dignity and. TASKS These are the principles involving the person-centered approach on older people with dementia and other common geriatric health problems with respect to the following: Individuality Each and everyone are unique and do have different moral stance, ideologies, philosophies, social outlook, and even likes and dislikes in life. Approaching an individual that has dementia through a person centered type; one must acknowledge the person’s history, interests and hobbies and respect the person’s whole uniqueness. Emphasize the moral worth of people with dementia and other common geriatric health conditions. Rights Every person is empowered and entitled to human rights. It is important to protect people with dementia against people who might want to harm them. Knowing the rights of the person and respecting them allows the person with dementia maintain their dignity. Choice Regardless of the level of physical or physical impairment people with dementia, families and friends are supported and encouraged in partaking in the decision making and care at the way they choose. This includes the respecting their choices that are dealt in simple things they do every day. Privacy Every individual has the right to hold information about them from being exposed. The person has the control if they allow others to gain information or details about themselves. Privacy of the person should be respected and not to be spread for his honor and reputation. Independence Encouraging people with dementia to participate as much as possible on the physical activities on a daily basis. Maintaining the strength and flexibility on the person with dementia will promote independence. One activity that can help maintain the person’s strength and flexibility is physiotherapy. Dignity and Respect – Just like any other individual, people that have dementia or any other common geriatric health conditions are people first. Their choices and perspectives are to be honored and heed. They have an inherent value and dignity which must remain with them throughout the whole course of the disease and should be respected at all times. It is appropriate to include in the planning and delivery of care their families, their beliefs, spiritual backgrounds and values of people with dementia. Autonomy – Person with dementia or any other common geriatric medical condition should have the opportunity to create informed decisions about the treatments and care that are provided, and in collaboration with their healthcare professionals. Review of the non-person-centered approach to dementia and other common geriatric health condition’s care, from the: Institution perspective There are various implemented activities are created together in a single rational plan purposely to meet the official objectives and goals of the institution. There are many aspects that this perspective encompasses to sustain the well being and health of the person with dementia; such as their physical and social environment. Bio-medical perspective This mainly focuses on diagnosing and treating the person with dementia. It concentrates on the person’s behavior and symptoms and finds ways to lessen these through drug studies and treatments. Biomedical perspective means that the cause of symptoms and behaviors is assumed to be the individual involved. A biomedical understanding of dementia is necessary in guaranteeing the person has a correct diagno sis, to provide treatment and support from memory clinics and to gain the latest and most proper medical treatments. Range of techniques used to meet the wavering abilities and the needs of individuals with dementia and other common geriatric medical conditions to maintain their health and well being: Reality-oriented approach Reality orientation is a therapy that lessens the feeling of memory loss, confusion and mental disorientation and also better the self-esteem of the person with dementia. This involves displaying of information such as current dates, events, location, and names of people. And thus reinforced by orientation cues such as sign posts, photos, color coded doors, weather boards and labels on cupboards. Validation approach Validation approach is a therapy that places emphasis on the probable thoughts and feelings behind the behavior of the person, and rather than forcing the person to be in our reality, it propose that we are to join with the reality of that person. Validation therapy may suggest that we ask her questions about the family of the person with dementia, such as what the person misses most about his family and what is his favorite family get together. With this therapy, the response to a scenario may pertain not castigating the person and accepting the concerns of the person with dementia, but also communicating about their issues and bit by bit steering the conversation in a different direction. This will help them acknowledge the meaning of their feelings and thoughts and that it would reduce their distress. Assistive technologies Assistive technology would refer to any system or device that provides the person with dementia to carry out a task that they find difficult and unable to do, or maximise comfort and will provide safety with any activity can do. These devices will help people who have medical conditions with: eyesight, hearing, speaking, moving around memory and thought processing activities of daily livingactivities Assistive technology can promoteautonomy and independence, both for the person with dementia and those around them and will help manage potential risks in and around the home, facilitates the memory and will help improve their quality of life even with dementia or any other common geriatric medical condition. Reminiscence techniques This technique involves re-experiencing and recalling the persons events especially that matter in his lives. This technique uses talking about the things from his past using familiar objects, sounds and photos. This technique respects the life of the individual’s character and life story to improve in depression, loneliness and further the individual’s psychological wellness. Holistic approach Holistic approach takes into account the specific needs of each individual, may it be physical, emotional, and social aspect of the person with dementia. Properly eliminating the potential problems surrounding the individual such as lighting, noise clutter and tweaks can minimize anxiety and agitation of a person with dementia. The care plans in holistic type of approach is looking at specific need of the person with dementia, the individual should be involved in the design of the services, tailored according to their needs and meeting their aspirations in order to guarantee that the health care facilities will be able to provide the proper care to give to the