Death of a Salesman- Essay-Reflection Essay

In Death of Salesman, the conflicts that the characters face through out in the play, can be interpreted as reflections of the problems in America’s society today. The majority, if not all of these problems can be traced back to Willy Loman as the source. Willy Loman’s longing to be successful (either actually through himself or through his sons) was the origin of all the other problems, and was the reason he could not control himself and he ruined his life and his family. The most obvious societal problem face in the play is greed. Willy’s obsession with having money is a perfect symbol of the larges part of society, the part whose lives revolve around acquiring money, and having â€Å"the best†. The people have unrealistic expectations just like Willy. In Act 1, Willy is hallucinating about his brother Ben and he says, â€Å"The man knew what he wanted and went out and got it! Walked into a jungle, and comes out, the age of twenty-one, and he’s rich!† (41). Willy and countless people in today’s society, have unrealistic expectations, and are never honestly satisfied. They are willing to do anything to get to the top, even if it means hurting others, and most of the time they are left with nothing. Just like Willy in the garden, muttering, â€Å"Nothing’s planted. I don’t have a thing in the ground†; because they have done nothing substantial with their lives and have not â€Å"planted† anything (122). They used all their time concerned with money and neglected to invest in anything concrete, like real love, and having a family. They have no real lives outside of materialistic things, just like Willy. Willy’s constant disregard for others and their lives is another example of a problem America’s society faces being represented in the play. In today’s society, it is seen as expectable to push others down, and put your self first. In Death of a Salesman, Willy does this constantly when it comes time to be honest and care for his family. Willy’s actions greatly affected his family, and were the reason for many of Biff, Happy and Linda’s problems. When he was fired, Willy said, â€Å"I was fired and I am looking for a little good news to tell your mother, because the woman has waited and suffered†(107). Willy, like many people with any sort of conscience today, feels bad and wants to tell Linda that he was fired (something that will  drastically effect his entire family, especially considering their already pending financial problems), but this want is smothered by his need to have â€Å"good news†. This want is essentially just a ploy to make him feel better about himself, so once again Willy puts Linda second to his own needs, which is really the reason for all the waiting and suffering she had to do. This disregard, is also obvious in today’s society, one person’s actions can affect the whole community. Like in the case of all the terrible decisions George Bush. George Bush made decisions for the country, that were not for the common good, but his good, and now America is left picking up the pieces now that he’s gone. Many people argue that a major problem with the order of today’s society is that people no longer respect their elders. Arthur Miller, obviously saw this occurring even in the 1950 when he wrote the book. Willy raised Biff and Happy, putting all in hopes, dreams and inhabitations into them. But when they were old enough no to have to depend on them anymore, they walked away from him. Linda even acknowledges it and says, â€Å"It sounds old fashioned and silly but I tell you he put his whole life into you and you’ve turned your backs on him†(60). Biff and Happy used their father to become who they were, but when he needed them to live, they walked away from him. This is even more obvious of the problems faced today when looked at as if Willy represents all the older people in our society. The elderly are looked down upon, are thought to be crazy, and have their jobs, license and overall most real concessions, taken away for no reason other than age. We discriminat e against people who should be our equals and treated with respect. Peer pressure, is not just something that effects school aged children on the playground. Adults are pressured every day by, family, friends, co-workers into doing things that do not necessarily want to do. This is a tremendous problem in society because most of the time when people are doing something they do not want to do they are going to be upset. This feeling of being upset, usually leads to emotions that are more drastic such as being stressed and just completely lost and unhappy. Willy’s pressure on the Biff and Happy is the perfect example of this pressure to do things you normally would not do. Willy constantly says through out the play, â€Å"the man who makes  an appearance in the business world, the man who creates personal interest, is the man who gets ahead. Be liked and you will never want†, this pressure to be well liked is what pushed Biff to neglect his school work and Happy to only care about pleasing woman and his father (30). Willy always pushed the boys to have and to be the greatest at everything they did. But in the end Willy’s pressure pushed the boys to make reckless decisions and made them feel like they could never do enough to please their father. Biff took to stealing and even admits that his father’s pressure got to him in Act 2 when he says, â€Å"I never got anywhere because you blew me so full of hot air I could never stand taking orders from anybody!† (131). Pressure can sometimes be positive, like when it pressure pushes you to give your best effort, and sometimes negative, like when it causes you to conform excessively. As in the case of Happy, who by the end of the play, even after his father kills himself is determined to follow in Willy’s foot steps and even says, â€Å"It’s the only dream you can have – to come out number-one man. He fought it out here, and this is where I’m gonna win it for him† (139). The biggest complaint that is heard from adults about today’s youth is the constant feeling of entitlement. Even when unjustified. Willy’s outlook on his life is a perfect example on teen’s unjustified feelings of entitlement in today’s culture. In the scene where he goes to talk to Howard about his job, Willy says, â€Å"You can’t eat the orange and throw the peel away-a man is not a piece of fruit.† (82). Willy feels that Howard (the son of the father who had formerly promised Willy that he would be rewarded for his service to the company) has gone back on the word of his father by forgetting the salesman in his golden years, throwing away the peel after eating the orange, so to speak. But what Willy does not realize is that Howard owes him nothing, and neither did his father. Anything people do out of kindness is simply that, kindness. Students sometimes think that just because they received a good mark in a class that it will automatically be the same the next quarter, and aren’t always willing to do the work needed to earn the grade. But what Willy and countless others don’t realize is that no one is owed anything. During and argument Willy has with his son, Biff makes the comment, â€Å"Pop! I’m a dime a dozen, and so are you!† This infuriates Willy who counterattacks, â€Å"I am not a dime a dozen! I am Willy Loman, and you are  Biff Loman!† (132). Seen through Willy and people thought the world, entitlement is an illusion that blinds our work/life ethic and us. Death of a Salesman shows both family and societiatal conflicts; however, these conflicts are definitely more powerful when looked at as societal problems .It forces you to evaluate the ethics and principles of the culture we live in. and how they eventually reflect the things we truly hold important. However the reflection is not just the problems, but also all the damage that results from making those the most valued things. Death of a Salesman is a disheartening play but it is an honest reflection of our society. Bibliography: Miller, Arthur. Death of a Salesman. New York: 1949. Print.

Innovation in Agriculture

Indian organizations have acquired a reputation for organizational and social innovation and strategies centered round new concepts of frugal innovation. It has been suggested that some of these developments reflect specific socio-economic and framework conditions peculiar to the Indian context. At the same time many Indian firms have yet to institute systems and procedures required for supporting technological, product and service innovations. The existence of formal R&D departments/divisions, offers a ritualistic fig leaf for innovation practice. The absence of organizational support and a holistic innovation strategy coupled with an integrative perspective obscures or limits the development of a proactive innovation strategy. The paradox of Indian innovation suggests that the necessity of developing and managing the abundant supply of human resources in the country is central to its conceptualization and realization. These innovations get manifested mainly in two different patterns, one of which relates to the management of human resources within organizations, and the other to the creation of social enterprises for the development of human resources outside; the latter may also take the form of CSR initiatives by corporate organizations. One of the implications of the ‘abundant supply of human resources in the country’ is that Indian organizations have to adopt people-focused business strategies rather than the command structures cantered round the use, performance and incentivisation of human resources. This issue probably makes India different from Western countries and there is a big opportunity both for comparative research and best practice exchange. A second interesting implication of the above is that over the years there has been a phenomenal growth in the number of social enterprises in India, which are different from commercial enterprises in having ‘social development’ (rather than ‘profit-making’) as their main objective. For this reason they are likely to be perennially operating under resource constraints, which make it difficult for them to survive without innovations. The aim is to investigate innovative HR and other related strategies adopted by Indian commercial as well as social enterprises. Innovation is rarely a product of the internal resources of the firm alone. Relations with other organizations are likely to be crucial to the success f innovations. We also wish to explore how innovations in Indian firms are influenced by their relations with other organizations. Topics to be covered in the presentation will include (but are not restricted to) the following: * Principal types and characteristics of innovations in Indian firms * HR innovations in Indian firms * Innovations in Indian social enterprises Role of public bodies in supporting firms’ innovation * Organizational constraints and facilitators of innovation * Innovation in different types of industries (manufacturing/service, h i-tech/low-tech, small/medium/large, etc) * Innovative relationships with other organizations * Support for innovations from inter-organizational relationships * Sources, means and types of information and knowledge important for firms’ innovation * National and regional innovation systems * Costs, benefits and impacts of Innovations Please note that the deadline for paper submission is  2nd January 2012.

