Health care Transparency Essay

Health care Transparency is openness about the quality of healthcare provided, sharing information whether it be good or bad for the purpose of improvement. In the past, health care transparency was secretive, people did not want to share patent information for reason of privacy to their clients as well to avoid law suits. However there is a way in which you can share information without violating doctor patient privilege. The future of health care transparency looks as though it is going to improve, I say improve because I agree with Dr. Patrick Crawley that the movement will allow sharing of information therefore allowing improvements to be made leading to less law suits. Really kind of taking on a best practices type of mentality as well sometimes we need others to step in and help work through issues that may arise. Overall I think that hospitals becoming transparent will force improvement, at first I am sure there will be a struggle just as in any new process however once the kinks are worked out improvement will shine through. Health care transparency will help patients make more informed decisions when deciding where to go when care is needed, this may cause longer wait times at first however raising the standards and outing the facilities that are not providing good treatment cause only force them to do whatever it takes to increase standards and service provided. We as consumers need to become more informed decisions makers however with information available to us is limited we are unable to make accurate decisions on where to receive our care. We have systems/sites in which we can choose babysitters, plumbers and other types of services we made need why would we not want to choose our health care facility with the same type of research. Some of this information is already made available by some facilities, such as checking out wait times and even being able to sign up to be seen before even arriving improving the time in which we would wait to  receive care. The more we alignment with this advancement the better the care we will see.

Television Broadcasts Limited

Television Broadcasts Limited, commonly known as TVB, is the first wireless commercial television station in Hong Kong. It was first established on 19 November 1967 with only about 200 staff. The Group has now grown to a size of about 4,200 including contract artistes and staff in overseas subsidiary companies. The major activities of TVB are television broadcasting, programme production and other broadcasting related activities such as programme licensing, video distribution and satellite broadcasting etc.It transmits over 17,000 hours of programming on its Chinese Jade channel and English Pearl channel free of charge to 2. 34 million homes in Hong Kong. It is one of the largest producers of Chinese language programming in the world. Many of the Chinese programmes are dubbed into other languages and are distributed to more than 40 countries and cities, accessible to over 300 million households. During the prime time viewing hours, the Chinese Jade Channel and English Pearl Channel a chieve a remarkable average of 87% and 80% of Hong Kong’s television audience share respectively.To cope with future development, the Company invested HK$2. 2 billion in the construction of a new state-of-the-art TVB City in Tseung Kwan O Industrial Estate. The management and production facilities, with a building area of over 110,000 sq metres, 30% more than the TV City at Clear Water Bay Road, came into full operation in October 2003. There are two outdoor shooting locations and 22 production studios in TVB City. The new TVB City is fully digitized to enhance its services to the public.On 31 December 2007, TVB officially launched its 24-hour HD channel, HD Jade, providing diverse and brand new audio/visual entertainment in the digital era. In addition to the simulcast of digital Jade and Pearl channel, TVB started operating J2 and iNews digital channels in June 2008 and January 2009 respectively. The Company has always been striving for excellence in serving the people of H ong Kong and its efforts are widely recognized. The Company, has thus received 450 international awards for its various television programming and programme promotions in the past.In 1997, TVB has also been awarded as one of Asia’s 50 most competitive companies; one of the top 20 companies in Hong Kong and one of the Asia’s 200 Leading Companies. In 2001, it was also awarded the National Association of Broadcasters (NAB) International Broadcasting Excellence Award 2001 for its outstanding contributions to the community. Now, let me sum up our proposal. Our mission is to develop a diverse development company. In the past, we have developed magazine industry, music industry, film industry and internet industry.In the future, we plan to develop agency industry, which are combine advertisements and sales. We plan to operate online sales thought the television and earn the commission. There are several reasons that can support our proposal to be a successful one. First of a ll, we have an excellent financial situation now and we have cash balance total HK$3,604 million in 2012. If the our proposal is implemented, more sponsorship in the clothing and jewelry of the TV series or some annual TV shows. It can decrease the cost of production. nline shopping become more popular, this development of this kind of business can really help the company to generate more earning. Secondary, TVB have already a huge fixed amount of audience and we believe that more audience will be attracted by the new scheme, which means that more customers are provided. Moreover, nowadays, online shopping has become a tendency in Hong Kong since it is convenient. When you are taking the train, on your way to work; or lying on the sofa, enjoy your weekend at home, you can watch our programs though your cell phone and TV.Our artists wear the fashion items that you want, you can only touch that item on the screen to get it. The details of the item will be shown after you touching the screen. If you decide to buy, you can add the item to your shopping bag and confirm you order. You can use any of the payment types listed on the screen to pay for your order, for example VISA, PAYPAL, AMERICAN EXPRESS. Your details are safe with us as we take security very seriously indeed. U may doubt that whether the proposal is feasible. It can surely give u an answer.Yes! We plan to cooperate with SONY to make the technology of touch screen can be perfected and fixed with this proposal. SONY which is an initiate company always seeks for a breakthrough has a strong technology to support us. It can match with the technology that our plan needs. TVB has been serving the audience for 44 years. It will continue to keep its promise, delivering excellence in programming and cutting-edge broadcasting technology to the people of Hong Kong and to Chinese communities around the world. umanitarian initiative Apart from fighting for greater profits, it is our obligation to perform our human itarian initiative. After shooting dramas, we can ask our clients for their clothes for charity sale. All income from charity sale will be donated to charities. Clothes which are abandoned can donate to charities as well. Our actors and actress are also willing to donate their clothes either for the charity sale or the charities. establish a new department in response for the agency job.

Sheena Pugh’s ‘The craft I left in was called Esau’ Poetry Analysis

We have been studying 3 of Sheena Pugh's poems which all relate to earth and mankind . In poem one titled ‘the craft I left in was called Esau' , it shows the weary travellers that had to leave earth for one reason or another in a timid and nervous mood , simply searching for a new place to live. The poem makes the reader feel tense almost waiting for something to happen. The fact they had to leave portrays a sense of imminent danger , the fact they scratched the word Esau on the door makes it seem like it was done in haste as if to say they could have been wiped out at any moment. The name Esau on the door relates to the bible story when Esau sells his heritage to his brother Jacob for a bowl of pottage which is to say that we've abused the earth. The second poem we read was called ‘Do you think we'll ever get to see earth sir? ‘ and it shows our characters taking trips to see earth like sightseers . Our teacher Christie stating the ideas concepts pointlessness as there is hardly anything to see. The third poem was called ‘Geography 1' and is about an island called Surtsey which was actually a volcano. This means that in the order of poems it shows the ‘end of the earth' , ‘returning to earth' , and ‘a new bit of earth'. In poem 1 the craft is called Esau because it insinuates that mankind threw away it's inheritance. They say in the text the name Esau was scratched on the door which portrays a sense of immediate danger or emergency which forced them to leave. ‘Incongruous' is used in the text and means something does not fit the pattern and so while the travellers are ‘joking nervously' it doesn't feel quite right somehow. We know the travellers are on their first journey of this kind because they were joking nervously as if they were just trying to ignore the fact they were travelling into the unknown. I don't think they are coming back because the reason they are nervous is that they know that if everything goes wrong then they don't have a safe-house to return to. The poet uses the word ‘still' twice in succession to emphasise it (the stillness) , a new ocean portrays a new task or challenge waiting to be mapped out. They say â€Å"it seemed natural to look for a horizon† because the word ‘natural' because it suggests that they're going purely on instinct while if it were normal then it would be a tried and tested method of tracking position. The ‘charted coastlines' mentioned in the poem suggest an unstarted map , a blindly followed path in search for a new home. â€Å"Our late guesthouse† suggests it's not the last part of the story , it isn't the end as if there's more to come or they are part of a much deeper plot. This poem has no poem but has simple language however the reader is compelled to continue reading just in case they miss something important that's about to happen. The second poem we have studied that is written by Sheena Pugh is called ‘Do you think we'll ever get to see earth sir? ‘. It is about a cynical earth survivor getting quite emotive about the concept of savouring lost memories or in this case , earth. The poem is written as a brief lecture to a student , which almost instructs the student about what to do if he sees even the smallest image of the past. The writer makes us think about the future by making us think about how we will be remembered by our descendants. While reading you can't help but think about what fate could lead to the evacuation of earth , the thing that hangs in my mind is the concept of a nuclear war , the reason this ties in with the poem is that we hear the teacher say â€Å"they're still toxic† †¦Ã¢â‚¬ ¦ nuclear war could potentially do this. This poem has a person telling it with a very sharp , sarcastic tone in their voice , this gives the impression that this person just wants the chance to forget. This poem makes me feel insecure because the best thing about earth is the sense of security you get when say†¦ at home in your room because in a way nothing can touch you there. The other thing about this poem is that it has no verses as if all the points that are made are inter-twined and need not be separated. The word ‘look' is used very often as if to say be a part of it not just stare and gaze upon it. She says things like â€Å"see it with your skin† etc which I think means that you should see it with all your senses and not just sight. If I had to pick one , my favourite word would be ‘damascening' because it sounds like a very rigorous describing word. The third poem we have studied is called ‘Geography 1' and the person in the poem is describing the birth of a new part of earth , the island of Surtsey. Surtsey was a small island that was formed by a volcanic eruption , Surtsey was said to be important because it was like seeing the earth being born again. I think Surtsey was used as a lesson to the pupils because it shows a fresh start which can lead on to better times. Throughout the poem I believe Sheena is trying to say that novelties do eventually turn old and unimportant. The mood of this poem is of a non-caring , ignorant – to – the past mood for example when he says â€Å"fancy that , but I hadn't time to look properly†. Throughout the poem Pugh makes us feel gripped and embraced until the ironic ending. The language does encourage this mood with powerful describing phrases ie â€Å"flood of colours†. I think this poem is written in verses to separate the different points the poet is trying to convey , for example in the 4th paragraph they show the novelty of Surtsey by saying â€Å"Surtsey was important† but the 5th paragraph contradicts this by saying that it was forgotten, â€Å"even the birds nested in a few years†. Christie is supposed to be teaching a Geography lesson in the poem. I quite like the phrase â€Å"with angry energy , it wanted to shout† because while reading it you do get a rush of energy. I do not like the phrase â€Å"Surtsey was important because it was like seeing the earth being born again† because I feel this point is obvious and has already been made. I do like the poem however because it has powerful phrases and has a point (volcanic eruption), which can be easily pictured because unlike the other two poems it is a concept that man can currently experience. I definitely prefer this poem as it has good describing phrases and high octane adjectives. The first poem made me feel quite tense because you had to imagine being on a ship seeing your life fade into the distance , poem two made me feel quite cynical as the fact it's a personal poem makes it easier to fal into the very plot of the character Christie and so you do see the point he is making. The third poem ‘Geography 1'gave you a feeling of having too much energy followed by too little because it's a transition from â€Å"that flood of colours† to â€Å"just an offshore island†. I did prefer the third poem because as I said before it has a conceivable concept. These three poems do show ‘the end of earth', ‘returning to earth', ‘and a new bit of earth', this shows devolution but in a way evolution because a new bit of earth implies a new, fresh start.