person with dementia. Responsive and flexible approach Responsive and flexible approach can be used to help handle individuals in many of the behavioral conditions that are involving dementia, such as aggression, delusional thinking, and depression. It is acknowledging the independence of the person and focus on what suits the individual. It is more on matching the activity to the individual and lessens the emphasis on the completion of person care tasks at particular time rather than coercing them. The impacts of equality, and cultural and diversity issues on the provision of the person-centered approach to individuals with dementia and other common geriatric conditions within the: Public health and promotion There are heaps of organisations that promote health and provide support people with dementia. And organisations such as the World Health Organisation collaborates with government bodies around the world in order raise global awareness about people who are experiencing dementia and the support they need. Organisations such as The Health Foundation, made it a priority in advocating for action on proper treatment, intervention, and care for the individuals. These organisations aid in dissemination of these information about the people with dementia and the demand of care that these individual needs will better the services in health care facilities. Attitudes to health and demand for healthcare The increase of demand of health care and the outsourcing of health care professionals from other countries is due to the ageing population of the country. The ageing population increases the demand of health care professionals in rest homes, hospitals, nursing homes and other health care facilities The impacts that health sector standard and codes of practice and other published standards have on the person-centered practice approach for individuals with dementia and other common geriatric health conditions. The person centered type of approach concentrates on individuals rather than on the health condition. A person-centered type of approach to dementia and other common geriatric health problems acknowledges each individual are unique and have different values, personal history and behavior and that each individual has an equal right to be treated with respect, right to dignity, and the right to fully participate in their environment. Understanding and respecting the person with dementia will help the health care sectors provide a very effective and efficient health care service. RECOMMENDATION Person – centered type of approach in the health care sectors towards people with dementia or any other common geriatric health conditions will provide an efficient and effective health and social facilities, in which it involves understanding and respecting these individuals. Demonstrating sensitivity, seeking to engage with them through their aspirations and values, and understanding their spiritual, social and cultural background will provide a great help in improving the services in the health sectors. Maintaining and monitoring regularly these health care practices must be observed in order to provide the appropriate amount of care to give in the health care facilities. CONCLUSION Believing that providing support to people with dementia and experiencing these hurdles in life is an important part of being a health care professional. Understanding these individuals and respecting their social backgrounds, rights, privacy, uniqueness, dignity, independence and their value as a human being is a very important aspect in providing care towards people with dementia or even people with any other common medical conditions. I believed health care facilities specializing people with dementia will dramatically improve the health care services through applying the person centered type of approach towards their clients. BIBLIOGRAPHY Electronic Sources AlzheimerSociety. Guideline for care: Person centred care of people with dementia living incare homes. Retrieved on 08 August 2014 from http://www.alzheimer.ca/en/About-dementia/For-health-care-professionals/~/media/Files/national/Culture-change/culture_change_framework_e.ashx LeadingAge. Building a Person Centered Culture for Dementia Care. Retrieved on 08 August 2014 from http://www.leadingage.org/Building_a_Person-Centered_Culture_for_Dementia_Care_V3N5.aspx The Dementia Services Development Centre. An Educational Resource to Support Early Interventions for People receiving a Diagnosis of Dementia. Retrieved on 08 August 2014 from http://www.nes.scot.nhs.uk/media/351619/early_interventions_dementia_education_resource.pdf Julian Hughes. Models of Dementia Care: Person – Centered, Palliative and Supportive. Retrieved on 08 August 2014 from http://www.fightdementia.org.au/common/files/NAT/Paper_35_web_v2.pdf Alzheimer’s Association. Respect for Autonomy. Retrieved on 08 August 2014 from http://www.alz.org/documents_custom/statements/respect_for_autonomy.pdf Alzheimer Scotland. Dementia: autonomy and decision – making Putting into practice. Retrieved on 08 August 2014 from http://www.nuffieldfoundation.org/sites/default/files/files/Dementia_autonomy%20_decision-making.pdf Alzheimer’s/Dementia. What Is Person – Centered Care in Dementia?. Retrieved on 08 August 2014 from http://alzheimers.about.com/od/caregiving/fl/What-Is-Person-Centered-Care-in-Dementia.htm Alzheimer’s Society. Understanding and respecting the person with dementia. Retrieved on 09 August 2014 from http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=84 Alzheimer’s Association. Personal care: Assisting a person in the middle or late stage of dementia with daily needs. Retrieved on 09 August 2014 from https://www.alz.org/national/documents/brochure_personalcare.pdf NHS choices. How is dementia treated?. Retrieved on 09 August 2014 from http://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-treatment.aspx Keep In Mind. Holistic Dementia Care Solutions. Retrieved on 09 August 2014 from http://keepinmindinc.com/holistic-dementia-solutions/ StudyMode. Promote Person – Centred Approaches in Health and Social Care. Retrieved on 09 August 2014 from http://www.studymode.com/essays/Promote-Person-Centred-Approaches-In-Health-And-1577167.html National Institute for Health and Care Excellence. Dementia: Supporting people with dementia and their carers in health and social care. Retrieved on 09 August 2014 from http://www.nice.org.uk/guidance/cg42/chapter/person-centred-care Alzheimer’s Association. Assistive Technology. Retrieved on 09 August 2014 from http://www.alz.org/library/downloads/search_assistivetechnology.pdf Inclusive Solution. SEN Draft Code of Practice 2014 – Person – Centred Planning. Retrieved on 09 August 2014 from http://inclusive-solutions.com/sen-draft-code-of-practice-2014-person-centred-planning/