The Stupidest Angel Chapter 22

Chapter 22 A PERFECT LONESOME CHRISTMAS The archangel Raziel hovered outside the Santa Rosa Chapel's big cathedral window, looking through a small pane of pink glass that formed Saint Rosa's cheek. He smiled at his handiwork, then beat his great wings and flew off to find some chocolate to sustain him on his trip home. Life is messy. Would that every puzzle piece fell into place, every word was kind, every accident happy, but such is not the case. Life is messy. People, generally, suck. This year, however, the Lonesome Christmas party in Pine Cove was coming off with clarified joy, an infectious goodwill, and a general harmony of spirit that shone in the guests with a smooth, high polish – a no-mess affair. â€Å"Theo,† Molly said, â€Å"can you grab the other lasagna pans out of the back.† She was carrying two of the long stainless-steel pans herself, and she was careful to bend at the knees as she set them down on the buffet table to keep the back of her short cocktail dress in the realm of decency. It was a plunging neckline LBD (little black dress) she'd borrowed from Lena just for the party – the first low-cut thing she'd worn in years. â€Å"We could have barbecued after all,† Theo said. â€Å"I told you fucksticks that the storm would turn south,† Mavis Sand growled as she sawed the end off a baguette like the moyl at a titanic bris. (Some people's goodwill shines differently than others'.) Molly set down her lasagna and turned around into the arms of her praying mantis of a husband. â€Å"Whoa, sailor, Warrior Babe's got work to do.† â€Å"I just wanted to tell you,† Theo said, â€Å"before everyone gets here, that you look absolutely stunning.† Molly brushed her hand across her neckline. â€Å"Scars don't do that, do they? They don't just disappear overnight like that, right?† â€Å"Doesn't matter to me,† Theo said. â€Å"Never mattered. Wait until you see what I got you for Christmas.† Molly kissed him on the chin. â€Å"I love you, even if you have mutant tendencies; now free me, Lena needs help with the salad.† â€Å"No, I don't,† said Lena, coming out of the back room carrying a huge salad bowl. Tucker Case followed close behind with a stainless caddie of dressings. â€Å"Oh, Theo,† Lena said, â€Å"I hope you don't mind, but Dale is going to come by in his Santa suit tonight.† â€Å"I thought you guys were in combat,† Theo said. â€Å"We were, but he surprised me a couple of nights ago when I was stealing some of his Christmas trees, and was just losing his temper when Tucker happened along and popped him in the nose.† Tucker Case grinned. â€Å"I'm a pilot, we're used to handling tense situations.† â€Å"Anyway,† Lena continued, â€Å"Dale was drunk. He started crying, getting maudlin, talking about how he was having trouble with his new girlfriend, saying how he hated that everyone saw him as the evil developer, so I invited him here. Thought maybe if he could do something nice for the kids, it would make him feel better.† â€Å"No problem,† Theo said. â€Å"I'm glad you two are getting along.† â€Å"Hey, Theo!† yelled Joshua Barker as he ran across the chapel floor toward them. â€Å"Mom says Santa will be at the party.† â€Å"A quick appearance, Josh, then he has to get on his route,† Theo said. He looked up to see Emily Barker and her boyfriend/husband/whatever Brian Henderson coming across the room. Brian was wearing a red Star Fleet Command shirt. â€Å"Merry Christmas, Theo,† Emily said. Theo hugged Emily and shook Brian's hand. â€Å"Theo, have you seen Gabe Fenton?† Brian asked. â€Å"I wanted to show him the shirt, I think he'll get a kick out of it. You know, nerd solidarity.† â€Å"He was here a little bit ago, Brian, but then Val Riordan arrived and they were talking. I haven't seen them for a while.† â€Å"Maybe they went for a walk. Beautiful evening, isn't it?† â€Å"Isn't it,† said Molly, coming to Theo's side. â€Å"He said he was good with weather,† said the Narrator. â€Å"Shhhhhhh,† said Molly. â€Å"Pardon?† Brian said. Out behind the chapel, the dead were feeling festive as well. â€Å"He's going to do her right here in the graveyard,† said Marty in the Morning. â€Å"Who would have thought a shrink could moan like that. A little carnal scream therapy, huh, doc?† â€Å"No way,† said Bess Leander. â€Å"She's wearing Armani, she's not going to mess up that outfit.† â€Å"You're right,† said Jimmy Antalvo. â€Å"They'll just suck face and take the party home for makeup sex. But how do you know she's wearing Armani?† â€Å"You know what?† said Bess. â€Å"I have no idea. Just a feeling, I guess.† â€Å"I do hope they sing ‘Good King Wenceslas, † said Esther, the schoolteacher. â€Å"I just love that song.† â€Å"Has anyone seen the biologist's dreadful dog?† asked Malcolm Cowley, the dead book dealer. â€Å"Last year the beast urinated on my headstone three times.† â€Å"He was sniffing around a minute ago,† said Marty in the Morning, â€Å"but he went inside when they started to bring the food out.† Inside, Skinner was sitting under the Christmas tree, looking at the strangest creature he'd ever seen. It was hanging from the lower branches, but it didn't look like a squirrel, or smell like food; in fact, it had a face that looked like another dog. Skinner whimpered and sniffed the air. If it was a dog, where was its butt? How could he say hello if he couldn't sniff its butt? He took a tentative step back to study the thing. â€Å"What are you looking at?† said Roberto.

An analysis of the long and short term causes of world war 1 Essay

An analysis of the long and short term causes of world war 1 - Essay Example People believed their state to be superior and when this feeling entered the negotiations between rival countries, reaching to peace was near impossible. The crisis also came because of long series of diplomatic and military treaties between countries. When one country was supported by other countries it considered itself on the winning side in the war. This meant that when these great powers met opposition from one of the rivals, they were ready to fight a war rather than back down from it. The Triple Entente made up of France, Russia and Britain, was strong enough to fight against The Triple Alliance (Italy, Germany and Austria-Hungary), The Balkans and The Ottoman Empire. Historians also believe imperialism to be the reason to start the war. The increasing tension between world empires to acquire as much trade and colonies as possible led to conflicts between them. Fights over trade route and foreign resource had started much before the Great War. By controlling foreign territorie s and markets, France and Britain had accumulated large wealth. On the other hand, Germany, Austria-Hungary and Italy all wanted to attain this economic advantage, resulting in greater tension between these empires. Common interest between some of these countries led to further and stronger alliance. Each country believed itself to be right and tried to follow a policy to extend its authority over foreign countries and colonies. The hostility between the world powers over this authority is significant in the Berlin-Baghdad Railway. This would have given Germany access to Iraqi oil and trade to Persian Gulf. Britain knowing the importance of the issue created a blockade to the Persian Gulf, excluding others from it. The arms race and presence of militarism in the large empires of the world made them confident of their victory in case the war was declared. The belief of Europe that the war would be â€Å"over by Christmas† shows the level of their confidence over their strength . Also, the feeling that a war was impending and inevitable, gave countries a strong reason to build up their military forces. This led to an increase in an arms race, where each country tried to be prepared to strike before the other did. In planning to begin mobilization before others and avoid the defensive position, military planning became a priority in most countries, resulting in an increased fear of war. The immediate cause of the war however was the ‘third Balkan crises. The Balkan and Morocco crisis occurred one after another and so led to a devastating result-the World War I. Serbia and Russia fought against Austria-Hungary for territory and influence in the region. After the Balkan wars, near bankruptcy and during a political crisis, Serbian military leaders trained and armed three Bosnian students to assassin the Archduke Franz Ferdinand of Austria. On 28 June 1914, he was shot dead along with his wife. The political motive behind this assassination was to break o ff Austria-Hungary's south-Slav provinces and combine them into a Greater Serbia or a Yugoslavia. In retaliation, Austria decided to end the South Slav separatism. It also issued an ultimatum of forty-eight hours, which asked for Austrian officials to be allowed to collaborate in the investigation and punishment of the assassinators. The ultimatum contained several very severe demands. Although both United Kingdom and Russia sympathized and agreed

Personal Learning Achievement Essay Example | Topics and Well Written Essays - 750 words

Personal Learning Achievement - Essay Example Moreover, I was engaged in team development activities through which I achieved trust and team loyalty. 1. Type of course activities helped me achieve those criteria Commitment, open-mindedness, dedication and readiness to learn are the main attributes that helped me meet the expectations of each activity. My greatest achievement was the realization that effective interpersonal communication is valuable when team members lend each other a listening ear while at the same time establishing conclusions on one another’s input. It is also precise that if a member tries to outshine others, effective interpersonal communication may not be achieved. Self-regulation is a key personal aspect that should prevail. Through group work, I was able to handle long and tough tasks that could not be solved by individuals (Duke & Appleton, 2000). 2. How I met the service, scholarship, or social change expectation through each activity as related to the framework's learning outcomes The service, s cholarship, or social change expectation outcomes were achieved through participation in service programs. Scholarship enables one to acquire knowledge and use it properly without disruptions. This allowed for easy interaction between research, theory and practice. I am able to communicate effectively and I can manage information technology tools for professional delivery of nursing services. Through the training, I have changed positively and I now understand better the patient needs and how I should handle them from a social perspective. 3. The insights I have about where I started, where I am now, and where I may go. How I would write my personal and professional goals now When I first went to practice, I had a negative attitude because I felt that the profession is too demanding especially in patient management. I thought the occupation created prolonged necessities and specialized training. There was the nagging thought of self-inefficiency, I felt like I did not have enough bo dy of knowledge to handle the numerous responsibilities and roles that I was supposed to perform. However, through this training, I have come to understand what a professional does. The skills that range from talking to listening are now clear to me. I have realized that nursing is an interactive profession, which involves interfaces with patients. Through (Kohl, 2000), I comprehended that confidentiality arises from a distinct relationship that is established between the patients and their caregivers. In this way, patients are free to seek medical attention, counseling, advice and treatment. However, I have realized that nurses have to tolerate aspects of hope, failure, fears and dreams that are presented by patients. The nurses take up this idiosyncratic dimension of professional life in meditative writing. I now know that nursing is one of the professions that need endless advancements. It calls for an all-time learning, which makes use of distinct understanding and skills. SUMMA RY OF THE LAST QUESTION 4. How my perception of the nursing profession was, my chosen specialty, and who I am as a nurse changed on this journey to become a master's-prepared nurse Initially I had an exceptionally different perception on nursing as a profession. I thought nursing as a profession does not require any drive or passion to pursue it. However, as I embarked on the course I realized that nursing requires more than the urge of pursuing it. In essence, nursing requires passion and

Malaria Research Paper Example | Topics and Well Written Essays - 1000 words - 1

Malaria - Research Paper Example For the female Anopheles mosquito to live and reproduce it must first consume blood meals, which provides the link between human beings and the mosquito genus’s life cycle. There are several vital factors that support the development of the malaria parasite in the mosquito from the "gametocyte" to the "sporozoite stage† stage. Mosquito’s Life Cycle These factors are humidity and temperature, which are directly proportional to the parasites’ rate of growth into adult mosquito. The female anopheles mosquito undergoes the four life cycle stages of egg, larva, pupa, and adult with the first three stages lasting between 5 and 15 days, varying from one mosquito species to another. It is in its adult stage, which lasts between 1 week and 1 month that the female anopheles mosquito acts a malarial vector (Fairhurst & Wellems, 2009). It lays between 50 and 200 eggs on water surfaces, which hatch after 2-3 days into the larvae stage in which the head, spiracles-for br eathing, larvae thorax, segmented abdomen, and mouth brushes for feeding are developed. At the pupae stage, which could last between 5 and 14 days, the head and the thorax merge to form the cephalothorax as the abdomen curves around underside. The adult stage is characterized by slender bodies composed of head, thorax and abdomen. Epidemiology According to the World Health Organization (WHO), of the 216 million reported cases of malaria in 2010, 655,000 deaths were reported, implying 2000 deaths due to malaria every day. Reportedly, most of the reported cases affected children of five years and below in age (Shah, 2010). The other vulnerable group is pregnant women with about 125 million pregnant women reported to be at risk of infection each year. Regionally, sub-Saharan Africa is the most affected by malaria in general and maternal malaria in particular, the latter resulting in an estimated 200,000 infant deaths every year (Shah, 2010). Although no efforts have been spared in erad icating and treating malaria in the last two decades, little has been achieved in reducing its risks and effects. This situation is made worse by the fact that malaria cases in the remotest parts of the world are not reported or treated as would have been expected. In accessibility and unavailability of health care facilities and information are specifically to blame for the negative effects of malaria and the lack of documentation of many cases of malaria from all over the world (Shah, 2010). Signs, Symptoms, Tests, and Diagnosis of Malaria The well known signs and symptoms of malaria are as caused by the release of merozoites into the bloodstream and the anemia, which results from the destruction of the red blood cells. Besides the female anopheles mosquito, mother-to-baby transmission and blood transfusion are the other mechanisms by which malaria could be transmitted (Fairhurst & Wellems, 2009). As mentioned earlier some of the signs and symptoms of malaria are anemia, bloody st ools, convulsion, muscle pain, nausea, chills, coma, sweating, fever, headache, jaundice, and vomiting. The diagnosis of malaria is a rather crucial step in its treatment hence should be highly regarded by patients and physicians. In medical examinations, enlarged liver and spleen could indicate the presence of malaria. However, confirmation using malaria blood smear at 6-12 hour intervals is highly recommended. To confirm the presence of m