Exam 3 Research Paper Example | Topics and Well Written Essays - 1500 words

Exam 3 - Research Paper Example This order faced many challenges with the migration of the African American to from southern to demonstrate against the violation of the order (Richard 78). This order helped the country during the war that emerged later with the African Americans being referred as janitors in the military sector. Civil Rights Act of 1964- In July 2, 1964, this Act got its creation as a landmark piece of civil rights in the United States in order to outlaw the major forms of discrimination against race, color, religion, sex, and women. The act ended the Jim Crow rules upheld by the Supreme Court that held the racial segregation purported as separate but equal and was constitutional. A congress later saw the benefits of the Civil Rights Act and expanded it to strengthen enforcement of the fundamental rights. During the proposed hearings by the Judiciary committee on the proposed legislation led to the amendment of the bill to broaden the scope of protections. These changes strengthen President Kennedy ’s original proposal on the response to the turbulent summer that saw several incidents of racially aggravated hostility across the south. After a continued fight against its approval, the country saw the benefits of the bill that saw the president in that particular time signs it into law. Equal Employment Opportunity Commission (EEOC)- This federal law enforcement agency enacts laws against workplace discrimination. It encompasses some other laws like the title of the Civil Rights Act 1964, the Equal Pay Act of 1963, which protects men and women who perform equal work in the same founding from sex- based discrimination. It also covers Age Discrimination in Employment of 1967, which protects folks above 40 years of age, or older (Hay 100). The United States Employment Opportunity Commission enforces all the above laws and provides an oversight and harmonization of all equal employment opportunity regulations, practices, and policies. Age Discrimination in Employment Act (ADE A) OF 1967- This protects folks of 40 years of age and above from employment discrimination. This applies both job applicant and employees. According to the law, it is illegal to discriminate any person because of age with respect to any term, condition, privilege of service. This includes hiring, sacking, endorsement, layoff, reimbursement, paybacks, training, and job assignments. It applies to those employers with 20 or more workers including state, local governments, employment agencies, labor organizations, and the federal government. This has helped the government from risks associated with equal considerations in the workplace. Americans with Disabilities Act of 1973- It is a federal law enacted on September 26, 1973 and is known as the Rehabilitation Act of 1973 that replaces the Vocational rehabilitation Act. It covers those individuals with a special history of handicaps or any health complications. Special programs held to pay tribute to people with disabilities prohibits discrimination against any disability in the agencies, in programs receiving Federal Financial assistance, employment among others. This helps value the contribution from those with disabilities. Question 2 Some people remain more fortunate than others in which they remain promoted while others stay at the middle or at the bottom of the positional ladder. This rise in rank

An analysis of the Culture of an organization Essay

An analysis of the Culture of an organization - Essay Example Hofstede’s theoretical framework Hofstede’s cultural framework focuses on the effects of the national culture on the organizational culture. The theoretical framework is explained using the five dimensions in relation to national work related values. The dimensions encompass the â€Å"power distance, individualism, masculinity, uncertainty avoidance, and long-term verses short-term perspective† (Boonghee, Donthu, & Lenartowicz, 2011). According to the power distance concept, small power distance cultures prefer consultative and democratic power relations while large power distance cultures like the one in UK prefer non-democratic power relations. It is worth stating that Ben and Jerry exude a distinct relationship amidst the personnel and management. For example, the organization appreciates the need for a traditional, homemade approach to operations (Data Monitor, 2004). This means that people at the lower ranks acknowledge powers of others according to their hi gher formal and hierarchical position (Orr & Hauser, 2008). The individualism verses collectivism concept explains how much the cultural members perceive themselves apart from being members of the group. It is clear that the company supports the community. Additionally, it values its association with employees, and other stakeholders. This has significantly contributed to its progress within the societal set-up. This has allowed the organization to attract diverse persons. Data Monitor (2004) indicates that the product was made with love and care. This allows it to attract varied participants in the market. Analysis of Ben and Jerry highlights a mixture of the diverse roles within an organization. However, masculinity verses femininity concept explains the value given to males and females traditionally, the Ben and Jerry seems to have dynamic roles for both genders. In masculine culture, people value competitiveness and acquisition of wealth regardless of gender. However, the femini nity culture value relationships and life quality. These two concepts appear to have found a balance at Ben and Jerry. (Xiumei & Jinying, 2011). For example, the pictures presented by Data Monitor (2004) accords women and men similar advertising space. For example, men highlight the wrestling match while the community outreach is a preserve of the women. Indeed, this clear depicts the gender roles at the company. The uncertainty avoidance dimension explains how the cultural members address potential risks. For example, the company houses unconventional and non-conformist persons. However, this has changed to embrace changes and address risks. The stakeholders are not trying to behave according to the expectation of the society leaders. Data Monitor (2004) indicates that it focuses on mainstream, and shuns mass marketing that target on benefiting several persons. In organizations with such cultures, employees are devoted to their employers. Cultures that exude diminished levels of un certainty avoidance have embedded and flexible rules. In organizations with this culture, employees tend change their employers frequently (Shah, 2012). The long-term verses short-term explains the society’s attachment to its present and to its past. In the societies that are long-term oriented, individuals focus on the activities that affect the society’s future. For example, Ben and Jerry shifted from being unconventional to addressing varied needs making

Do the right thing Movie Review Example | Topics and Well Written Essays - 1000 words

Do the right thing - Movie Review Example This provides a petition to Sal as a kin man (Ebert, 1989). Right from the begin Sal is depicted as a hard working, kind, and dedicated individual (Ebert, 1989). Just the reality that he owns his own commerce in this bumpy and harsh epoch shows that he is a tidy, competent, and enthusiastic man. Later in the film we learn that Sal did in actuality build his pizzeria by himself from the floor up. The verity that Sal gets to split his creation and solid work with his sons crafts it all the extra unique to him (Ebert, 1989). After Sal has ended his pre-opening arrangements, Sal's Pizzeria is open for the daylight hours. Shortly after this, the major character of the movie, Mookie, comes promenaded into the bistro (Ebert, 1989). Mookie facility is as the liberation man for Sal in this film. Mookie accurately delivers pizza, yes, but he as well acts as an intermediary between the two ethnicities (Ebert, 1989). Sal relies on Mookie not merely to get the pizzas transported, but to as well a s to keep his associate black folks pleased with Sal so they will approach and support his bistro. I think that this shows an extremely appealing elevation of Sal (Ebert, 1989). It for the predominantly part trade in him off as a chauvinistic (Ebert, 1989). On one, allot, he can put on a happy visage and make the acquaintance of all the black populace as they crust their hard earned cash out to him for his pizza, whereas on the other dispense, he turns into an extremist, hating the majority of black people and discussing behind their back even as they are not approximately (Ebert, 1989). Now I say most black populace because Sal appears to have this father-son bond departing on amid him and Mookie where Sal is the white dad and Mookie the black lad who in the conclusion finally mutineers like all siblings do at some instance in their life (Ebert, 1989). In addition, Sal appears to have various kind of liking or love for Mookie's sister, Jade (Ebert, 1989). Whilst she comes in the pi zza parlor Sal persist to be made some remarkable wedges of pizza (Ebert, 1989). He then plunges what he is doing to go take a seat and stopover with her. This may prompt one to inquire them if Sal is a chauvinistic then why does Sal own a bistro in the hub of black vicinity (Ebert, 1989). Well as Sal explains to Pino early on the movie it is solely commerce. Sal recognizes that he is not competent to compete with the massive restaurant manacles, so he must journey to someone else's lawn to formulate a go of it (Ebert, 1989). A scary, conventional idea voiced more and again in the movie is that everyone is safest in their "own" vicinity and that it is most excellent if we stay put with the populace like ourselves (Ebert, 1989). Now this does not appear to grasp true for Sal and his pizzeria at foremost (Ebert, 1989). Just gaze at the particulars, he has been in this vicinity for not less than 15 to 20 years with no tribulations that we are made conscious about (Ebert, 1989). Percept ibly he must be creating a profit or he would have closed days ago. The way I observe it is that the major predicament with Sal this time is that he is not in the commerce for the love of it any longer, he is in it for the money (Ebert, 1989). Subsequent to all of these days while making pizza he has misplaced some of the blaze that always got him living (Ebert, 1989). I would be eager to stake that when Sal first unlocked up his pizza cooperative he was ostensibly friendly to all the populace, including the black populace, which came into his

Canadian & US Immigration and Discriminition Essay

Canadian & US Immigration and Discriminition - Essay Example Therefore, around the globe many people eyes on the developed countries as a staircase towards their dreams. They believe that being in a developed state will provide them with proper job opportunities and a reward that is equivalent to their efforts. This partly may be true, but the first step of immigration is a big hindrance and may itself be a discouraging factor. Developed countries like United States and Canada have their own policies of immigration. Some may be beneficial for the immigrants while some poses a challenge to their existence. These negative aspects of these two countries immigration policies can be attributed to the fact that most developed nations are not very receptive to immigrants. A lot of discrimination exists on the bases of original nationality of the immigrants and various other factors. The paper will highlight and compare the difference in these policies and how they might discriminate on various bases. History of immigration in Canada and America: Both Canada and America are major recipients of immigrants from all over the world. As the statistics show that both of them accepted over 12 million immigrants between the period of 1960 to 1980 (Borjas 1991). This was a result of various changes in the policies implemented by the governments in the early 1960s. Before this period both the countries had a policy to issue only very few visas based on the nationality of the applicant. For example in the United States national origin quota system influenced the immigration policy prior to 1965 amendments. There was a definitive discrimination as Asian were only allocated a very low percentages of the total available quota. Most of these accepted immigrants were from European countries, Germany and Russia. Now we know that the source of immigration is an important factor that can determine the skills of the workers. This is partially due to the fact that cultural and social aspects of any country mould an individual’s talent. A sing le cultural immigration, therefore, caused a decline in the diversities of skills present in both countries. After 1960 both United States and Canada started to accept immigrants from diverse nations. US evolved a policy that allocated visa permits to those immigrants with relational ties to the residents of US. Whereas Canada initiated issuing visas on the basis of applicants observable socioeconomic characteristics (Borjas 1991). So overall these transmutation in the policies of both countries attracted workers with diversity of technical skills that aid in the economic development of these countries. US and Canadian immigration policy 1960 to 1980: The amendments made in 1965 in United States immigration policies abolished the national origin quota system and introduced a more versatile approach in allocation of the visas to the immigrants. These amendments influenced immigration system for the next two decades. Total number of visa allocation was increased to 270,000 and no more than 20,000 can be issued to the origin of a specific country. This is was totally in contrast to the earlier policies where most percentage of the visas was allocated to only few specific countries. Moreover, about 80 percent of those total visas were given to those with close relational ties with the US resident. This in particular was an important amendment because it