Flowers from the Storm Essay -- Literary Analysis, Jane Eyre

Romancing the Gothic Romance novels come in many different styles with a variety of subgenres, themes, and character blueprints. Jane Eyre and Flowers from the Storm are no different. Both Jane Eyre and Flowers from the Storm are romance novels, with Jane Eyre continuing early nineteenth century Romantic period traditions as well as a novel with a romantic relationship between two characters. Flowers from the Storm is a historical romance which is patterned after Bronte’s Jane Eyre. Laura Kinsale, author of Flowers, has won a variety awards for her writing, including the 1996 RRA-L Romance award for best all-time favorite romance for Flowers; Bronte’s Jane Eyre came in second. Jane Eyre, a novel by Charlotte Bronte, is a gothic romance about a plain governess and a dark hero who eventually fall in love with one another. Likewise Kinsale’s, Flowers from the Storm, delivers the same generic conventions with a religious, plain, young woman and a misunderstood hero, who come together to develop a lasting romance. Charlotte Bronte first published Jane Eyre in 1847, under the pseudonym Currer Bell, a novel which has since become a success by earning its way into the literary canon. Bronte was born in 1816 in Yorkshire England and studied at the Clergy Daughters' School. After leaving school she became ever more interested in writing and reading Byron, after whom she later fashioned Rochester. Joyce Carol Oates relays, â€Å"for Jane Eyre, whatever its kinship to eighteenth-century Gothic and however melodramatic certain of its episode [†¦], is nonetheless a work of stubbornly idiosyncratic intelligence.† (7) With the publication of Jane Eyre, Charlotte Bronte earned the respect of every generation that followed. Laura Kinsale, ... ...le for historical fictions and furthered the love of the style for many writers and readers alike. The romantic period is over. Yet the writers and characters who flourished in the period are still around in the homes and minds of many aspiring writers. Of course Charlotte Bronte and her peers are important to novels like Flowers and others like it. They are the blueprints for not only the way many authors write, but the way the readers expect the stories to unfold. They are the reason for the memory of the Romantic and gothic and their influence is the reason why so many choose to write the style. Forgetting which novel holds the most value, one must remember that literature doesn’t just refer to what’s in the literary canon; it also refers to what’s on the bookshelves in the homes across this country, because today, Jane Eyre is almost as popular as Flowers.