Case study for subjest ( Strategic Leadership in Criminal Justice ) Essay

Case study for subjest ( Strategic Leadership in Criminal Justice ) - Essay Example e criminal justice setting are faced with several dilemmas when it comes to implementing disciplinary actions that would foster a positive change among subordinates. This paper seeks to analyze one of a typical leadership dilemma in the criminal justice setting. I am Gary Hart, a leader of a small team of correctional officers at the Undon Correctional Facility. It has come to my attention that one of my team members and subordinates has been engaging in poor work practices. By poor working practice, I mean the team member is reported to be involved in unexplained absenteeism, sleeping on night shift, not making mandatory security checks and so on. Presently, I have undertaken a performance review meeting to outline the work performance concerns with the officer and develop an action plan to improve performance. The performance review meeting involves the team member in question. I am quite nervous of the meeting and issues to be raised by the team member is going to be because based on previous performance review meetings that I have had with the team member, it is likely that the team member will be very defensive about his work performance and will seek to blame management for this behaviour. My real dilemma therefore has to do with choo sing one leadership theory and design ways of making this leadership theory in the wake of the current leadership dilemma. The criminal justice setting is an important agency of our national development (Abion, 2001). Exceptionally important is the role played by the various correctional facilities. The Centre for Mindfulness and Justice (2011) notes that â€Å"the role of correctional employees is to provide safety for community residents, inmates and employees residing in and working in correctional facilities.† This makes the correctional facility a transformation centre where people are expected to leave with a lot of change of behaviour and character. People are expected to leave the correctional facilities, becoming

Web Site Evaluation Paper Essay Example | Topics and Well Written Essays - 750 words

Web Site Evaluation Paper - Essay Example The essay "Web Site Evaluation Paper" discovers the evaluation of Forbes website. The website defines the credentials of the author by showing that he was part of the Great Premium Content Experiment at AOL as a media columnist for the business website Daily Finance. As such, he has authority and credibility to author this web page. Moreover, the introductory materials reveal that the author was motivated to publish this information on the web. In fact, the author claims that he would be bored if things were not different which means he is motivated to publish this information on the web. Ultimately, the website provides the contact information of the author by offering his email address, his twitter account, and his Google account, which means that the audience can respond to his works and interact with him freely. The website’s purpose to inform, explain, or persuade is very clear. The title of the website reflects a clear opinion that the website seeks to pass to the target audience. The title, â€Å"Larry Page: Google Should Be Thinking Bigger with Its R&D† reflects a clear purpose to inform, and persuade the audience. Indeed, the site is explicit, as the title leaves no room for confusion or doubt about the author’s point of view. In fact, the website starts by introducing the author’s points of concern, which are some of the blue-sky products that Google is developing now. The website indicates clearly that the author has an affiliation with a specific organization by asserting that Jeff Bercovici is Forbes. staff. It goes ahead to give the organization’s domain as part of the author’s contact information by giving his email as jbercovici@forbes.com (Bercovici 1). Most of all, the website does not indicate its specific audience since it claims the author covers media, business, entertainment, and technology. We can establish that the topic covered by the website is very clear since it is explicit. However, part of the audience might not know what the initials R&D mean in this context and hence some ambiguity. The website equally uses an easy language to present the relevant information discussing the topic and thus its clarity and effectiveness. Notably, the site exhibits suitable depth and comprehensiveness to fulfill its purpose. To this effect, the website uses relevant information, presents the inner and crucial details of the company in reference, quotes the views of relevant business leaders (Bercovici 1), and integrates all pieces of information to support the author’s view. Indeed, the information presented by the website clearly supports the opinion of the author. It uses historical evidence like when it quotes the example of Google’s massive success in mobile (Bercovici 1). It also quotes the actual words of Google CEO, Larry Page who sought to persuade investors on the viability of the current project. The website clearly states the sources of information and we can indeed ascertain that the information is original. This is because the author uses direct quotes to state what

Declaration of Independence- Thomas Jefferson Final Term Paper

Declaration of Independence- Thomas Jefferson Final - Term Paper Example Distinctively enumerated into exceptional divisions, the writer demonstrated some rare writing skills that make it one of the best literal state papers. The Declaration of Independence can be divided into an introduction, a clearly developed preamble, a section describing the indictment of the Crown, denunciation of the American oppressors (the British) and a good conclusion. Any paper passing the test of good writing must at least show such organization. Throughout the document, artistic or literary devices (rhetoric devices) can be pointed out to prove the fact that the writer must have had tremendous proficiency with the topic of artistic discourse. With the topic of the Declaration of Independence at hand, this paper will tackle Thomas Jefferson’s rhetoric and the play of words he had used in the formation of this historical document. With the basis of textual analyses of the Declaration of Independence, historical interpretations will be conducted in order to explain the American context under the British colonial government. This paper will also explain the educational background of Thomas Jefferson – one that honed him as an eloquent writer of the mentioned document. Before going into the analyses of the Declaration’s text, it is important to give light to its author Thomas Jefferson. Although history has had laughable doubts of according Jefferson the credit of the text authorship, controversies of such nature are interesting to tackle. One good example of a weak school of thought that the authorship of the Declaration of Independence could be not of Thomas Jefferson is the belated publication of Mecklenburg Declaration. Mecklenburg Declaration which was allegedly duplicated by Jefferson. But as the proponents of this thought steadfastly argued, the controversy was later found out to be a â€Å"hoax†. It was disproven by Jefferson himself. Scholars

Sex Offenders has to be related to criminal justice Essay

Sex Offenders has to be related to criminal justice - Essay Example An attempt will be made to establish the extent to which criminal justice can be leveled against sexual offenders. A conclusion summarizing the main points discussed in the essay will be given at the end of the essay. In order to get a clear understanding about the topic, it is imperative to begin by defining the term sexual offence. A sex offence can be loosely defined as abuse of another person which mainly involves deriving sexual pleasure from that person without consent. For instance, research has shown that rape within marriage, which has not always been recognized as a crime, is a growing area of concern in American criminal justice, and many laws have been enacted during the past few decades to deter it. â€Å"Similarly even though UCR/NIBRS Program statistics officially report only the rape or attempted rape of females, some states statutes criminalize the rape. In 2007, for example, sixth-grade Wilmington, Delaware, science teacher Rachel L. Holt, a 34-year-old divorcee, w as sentenced to 10 years in prison after pleading guilty to second-degree rape. She had initially been charged with 28 counts of first-degree rape---which prosecutors said was based on the number of times she had had sex with a 13 year-old male student whom she had supplied with alcohol and let drive her car,† ( Frank Schmalleger, p. 49). ... ibes certain norms of conduct that bind all members of the state upon which it has a jurisdiction to punish a person who transgresses against these norms. As far as criminal law is concerned, the state is there to act against the defendant and criminal justice is seen as an effective tool of dealing with particular acts by the members of the society that are considered to be in violation of the prescribed norms. For partners to engage in sexual activities, there must be common understanding between them and they should first reach an agreement so that no one will feel betrayed or abused. It can be noted that there are many different forms of sexual offences and these range from rape, fondling, juvenile prostitution and sexual exploitation through child pornography. Basically, rape and child sexual abuse are more rampant forms of sexual offenses during the contemporary period. A closer look at the trends of sexual offences reveals that rape cases are on the rise in different states an d these often take different forms but all the same, this will constitute a criminal offence. A crime involving sexual abuse without consent is in violation of the societal norms and values which are protected under the public law. Criminal justice has to be effected in such scenarios. Cases involving rape within marriages have significantly gained prominence during the contemporary period especially in the US as noted above. This type of offence used to be treated lightly but some of the sexual aggression displayed to another partner can be classified as a criminal offense. Indeed, married people form the union out of love and common understanding but in some cases, when it comes to the subject of conjugal rights, there may be no common understanding between the married partners. If a

Architecture in the Modern Arab and Islamic World Essay - 1

Architecture in the Modern Arab and Islamic World - Essay Example The US embassy in Baghdad was built to these specifications. It was designed by Josep Serts taking into consideration the need to protect the building and staff and be able to withstand explosions at the same time. Serts bold design was to crown the ambassadors residence with a spectacular concrete canopy. The canopy as seen from an aerial view, evoked some striking geometric patterns that highlighted the ceramic tiles and wood inlay. In addition, the concrete canopy was constructed to specifications that would provide protection for the ambassador and staff, should there be an aerial attack. On the other hand, the US embassy in Baghdad is a fortress that few can see. Such a building in Iraq defied the Islamic architectural traditions and instilled little confidence in the government. Furthermore, critics argue that the Americans built the US embassy with its security modifications in order to signify its strength and impose its will on the surrounding areas. Also, in some opinions, the embassy depicts one of the most beautiful and well designed modernist structures in the region. In conclusion, the rise of the US embassy in Baghdad symbolized a successful architectural experiment for the region, which paved the way for further transformation decades later, with thought-provoking and original Western influenced