Analysis paper Essay Example | Topics and Well Written Essays - 750 words - 3

Analysis paper - Essay Example reations inspired by phenomenal aspects related to human emotions and cognition to serve its function, and developed from one or multiple of art elements. Production of art utilises different components. Artists produce different effects using elements such as colour, textures, shapes, lines, dimension and space. The ability to use lines of diverse lengths and thicknesses and taking a particular direction tend to signal an action that perhaps other elements cannot produce. Colour has got critical purpose in producing effects whether used alone or in structures produced using other elements as shapes. It benefits the art through the hue, its intensity in brightness or dullness and value in terms of lightness or darkness. By joining lines together, flat shapes, either geometric or irregular forms can be created to express drawings. Art can arise from use of 3-dimentional objects that allow the artists to control their appearance. Such structures are expressed through length, width and height. Texture gives the feel of an art (e.g. rough or smooth) and allows viewers to relate with it as they do in reality. Art can also be produced under the illusion of space. Art productions grow with time and are inspired by certain happenings in particular moments. Some art pieces were created several centuries ago, but have been recreated severally which all show certain divergence in appearance, finishing and aesthetic quality. Art has proved not to be limited by time. Hence an art piece can best be described in the time it was developed. It has transformed from the stone-age art when expressions were mere carvings and sculpts on the walls and stones. Then came the clay works, but today they have expanded to the computer aided graphics. It’s not merely about a tangible piece, but more of feel as in choreography and music. Art has come to encompass great dynamism and complexities through use of advanced technology to incorporate motions and different visual impressions that

Leadership and management Essay Example | Topics and Well Written Essays - 1250 words

Leadership and management - Essay Example According to Waite, leadership â€Å"covers a complex set of circumstances that include the psyche of the period, the economic situation, and the structure of a culture. In other words, leadership transcends all boundaries† (1). However, not all individuals have the attributes of becoming capable leaders. Influence is the primary concept involved in leadership. It is a human invention process that is compared with successful business control, with powerful, influential and charismatic leaders, and Chief Executive Officers. Daft defines leadership as a relationship between followers and leaders that is based on influence in order to achieve actual changes and results based on their common objectives (4). Daft defines management as â€Å"the attainment of organizational goals in an effective and efficient manner through planning, organizing, staffing, directing, and controlling organizational resources† (14). The efforts in management involve members of an organization focused on a particular goal. Management is therefore a group of people responsible for directing the workforce and ensuring that the organization meets its goals and objectives. Management is the act of getting work done through people. Management has various functions which include, planning, organizing, staffing, motivating, and controlling. Planning involves setting organizational objectives and outlining plans to achieve the objectives, organizing involves classifying and allocating tasks, and supplying necessary power to perform tasks. Staffing includes recruiting relevant and qualified individuals for various positions, motivating involves inspiring people to make great efforts in attaining organizational goals, while controlling involves seeing to it that organizational goals are achieved. Although leaders are sometimes managers and managers have to be leaders, leadership and management are different in a number of ways. While management concentrates on achievement of results through effective acquisition, arrangement, implementation, and regulation of all resources such as money, facilities and people, leadership â€Å"focuses on the most important resource, people. It is the process of developing and communicating a vision for the future, motivating people and gaining their commitment and engagement† (Armstrong and Stephens 5). Management is focused on managing complex issues pertaining planning and budgeting with an aim of producing results, while leadership focuses on producing change by developing a vision that will last for the future, along with strategies that bring about the changes needed. Management involves itself with the development of the capacity to achieve pl ans by creating an organizational structure and developing human system, while leadership organizes people by communicating the new created direction, and the creation of collaboration that understands the vision and is committed to achievement. Management ensures that plans are undertaken through controlling and problem solving, while leadership uses motivation to energize people, leadership tries to satisfy basic human needs through achievement (Armstrong and Stephens 6). Management is the most important human activity; because it’s the basic task of managers at all levels in all business and institutions. A leader has the ability to influence people, while a manager may not. Leaders have three major roles; defining a task, where they ensure to make it clear what they expect a group to do, achieving a task, where they ensure that the group`s purpose and goals are achieved, and maintaining effective relationships. They ensure that a good relationship is built between themsel ves and group members, and among the group

Marketing Essay Example | Topics and Well Written Essays - 250 words - 6

Marketing - Essay Example Thus the ‘victims’ of its unethical marketing strategies were children whom the company ill-used by manipulating their exposure to addictive / drug-abusing habits. According to the source, the company has also employed teenage girls to distribute free Marlboro cigarettes to children and youngsters at the clubs and concerts. Not only the company marketed a health-hazardous product but also harmed the children morally by exploiting them to addiction. What’s worst, the company claimed that premature smokers’ deaths have ‘positive effects’ because they save governments money (â€Å"Top 10 Unethical Companies.†) In this way, Philip Morris’ unethical marketing practices hurt children and teenagers by illegally familiarizing them with addictive products that are supposed to be much harmful for them, physiologically as well as morally. The company, in response to the criticism, has launched a ‘We card’ Programme, which provid es retailers with tools and resources to help prevent underage tobacco sales. Works Cited â€Å"Top 10 Unethical Companies.† Actionforourplanet.com. Action for Our Planet, n.d. Web. 1 May 2011.

Entitlements Research Paper Example | Topics and Well Written Essays - 500 words

Entitlements - Research Paper Example 95). Reaching a total of $2.16 trillion, table below summarizes the most recently projected U.S. non-discretionary spending on mandatory programs and the amount of annual expenditure of each program FY 2011. Others: Food Stamps, Unemployment Compensation, Child Nutrition, Tax Credits, Income Support Program, Crop Insurance or agricultural subsidies, Supplemental Security for the Disabled, and Student Loans. The most significant discretionary spending of the U.S. government is allocated for defense budget. Estimated by Donald M. Snow – a professor at the University of Alabama, approximately 58 percent of the total discretionary funding or 15 percent of the annual federal budget is spent on defense (Kennedy, 2010). Unlike the mandatory or non-discretionary expenditures, discretionary budget that is being allocated for Congress is controllable. It means that the Congress can decide whether or not to spend a portion of discretionary budget on certain projects. It is unfortunate to learn that two-thirds or almost 67% of the total federal budget has to be allocated for non-discretionary or mandatory expenditure (Kennedy, 2010). According to Kennedy (2010), the Veteran’s Health Administration is already serving the pension and health care needs of more than 8 million veterans. Given the amount of non-discretionary expenditure (2/3 of federal fund) with the amount of discretionary expenditure (1/3 of federal fund), it is clear that the U.S. government should strictly avoid getting involve in the war between Iraq and Afghanistan to control the increasing number of Veterans that is entitled to receive not only pension but also health care support. By doing so, the large number of veterans that is currently being financially supported by the U.S. government through entitlements can be controlled. Likewise, the U.S. government can also be free from having to spend a significant portion of the federal fund on defense budget. On top of the $5.5 billion