Creon As Tragic Hero of Sophocles’ Antigone Essay -- essays papers

Creon As Tragic Hero of Sophocles’ Antigone Since the play’s inception, there has always existed a contention concerning the true hero of Sophocles’ Antigone. It is a widely held belief that Antigone must be the main character simply because she and the drama share name. This is, of course, a very logical assumption. Certainly Sophocles must have at least meant her to be viewed as the protagonist, else he would not have given her the play’s title. Analytically speaking, however, Creon does seem to more categorically fit the appellation of â€Å"Tragic Hero.† There is no doubt as to the nature of the work, that being tragedy. Along with this genre comes certain established prerequisites, and Creon is the only character that satisfactorily fits them all. There are certain qualities that a character must posses in order to qualify as a tragic hero. Ideally, the subject is to be a person of high rank, so that they may have much to lose. (Most frequently a monarch is used.) Granted, Antigone is a member of the royal bloodline. But we must not forget that she is the daughter of incest, hardly a glamorous position to start with. In Oedipus Rex, Antigone was indirectly disgraced, while Creon was socially elevated by inheriting kingship from Oedipus. Also, Creon’s being king comparatively trumps Antigone’s lesser status of orphaned princess. While this in itself objectively proves nothing, it does at a minimum make Creon the more likely choice of protagonist. Another essential component of a tragic hero is that of the tragic flaw, the one attribute that causes the inevitable downfall of the character. A case could be made for Antigone’s hamartia being obduracy. She is called stubbornly wild in the play by both Creon— â€Å"Th... ...d no wrong. Antigone needs no redemption because she has committed no great misdeed. Creon, however, comes to see his grave mistakes after he has fallen from grace. Creon repents, and is even brought to the verge of suicide. Like all tragic heroes, he can only realize his vice once everything has been taken away from him. So who was meant to be the lead character of Antigone? Antigone. So who is the lead character of Antigone? Creon. Somewhere along the line, Sophocles found a more complex story in the insecure king than in the defiant noblewoman. Using Aristotle’s outline of Greek tragedy (which ironically was primarily based on Sophocles), Creon is the only character who meets the criteria. Creon started from the highest position, suffered the greatest net losses, and possessed the only inarguable flaw. Titles aside, the literary content speaks for itself.

Internet Censorship :: essays research papers

Internet Censorship For centuries governments have tried to regular materials deemed inappropriate or offensive. The history of western censorship was said to have begun when Socrates was accused "firstly, of denying the gods recognized by the State and introducing new divinities, and secondly of corrupting the young." He was sentenced to death for these crimes. Many modern governments are attempting to control access to the Internet. They are passing regulations that restrict the freedom people once took for granted. The Internet is a world wide network that should not be regulated or censored by any on country. It is a complex and limitless network which allows boundless possibilities and would be effected negatively by the regulations and censorship that some countries are intent on establishing. Laws that are meant for other types of communication will not necessarily apply in this medium. There are no physical locations where communications take place, making it difficult to determine where violations of the law should be prosecuted. There is anonymity on the Internet and so ages and identities are not known this makes it hard to determine if illegal activities are taking place in regards to people under the legal age. As well, it is difficult to completely delete speech once it has been posted, Meaning that distributing materials that are obscene are banned becomes easy The American Library Association (ALA) has a definition that states censorship is â€Å"the change in the access status of material, made by a governing authority or its representatives. Such changes include: exclusion, restriction, remove, or age/grade level changes.† This definition, however, has a flaw in that it only recognizes one form of censorship-governmental censorship. Cyberspace, a common name for the Net, has been defined by one author as being "made up of millions of people who communicate with one another through computers. It is also "information stored on millions of computers worldwide, accessible to others through telephone lines and other communication channels "that" make up what is known as cyberspace." The same author went on to say " term itself is elusive, since it is not so much a physical entity as a description of an intangible." The complexity of the Internet is demonstrated through its many components. The most readily identifiable part is the World Wide Web (WWW). This consists of web pages that can be accessed through the use of a web browser. Web pages are created using a basic programming language. Another easily identified section of the Internet is e-mail. Once again it is a relatively user-friendly communication device. Some other less publicized sections of the Internet include: Internet Relay Chat (IRC), which allows real time chatting to