How Cooking Free

How Cooking Frees Men Article Essay This article explains how the discovery in cooking foods has dramatically changed the way we live, and the amount of time freed up by spending less time chewing. Raw food takes much longer to eat than soft cooked foods. The discovery of cooking changed our social division of labor between men and women. The Hadza tribes are foragers; hunters and gathers, and now that cooking food is possible, the men hunt for meat, while the women forage the land for anything edible. When the men come back to the village, the women hope they have meat or honey to provide, but if they come empty handed, the women have the food they have gathered already prepared for the hungry men. The men and women share their food with one another, their children, and extended family. Even though my family and I are not foragers, this sounds very similar to the same way I was brought up. My father would make the money that paid for the food, while my mother would stay home to raise us children and cook. She always had dinner ready for my father whether he was coming home from work or home after looking for a job. Either way, we always had food on our table. There were even summers that we had to pick fruit with my mother on farmers land so we can have canned fruit stock our pantry. We would forage in the fall walnuts that have fallen off a walnut tree on the side of some road, so she can make banana nut bread. As a child I was put to work on several occasions to help my mother, and that was not the same way my brothers were raised, they would be allowed to go hunting or fishing with my father. Even though my family and I are not foragers we have a lot of similarities with the Hadza tribe and how they divide their labor based upon gender and age. Foragers follow the method of hunter and gatherer, to collect their food. They form small communities of mainly family; immediate and extended family. The men hunt for food while the women and children forage for edible plants. The tribes join occasionally to celebrate things; and they share their food. The Hadza believed if a single man provided the meat for the day, he would divide the food with his family first, and then divide it amongst the rest of the tribesmen. Foraging may have been the way to gather food in the beginning of man (several small tribes still live as foragers, like the Hadza tribe). Today, America and many other countries use intensive agriculture; we use machinery to irrigate and fertilize to increase our surplus. This is necessary because of our population; we are not only a few like the foragers. We are primarily controlled through a government, as apposed to moving about with a village. My first impression of this article was not too great; I felt the writer discussed the difference of chew time within too much detail. I understand the concept of â€Å"less time chewing = more time†. What I found most interesting, and gained insight from, was the knowledge that cooking food to make it soft, freed up the time of man. Without that simple action of cooking our food, man would be very different today. Not just time wise, but that was the start of division of labor within a family. This is still practiced within many American families and tribes that still live off the land. I think a big difference between us and them (which there are a few tribal foragers still today), they live creating little impact on their environment, while we seem to not care so much about the harm we do to ours. I feel because of more time, we not only have the means to relax and socialize, but we also abuse it. We are not as active, and to some people their social part of life is their most important. So because of more time, people are becoming obese, lazy, and gossipy. That pretty much sums up over half of the American population.