Stakeholder in a Business Essay Example for Free

Stakeholder in a Business Essay If a customer’s concern was that the product they want to buy is never in stock Tesco’s aim would then be to make sure they always had products in stock and on the shelves. Customer comments make the most impact because they are telling Tesco’s exactly what it is doing wrong and what needs to be done to improve it so Tesco is encouraged to improve their store for the sake of their customers. They have a big influence on the store because if Tesco’s did not listen to their concerns it would lose customers and sales which could go to other competitors. Customers are split into socio economic groups based on he occupation of the head of the household. It is used to see how people in different socio economic groups react to the same stimuli. The first 3 socio economic groups A, B and C1 will shop at Harrods because they have better more professional jobs which in return they will have more money so they like the finer things in life so therefore shop at Harrods. The last 3 socio economic groups C2, D and E will shop at Tescos because they have average jobs and are likely to be on minimum wage and Tesco if affordable so will therefore shop there. The groups are as followed: Socio economic group| Occupation| Tesco or Harrods| A| Higher managerial, administrative, professional example surgeon| Harrods| B| Intermediate managerial, administrative, professional example bank manager and teacher| Harrods| C1| supervisory, clerical, junior managerial example shop floor supervisor, bank clerk, sales person| Harrods| C2| skilled manual workers example electrician or carpenter| Tesco| D| Semi skilled and unskilled manual workers example assembly line worker, refuse collector, messenger| Tesco| E| Casual labourers, pensioners, unemployed example pensioners without private pensions and anyone living on basic benefits| Tesco| Customers of Tesco and Harrods could complain or give feedback in store or online and the business would do their best to fix these problems in order for the business to run at its full potential. (B) Employees Employees are an important stakeholder to Tesco because without them there would be no one to sell the products. Their job affects the growth of the business because if they do their job well and sell the products the business will bring in money. Employees depend on the business to make sure they are working in a clean and safe environment, there is job security and opportunities for promotion and discounts. Employees can also affect the business if they go on strike because then the business would have no workers to help the business run. They also want the business to do well so they can keep their job because if the business wasn’t doing well it might have to lose workers or close completely. Employees can also have an effect on the business if they let their personal life get in the way of their job. Relationships and emotions can cause an employee not to put their full effort into the job which could result in poor sales and losing customers. It is vital Tescos employees put all their effort into their jobs so the business excels. The employees at Tesco’s and Harrods could potentially quit their job if they feel they are not getting treated properly so it is a main priority that the employees are a big priority to the business. For the employees to be treated well at Tesco they want 24 hour security to make sure they are always safe, to know that anything personal is kept confidential and that they get a fair income for the work that they do. Employees at Tesco will be much different to employees at Harrods and they will both want different things. C) Suppliers Suppliers supply the products and services to a business. They can affect the running of a business if the products are not supplied on time. Not having stock on the shelves could lead customers to competitors. The suppliers want to have a long term contract with the businesses so they know they are always in business and will never lose money. The suppliers can affect the time, quantity, quality and cost of a product. Without suppliers the business could not guarantee that it will always have sufficient high quality materials. It is important that the business maintain good quality relationships with the suppliers so that raw materials and components can be ordered and delivered at short notice. The suppliers of Tescos and Harrods need to maintain their standard if they want to keep contracted with the business losing customers would affect the sales of the suppliers and also the running of the business. (D) Owners Owners and shareholders are interested in the business because they will be interest in their dividends and capital growth of their shares. Shareholders also have the power to elect the managing directors who make the decisions for the business. Owners have a big say in the aims and objectives of the business and how they should be decided. The shareholders can receive return in two ways. Firstly by a rise in the share price, so that they can sell their shares at a higher price than the purchase price known as capital gain and secondly based on the level of profits for the year, the company issues a portion of this to each shareholder for every share that they hold called a dividend. Below I have a copy of the major shareholders of Tesco. Harrods is a private limited company therefore is owned fully by quartar holdings. (E) Pressure groups Pressure groups are interested in whether the business is acting appropriately towards their area of interest. They are organisations of people who believe in the same cause. They have strongly held views and wish to influence some aspect of the society. These groups of people have more affect to the business than just one individual. Pressure groups have the right to criticise the government, hold meetings, protest and be able to have their views broadcasted and heard by the media. Pressure groups have to inform the local authorities and police to let them know they are going to protest. Pressure groups can protest in a number of different ways such as Internet, petition, letters and mass media. These can have a big effect9i on the public and if large numbers of people protest this could lead to the business changing. Pressure groups at Tesco’s will campaign for Tesco’s to stock fair trade products because they believe the workers are getting paid a fair price. (F) Trade unions Trade unions represent the interest of workers. Their main priorities are to guide, protect, help and support fellow workers. This creates a group of professionals wanting a say in their profession making individuals power stronger. They aim to achieve common goals such as protecting the integrity of its trade, achieving higher pay and increasing the number of employees. Trade unions originated in Europe and then they became popular in many countries during the industrial revolution because many workers were mistreated and underpaid. Trade unions may enforce strike or resistance to lockouts in furtherance of particular goals. Trade unions can also promote legislations favourable to the interests of their work members. Trade unions can provide benefits such as to insure members of unemployment, old age and funeral expenses. If trade unions put forward they wanted a pay rise of 5% there would be negotiation on both sides, the case would be unlikely but they could reduce the pay rise to 2. 5%. In France, Germany and other European countries, socialist’s parties and democrats played a prominent role in forming and building up trade unions. Trade unions have been said to have ineffective policies on racism and sexism, such that a union is justified in not supporting a member taking action against another member. The 4 main trade unions in the UK are: * General unions – these are for skilled and unskilled workers performing different jobs in different industries such as cleaners and transport workers * Industrial unions – these are for different workers in the same industry example the national union of miners covering workers at all levels in the hierarchy. Craft unions – these are fairly small unions for skilled workers performing the same or similar work in different industries such as musicians. * White-collar unions – these are for professional workers who perform the same or similar tasks in the same industry example teachers or scientists. (G) Local and nationals communities The community have an interest for the business because they get their products and services from them and they l ook for jobs from them. The community can have a big say on where the businesses location will be and expects the business to be environmentally friendly and as less disruptive as possible. The community have a big impact on the business because it is them that are customers to the business. If a new business was placed in a small community such as Tesco’s it could put other small businesses out of business example butchers, corner shops which could then affect the community if there shops that they shop at regularly have been put out of business due to this one store. (H) Governments Governments have an interest in the business because they collect tax from them. The government can affect the business in many ways such as businesses have to pay a variety of taxes to central and local governments including corporation tax on their profits, VAT on their sales and business rated to the local council for provision of local services. Businesses can also benefit from government incentives and initiatives, such as new infrastructure, job creation schemes and business relocation packages, offering cheap rent, rates and low interest loans. Tesco’s and Harrods have to work with certain acts of parliament such as the; 1. The employment relations bill, 1999 which states that employees who have been in employment with the same business for a period of one year have the right not to be unfairly dismissed. 2. The employment rights act 1996, which covers unfair dismissal, redundancy and maternity. 3. The sex discrimination act 1975, which states that it is illegal to discriminate against, an employee based on their gender or marital status. 4. The disability discrimination act, 1995 stating that is illegal for a business with more than 20 employees to discriminate against an employee or applicant or a job who may be disabled. Conflict between stakeholders * The local community can often suffer at the hands of a large business. Things such as pollution, noise, congestion and the building of new factories can lead the community to complain and if the business faces strong protests from residents and pressure groups it could cause the business to relocate o shut down meaning people would be unemployed. * Levels of authority can cause conflict between stakeholders. Example, a manager may not feel it has to respect and follow anything an employee says because they are lower and less important them then. There can be conflict between owners and employees if they feel they are not getting fair pay or bonuses. To keep the employees happy you need to build up trust and offering higher benefits and award programmes will assure this. * Suppliers and owners can have conflict if the products and services are not delivered correctly or on time. If a product was not delivered on time and the shelves were out of stock of that product the customers would have to go to competitors and the business would lose out on sales. Conclusion To sum it up stakeholders are very important for Tescos and Harrods to run efficiently and smoothly. Without the stakeholders the business wouldn’t have the money to run and they would not be as successful as they are today. To conclude stakeholders are one of the key factors to a business’s success or failure. The customers are Tescos and Harrods main stakeholders and these have the power to determine whether the business is a success or failure. The employees must do their job properly to retain customer happiness and ensure they will come back. Suppliers are an important stakeholder to the company and must maintain good relationships which will result in a less amount of problems and faster service. The owners are the heart of Tescos and Harrods and their decisions can affect many things in the business. They have to make sure their decisions will not result in a downfall of customers or cause problems with other stakeholders. Pressure groups must be listened to in order for the businesses to know what to improve on and what other stakeholders want from them. Trade unions are also an important stakeholder because company’s want to know what their workers want in order for them to do their best ability when doing their job. These stakeholders all must work together in order for the business to run smoothly. One problem can complicate relationships between other stakeholders which can put a stop to the business. Recommendations * I recommend that Tescos and Harrods listen to customer concerns and take them on board, acting on them to the extent that customers stop complaining, because they are the main source of income and they are vital to the business. I recommend that Tescos and Harrods treat all employees fairly and listen to what they want so they are treated with respect. If all the employees get what they want it makes sure that they are comfortable when doing their job and there will be no complaints. * I recommend that suppliers keep a good relationship with the business so they maintain a contract with them that will always keep them in business. Doing this will also return in the businesses favour because if Tesco needed something on short notice the suppliers might be able to get the product to them quicker.