Facility Planning

To provide patients with quality health care services, it is important to improve health care facilities and build new facilities to accommodate the growing population. Community or facility need for the building or renovation An emergency room is an area in a hospital that provides treatment to patients with acute illness, trauma and other medical emergencies. Harlan Medical Center provided emergency care to 25,000 patients last year. This makes the facility the most experienced and busiest hospital in the area. To accommodate the growing demand of services I have decided to renovate the department. Renovating the emergency room will make a huge difference in terms of capacity for serving the community. Type of population you are serving HMC emergency department will provide quality health care services to every individual in the community. The new renovations will services the residents of Harlan, and the resident of all the surrounding counties with the population of more than 250,000. As mentioned before the emergency department provides patients with rapid treatment for sudden illnesses or trauma. The patients are made up of different races, genders and ages. Description of the facility that you have selected The proposed renovations to the new emergency room will be greatly beneficial and invaluable to the medical center. Making the renovations should not only improve treatment times but should also attract new patients to the facility. The first renovation would be the addition of 22 new private treatment rooms. These rooms will be used for patients with more serious injuries as they will be treated as VIP (very important person) guests. For some people a trip to the ER is unnerving in itself. However, if having a private room can provide a sense of calm and ease nerves, then having a private room is exactly what the patient should get. The second improvement will be the addition of 16 general treatment rooms. These treatment rooms will be geared toward patients with less serious injuries. The goal of these rooms will be to turn them over within two hours or less to keep patient census low and discharges steady. A third improvement that will help keep discharges steady will be the addition of 2 â€Å"fast-track† rooms for rapid medical evaluation. The concept â€Å"fast-track† is just what it means; fast service. The fast track rooms will be for treatment of acute illnesses such as stitches and nose bleeds, etc. The goal of the â€Å"fast-track† rooms will be to diagnose and treat the patients with minor injuries within an hour or less. However, by doing this will allow for acute treatments to be handled swiftly and more in depth cases to be handled accordingly. There will be multiple dedicated staff working in each area of the new ER. Finally, the last addition to complete the new renovation will be two new trauma rooms. This addition will allow for multiple serious cases to be treated and transported into the facility that might otherwise be treated elsewhere. Shorter wait times along with faster discharge ratios should definitely entice new patients to come to the facility and generate new revenue. Conclusion Emergency department are the busiest departments in a medical center. To cut back on wait time for patients a renovation needed to take place. With all the new addition to the emergency department patients wait time will be shorter and rapid discharge ratios will keep patients coming back. We all know the saying first impressions are everything and the same holds true with emergency departments.

American Civil War Essay

The founding father approximately concerned with discharge speech and free religious transaction was Thomas Jefferson, who had already implemented several similar protections in the constitution of his home state of Virginia. It was Jefferson who in conclusion persuaded James Madison to propose the news report of Rights, and the first-class honours degree Amendment was Jeffersons top priority. The First Amendment states Congress sh entirely make no fairness respecting an establishment of religion, or prohibiting the free exercise thereof or abridging the freedom of speech, or of the press, or the right of the people pacifically to assemble, and to petition the Government for a sort out of grievances.It is the bedrock of the Bill of Rights, the first cristal amendments of the war paint that define the basic rights of all who croak in the United States. It changed the commission we were up to(p) to live our lives and protect our nation. Our Constitution is one of the only lasting ones in history. This amendment has been successful because it is meant to protect our citizenship from tyranny or every violations of our freedom. This is the first and key amendment because it addresses our rights and freedoms as human beings first.It has helped, along with checks and balances, federalism, other amendments, to save up America for and by the people. We hold non changed this amendment even to today, but abided by it. Immigrants establish fix to our country for generations seeking these real things freedom of religion, speech, etc. The sixteenth amendment is an all-important(a) amendment that allows the federal regime to collect an income valuateation from all Americans. Income tax allows for the federal government activity to keep an army, build roads and bridges, go through laws and carry out other important duties.The federal government realized in 1913 that in order for it to collect taxes inwardnessively, and non have to share that tax si lver with the states, federal income tax was necessary. there was an income tax before the 16th amendment, and it was in effect during the Civil fight. This income tax ended in 1866. The desire of Americans to pass an income tax on the rich was strong in 1909, when electric chair William Taft proposed a 2% of big businesses agnize as corporations.Following this lead, Congress wrote the 16th amendment and after agreeing on the rules of the amendment about income tax, send to the states to be voted on. Although many northern states did not like the idea of an income tax in the 16th amendment, western states strongly back up it. For the amendment to become give away of the constitution, 36 states postulate to adore it. The 36th state to approve the 16th amendment was Delaware in 1931, al nigh foursome years after the first state, Alabama, ratify the 16th amendment in 1909.The 16th amendment became part of the constitution after it was ratified and since thence the federal gov ernment has collected taxes from Americans each year on their income. 16th amendment affects us very much. For those who pay income taxes, the pay most of it to the Federal government. And most of our governments money comes from these income taxes. If it were not for the 16th Amendment, we would have a dramatically different organisation of taxation, or the government would be essentially unable to function in any way similar to the way it does now.There would be no social protective covering or Medicare. We would not have been able to intervene in World War II. We probably would never have come out of the Great Depression unless we had a revolution. In conclusion amendments have changed our government and society. United States was very much influenced by these amendments. If it wasnt for these amendments the United States wouldnt be where it is right now. People from all about the world wouldnt want to live in the United States, if it wasnt for these amendments.