Strategic Development of Starbucks

Strategic Development of Starbucks STARBUCKS INTRODUCTION The Starbucks coffee company was founded in the year 1971. The starbucks headquarter is situated in Seattle, Washington (USA) Starbucks operates a chain of branded coffee shops in around more than 35 countries of the world. The outlets offer hot and cold coffee drinks and few food items such as beans, coffee accessories and teas. The Starbucks owns 7100 of outlets which located more than 10 countries but most of the stores situated in USA. The major process of enlargement of starbucks started from 1982 when Howard Schultz joined the company in order to see the marketing and the retailing activities. Since then Starbucks has evolved from a modest $0.5 million business to a whopping $6.4 billion of turnover. In this assignment the time frame of 5-25 years and analyze development of Starbucks along with strategies applied and the present scenario of the organization with the help of Porters five competitive forces, SWOT analysis and value chain analysis. The future recommendations to Starbucks would also be included in this assignment. 1 ANALYSIS OF THE PAST THE STRATEGIC DEVELOPMENT OF THE STARBUCKS In 1971 Starbucks was settle in Seattle (USA) In 1984 Mr. Howard Schultz join Starbucks to boost up marketing and retailing Starbucks acquire 5 stores in San Franciscos peet coffee and Tea chain in 1984 In 1985 Starbucks start the espresso bar concept in their store In 1986 Schultz left Starbucks In 1987 Starbucks expands in the American market by starting its outlets in British Columbia and Chicago In 1992 Starbucks get listed with its first public stock offering with 165 business comprise outlets In 1996 Starbucks open its branch in Tokyo (JAPAN) In 2003 Starbucks continues to open branches all over the world and reached 6400 0utlets worldwide In 2008 the global recession hits Starbucks badly, due loss in business Starbucks shuts 600 outlets all over the world In 2009 Starbucks released a public long-term growth strategy that included meeting customer need for quality and value as key goal 1.2 THE STRATEGIES APPLIED BY STARBUCKS Integrate horizontally Starbucks has gone for acquisition of a large number of companies in abroad market, and expanded their outlets whole over the world. This strategy gave Starbucks a chance to reach customers whole over the world. For instance Starbucks acquired Seattles Best, Torrefazione Italia and Coffee People. Penetrate the market To increase the market share, Starbucks has differentiated itself in providing a unique experience to its customers by giving specific themes in stores. The product mix consists of different beverages to suit peoples needs. Starbucks have also tied up boost up company profitability with other beverage companies such as Pepsi co and Kraft food. Developing the market Starbucks has developed the market for specialty coffee industry for America. In this context, Starbucks has created brand awareness and demand for coffee stores amongst American population. This is enabled by better market penetration through apt store locations and standardized services offered all through the world. Diversification strategy To gain higher market share, Starbucks has provided a diversified product mix. To move forward starbucks produced new product linked with beverage business. This strategy helps Starbucks to grow both on the base of the operations and overall proportion of services. They have developed unique products and at the same time acquired companies like Ethos water. The product differentiation has been its core competence all through since its inception. Alliances strategy The Starbucks also applied alliance strategy to became player in the leisure and service industry, and not only a specialty restaurant business, Starbucks has tied up with companies like i-Tunes to create the Hear Music campaign and XM Studios to offer customized music services for Starbucks customer, which has helped Starbucks to attain a level of niche over a period of time where even the nations where its presence is still at a nascent stage. CSR strategy Starbucks have also applied the CSR strategy to enhance the brand image and they also funded non-governmental organization to improve the level of literacy amongst the educationally backward communities. Starbucks also run the Green Store campaign to reduce the usage of paper cups. A 10% discount was given to customers who brought their own mugs to the store. Its latest campaign of Fair- trade coffee has spread on a subtle yet widespread manner. 1.3 CRITICAL SUCCESS FACTORS FOR STARBUCKS The important factors that helped Starbucks to associate with success in the initial years of its operations are as follows: Market Research The factor market research helps Starbucks to apply the strategy to move forward their business through expansion. In year 1980 Starbucks expanded to Chicago. This helped management to learn how to expand business over the country. In the years 1991 Starbucks moved to California. This was a major strategic decision that came in after a lot of market research. Employee Motivation and Rewards One of the major success factors of Starbucks has been its employee motivation and giving time to time performance base incentives. One of the major steps taken by Starbucks to retain their employees was to increase the health and safety benefits for employees who worked more than twenty hours in a week. The top management to select the right employee for the right job in the store in order to reduce employee turnover ratio. First Movers Advantage In the year 1987 under the supervision of Howard Schultz Starbucks open 150 store in the first 5 years. Being the only player in the market Starbucks profits were huge enough to allow them invest in their expansion plans all over the world. Catalogue Retailing In the early years of the companys operations, Starbucks started the process of catalogue retailing. This played a major role in determining the location of stores for Starbucks. Starbucks had a catalogue which comprised of a range of packed coffee beans with their prices. Consumers from along the world ordered them and looking at the zonal preferences the store locations were decided. 2. ANALYSIS OF THE CURRENT SCENARIO AS starbucks is a popular coffee company so we look at a scenario of the period around 2008 and 2009. In this section we will look at the strategies of Starbucks through SWOT analysis, Porters 5 forces analysis 2.1 SWOT ANALYSIS STRENGTHS Strong Brand Image Starbucks has been ranked amongst the top 100 brands in the world consistently over the last ten years. Innovative marketing strategies and its cost effective campaigns Starbucks have created brand awareness among the American population. High visibility of store in the market helps Starbucks to attract more customers and make company more profitable. Starbucks has maintained a high level of service through which it has achieved a consistent level of customer satisfaction with strong relationship with its supplier. The global presence of the Starbucks with quality based services of food and beverage, at the same time entertained their customer with music and internet in their stores. Starbucks is applying the innovative strategy to provide unique themes in their store to make their customer loyal to brand. One of the strong strength of Starbuck is his CEO Mr. Howard Schultz. Due to efficient HRM strategy to motivate and time to time performance based incentive and giving proper training to staff according to job specification. WEAKNESSES The one of the weakness of Starbucks is lack of internal focus and too much think to expand their business. Increasing number of the competitor in the growing market such as Dunkin Donuts, Nestle and Tim Horton (Bramhall). The dependency of Starbucks in US market, Starbucks company earn its more than 70% of revenue only from the US market however they have presence more 35 country in the world and market cannibalization. The weak financial position in the market due to the recent global recession in the 2008. Starbucks has loss in the share price and they have shut more than 600 stores. OPPORTUNITIES The continuously expand their store globally with expansion into the retail market and advancement of technology by using different kind of coffee machine in their store. Emerging international market specially BRIC nation Brazil, Russia India and China to plan to expand in these countries. Starbucks also continue to expand in the rural area of US and also segment the high populated area of the city. Brand expansion through selling T- shirt and coffee mug to their customer in their store on discounted rates. THREATS Competition in the market (restaurant, street cart, supermarket, other competitor such as McDonalds and Dunkin Donuts. The chain such as Dunkin Donuts and McDonalds do not serve coffee is a core product but they give food as well to their customer in cheap prices than Starbucks. US market saturation and coffee prices volatility in developing coffee producing country such as Brazil, India etc. US consumer trends towards more health ways and away from caffeine. The current economic recession is a major threat for Starbucks since they had to close down a large number of stores around 600 stores leading to declining profits and large level of unemployment. Large size of the Starbucks Corporation cause in decrease in quality of customer services. 2.2 STARBUCKS VALUE CHAIN ANALYSIS All firms consists of activities that links together to develop the value of business, Starbuck main activity includes in the value chain human resource management, marketing and retailing operations. In this section of assignment the value chain can be used to analyze the different competencies of Starbucks and then competencies will be discussed in later section. The core competencies of the Starbucks lie in its human resource management, marketing and retailing activities. Infrastructure In this activity includes planning of store locations, controlling such as financing, accounting and corporate strategy etc (lynch 2003). Human Resource Management Due to the global expansion the Starbucks faces a lot of problems in the management human resources. Starbucks have faced the problem of high level of employee turnover, but deploying right human resource still remains one of their key competencies. The company still believes that employees are its biggest assets. Starbucks continues to maintain a high level of corporate culture due to above industry standard employee benefit plans and employee stock exchange and ownership plans. Procurement The procurement relates to purchasing the material that is necessary for Starbucks. Efficient procurement of the starbucks is about buying highest quality coffee on lowest prices form developing countries. Marketing Marketing of Starbucks play a vital role to boost up profitability globally as Starbucks is strong coffee brand. Most of the advertising campaigns include, online advertising and store advertising. Retail Sales Starbucks is mainly focus on store retailing around 80% Starbucks sales come from store sales. Consistent upgradation of service levels by hiring the right people for right job in store through efficient HRM practices. 2.3 ANALYSIS OF THE STARBUCKS USING PORTERS FIVE FORCES MODEL COMPETITIVE RIVALRY The Starbuck faces strong competition from small domestic coffee players and large competitors in the market. The high price factor leads to decrease in sales compared to other coffee player all over the world. BARGAINING POWER OF SUPPLIERS The overcrowded market of the US is the main cause of to increase the barraging power of supplier because most of the farmers growing coffee beans are now united together to sell coffee beans. They started certified coffee beans through the fair trade policy in the US. BARGAINING POWER OF CUSTOMER High pricing is the main reason for decrease in sales. The low switching cost in the industry plays a negative factor to the companys growth by increasing the bargaining power of buyer. THREAT OF NEW ENTRANTS The specialty coffee industry does not put a high premium on economies of scale. Most players in the specialty coffee industry have developed their own distribution channels in their own countries, thereby gaining greater economies of scale and reducing cost. The low cost imposes an entry barrier for new players who want to set up an international chain, thus reducing their threat. The high differentiation within the specialty coffee industry made possible to establish brand that could act as barrier to entry. The specialty coffee retail store may switch high cost to new player, cost such as ambience and skilled employee in the store giving complimentary drink or any food to make customer loyalty. Therefore it may become difficult for new player to set business in the specialty coffee. So threats from the new entrants relatively low. THREAT OF SUBSTITUTE PRODUCTS The primary substitutes to the specialty coffee company such as Starbucks from the beverage companies make caffeinated soft drinks such as Pepsi and Coca Cola, which has the caffeine inherent in the specialty coffee; at significantly lower prices.(Quelch 2006) The tea is also a substitutes in some country such as UK, the English people like different kind of tea instead of coffee 2.4 FINANCIAL PERFORMANCE OF STARBUCKS In year 2008 Starbucks hit by the loss in share prices because of world economic recession and net income down by 70% and the figure 1.4 show that how badly Starbucks affected in the world economic recession hence the chairmen announce the report of decline share prices to $ 9.33 of Starbucks Corporation. Starbucks is well positioned company to challenge any economic recession with strong cash flow and solid balance sheet. The year 2008 strongly hurt Starbucks with shutting down 600 store, loss of 6700 job and $ 500mn operating cost saving for 2009. Mr. Schultz cut in their salary $1.2mn to $ 10000. Here in the figure 2.5 show that clearly result operation with the information of net revenue, balance sheet of between 2004-08 and also shown that the stores information in the percentage and store opened in the between 2004-08. 2.5 ORGANIZATION STRUCTURE OF STARBUCKS CORPORATION Finance Marketing CEO Howard Schultz HOW Deputy Legal Compliance CFO Administrator Board of Directors Global Coffee Procurement Legal Global Logistic Supply Chain Operation Partner Resource (Hr) Us Retail, Human Resource Development Greater China Public Affairs International Development Consumer Food Services Consumer insight Support US development Global beverages Global Development Marketing Seattle Best Coffee France International EMEA Retail Japan China Starbucks Coffee Us Asia pacific CIO And Digital Ventures North East/Atlantic North West / Mountain South East/ plain Western Pacific 3. FUTURE RECOMMENDATIONS Strategic future recommendation to overcome from the declining profits of the Starbucks would be mentioned below. 3.1 EXPAND INTERNATIONALLY Expand internationally is one of major strategy starbucks has applied to become most profitable specialty coffee company. The one of the major problem Starbucks face continuous declined in the sale of in stores. The main reason for this is Starbucks is self cannibalizing its own business in the United States. Cannibalization is the negative impact of a companys new product on the sales performance ofÂÂ  its existing related products. Therefore Starbucks should focus more on opening stores in growing economies such as BRICK nation where the product purchase power is high among the people of India and the Middle Eastern countries, Brazil and Russia rather than on just concentrating on US market. Starbucks should have to think about international expansion primarily for two reasons. The first reason being that because many developing economies lack the penetration of specialty coffee chains. For many countries Starbucks can adopt the Market Development strategy to strengthen their brand, gain more market share and minimize their risks. Second reason for international expansion is that, migrating to different countries would give Starbucks a chance for product innovation. For example Tazo tea was first tested and tried in the Japanese market and then it was introduced in US market. 3.2 FRANCHISING Starbucks should have concentrate on the franchising model like McDonalds is doing in to expand whole over the world. Most of the Starbucks stores are company owned company operated stores. This strategy is good but not good to survive long term profitability this increases the cost of control, it he case of franchising they can minimize control and concentrate more on building up their quality and maintain their high brand image, something similar to what McDonalds, pizza hut and Dominos have done over the years in US market and globally. The practice of expansion through franchising would also help Starbucks in entering potential markets such as India and speared in the Middle East country. In India, the foreign direct investment (FDI) restrictions allow only 49% investment of paid up capital by any foreign retailer. This restriction is playing a major role in Starbucks entry to the country. Franchising would allow Starbucks overcome such problems. 3.3 INTRODUCE LOYALTY CARDS To make any company profitable the loyalty of customer may plays a vital for the Starbucks. It has been observe Howard Schultz has envisioned selling coffee at a lower price in order to attract new customers. According to my view the overall price cut would tarnish Starbucks brand image in the eyes of the loyal customers, who have been committed with the company due to strong brand image. However the price cutting policy should not be left away completely. It should be practice at certain places where the demographic income is low, in other places discount should be introduced customer loyalty card and point reward system for instance retail companies Tesco, Sainsbury, and Mark Spencer. With every purchase made at a Starbucks store points will be added to the customers loyalty cards. The customers will have schemes to redeem these points at specific time to get price discounts or extra quantity of product. 3.4 CORPORATE THEME STORES Starbucks can come up with a new theme of stores which is the corporate theme stores specially to keep in mind corporate people. In this theme, Starbucks should remodel store to keep in mind the interest of corporate people. Starbucks store should have to be situated in the commercial business places such as Westminster, Holborn in London and if look at the US Manhattan in New York. The facility should include free Wi-Fi internet, corporate business Magazine and financial times Newspaper availability in the morning. There should be any specific area in stores for corporate meeting to make extra revenue for the company. 3.5 LEISURE THEME STORES Starbucks should also have stores with leisure theme that should have a comfortable and lively ambience that encourages people to come to the stores for a peaceful time. These stores should have facilities such as soft music, instant digital photography for taking snaps and arranging get-togethers like parties and official meetings. Many pubs and bars have pictures of their regular customers and special events. Similarly, Starbucks can also have a wall dedicated to pictures of local customers or memorable events in the store. This will help Starbucks to maintain a close relationship with its customers and will attract potential customers. 3.6 CONTINUOUS IMPROVEMENT OF THEIR PROCESSES A recent survey conducted in the year 2008 showed that people prefer more of McDonalds coffee than Starbucks. Starbucks recently has failed to deliver newer exotic range of flavours. Variety is missing in their menu. Hence from time to time the company must review its coffee making process and consider renovating their equipments and technology from time to time. 3.7 EMPLOYEE TRAINING AND MOTIVATION The most important asset for any company is their employees, as Starbucks is expand already in more 35 countries in whole over the world with strong brand name; with the closure of large number of stores and lay off of over 6000 staffs, Starbucks have lost a considerable amount of its employees. So to keep in mind the starbucks should have review on their recruitment processes and give them proper training regarding to their work area. For the job satisfaction and to motivate team member company should have give performance based incentive and paid holidays. It should hence now identify new leaders for the future, from the existing sales team members. The company should have give the chance of cross training in other department of the company and according to the performance company should have to give internal job promotion. 3.8 CORPORATE SOCIAL RESPONSIBILITY (CSR) For food and beverage company should also have to keep in mind environmental issue and minimize wait. Now days all service company are using Corporate Social Responsibility (CSR) as strategy and its work for brand awareness among domestic people. Starbucks should also invest more in developing products and services that are more eco friendly and would also enhance the companys brand image. For instance they should use porcelain and glass mugs in the stores rather than paper cups. This would minimize the usage of paper. Also they should encourage customers to use recycle bins in stores that would allow recycling of food waste. REFERENCES Larson.C.Ryan; 17/4/2008; Starbucks a Strategic Analysis Anders, George, Starbucks brews a new strategy; Fast Company; July 2001; Issue 49:144. Datamonitor Report Starbucks Corporation, May 2006; www.datamonitor.com Adamy, J. (2007, November 15), At Starbucks, Too Many, Too Quick, Wall Street Journal. 2008, January 7 McDonalds takes on Starbucks; http://online.wsj.com/article/sb119967000012871311.html 2008, February 22; Starbucks Cuts 600 positions, http://online.wsj.com/article/sb120362397558983703.html http://www.starbucks.com