Describe a patients health condition and needs

Describe a patients health condition and needs PATIENTS CASE STUDY. This essay aims to describe a patients health condition and needs during their stay at the hospital. Patient chosen has a chronic diarrhoea and abdominal cramping, his assessment will be fully discussed using Roper Logan nursing framework and rationale for choice of patient and framework will be considered. In addition, an aspect of care in relation to the clients needs will be identified and the strategies used in achieving the goals and aims of care will be analysed and discussed from a biological, psychological and social perspective. According to (NMC2008) code of professional conduct which stipulated that information about the patient, must be maintained and protected and should only be used only for the purpose it is intended. The patient will be addressed as Mr Abdul Cole in other to maintain confidentiality. Members of the multi-professionals involved in the care of the patient will be discussed as well. Mr Cole a 74 years old man lives with his son and daughter in-law in a two bedroom flat. He was admitted in the hospital due to chronic diarrhoea and cramping abdominal pain. After series of test done by the AE team, he was diagnosed with Clostridium defficile (C. diff.). Mr Cole has history of chest pain and pneumonia. The rationale for choosing this aspect of care is because I was assigned with a registered nursing to carry out the patients admission and all aspect of nursing process. Choosing this patient will also enhance my understanding of care delivery by examining the flexibility and responsiveness of implementing care plan and nursing frame work to changes in patient conditions. Cunha (1998) defines Clostridium defficile as a slender, Gram-positive anaerobic rod which is spore formation and motile and is capable of surviving in the environment for prolong period. Bacteria of this type may be a normal component of gut flora and flourish when other gut organisms are eradicated by antibiotics (Zadik Moore 1998). In 1980s it was identified as a major cause of antibiotic associated diarrhoea (AAD) (Duerden et tel. 1994). It is now one of the most commonly detected enteric pathogens and an important cause of nosocomial infection in nursing homes and hospital (Zadik Moore1998). C. difficile does not cause any problems in healthy people. However, some antibiotics that are used to treat other health conditions can interfere with the balance of good bacteria in the gut. When this happens,  C. difficile bacteria can multiply and produce toxins which then cause illness such as diarrhoea and fever. Diarrhoea results when the balance among absorption, secretion and intestinal motility is disrupted (Hogan 1998). It has been defined as an abnormal increase in the quantity, frequency, perianal discomfort and incontinence (Basch 1987). In Mr Coles case, his diarrhoea was associated with prolonged use of antibiotic to help cure his pneumonia which led to C.diff infection. In other for healthcare professionals to identify patients needs and ways to meet them, assessment has to be carried out on the information obtained by observing the patients general appearance, information from patient and their family, medical and social history, observation and physical examination (Hinchliff, 2003). According to Person et al (2002) nursing process is a dynamic and logical method in which the nurse may sensitively and systematically approach-nursing practice to achieve goals with patient and ensures care is planned and executed appropriately. The nursing process consists of five stages, assessment, diagnosis, planning, implementation and evaluation. Assessment is importance to determine a clients care needs and it is the crucial first step. Patients pattern and behaviours are compared with their current health status to avoid omitting care needed or may be provided care which are not needed. Nursing Diagnoses according to (Carpenito 1993), provides the basis for selection of nursing intervention to achieve the outcome fro which the nurse is accountable. Planning is the stage that helps to decide which problems are priorities, determining the goals for care and selecting interventions to create a plan of care. Implementing involves giving the care with interventions that are appropriate for the clients. Also includes documentation of care. Evaluation is the final step which involves deciding whether the intervention has helped the patient or the plans might need changing. Whilst the nursing process offers a systematic way of looking at care delivery, on its own it is not particularly useful as it does not give any indication as to what to asses. It indicates that care should be planned, implemented and evaluated but again offers little direction as to how to do this. Another way of organising the information needed collected by nurses is using Activity of Daily Living Model proposed by Nancy Roper, Winifred Logan and Alison Tierney (1996), this model can be summarised as consisting of four components, which all contributes to individuality in living , namely; the lifespan continuum from conception to death; 12 activities of daily living, five factors that influence each of these activities, that is, physical, psychological sociological, environmental and politico-economic; and a dependence/independence continuum. Although, all the stages of the nursing processes was mentioned and summarised, this essay only focuses on the process of assessment based o n activity of daily living by Roper Logan et al (1996). According to Miller (2000) assessment consists of collecting and receiving in formation about the patient and identifying any problem that may be detected during the process. It also involves systematic way of organising care through skilful interaction with patients, family and friends to asses how their condition has impact on their activity of living (Roper et al 1996). However, the equality of the assessment will depend on the nurses ability to put together all the sources at their disposal. According to Roper et al (1960), information gained in the initial assessment form baseline from which further information can be evaluated. The assessment carried out was base on Roper Logan and Tierney (1996) nursing frame work. The rationale for choosing this framework is that it uses a list of patients activity of daily living, maintaining safe environment, breathing, mobilising, eliminating, controlling body temperature, working and playing, sleeping, communicating, eating and drinking, personal cleaning and dressing, expressing sexuality, dying. This highlights basic human needs, impact of ill health on patients lifestyle (Andrews 2002). According to Roper et al (2002) the model allows the professionals to concentrates on the physiological functional abilities of the patient to carry out those activities of daily living independently. This essay will focus mainly on activities which are affected by the patients condition. Mr Cole was admitted in to one of the side rooms on the ward as he requires barrier nursing due to his toxic producing C.diff. Diarrhoea and enteric isolation notice was placed on the door of the isolated room. Segregation from other patient must continue until stool cultures are clear of infectious organisms. The policy of my place of practice is to treat infectious conditions seriously and adopt universal precaution such as wearing gloves, apron and gowns, disposing of all excreta immediately to reduce the risk of spreading the infection to others. I was accompanied to the patients side room by a registered nurse to begin the patients assessment. The doors were shut and curtains drawn to maintain patients privacy and dignity. Mr Coles information was collected from various sources such as her medical notes and families. Maintaining a safe environment It is very important that patient is safe in a particular environment especially when not supervised. This includes orientation, alertness and mental being. Mr Cole was very conscious at alert on arrival and during the assessment; he had no hearing or sight difficulties, no physical or learning disabilities. However patient was very restless and uncomfortable due to his abdominal cramp. Communication Ability to communicate effectively contributes to successful assessment, as it builds a relationship with the patient. According to Brooker (2003) communication is an important aspect of nursing intervention for any individual patient. In all form of care situation, the basic of the care is centred around the ability of the carers to form a relationship is deemed to therapeutic in that it based on mutual respect, trust and friendliness, which start from admission onwards (Roper et al 1990). Communication involves both verbal and non-verbal messages that convey feelings and information. The purpose of successful communication is to ensure appropriate social contact and professional interaction to meet the needs of patients and their families (Macleod Clark et al 1991). The provision of clear information and explanation on admission to hospital and prior to medical procedures may result in decreased anxiety, decreased pain levels, a reduced number of complications and side-effects of treatment, improved compliance, an enhanced coping ability and an increase speed of convalescence (Wilson-Barnett 1982). Patient was able to speak clearly he can hear and see but has difficulties communicating with us due to language barrier. Mr Cole understands very little English and was unable to give major information to nursing staff during the assessment. Consent was obtained from Mr Cole for his family to translate and express his needs. It is suggested that effective communication makes a positive contribution to an individuals recovery by acting as a buffer against fear and confusion (Nichols 1993). Other different way of communicating with patient includes body and sign language. Breathing The process of breathing is a fundamental aspect of life it is inevitable and could lead to a fatal consequence when the process is interfered. Breathing helps the balance between carbon dioxide (C02) and oxygen (02) in the blood. 02 is required by the body to release energy at cell level so that the individual can participate in activities. The waste product produced through the use of 02 is C02. During the assessment, we detected that Mr Cole recently had major episodes of pneumonia and chest pain, which might still have some impact on his breathing and health. Respiration supplies the body with oxygen and removes carbon dioxide through diffusion between alveolar of lungs and blood in the capillary (Marieb, 1998), changes could lead to tachypnoea or bradyproea, Mr Coles respiration rate was observed and recorded at 16 breaths per minute, oxygen saturation was 98% at that moment, he could breathe clearly without struggle and no whizzing noise was heard during the assessment. Ability to undertake a swift assessment of the clients ability to breathe and instigate removal of an obstructive and/or rescue breathing if needed is crucial. Factors which may affect breathing includes: psychological; stress, anxiety or depressions. Sociocultural; smoking, level of family support. Environmental; pollution or work related factor. Politico-economic; poor diet and or limited finances. Past history; past illness. Eating and drinking According to Catherine Caskett, good nutritional status is essential to an individuals health and well-being. Poor nutritional status as been associated with delayed recovery and an increase in mortality, which also increase the cost of health care. As the assessment continues, Mr Coles family was encouraged to discuss the patients diet history, medical history, social setting and his usual weight. Information given shows that Mr Cole has lost weight during the past 2weeks and due to his current condition he is prone to loosing more weight if a goal is not set to minimise his diarrhoea. Taylor (1997) state that diarrhoea can have profound physiological and psychosocial consequences on a patient. Severe or extended episode of diarrhoea may result in dehydration, electrolyte imbalance and malnutrition. Food aversions may develop or patient may stop eating altogether as they anticipate subsequent diarrhoea following in take. Consequently, this leads to weight lose and malnutrition. Mr Cole refused to eat and drink since the time of his admission. His weight and height was measured to calculate his body mass index (BMI) to monitor his weigh pattern whether gain or lose. According to bacon (1996) it was stated that body mass index is on of the most commonly used indices for assessing the weight status of adult patient. Mr Coles BMI measurement was 18 which prove that he was malnourished and underweight. Garbett(1999) argued that in nursing , it is important to understand anatomy and physiology of the body in order to detect any abnormalities, and make necessary intervention. Roper et al, (2000) stated that in the model of nursing, the state of individual in anatomical and physiological terms is planning and implementing relevant nursing intervention and evaluate the effects to help Mr Cole maintain sufficient food and water intake, he was prescribed IV fluids 200ml hourly and offered him frusibin energy drink. Mr Coles family were also encouraged to bring patients preferred drink and food which in turn might appeal him and help restore his appetite. Mr Cole was offered halal meal which is similar to that he has at home, reflecting religion and ethnic background. Small amount of food were presented because large r amounts may cause him to experience chest pain due to abdominal distension. (Redfern and Ross, 2001). A member of multi disciplinary team such as dietician was informed of his nutritional status. Eliminating This process is essential to life. Ability to maintain a balance between what amount to retain and excrete is important to patients well-being and preserve life. This can be a very sensitive topic to discuss with patients as many patient s despair at the thought of being unable to manage their own toilet requirements. Many of nursing interventions required are of a very intimate nature, and gaining the patients trust and consent along with their permission is very crucial. Mr Cole came in with frequent bowel movement which occur around 4 times every hour, he also experience abdominal cramp each time. During assessment, patient was very distress due to his condition because he has to cope with increased frequency of bowel movement, abdominal pains, proctitis and anal or perianal skin breakdown. Mr Cole was incontinence and was provided with commode for his private use to preserve his privacy and dignity during his episodes of diarrhoea. Mr Cole never had diarrhoea before and this episode of diarrhoea started after prolonged use of antibiotics prescribed for his pneumonia. After the assessment, a stool and fluid chart was implemented immediately; this includes noting the consistency and colour of stool, presence of blood, smell and type. To complete a fluid chart, patients input and output need to be monitored, recorded and documented on a fluid chart. Chart to be updated after every bowel motion type to be recorded using Bristol Stool Scales. According to (Wei et al 1997), initial treatment involves discontinuing antibiotics and providing supportive care. Mr Cole was prescribed vancomycin 500mg every six hours and paracetamol 500mg every 6 to 8 hours to control his pain and diarrhoea. A sample from the faeces was sent to lab for further investigation. Personal cleansing and dressing This activity involve far more than the physical act of cleansing the skin to reduce the potential of infection and injury. Personal cleansing and dressing is also important in promoting the psychological, social, cultural and overall well-being of the patient. Assessing the patient is important so as to offer them adequate level of assistance and to provide client with necessary information to help them maintain their personal hygiene needs. Mr Cole is independent with his personal care and requires no help to maintain good personal hygiene. However he needs prompting according to his son, patient can sometimes neglect himself. Information shows that patient lived with his son and daughter in-law, however he will soon be moving on to live in a shelter home. His moving had a great psychological and emotional strain on both his family and himself, especially considering the new environment he was going to live in. they were worry about how he was going to cope. Newton argues that anxiety mainly become a coping strategy like Mr. Cole felt his ill health inhibited him form staying with his family hence the high level of anxiety. Alexander et al (2002) believe that a patients anxiety may contribute to their symptoms getting worse than they actually are. From the outcome of assessment, I have learnt that psychological support is vital in anxious patients. Following the assessment, the nurses and other members of multi-disciplinary team liaised effectively to provide the care by responding to query raised by the nursing team e.g. psychologist for him and his family to address their anxiety and emotional worries. According to Hudak et al (2000) social cultural needs may refers to needs relating to the enlightenment of the mind or manners especially through intellectual activities , customs, culture and kinship system, lifestyle and habits and mutual relations of people around us and environment we are brought up in. As a function that is vital to sustain life, diarrhoea can cause anxiety, fatigue, sleep disturbances, feeling of isolation and depression (Roberts 1993: Hogan 1998). The impact on the ability to engage in necessary activities of living might result in dependence on others, loss of social and family roles and reduced quality of life (Margereson, 2001). Mr Cole belongs to Sikh religion therefore he is encourage and supported by family to socialise by visiting the temple regularly (twice a week) and celebrates other special occasions such as Diwali and birthdays. Family support is very important as it decreases the individuals stress (rock 1984 cited by Margereson). Failure to provide appropriate support may contribute to further psychological stress (Margereson, 2001). In conclusion, the frame work used helped to determine the patients ability in relation to activities of daily leaving. It has aid delivery of holistic care as each factor of each activity as been assessed and his level of independence or dependence determined to provide adequate level of care and nursing intervention. by using this simple framework, Roper, Logan and Tierneys help to direct our thinking in a more logical, sequential way and if every aspect of each activity is covered when patients are assessed a clear picture of their individual needs should emerge without the omission of any important point. However, the model has been criticised not to meet the needs of patient with learning disability or mental health problems. It also has a danger of reductionist approach in which patient are made to fit into the boxes rather than allowing flexibility. Nursing intervention is very important to help patient regain their normal self. One of these interventions includes pharmalogical approach and just simply providing a comfortable environment which enable client maintain his sexuality and dignity. For every nursing practice, there must be a rationale for decision on evidence based research other than experience as this defend care giving and safe guide the patients. An effective care requires not only a full understanding of patients particular illness, but also a grounding in social and physical science so that experience of each individual and family can be interpreted accurately. .