Pressure Ulcers: Reliability of Risk Assessment Tools

Pressure Ulcers: Reliability of Risk Assessment Tools The purpose of this assignment, is to identify a patient, under the care of the district nursing team, with a Grade 1 pressure ulcer, to their sacral area. To begin with, it will give a brief overview of the patient and their clinical history. Throughout the assignment the patient will be referred to as Mrs A, in order to protect the patients identity and maintain confidentiality, in accordance with the guidelines set out by the Nursing and Midwifery Council (NMC 2008). A brief description of a Grade 1 pressure ulcer will be given, along with a description of the steps taken in assessing the wound, using The Waterlow Scale (1985). This assignment will discuss the literature review that was carried out, along with other methods of research used, to gather vital information on wound care , such as the different classifications of wounds and the different risk assessment tools available. This assignment, will include brief overviews, of some the other commonly used pressure ulcer risk a ssessment tools, that are put to use by practitioners and how they compare to the Waterlow Scale. This assignment will also seek to highlight the importance of using a combination of clinical judgement, by carefully monitoring the patients physical and psychological conditions, alongside the at risk score calculated from the Waterlow Scale, in order to deliver holistic care to the patient. Mrs A is a 84 year old lady who has been referred to the district nurses by her General Practitioner, as he has concerns regarding her pressure areas . Following a recent fall she lost her confidence and is now house bound. She now spends more time in her chair as she has become nervous when mobilising around the house and in her garden. She has a history of high blood pressure and occasional angina for which she currently takes Nicorandil 30mg b.d. as prescribed by her General Practitioner , Nicorandil has been recognised as an aetiological aspect of non healing ulcers and wounds (Watson, 2002), this has to be taken into consideration during the assessment and throughout the management of her wound. Mrs A has no history of previous falls or problems with her balance. She has always been a confident and independent lady, with no current issues surrounding continence or diet. She has always enjoyed a large network of friends who visit her regularly. It is recommended by National Inst itute for Health and Clinical Excellence (NICE) that patients should receive an Initial assessment (within the first 6 hours of inpatient care) and ongoing risk assessments and so referrals of this nature are seen on the day, if it is received if not within 24 hrs. In order to establish Mrs As current risk of developing a pressure area, an assessment must take place. An initial holistic assessment, looking at all contributing factors such as mobility, continence and nutrition will provide a baseline that will identify her level of risk as well as identifying any existing pressure damage. A pressure ulcer is defined as, a localised injury to the skin and / or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing, or confounding factors, are also associated with pressure ulcers. According to the European Pressure Ulcer Advisory Panel (EPUAP 2009), the significance of these factors, is yet to be elucidated. Mrs A is more vulnerable to pressure damage, as her skin has become more fragile and thinner with age (NICE 2005). There are risk factors associated to the integrity of the patients skin and also to the patients general health. Skin that is already damaged, has a higher incidence of developing a pressure ulcer, than that of healthy skin. Skin that becomes too dry, or is more moist due to possible incontinence, is also at higher risk of developing a pressure ulcer than healthy skin. An elderly persons skin is at increased risk, because it is more fragile and thinner than the skin of a younger person. Boore et al (1987) identified the following principles in caring for the skin to prevent pressure damage, skin should be kept clean and dry and not left to remain wet. The skin should also not be left to dry out to prevent any accidental damage . Due to Mrs A spending more time sitting in her chair, she has become at a higher risk of developing a pressure sore, as she is less mobile. The reason being It becomes difficult for the blood to circulate causing a lack of oxygen and nutrients to the tissue cells. Furthermore, the lymphatic system also begins to suffer and becomes unable, to properly remove waste products. If the pressure continues to increase and is not relieved by equipment or movement. The cells can begin to die, leaving an area of dead tissue resulting in pressure damage. Nelson et al (2009) states, pressure ulcers can cause patients functional limitations, emotional distress, and pain for persons affected. The development of pressure ulcers, in various healthcare settings, is often seen as a reflection of the quality of care which is being provided (Nakrem 2009). Pressure ulcer prevention is very important in everyday clinical practise, as pressure ulcer treatment is expensive and factors such as legal issues have become more important. EPAUP (2009) have recommended strategies, which include frequent repositioning the use of special support surfaces, o r providing nutritional support to be included in the prevention. In order to gather evidence based research, to support my assignment. I undertook a literature review of the Waterlow Scale and Classifications of Grade 1 pressure sores. The databases used were the Culmulative Index to Nursing and Allied Health Literature (CINAHL) and OpenAthens. I used a variety of search terms including pressure sores, Grade 1 classification, Waterlow Scale, and How pressure sore risk assessment tools compare. Throughout the literature review the information was gathered from sources using a date range between the years of 2000 2011, although some references were found from sources of information that are from a much later date. This method of research ensured a plethora of articles and guidelines were collated and analysed. The trust guidelines in wound care were used, to show how we implement theory into practise in the community, using the wound care formulary. There was a vast amount of information available, as pressure area care is such a broad subject. The search criteria had to be narrowed down, in some cases to ensure the information gathered was relevant and not beyond the scope of the assignment. The evidence used throughout this assignment, is based on guidelines and recommendations given by NICE (2001), EPUAP (2001) and articles sourced from The Journal of Community Nursing (JCN). This was the most accurate information and guidance on pressure ulcer classifications and assessment although, some articles may not have been the most recent. The assessment tool used throughout my area of work, is the Waterlow Scale. The Waterlow Scale was developed by Judy Waterlow in 1985, while working as a clinical nurse teacher. It was originally designed for use by her student and is used to measure a patients risk of developing a pressure sore. It can also be used as a guide, for the ordering of effective pressure relieving equipment. All National Health Service (NHS) trusts have their own pressure ulcer prevention policy, or guidelines and practitioners are expected to use the risk assessment tool, specified in their trusts policy. NICE (2003), guidance states, that all trusts should have a pressure ulcer policy, which should include a pressure ulcer risk assessment tool. However, it reminds practitioners that the use of risk assessment tools, should be thought of as an aid to the clinical judgement of the practitioner. The use of the Waterlow tool enables, the nurse to assess each patient according to their individual risk of dev eloping pressure sores (Pancorbo-Hidalgo et al 2006). The scale illustrates a risk assessment scoring system and on the reverse side, provides information and guidance on wound assessment, dressings and preventative aids. There is information regarding pressure relieving equipment surrounding, the three levels of risk highlighted on the scale, and also provides guidance, concerning the nursing care given to patients. Although the Waterlow score is used in the community setting, when calculating the risk assessment score, it is vital that the nurse is aware of the difference in environment the tool was originally developed for. The tool uses a combination of core and external risk factors that contribute to the development of pressure ulcers. These are used to determine the risk level for an individual patient. The fundamental factors include disease, medication, malnourishment, age, dehydration / fluid status, lack of mobility, incontinence, skin condition and weight. The external factors, which refer to external influences which can cause skin distortion, include pressure, shearing forces, friction, and moisture. There is also a special risk section of the tool, which can be used if the patient is on certain medication or recently had surgery. This contributes to a holistic assessment of a patient and enables the practitioner to provide the most effective care and appropriate pressure relieving equipment. The score is calculated, by counting the scores given in each category, which apply to your patients current condition. Once these have been added up, you will have your at risk score. This will then ind icate the steps that need to be taken, in order to provide the appropriate level of care to the patient. Identification of a patients risk of developing a pressure sore is often considered the most important stage in pressure sore prevention (Davis 1994). During the assessment a skin inspection takes place of the most vulnerable areas of risk, typically these are heels, sacrum and parts of the body, where sheer or friction could take place. Elbows, shoulders, back of head and toes are also considered to be more vulnerable areas (NICE 2001). When using the Waterlow tool to assess Mrs As pressure risk, I found she had a score of 9. According to the Waterlow scoring system she is not considered as being at risk as her score is less than 10. As I had identified in my assessment, she had a score of 2, for her skin condition due to Grade 1 pressure ulcer to her sacrum. I felt it necessary, to highlight her as being at risk. A grade 1 pressure ulcer on her sacral area, maybe due to her recent loss of confidence and reduced mobility which has left Mrs A spending more time in her chair. Pressure ulcers are assessed and graded, according to the degree of damage to the tissue. The National Pressure Ulcer Advisory Panel (NPUAP), classifies pressure ulcers based on the depth of the wound. There are four classifications (Category/Stage I through IV) of pressure damage. In addition to these, two other categories have been defined, unstageable pressure ulcers and deep tissue injury (EPUAP, 2009) Grade 1 pressure damage is defined, as a non-blanchable erythema of intact skin. Indicators can be, discolouration of the skin, warmth, oedema, induration or hardness, particularly in people with darker pigmentation (EPUAP, 2003). It is believed by some practitioners, that blanching erythema indicates Grade 1 pressure damage (Hitch 1995) although others suggest that, Grade 1 pressure damage is present, when there is non-blanching erythema (Maklebust and Margolis, 1995; Yarkony et al, 1990). The majority of practitioners, agree that temperature and colour play an important role, in identifying grade 1 pressure ulcers (EPUAP, 1999) and erythema, is a factor in alm ost all classifications (Lyder, 1991). The pressure damage usually occurs, over boney prominences (Barton and Barton 1981). The skin in a Grade 1 pressure ulcer, is not broken, but it requires protection and monitoring. At this stage, it will not be known how deep the pressure damage is, regular monitoring and assessment is essential. The pressure ulcer may fade, but if the damage is deeper than the superficial layers of the skin, this wound could eventually develop into a much deeper pressure ulcer over, the following days or weeks. A Grade 1 pressure ulcer, is classed as a wound and so I have commenced a wound care plan and also a pressure area care plan. I will also ensure, Mrs A has regular pressure area checks in order to prevent the area breaking down. The pressure area checks will take place weekly until the pressure relieving equipment arrives, this will then be reduced to 3 monthly checks. Dressings can be applied to a Grade 1 pressure ulcer. They should be simple and offer some level of protection. Also, to prevent any further skin damage a film dressing is often used, or a hydrocolloid to protect the wound area (EPAUP, 2009) . These dressings will assist in reducing further friction, or shearing, if these factors are involved. It is considered the best way to treat a wound, is to prevent it from ever occurring. Removing the existing external pressure, reducing any moisture, which can occur if the patient is incontinent and employing pressure relief devices, may contribute to wound healing. Along with adequate nutrition, hydration and addressing any underlying medical conditions. The advice given to practitioners, on the reverse of the Waterlow tool is to provide a 100mm foam cushion, if a patients risk score is above 10. As Mrs A has an at risk score of 9, with a Grade 1 pressure sore evident, I feel it appropriate to provide the pressure relieving mattress and cushion to prevent any further pressure damage developing. All individuals, assessed as being vulnerable to pressure ulcers should, as a minimum provision, be placed on a high specification foam mattress with pressure relieving properties (NICE, 2001). As I am providing a cushion and