This reflective essay is centred on pain assessment

This reflective essay is centred on pain assessment For the purpose of the case study I intend to use Gibbs(1998) model of reflection as this model is clear, precise allowing for description, analysis and evaluation of the experience, then prompts the practitioner to formulate an action plan to improve their practice in future(Jasper, 2003). Wilkinson (2007) identifies assessment as the first phase of the nursing process in which a nurse uses their knowledge and skills to express human caring. It is important to choose an organised and systematic approach when caring out an assessment that enhances your ability to discover all the information needed to fully understands someones heath status (Alfaro-Le Fevre,2004) .This can be achieved by obtaining your information form medical record and nursing charts by physical examination of the patient and also talking to patient and their families(Wilkinson,2007). The use of objective data is more helpful in collecting information when the patient is ventilated and sedated, as they are often in the critical care setting, and this can be done by examining the patients vital sign, blood pressure, heart rate, temperature and blood results (Bulman and Schutz 2004). I have chosen pain assessment in post- operative ventilated patient. I have worked in ICU for 4 years during this time I have nursed many post- operative ventilator patients who were on continuous infusion of sedatives and analgesics. Many of them showed signs of inadequate pain relief and associated complications. Having undertaken this module I further educated myself in this field of nursing assessment I now know, or rather have an improved knowledge base and understanding of the different aspects of pain assessment tools and recognize the possibility that I have probably nursed many more patients who were demonstrating symptoms of inadequate analgesia and associated complications. Given an increased awareness and knowledge I have gained through teaching, research and current literature on this topic I now, also recognise the importance of this assessment practice in particular in relation to the ventilated, non- communicated patients in ICU. According to International Association for the Study of Pain (IASP,1979) pain is described as unpleasant sensory and emotional experience associated with actual or potential tissue damage. Clinically pain is whatever the person says he or she is experiencing whenever he or she says it does (Mc Caffery 1979) .Appropriate pain assessment is crucial to pain management. Patients self- report is the gold standard of pain assessment. However pain tools that rely on verbal self-report may not be appropriate for using non- verbal ventilated sedated patients in ICU. Pain assessment tool used in our critical care setting is based on a numerical pain rating score from 0-4, a score of 0 being no pain at all and 4 being the worst pain ever experienced. There is also a visual analogue scale for patients who have difficulty communicating, they can indicate by looking at the chart and pointing at either the happy face that has no pain or a series of faces showing different stages of pain (appendix t hree). These tools were chosen by the specialised pain care nurses working for the trust. The tools are favoured as they provide nurses with a quick, easy assessment. They are used widely throughout the trust to provide continuity of pain assessment.Both of these tools have proved successful in practice and are supported by the literature as being reliable and accurate in practice. However they depend greatly on the patient being able to express themselves or communicate verbally with the practitioner .Using these methods of pain assessment is not accurate on sedated patients with altered conscious level. In nonverbal patients the use of behavioural or physiological indicators are strongly recommended for detection of pain (Jacobi et al 2006). The patient in critical care may experience pain from many sources. Along with physical pain, psychological factors such as fear, anxiety and sleep disturbances may play a significant role in patients overall pain experience (Macintyre and Ready 2002). Urden et al (2010) states, pain can be acute or chronic, sensations are different in relation to its origin. Acute pain-duration is short corresponds to the healing process, ranges between 30 days to 6 months. Chronic pain lasts more than 3 to 6 months and can either or not associated with an illness. Somatic pain is well localised sharp, acute pain arising from skin, muscle, joints. Visceral pain refers to the deep, ill localized arising from an organ. Nociceptive pain occurs when inflammation stimulates pain receptors ( Urden et al 2010). Pain experienced in critical care patients are mostly acute and has multiple origins. Mr. Smith a 45 year old gentleman admitted to ICU following Laparotomy for small bowel perforation and faecal peritonitis. Mr Smith was cardiovascularly unstable and was unable to be extubated immediately after surgery due to secondary sepsis. He was receiving an infusion of Propofol and Fentanyl to keep him comfortable and provide analgesia. His medical notes revealed his past medical history of previous Cholecystectomy for gall bladder stones and biliary obstruction. I was assigned to nurse him on his second day in ICU. During handover the previous staff member reported that Mr. Smith became very agitated and hypertensive soon after he was repositioned to his side. Mr. Smith was given a bolus dose of Propofol infusion and the rate of Infusion increased. Whilst doing the Patient assessment I noticed Mr Smith is restless and not compliant with the ventilator. Arterial Blood Gas (ABG) performed which showed Mr. Smith is hypo ventilating. Meanwhile Mr. Smith became more agitated with e scalating non-compliance with ventilator and significant increase in his Mean Arterial Pressure (MAP) which was being monitored continuously by the arterial line and transducer. He was showing facial grimaces and moving his extremities restlessly. I tried to reassure him by talking to him, reorientating him to time, place and person, explaining to him that he is safe. Adam and Osbourne (2005) identifies that critically ill patients frequently require help with coping with many of the stresses like physical discomfort, isolation, fear of pain and death. By using strategies like communicate caring and understanding and provide information repeatedly and in sufficient detail for the patient etc. helps the patient to cope with the stress. But repeated reassurance and reorienting has not made any improvements in his current status. Pain is an important problem in critical care and its detection is a priority. Pain assessment is vital to detect pain (Urden 2010). Pooler-Lunse and Price(1992) emphasises that critically ill patients who are unable to communicate effectively are at high risk of suffering from pain. Poorly controlled pain can stress the sympathetic nervous system leaving vulnerable patients at risk of complication and can compromise recovery and negatively affect both morbidity and mortality(Puntillo et al 2004, Dracup and Bryan- Brown 1995).Mr Smith was ventilated and due to the effect of sedatives his level of consciousness was altered. In critical care factors alter verbal communication is mechanical ventilation, administration of sedative agents and the patients change in level of consciousness (Hamill-Ruth R J, Marohn L 1999 ,Kwekkeboom K L, Herr K 2001,Shannon K, Bucknall T 2003). The consequences of untreated acute pain in critically ill patients include increases in catecholamine and stress hormone levels which are potential causes of tachycardia, hypertension, increased oxygen requirements and decreased tissue perfusion (Blakely and Page 2001, Hamill-Ruth and Marohn 1991). Mr Smith was increasingly hypertensive and tachycardia. Despite giving increased oxygenation Mr.Smith was hypo ventilating due to non- compliance to the ventilator. Marshall and Soucy(2003) identifies agitation is a common problem in critically ill patients and has been shown to be associated with inadequate pain management. Agitation can have serious consequences with patience removing access lines compromising their oxygen needs by self extubating (Cohen et al 2002). Following discussion with the nurse in charge of the shift it was apparent that Mr. Smith was showing behavioural signs of pain. There were no other obvious reasons as to why he had become compromised with his ventilation.When I approached the medical team concerning Mr.Smiths increasing agitation and non- compliance to ventilation I was instructed to give a bolus of propofol and fentanyl and to increase the rate of propofol and fentanyl until Mr Smith was deemed medically manageable. I was decided to increase Mr.Smiths ventilatory support. Following the treatment Mr Smith became much more stable, he became less tachypoenic was synchronising with the ventilator; his blood pressure was within acceptable limits and monitoring in sinus rhythm. The clinician did not assess Mr Smith for signs of inadequate pain management. Unfortunately due to hypoventilation and non-compliance to mechanical ventilation, Mr Smith had to be remained on high levels of ventilation and increased levels of sedatives for the next few hours emphasising evidence by Pooler-Lunse and Price(1992), the physiological complications associated with pain including Pulmonary complications and increased cardiac workload as well as depression and anxiety and increased days of hospital stay(Desbians et al 1996).Upon further reflection I should have noted Mr Smiths agitation associated with inadequate pain relief. Had I been knowledgeable in this field Mr.Smiths agitation and physiological signs of restlessness and facial grimaces would have prompted me to carry out a detailed pain assessment. Had there been a behavioural pain assessment scale on the unit where I work that may have prompted me carry out the assessment and linked these signs as indicators of inad equate pain relief. During my further assessment of Mr.Smith I had various thoughts and feelings which included feeling apprehensive and self-doubt regarding the decision to increase sedation and ventilator support. Whilst reviewing his past medication history I noticed that Mr Smith had been on regular analgesics which are co-codomol and paracetamol and there was no indication for their use in his notes. Fink R (2000) recognises that reviewing patients past pain experiences and how did he or she usually react to it can be of good value when assessing pain and can help to decide treatment options ,by questioning patients family or significant other can provide us the information about patients pain history. Later during the visiting hours Mrs Smith came to visit Mr Smith. I have given her a brief update of his condition including the changes made to his sedation and ventilation. Then I enquired to Mrs Smith about the indication of those analgesics he was on .She revealed that Mr.Smith developed back pai n when he discharged to home after undergone cholecystectomy six months ago and he was prescribed those analgesics by his G.P(General Practitioner). She also mentioned that he had problems getting optimal pain relief post operatively even when he had cholecystectomy, and he would not tolerate lying on his sides. This co-related his agitation and restlessness happened when the night staff turned him to his side. I notified these things to the ICU doctors and raised my concern that lack of adequate pain management could be the reason for Mr Smiths earlier agitation. They also agreed on this possibility and advised to change fentanyl infusion to remifentanyl and to adjust the rate of the infusion to keep Mr Smiths pain relief optimal. Remifentanyl is potent analgesics, so ensure the patient is pain free but prevents over sedating the patient, allows rapid arousal and recovery from sedation thus facilitates daily sedation holds and neurological assessment( Dhaba et al 2004). He was also prescribed regular paracetamol and Tramadol when required. It was then decided to reduce Mr.Smiths sedation as he was haemodynamically stable, he was then able to respond and started following commands. Mr. Smith was now able to communicate if he had pain or not by squeezing my hand to command. Invasive technology can restrict the reliance on many behavioural indicators of pain (Bucknall and Shannon 2003) on the other hand it is argued that invasive lines enables constant monitoring of blood pressure (B.P) and heart rate (H.R), two commonly utilised indicators of pain and thus help to assess pain (Bucknall and Shannon 2003) .Even though Mr Smith was hypertensive and tachycardic this was presumed to be due to agitation. In a contradicting statement Bucknall and Shannon(2003) points out that the sympathetic symptoms i.e. Increasing B.P and H.R are also been found to be unreliable. Pooler-Lunse and Price (1992) emphasises that the Para sympathetic stimulation can result in less observable signs with prolonged pain, but pain intensity remains unchanged. The American Society for Pain Management Nursing (ASPMN) recommendations cited in Herr k et al ( 2002) emphasises that vital signs can be affected by other distress conditions, homeostatic changes and medications there for they should not be considered as primary indicators of pain.With conflicting evidence it is difficult to make decisions that best support this assessment practice. Anand K J S,Craig K (1996), Herr K et al (2006) states that behavioural indicators are strongly recommended for pain assessment in non- verbal patients , few tools have been developed and tested in critically ill patients. The Behavioural Pain Scale (BPS) and the Critical Care Pain Observation Tool (CPOT) are suggested and supported by experts for using uncommunicative critically ill patients (Li-D, Puntillo, Sessler 2008). BPS was tested and validated exclusively in ventilated, unconscious patients (Payen et al 2001,Young G 2006, Aissaoui Y et al 2005).The Behavioural Pain Scale (BPS) includes three behaviours 1) facial expression 2)movements of upper limbs3)compliance with the ventilator. Each behaviour is rated on a scale from 1 to 4 for a possible total score from 3 to 12. The BPS can be used quickly (2 to 5 minutes), most clinicians were satisfied with its ease of use (Payen et al 2001). The Critical Care Pain Observation Tool (CPOT) was tested in verbal and non- verbal critical ly ill adults (Gelinas C 2006,2007) its content validity supported by ICU experts including nurses and physicians (Gelinas C 2009). CPOT includes four behaviours 1) facial expression 2) body movements 3) compliance with the ventilator 4) muscle tension. Each behaviour is rated from 0 to 2 for a possible score of 0 to 8.Gelinas C and Hammond reports that feasibility and clinical utility of CPOT were positively evaluated by ICU nurses and agree it is easy to complete, simplicity to understand the usefulness for nursing practice. My experience of using a behavioural pain scale tool is limited, however I feel that if practitioners were able to assess pain more accurately then they would be able to manage there patients pain more effectively. Use of a behavioural pain score (BPS) evaluating facial expressions, limb movement and compliance with the ventilator has proved to be a valid reliable tool in practice. A recent study evaluating the reliability and use of the BPS consistently identified increases in pain scores after repositioning patients in the ICU. There were only small non- specific changes in the BPS after non painful intervention of eye care (Gelinas etal 2006). I nursed Mr Smith again 5 days later. He had since been extubated and was alert and oriented. Even though he could not remember the events when he was ventilated and sedated, he learned from his wife what had happened. He was very thankful to me for investigating the possible reason for his agitated behaviour and prompting the doctors about this and thus provide him adequate pain relief. Upon further reflection and evaluation of my assessment of Mr.Smith I feel there have been positive and negative aspects of the assessment. The positive aspects include- I have been able to gain further knowledge in various aspects and tools of pain assessment .By reviewing patients medical notes and gaining history from his wife I have linked his agitated behaviour and taken the possibility that these are signs of inadequate pain relief and I have managed to convince the medical team regarding this in order to act on it. Current research identifies multidisciplinary collaboration provides optimum care for the patient (Bucknall T, Shannon K 2003), this emphasises the need to perform regular, accurate pain assessment and care full documentation (Bucknall T, Shannon K 2003). When considering the negative aspects of my assessment I feel I did not use a holistic approach instead I considered Mr.Smiths agitated behaviour as a physical problem, I was concentrated to treat the symptoms and not the patient. As described in Roper Tinney L(1989) assessment tools achieving patient centred nursing is important. I could not identify Mr.Smiths behavioural indicators of pain primarily due to my lack of knowledge about this assessment tool as well as there was no unit assessment protocol which includes the behavioural assessment scale, Unfortunately this is not isolated, it is in fact a universal problem .Camp (1998) points out that like many speciality nurse critical care nurses and physicians recognises that there basics education was insufficient for caring for patients in pain. Accurate detection of the critically ill patients pain is not an easy task for ICU nurses especially when the patient is unable to self-report because of mechanical ventilation or due to the effects of sedatives. Stanton (1991) argues that pain assessment and management may be significantly improved by enhancing nurses knowledge combined with improved communication of the problem. NMC(2008)emphasises that having appropriate knowledge, skills and attitude towards pain, pain assessment and its management is essential to provide optimum patient care. Use of pain assessment tools is highly recommended by Kaiser(1992), identifies that an effective pain assessment tool as part of the documentation improves communication between patients and nurses as well as nurses and medical staff. Even though we had a pain assessment tool (0 to 4 numeric pain assessment scale) due its limitations on the use in non-communicative patients it was not contributing much in patients pain management. The previous practitioner documented the patients pain score is Unable to assess as the patient is sedated and ventilated. This highlights the inappropriate use of our pain tool currently being used in practice as a patient is unable to verbalise or communicate their pain if they are sedated and ventilated. Although todays guidelines strongly suggest that the use of a standardised behavioural pain scale to nurses who care for uncommunicative patients, further research is still needed to fully understand the behavioural and physiological responses of critica lly ill patients who are experiencing pain (Herr K et al 2008). On reflection my underpinning knowledge and confidence in this area of assessment has developed tremendously. I feel that I have gained knowledge and insight into an important patient assessment, from an initial lack of sufficient knowledge I am now able to bring evidence based practice in the clinical area which will benefit the patient and my colleagues. By understanding the physiology, pain assessment tools and the complications of poorly managed pain, I will have the knowledge and skills to manage these patients. The use of sedatives and analgesics places a great deal of responsibility on critical care nurses and they must understand how the drugs work , complications of their use and how to monitor effectiveness staff must understand sedation does not equate analgesia (Ashley and Given 2003). The use of an appropriate pain assessment tool and management algorithm is essential for adequate pain management. Since undertaking this study, it is of interest to note that our practice development nurse and the specialist pain nurse for ICU ,have jointly developed a behavioural pain assessment scale similar to the BPS and CPOT scale, and staffs are encouraged to use it routinely. I feel that my action plan and recommendations are to promote the use of the pain assessment tool by educating the nurses and emphasising the importance of this assessment to improve patient outcome. The need for education to train staff on how to use the tool would take both time and money. The NHS is already under extreme financial pressures and money for training is not readily available. However if an improvement in pain management was successful then patients stay may be shorter, thus having a beneficial effect. I am also aware of the importance of not relying solely on the assessment tools but the use of both good nursing assessment and assessment tools to improve optimal patient management, shortening the recovery time and reducing the likely hood of complications (Ashley and Given 2003). A sedated, ventilated, non-communicative patient is vulnerable and relies completely on those providing care for them but as to their family at this anxious time. Education and training will improve patient care and ultimately patient safety which is paramount. Therefore I will take the knowledge and information I have acquired back to my clinical area as I have a duty to provide a high standard of practise and care at all times (NMC 2008)