a mattress, it is not felt necessary to apply a dressing at this point. However, the area will need regular monitoring, as at this stage it is unknown how deep the pressure damage is. If proactive care is given in the prevention and treatment of pressure ulcers, with the use of risk assessments and providing pressure relieving resources, the pressure area may resolve. Pressure ulcers can be costly for the NHS, debilitating and painful for the patient. With basic and effective nursing care offered to the patients, this can often be the key to success. Bliss (2000) suggests that the majority of Grade I ulcers heal, or resolve without breaking down if pressure relief is put into place immediately. However, experiences in a clinical settings supports observations, that non-blanching erythema can often result in irreversible damage (James, 1998; Dailey, 1992). McGough (1999) during a literature search, highlighted 40 pressure ulcer risk assessment tools, but not all have be considered suitable, or reliable for all clinical environments. As there are many different patient groups this often results in a wide spectrum of different patient needs. The three most commonly used tools in the United Kingdom (U.K.) are, The Norton scale, The Braden Scale and The Waterlow Scale. The first pressure ulcer risk assessment tool was the Norton scale. It was devised by Doreen Norton in 1962. The tool was used for estimating a patients risk for developing pressure ulcers by giving the patient a rating from 1 to 4 on five different factors. A patients with a score of 14 or more, was identified as being at high risk. Initially, this tool was aimed at elderly patients and there is little evidence from research gathered over the years, to support its use outside of an elderly care setting. Due to increased research over the years, concerning the identification and risk of developing pressure ulcers, a modified version of the Norton scale was created in 1987. The Braden Scale was created in the mid 1980s, in America and based on a conceptual schema of aetiological factors. Tissue tolerance and pressure where identified, as being significant factors in pressure ulcer development. However, the validity of the Braden Scale is not considered to be high in all clinical areas (Capobianco and McDonald, 1996). However, EPAUP (2003) state The Braden Risk Assessment Scale is considered by many, to be the most valid and reliable scoring system for a wide age range of patients. The Waterlow Scale, first devised in 1987, identifies more risk factors than the Braden and the Norton Scale. However, even though it is used widely across the U.K., it has still be criticised for its ability to over predict risk and ultimately result in the misuse of resources (Edwards 1995; McGough, 1999). Although there are various tools, which have been developed to identify a patients individual risk, of developing pressure sores. The majority of scales have been developed, based on ad hoc opinions, of the importance of possible risk factors, according to the Effective Healthcare Bulletins (EHCB, 1995). The predictive validity of these tools, has also been challenged (Franks et al, 2003; Nixon and Mc Gough, 2001) suggesting they may over predict the risk, incurring expensive cost implications, as preventative equipment is put in place, when it may not always be necessary. Or they may under predict risk, so that someone assessed as not being at high risk develops a pressure ulcer. Although the Waterlow scoring system, now includes more objective measurements such as Body Mass Index (BMI) and weight loss after a recent update. It is still unknown, due to no published information, whether the inter-rater reliability of the tool, has been improved by these changes. It has been acknowled ged, that this is a fundamental flaw of these tools and due to this clinical judgement, must always support the decisions made by the results, of the risk assessment. This is clearly recognised by NICE, as they advise their use as an aide-mà ©moire (2001). The aim of Pressure ulcer risk assessment tools, is to measure and quantify pressure ulcer risk. To determine the quality of these measurements the evaluation of validity and reliability would usually take place. The validity and reliability limitations, of pressure ulcer risk tools are widely acknowledged. To overcome these problems, the solution that is recommended is to combine the scores of pressure ulcer risk tools, with clinical judgment (EPAUP 2009). This recommendation, which is often seen in the literature, unfortunately is inconsistent as Papanikolaou et al (2007) states: If pressure ulcer risk assessment tools have such limitations, what contribution can they make to our confidence in clinical judgment, other than prom pting us about the items, which should be considered when making such judgments?. Investigations of the validity and reliability, of pressure ulcer risk tools are important, in evaluating the quality, but they are not sufficient to judge their clinical value. In the research of pressure ulcer tools, there have been few attempts made to compare, the different pressure ulcer risk assessment strategies. Referring to literature until 2003, Pancorbo Hidalgo et al (2006) identified three studies, investigating the Norton scale compared to clinical judgment and the impact on pressure ulcer incidence. From these studies, it was concluded that there was no evidence, that the risk of pressure ulcer incidence was reduced by the use of the risk assessment tools. The Cochrane review (2008), set out to determine, whether the use of pressure ulcer risk assessment , in all health care settings , reduced the incidence of pressure ulcers. As no studies met the criteria, the authors have been unable to answer the review question. At present there is only weak evidence to support the validity, of pressure ulcer risk assessment scale tools and obtained scores contain varying amounts of measurement error. To improve our clinical practise, it is suggested that although tools such as the Waterlow Scale are used to distinguish a patients pressure ulcer risk, other investigations and tests, may need to be carried out to ensure a effective assessment is taking place. Practitioners may consider, various blood tests and more in depth history taking, including previous pressure damage and medications. Patients lifestyle and diet should also be taken into consideration and where appropriate, a nutritional assessment should be done if recent weight loss, or reduced appetite is evident. Nutritional assessment and screening tools are being used more readily and appear to be becoming more relevant in managing patients who are at risk of or have a pressure ulcer. The assessment tools should be reliable and valid, and as discussed previously with other risk assessment tools they should not replace clinical judgement. However, the use of nutritional assessment tools can help to bring the nutritional status of the patient to the attention of the practitioner, they should then consider nutrition when assessing the patients vulnerability to pressure ulcer development. The nutritional status of the patient should be updated and re-assessed at regular intervals following a assessment plan which is individual to the patient and includes an evaluation date. The condition of the individual will then allow the practitioner to decide how frequent the assessments will occur. The EPUAP (2003) recommends that as a minimum, assessment of nutritional status should include regu lar weighing of patients, skin assessment, documentation of food and fluid intake. As Mrs A currently has a balanced diet, it is not felt necessary to undertake, a nutritional assessment at this point. Her weight can be updated on each review visit, to assess any weight loss during each visit. If there is any deterioration in her condition, an assessment can be done when required. Continence should also be taken into consideration and where necessary a continence assessment should take place. Incontinence and pressure ulcers are common and often occur together. Patients who are incontinent are generally more likely to have difficulties with their mobility and elderly, both of which have a strong association with the development of pressure ulcers (Lyder, 2003). The education of staff, surrounding pressure ulcer management and prevention, is also very important. NICE (2001) suggest, that all health care professionals, should receive relevant training and education, in pressure ulcer risk assessment and prevention. The information, skills and knowledge, gained from these training sessions, should then be cascaded down, to other members of the team. The training and education sessions, which are provided by the trust, are expected to cover a number of topics. These should include, risk factors for pressure ulcer development, skin assessment, and the selection of pressure equipment. Staff are also updated on policies, guidelines and the latest patient educational information (NICE 2001). Education of the patient, carers and family, is essential in order to achieve optimum pressure area care. Mrs A is encouraged to mobilise regularly, in order to relieve the pressure as a Grade 1 pressure sore has been identified, she is at a significant risk of developing a more severe ulcer. Interventions to prevent deterioration, are crucial at this point. It is thought, that this could prevent the pressure sore from developing into a Grade 2 or worse. NICE (2001) have suggested, that individuals vulnerable to or at elevated risk of developing pressure ulcers, who are able and willing, should be informed and educated about the risk assessment and resulting prevention strategies. NICE have devised a booklet for patients and relatives, called Pressure Ulcers Prevention and Treatment (NICE Clinical Guidance 29), which gives information and guidance on the treatment of pressure ulcers. It encourages patients to check their skin and change their position regularly. As a part of good practise, this booklet is given to Mrs A at the time of assessment, in order for her to develop some understanding of her pressure sore. This booklet is also given to the care givers or relatives so they can also gain understanding, regarding the care and prevention, of her pressure ulcer. An essential part of nursing documentation, is care planning. It demonstrates the care, that the individual patient requires and can be used to include patients and carers or relatives in the patients care. Involvement of the patient and their relative, or carer is advisable, as this could be invaluable, to the nurse planning the patients care. The National Health Service Modernisation Agency (NHSMA 2005) states clearly that person centred care is vital and that care planning involves negotiation, discussion and shared decision making, between the nurse and the patient. There were a number of improvements that I feel could have been made to the holistic care of Mrs A. I feel that one of the fundamental factors that needed to be considered , were the social needs of the patient. As I feel they are a large contributing factor, towards why the patient may have developed her pressure sore. The patient was previously known to be a very sociable lady, who gradually lost her confidence, resulting in her not leaving the house. There are various schemes and services available, which are provided by the local council or volunteer services, to enable the elderly or people unable to get around. For example, an option which could of been suggested to Mrs A are services such as Ring and Ride, or Werneth Communicare. Using these services or being involved in these types of schemes, may have empowered Mrs A to leave the house on a more regular basis. This would enable her to build up the confidence, she lost following her fall. This would have also lead to positive impact on the patients psychological care, as Mrs A would have been able to overcome her fears of leaving the house, enabling her to see friends and gain communications lost. As previously mentioned in this assignment, although Mrs A had a score of 9, which is not considered an at risk score. I still felt it necessary to act on this score, even though the wound was a not considered to be critical. If it is felt the patient is at a higher risk than that shown on the assessment tool, the practitioner should use their clinical judgement, to make crucial care decisions. It should also be considered, by the practitioner that risk assessment tools such as The Waterlow scale, may not have been developed, for their area of practise. Throughout the duration of Mrs As wound healing process, a holistic assessment of her pressure areas and general health assessment were carried and all relevant factors, were taken into consideration. The assessment tool used to assess her pressure areas, is th e most common tool used currently in practise and the tool recommended by the Trust. To conclude, there is evidence to prove that pressure ulcer risk assessment tools are useful, when used as a guide for the procurement of equipment. However, they cannot be relied upon solely to provide holistic care to a patient. It has been highlighted, that to ensure a holistic assessment of patients, it is necessary to complete a variety of assessments, to create a complete picture. Although The Waterlow scale covers a number of factors that need to be considered, throughout the assessment, it has become evident that the at risk score, can often be over or under scored depending on the practitioner. Clinical judgement has proved to be, a very important aspect of pressure ulcer prevention and treatment. The education of the patient, carer and relatives has also been highlighted, as an important aspect of care. Empowering the patient with information regarding their illness, may decrease the healing time and help prevent has further issues.