Julius Lester Essay examples -- Children Literature African American E

Julius Lester Julius Lester is an African American Jewish Professor at UMass-Amherst who writes children's books along with teaching classes in departments of Judaic Studies, History and Literature. Before Julius was a professor at UMass-Amherst; he was a graduate of Fisk University in 1960, where he began as a professional musician and singer. He then furthered his career to direct the Newport Folk Festival and then went on to host a live radio show. Presently, Julius is known as "foremost among black writers who produce their work from a position of historical strengths." Julius writes children's books to teach moral and political values. In many of his books, he uses African American characters to relate back to the days of slavery. For example in his book; John Henry, he uses an African American character and ,makes him into a hero. The character in the book is able to break through a cave faster than a machine which symbolizes strength and courage among the African American race. In Les ter's book, How Many Spots Does A Leopard Have?, he uses n...

A Comparison of Runes and Magic in Beowulf and in Anglo-Saxon England :: comparison compare contrast essays

Runes and Magic in Beowulf and in Anglo-Saxon England      Ã‚  Ã‚  Ã‚   In the Old English poem Beowulf we see the mention of runes, which were used with connotations of magic or charms. Examining evidence from historic times, we find that early Englishmen were fully conversant with the Germanic runic alphabet and that runes did have special connotations.    In Beowulf the hero is in deadly combat with Grendel’s mother in the mere. He is at the point of being killed by the monster when suddenly God shows to him the presence of a special sword nearby on the wall. Beowulf seizes the giant weapon and kills the monster. Then:      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   that sword had begun to melt  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   in battle-bloody icicles; that it melted away  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   was as much a marvel as ice itself  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   when the Father unwinds the bonds of frost,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   loosens the freezing chains of water,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Who keeps the power of times and seasons;   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   He is the true God. . . . Already the sword  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   had melted away, its blade had burned up;  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   too hot the blood of the poisonous spirit  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   who had died within. . . . the wave-sword burned up,  Ã‚  Ã‚  Ã‚  Ã‚   quenched in that blood. . . . then the strange gold hilt  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   was placed in the   hand of the gray-bearded king,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   wise war-leader old work of giants;  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   after the fall of devils it came into the hands  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   of the lord of the Dane-men, from magic smithies;  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   once the fierce spirit, long God’s opponent,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   guilty creature, and his murderous mother  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   had quitted this world, it came to the power  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   of the best overlord between the two seas,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   of all world-rulers in Scandanavia  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   who gave good treasures. Hrothgar spoke,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   examined the hilt, great treasure of old.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There was engraved the origin of past strife,   when the flood drowned, the pouring ocean killed  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   the race of giants. . . . On its bright gold facings  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   there were also runes set down in order,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   engraved, inlaid, which told for whom   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   the sword was first worked, its hair-keen edges,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   twisted gold scrolled in the hilt,  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   the woven snake-blade(1605ff).    Chickering in his â€Å"Commentary† would have us believe that the melting sword is a reference to patristic theology, to St.

Defeating the Aztec Empire

Hernan Cortes, a fierce Spanish conquistador, landed at San Juan de Ulua, in April 1519. With him, Cortes had 508 soldiers, one hundred sailors, artillery cannons, eleven ships and sixteen horses. Cortes and his small army, marched through Mexico, forming alliances with Aztec rivals, until reaching the Aztec capital of Tenochtitlan. Tenochtitlan was the capital city of the massive Mexican empire known as the Aztecs or Mexica. It had a population of 200,000 people; almost three times that of the largest city of Spain, Seyville (Windschuttle, 43). Within the next two years, Cortes and his men had triumphantly defeated the Aztecs and taken control of Tenochtitlan against all odds. (Daniel, 1992) So how, despite be hopelessly outnumbered, without the possibility of new supplies or reinforcements, fighting other native tribes and Spaniards, and the Aztecs on their own turf, did this tiny Spanish force defeat such a formidable army. Today, there are a number of reasons why the Spanish have believed to been able to overcome such odds. A combination of poor Aztec military tactics against advance Spanish weaponry and strategy, a weak Aztec ruler, the spread of disease, Tenochtitlan’s poor governing over its populace, and the interconnectedness of Aztec military and religion ultimately led to the demise of its empire. The first phase of the Spanish invasion of Mexico took place in April 1519. In defiance of the Governor of Cuba and his expedition sponsor, Cortes took control over his forces and moved them inland. On the way, Cortes met resistance from other locals, who he eventually conquered and absolved into his army as allies. After reaching Tenochtitlan, capital of the Aztec Capital, the Spaniards were initially greeted as foreign ambassadors. Other claims state that the Aztecs viewed Cortes as the god, Quetzalcoatl (Windschuttle, 50). The Spanish did not return the favor, eventually kidnapping Emperor Montezuma and, using him as a puppet, ran the country. The Governor of Cuba, angry with the defiant Cortes, sent a force under Panfilo Narvaez to end his exploration. As the natives before him, Cortes defeated this force and had them join him in his conquest. In Cortes’ absence, the Spanish troops left behind had massacred Aztec nobles during a religious festival, a confrontation that also left emperor Moctezuma dead. The Spanish were forced to leave Tenochtitlan, ending the first phase of the conquest. For a year, the Spanish forces recuperated, gathering eight thousand native allies and new supplies, including three naval vessels. â€Å"To ay siege to a lake-girt city requiring the prefabrication of thirteen brigantines on the far side of the mountains, eight thousand carriers to transport the pieces, their reassembly in Texcoco, the digging of a canal and the deepening of the lake for their successful launching (Clendinenn, 72)† For a year, Cortes and his native allies lay siege to the city of Tenochtitlan. Using experience military tactics, against an Aztec force unprepared for them, Cortes and his troops captured the capital cit y, killing almost all inside. This would be the end of the Aztec empire. Moctezuma II was the ninth ruler of Tenochtitlan and the first Aztec emperor to make contact with Europeans. Moctezuma’s poor leadership and unwillingness to deal with the invading Spaniards are regarded as large factors of the Aztec’s demise. He immediately assumed the foreigners to be foreign ambassadors and was blindly unable to see their true intent. At their first meeting, the two leaders exchanged gifts. Clendinnen stated that â€Å"Cortes interpreted Moctezoma’s first gifts as gestures of submission of naive attempts of bribery. To the Aztecs, Moctezuma gifts were most likely â€Å"statements of dominancy, superb gestures of wealth and liberality made the more glorious by the arrogant humility of their giving (Windshuttle, 40). † After living months in Tenochtitlan, the Spaniards launched a coup, taking Moctezuma as a hostage. When he was taken hostage, he preferred to attempt to bribe the invaders rather than, although have the ability to, expel t hem from the city. Being heavily religious, Moctezuma would depend on his oracles for a plan of action, proving his indecisiveness and wasting valuable time. Indecisiveness of the leader and inaction to deal with the invaders led to the demise of the Aztec empire (Windschuttle, 45). The Aztec’s authoritative rule over its different cities and populations allowed for Hernan Cortes to recruit thousands of native allies. Only recently rising to power, the Aztecs depended on governed regions and populations for taxing tribute that included food and other necessities. â€Å"They exacted tribute by threat of terror and retribution. In fact, each year, the agricultural harvest heralded the onset of a six-month season of war, in which warriors from Tenochtitlan would go out to other settlements to challenge them to battle, to bring back captives for sacrifice, and to carry off women, children, and slaves (Windschuttle, 54). † The capital city of Tenochtitlan’s use of murder, sacrifice, and firm rule over its lands caused other Aztec cities to desire them to be overthrown. The Aztec’s authoritative rule was heavily resented, and did poorly to attain any loyal sentiments among its far-reaching population. Cortes was able to easily break these shaky alliances, and have these angered native populations join him in getting rid of the Aztecs. By the second siege of Tenochtitlan, Cortes had almost every other Aztec city fighting behind him. It was these native allies that led to the final massacre of the remaining Aztecs in Technoctitlan (Clendinenn, 91). Since the first contact between Europeans and American natives, diseases such as smallpox, measles, and yellow fever had spread like wildfire, killing millions of natives. The spread of disease to natives lacking immunity also contributed to the fall of the Aztecs. During the second siege of Tenochtitlan, a Spanish soldier from the force sent by the Governor of Cuba, had brought the smallpox disease with him. This disease spread quickly and was very effective at killing the natives. â€Å"Smallpox was the biggest single cause of death in the Valley of Mexico and killed off many more Aztec warriors than did Spanish swords or guns (Windschuttle, 46). † When the second siege of Tenochtitlan began, their population had dwindled so much that defeat was seemingly imminent. A major reason for the Spanish victory over the Aztecs was their experienced and trained military soldiers. They had foot soldiers with pikes, swordsmen, muskets and artillery. Spanish forces, trained by numerous wars with the French, were comprised of tercios, or units of 250 men. Soldiers were well-trained and put through drills that stressed the importance of the unit working together. Cortes and his army, due to lack of men, had to adjust to follow Spanish military strategy. â€Å"During the siege of Tenochtitlan the force was reformed into nine companies of about fifty men each, grouped in turn into three â€Å"divisions,† each of three companies. This handling of troops was in keeping with Spanish practice of the period (Daniel, 189). Cortes’ sixteen horses also proved to be incredibly effective against the Aztec soldiers and a played a vital role in their victory. â€Å"At Cintla in Tabasco, early in the expedition, thirteen horseman route a huge enemy force engaged with the infantry. At Otumba the wounded and exhausted cavalry repeatedly broke through the overwhelmi ng numbers of Aztec troops until they retreated (Daniel, 189). † Without the help of rival native groups, such as the Tlaxcala and Texcoco, the Spanish would have been even more outnumbered by the Aztec forces. This tactical use of alliances was possibly the most important aspect of Cortes’ conquest of Mexico. Overall, the use of infantry, cavalry, and allies seemed to be too much for the Aztecs. The tactical organization of the Aztec military was much different than that of the Spanish. The Aztec forces were comprised of every able man, who had little option, as opposed to the Spanish forces comprised of volunteers. Their forces were divided into four units of four hundred men, commanded by a councilor of the emperor. Most of these troops were low class commoners. There were also units of elite soldier fraternities, such as the Eagle and the Jaguar, that provided increased military skill to the Aztec army. Typically, Aztec forces would use open formations and attempt to overcome their foe using flanking tactics (Daniel 120). The Aztecs and their fortified cities were also not used to siege warfare or the use of cannons. â€Å"European cities had over this time adapted their construction, supplies and defenses to the possibility of a siege. Moreover , at the time the Spaniards were departing from America, European fortifications were going through a rapid redesign because of the challenge presented by the invention of cannon. In Tenochtitlan, however, Cortes found a people who had never even conceived of European-style siege warfare, let alone constructed defenses against it (Clendinenn, 56). † The Aztec use of open formations and inability to defend against cavalry attacks led to a disadvantage on the battleground. The Spanish army’s closed sword-wielding formations were able to hold up well against the Aztecs, often breaking through their lines. The cavalry, time and time again, were able to break up the Aztec formations, causing them to retreat. An example of the overpowering Spanish army tactics was highlighted by the Battle of Otumba. Here, a large Aztec army confronted exhausted Spanish forces. Cortes ordered his cavalry to attack the military leaders and the Aztec army’s flanks, breaking through their lines and causing confusion. The Spanish infantrymen engaged the Aztec foot soldiers, continuing to attack as the Aztec retreated. These tactics of Cortes and his men proved to too much even large Aztec force. Aside from military tactics, the military technologies utilized by the Spanish army were far more superior to the weapons of the Aztecs. Europeans were much more advanced in terms of weaponry, using weapons of steel and iron against the Aztec’s wood and stone. As the Aztecs considered kills with long-distance weapons to shameful, their arrows and darts were only meant to injure their opponents. Aztec warriors carried wooden arrows, knives of flint stone and wooden clubs embedded with flakes of obsidian, a form of volcanic glass (Windschuttle, 45). † These clubs with stone tips were the most effective weapons carried by the Aztecs. Spanish soldiers on the other hand carried â€Å"cutlasses, lances, arrowheads and armor all forged from iron and steel, plus hand guns, crossbows, and cannons (Windschuttle, 1997-45). Their lances and cutlasses were much more efficient in hand-to-hand combat, with the ability to kill opponents with one strike. The Spanish also brought with them armored cavalry, cannons, crossbows, brigantines (ships), and handguns. In the second siege of Tenochtitlan, the three brigantines lay waste to Aztec canoes fighting in defense of the city. The Aztec military was seemingly outmatched and did not intimidate the invaders in the least. â€Å"Spanish soldiers, in fact, found Aztec weapons so inconsequential that they abandoned their own heavy metal armor in favor of quilted cotton (Windschuttle, 55). The Spanish weaponry was too much for the outdated weapons of the Aztecs to have a chance. One historian, Inga Clendinnen, argued that the biggest Aztec disadvantage was how they viewed military confrontations. As they did with the Spanish, the Aztecs would send food and gifts to an enemy viewed as inferior. The Aztecs felt that war and religion were interconnected. The Aztecs preferred hand-to-hand combat with the intention of using captives for sacrifices to the gods. They were opposed to killing opponents from a distance and viewed surprise ambushing as an unthinkable military tactic. The Spanish army, however, cherished their long-ranged weapons, such as their muskets and crossbows. To make matters worse, Aztec warriors considered being killed by a long-distance weapon as an unworthy death. â€Å"Spaniards valued their crossbows and muskets for their capacity to pick off selected enemies well behind the line of engagement: as snipers, as we would say. The psychological demoralization attending those sudden, trivializing deaths of great men painted for war, but not yet engaged in combat, must have been formidable (Clendinnen, 80)† Cortes also launched numerous attacks in the orning, known as dawn raids, charging on unsuspecting villages and slaughtering men, women, and children. Cortes and the Spanish army learned to take advantage of the Aztecs’ religious military tactics. Spanish soldiers would pretend to retreat, tempting Aztec troops to pursue chases in the hopes of acquiring sacrificial captives. Cortes would then simultaneously have his troops turn around and slaughter the unsuspecting Aztecs (Windschuttle, 52-53). Cortes states that â€Å"Sometimes, as we were thus withdrawing and they pursued us so eagerly, the horsemen would pretend to be fleeing, and then suddenly would turn on the,; we always took a dozen or so of the boldest. By these means and by the ambushed which we set for them, they were always much hurt; and certainly it was a remarkable sight for even when they well knew the harm they would receive from us as we withdrew, they still pursued us until we had left the city (Clendinenn, 80). † The Spanish used siege warfare to ultimately bring down Tenochtitlan. They constricted its perimeter, forcing other tribes to join them against the Aztecs, and cutting off supplies to the Tenochtitlan’s inhabitants. â€Å"Siege was the quintessential European strategy: an economical design to exert maximum pressure on whole populations with active engagement, delivering control over people and place at least cost (Clendinenn, 83). † Aztecs detested this form of warfare, preferring the more honorable hand-to-hand combat. The Spanish, however, would avoid this type of warfare, sticking together in tight formations and using long-distance weapons and artillery. In the end, despite being heavily outnumbered, outgunned, and malnourished the Aztecs followed their prideful ways and refused to surrender. â€Å"Again they encountered ghostly figures, of women and gaunt children, and saw the warriors still stationed on the rooftops, but silent now, and unarmed, close-wrapped in their cloaks. And still the fruitless pretense at negotiation, the dumb, obdurate resistance (Clendinnen, 91). † Here Cortes seems to be dumbfounded by the resilience of the seemingly defeated Aztecs. In the coming day, Cortes and his army killed twelve thousand more Tenochtitlan inhabitants. Cortes again tried to get them to surrender. â€Å"I said many things to persuade them to surrender but all to no avail, although we showed them more signs of peace that have ever been shown to a vanquished people for we, by the grade of our Lord, were now the victors (Clendinnen, 91). † After two more days of Aztec refusal, Cortes released their native ally forces, which mercilessly murdered â€Å"forty-thousand† more Aztec civilians. Between the 15th and 16th centuries, the Aztec empire had been a thriving empire with far-reaching influence throughout Mexico. The eventual demise befalling them would go blindly unknown as Hernan Cortes and his army of Spanish Conquistadors explored Mexico. Within two years of seeing Tenochtitlan and meeting its emperor Moctezuma II, the Spanish forces of roughly five hundred men had destroyed the Aztec city and killed off most of inhabitants. There are many reasons that contributed to this extremely unlikely scenario. Moctezuma made the first blunder by accepting the invaders as foreign ambassadors and basically allowing them to roam freely around the city. His eventual kidnapping at the hands of the Spanish seemed to be the beginning of the end. After the initial siege of Tenochtitlan was unsuccessful, the Spanish were able to recuperate in a neighboring city of Texococo. Preying on weak ties between Technotitlan and the cities it cruelly and authoritatively ruled over, Cortes was able to combine a native ally army. In conjunction with the Spaniards’ advanced weaponry and military strategy, and using the poor religious-backed military tactics of the Aztecs to their advantage, the Aztecs fell within a year. The defeat of the Aztecs seemingly opened the door to European colonization of the Americas and the further destruction of the continents’ natives.