Plea Bargains and Mandatory Sentencing Essay -- essays research papers

Plea Bargains and Mandatory Sentencing I would like to take this time to explain my position on Plea Bargains and Mandatory Sentencing. I will show both pros and cons for each topic, as well as give you my personal brief on which one I support. There are two types of plea bargains : The first one is a charge bargain. When the prosecutor allows a defendant to "plead guilty to a lesser charge†, or to only some of the charges that have been filed against him. For example, a defendant charged with burglary may be offered the opportunity to plead guilty to "attempted burglary". A defendant charged with Drunk Driving and Driving with License Suspended may be offered the opportunity to plead guilty to just the drunk driving charge. The second plea bargain is when a defendant is told in advance what his sentence will be if he pleads guilty. This can help a prosecutor obtain a conviction if, for example, a defendant is facing serious charges and is afraid of being hit with the "maximum" sentence. Typically, sentence bargains can only be granted if they are approved by the trial judge. Many jurisdictions severely limit sentence bargaining. Sentence bargaining sometimes occurs in high profile cases where the prosecutor does not want to reduce the charges against the defendant, usually for fear of how the newspapers will react. A sentence bargain may allow the prosecutor to obtain a conviction to the most serious charge, while assuring the defendant of an a...

Karl Marxs The Communist Manifesto Essay -- Communist Manifesto Essays

Karl Marx's The Communist Manifesto The Communist Manifesto written by Karl Marx explains the history of all societies as the history of class conflicts, he claims that the power and direction of all societies is determined by the modes of production, as such when the mode of production no longer suits the relations of society there is a revolution. He predicts that a revolution is coming between the proletariat and the bourgeoisie, and calls its coming inevitable. Marx argues that the bourgeoisies are no longer fit to rule, nor is their rule sustainable, as such the proletariat will overthrow them and end all class antagonisms with the creation of a classless society. However, Marx does not give enough credit to nationalism, nor does he ascribe to the possibility of compromise between the classes. Due to this he predicts a class war which never, and might never, take place. The first section of the Communist Manifesto describes the history of all society as the history of class conflicts. Claiming, that every society is essentially divided into, the oppressors and the oppressed. Furthermore, Marx adds, in the past, societies were organized in more complex combinations and hierarchies, but modern society is being split into two ‘hostile camps’. There has always been a continuous conflict between the different classes; the end result of these conflicts is always, either the total suppression of the oppressed classes, or a revolution, which leads to an overhaul of society. He blames the cause for the separation of modern society into only two groups, on the fall of feudalism. These new class antagonisms are between the proletariat, and the bourgeoisie. Marx views the rise of the bourgeoisie in Europe as the result of a couple of factors; firstly, he believes that, the initial elements of the bourgeoisie, were developed by the chartered burghers who evolved from the serfs of the medieval ages. Next, following the great colonization of the 16th and 17th centuries the market expanded, leading to a great need for increased production. This great demand could not be sufficed by the feudal guilds, as such they were replaced with manufacturing. However, the markets and the demand kept increasing and the manufacturing system could no longer keep up, as such it also was replaced, by Modern Industry. The Industrial Revolution of the late 18th century and th... ... the revolutionary parties. These sorts of compromises happened, and different socialist parties left behind the ideas of radical revolution and instead pursued gradual improvement through unions and parliament. Thus the previously constant decrease in workers state did not continue, rather the workers started getting more rights, for example universal male suffrage. Also they fought for, and won, social and economic improvements, for example more employment stability, higher wages and laws such as the Ten Hour Act of 1847 and the Factory Act of 1833. Such reformations, the increase in the power of Unions and the ability of the workers to vote led to sustainable compromises between the classes, as such no class war took place. Marx’s description of European society as driven by economics and divided by class lines is correct. However he fails to see the great influence of nationalism and he does not entertain the idea of compromise between the classes, because of this he wrongly predicts the destruction of the capitalist system and the bourgeoisies by the proletariat. Works Cited: McLellan, David. Karl Marx: Selected Writings (Oxford, NY: Oxford University Press, 1977)

Geriatrics and Long-term Care Essay

Though her sons and daughters check in on her all of the time, they are not there 24 hours a day. She does not want to have something happen and no one find out until several hours or days go by. She is very active in the community and church and I expect that she will remain so, even after moving into the assisted living facilities. This report seeks to uncover long-term care/housing programs and services provided to older adults. I will focus on the mission and services provided. From this report, I expect to gain an understanding of long-term care options and the differences amongst them, so it will be useful for my aging parents. Introduction There are 1,065,502 people (15. 1%), aged 60 and above, in Virginia (U. S. Census Bureau, 2000). There are 216,588 households with those aged 65 and over living alone with 565,204 households that contain individuals aged 65 and above (U. S. Census Bureau, 2000). The second number, 565,204 does not state that the household contains only 65 and over individual or could be an older person living with their son or daughters family. If taken into the later context that leaves 283,728 elderly that lives other than their own home or with another family member. This results in a huge demand for housing of the elderly on this country. With the onset of the baby boomers coming of old age, it is necessary that the government looks at ways to handle the increased need for housing of the elderly. Determining long-term care options Not everyone will need a long-term care option when they age. In fact currently most of the elderly remain in their residence. The questions elderly must ask themselves if considering long-term care are many. Elderly may consider long term care if they have a physical or mental disability, chronic illness, terminal illness or if they are not able to care for themselves. Everyone will need to make their own decision when it comes time, but having the information about what services and programs are available will make the decision much easier. Long-Term Care Options There are seven types of licensed care services and facilities; Home Care Services, Community Based Care Services, Adult Day Care Centers, Continuing Care Retirement Communities (CCRCs), Assisted Living Facilities, Nursing Homes and Senior Housing. Which one to choose depends on factors that include, cost, insurance, health needs, medical condition of the person and value for services provided? Home care services Home care services are broken down into skilled care and home support. Skilled care is provided under direction of a physician and administered by registered nurses, physical, speech and occupational therapists. Home support provides shopping, meal preparation and light housekeeping, to include bathing and dressing. Other home support services provided include counseling and social work services. Home care services allow older and disabled persons to remain in a familiar environment while maintaining their independence and security. Home care is designed for elderly and disabled people that do not need nursing home care, but needs assistance with day-to-day health and personal needs. The cost of home care is often less expensive than hospital and nursing home care. Home care service can: †¢ Preserve independence and security; †¢ Allow recipient to remain home; †¢ Relieve stress for recipient and family members or caregivers; and †¢ Prevent unnecessary hospital or nursing home bills. Community-Based Care Services If you have the ability to transport yourself to social activities, health appointments or go out for meals, community-based care services are probably not needed. However, for the elderly who cannot get out on their own, or have family that can provide transportation, community-based care services can help. Community-based organizations are broadly made up of an all volunteer staff. Services offered differ amongst organizations. Adult Day Care Centers Provides social interaction and meals in a protected environment, thus allowing those take care of the elderly person time-away. Social interaction includes activities such as physical exercise, games, trips, art and music. Some adult care programs offer medical services, such as help taking medications or checking blood pressure. In the United States of America 1,141 of 3,141 counties lack enough space for adult day care (Shellenbarger, 2002). Transportation to and from adult daycare is sometimes offered by the adult day care center. Currently cost of adult day care averages about $60 a day. Though it sounds expensive it is cheap compared to home-care, assisted living and nursing home care. Adult day care is covered through Medicaid and those insurance companies that offer long-term care policies. Continuing Care Retirement Communities Continuing Care Retirement Communities (CCRCs) offer independent living in a cottage setting to skilled nursing care and in between. The services can be all-inclusive, modified to meet the residents needs or in a fee-for-service. CCRCs promote wellness, independence and socialization in a residential environment. The idea behind a CCRC is that elderly can stay in one place rather than moving from one long-term care option to the next. Example, your parents move into senior housing, then assisted living area, then for further care move into a nursing home, all of which are located in the same complex. Vice paying monthly for rent and services provided, elderly pay a fee or endowment to be part of the CCRC. Assisted Living Facilities Assisted living facilities are broken down into independent, residential or assisted living facilities. Independent and residential living facilities provide minimal assistance for those elderly with minor limitations. Assisted living provides more assistance for those elderly that need help due to major limitations. Services offered include oversight, health care services and help with daily living activities. Assisted living facilities are one of the fastest growing long-term care options available today. In 2000, there were only about 1,000,000, aged 65 and above living in assisted living or residential care (Munn, Hanson, Zimmerman, Sloane, Mitchell, 2006). Since then assisted living facilities have blossomed to over 36,000 licensed facilities providing for more than 9,000,000 residents (Hernandez, 2005-2006). The boom is due to affordability and the homelike living arrangements offered. Nursing Homes When family can no longer take of their elderly member that is injured or disabled, home cares is the preferred option, but if there are no availabilities, then nursing homes are appropriate. In 2000, 1,557,800, aged 65 and above lived in nursing homes (Munn, Hanson, Zimmerman, Sloane, Mitchell, 2006). Most elderly that utilize nursing homes are recovering from illness or injury. Nursing homes also provide hospice care for those terminal elderly; provide rehabilitation; or maintain care for those elderly with chronic health care needs. Nursing homes provide around the clock care for those recovering from illness and injury. The homes are for those elderly that need more medical attention than social gathering. Nursing homes also provide personal care in the form of bathing, dressing and going to the bathroom for the elderly. Senior Housing This is for those elderly that do not need long-term care, but live in a home that is not considered safe. Senior housing often is apartments that have been adapted for the elderly and include railing in bathrooms, wider hallways and raised outlets. Optional services provided include meals, housekeeping and social activities. Choosing the right long-term care option With the long-term care options, mentioned above, selecting which program or service is right can be overwhelming. Think about what it is that you mother, father, or both want in their older years. Ask the elderly what it is that they want? What are their needs? Do they need help with chores? Do they prefer small facilities, certain location, special living conditions? What is their financial situation? Will you be paying for long-term care or is insurance providing coverage? Is Medicare or Medicaid involved? Research available long-term care facilities near your residence first. Ask questions about what services/programs that are/are not provided, if they are insured, costs and vacancies. Check on fee’s for special care services or if extra fees are charged for services. Think about waiting list, if you find the one you want, but are not needed immediately or near term. Visit and tour the facility with your loved ones. Is it friendly, does it look clean, are people happy, what activities do the have for residents. How many staff is available, come back during different times of the day on different days. What the rooms are like are any options available? What are the residents allowed/not allowed doing? Is there a schedule for anything, eating, naps, bedtime, and social visits? How often are your loved ones checked on? Does the staff conduct regular care training? Ask other residents what their opinion of the long-term care facility? Check with the Better Business Bureau to check for any complaints filed. Conclusion In conclusion, though there are many choices for long-term care, it will come down to the individual, the elderly, the elderly family or a combination to determine which type of care will best fit there needs. There is no one fits all long-term care facility, such as there is no specific type of elderly person. Everyone age’s differently and each will have their own very specific needs when it comes time to make a decision on long-term care. Some will choose to remain in their home while others may choose a community setting. However, one thing is known and that is the elderly population is increasing in the United States. This will lead to a higher demand for long-term care services in the future. In the past families tended to take care of their own and their parents, whereas now the elderly will have to start looking at looking at for themselves, though some will be taken care of by their children. In the end, follow your instincts. Choose a place that treats your parents with respect and makes them feel comfortable. References Bolda, E. J. (2006). Community Partnerships for Older Adults: Meeting the Housing Challenge. Generations, 29(4), 61-63.