The Critical Success Factor Report for Oriental Mart Nottingham Coursework

The Critical Success Factor Report for Oriental Mart Nottingham - Coursework ExampleThis growth in business prompted its expansion into traditional retailing by opening its first store in cc8 view it in the busy city centre. The reason for this move was to provide a convenience store for spate at the city and for people who are visiting it on a daily basis. 1.2 Research Objectives The moment of carrying out this Critical Success Factor Report (CSF) was to establish the factors that contributed to the success of a business. This report is aimed at researching on the factors that made orient mart to be successful in the online retail business sector. This is to be achieved through collecting feedback from customers and asking the management questions relating to the strategies and practices that make the order a success. This is in order to pin down what makes the business a success in its area of specialization. The rationale of this study was to gather culture regarding the com panys success in the retail sector. 1.3 Methodology In carrying out the research process, the use of questionnaires was assiduous to get the required selective information from customers. This research process involved the printing a total of 200 questionnaires that were distributed to the public. Half of these questionnaires totalling 100 were given to regular customers who were willing to take part in this survey. The other half(a) was distributed among the public consisting mostly of the people passing near the store. This was to ensure that the individuals participating in the study were conscious of the store. This was necessary for the research to collect accurate data. The research was done for a period of one week, and the participants came from the unalike parts of the city. For this research, 165 of the 200 questionnaires were valid, and their feedback was relevant to the exercise. The remaining 35 were discarded since they were invalid. It was important that the custo mers took part in the exercise since the data will give a reflection of the customers thoughts and perceptions in the subject. Out of the 165 questionnaires that were valid, the customers make full only 62. The number was relatively lower compared to the 97 forms questionnaires that were filled by the public. In addition to the data collected, the manager of the store participated in an informal interview to give added information that was useful for the research. This was to get information from the managements perspective. This provided a balance in the data collected in that it was all inclusive of both the consumers and the convenience store. 2. The Retail Audit The retail audit is carried out to determine the target commercialize and the factors that affect this mart in relation to the business. These factors influence how the market responds to the retail business. This is essential since markets are high-voltage in that their needs and preferences change over time (Bullen, 1995, p14). . 2.1 The Market The market refers to the section of the population progress to a demand for the goods or services of a business. For any business to be flourishing, they require to take over the capability to attract and maintain their market. If a business realizes this, it will have a profitable upset leading to further growth and expansion of the business. Nottinghams market consists of the city dweller and visitors that come to the city. Their market is broad since a convenience store offers products that are needed by the public in

San diego pension crisis Research Paper Example | Topics and Well Written Essays - 1250 words

San diego pension crisis - Research Paper ExampleThis was a bad designer that would set a devastating trend way into the future. Successive local governments would use the pension funds in hand for other purposes when the economy started to slow down. To give an example, in 2002 when the city government was unable to give provoke raises to employees, the city offered increases in pension of 25 percent. This was done despite the fact that the citys cash contributions into the pension fund had lowered. It was under this corrupt scheme that the City Council promised to increase the pension benefits provided a visualise that allowed the city reduce funding to the pension kitty was approved by the retirement board which is controlled by the labor union and city employees. Despite warnings military issued by Diann Shipione, who was a trustee of the pension board, the underfunding was approved. Diann warned that the see would in the long run bankrupt the city. A private attorney who represented the board as well as indicated that the plan was most likely illegal. Mayor Dick Murphy, who was running for re-election in 2004, denied allegations that the city had serious financial problems at a time when deficit in the pension fund was close to hitting one one million million dollars. Murphy was forced to resign later due to the pension scandal. In January 2006, seven people were indicted for confederacy to commit fraud. These included the former pension systems director and the staff attorney. It is believed that this system of dipping into the pension funds was also emulated by other cities but its effects in San Diego were extreme. Recent efforts by Mayor Jerry Sanders to develop measures to clean the pension situation have been met with resistance from different circles. The ballot measure which was proposed by the mayor and councilman Kevin Faulconer was plant under a lot of scrutiny. The proposal would have overhauled the retirement benefits for the cit y workers. It was met by heavy literary criticism from both sides of the political divide. Councilman Carl DeMaio who developed another separate proposal on how to deal with the pension issue was one of the most vocal critics of the mayors proposal. He is at one time quoted to have referred to the mayors proposal as a toothless tiger (Gustafson, Critics Say). He reiterated that the proposal did not comprehensively deal with the pension problems that the city faced. The proposal if approved would have introduced strict measures of conducting red-hot hires for public safety jobs. It would also have eliminated guaranteed pensions for new hires and replaced this with 401(k) s (Gustafson, Critics Say). The suggestion that guaranteed pensions for firefighters, police officers and lifeguards was not supported by politicians. Other leaders of unions especially those whose members were to be touched also vowed to rally their members to fence the proposal. Frank De Clercq who heads the fir efighters union in San Diego projected that if implemented ideals of the proposal will lead to challenges during recruitment into the affected jobs (Gustafson, Critics Say).This is because people will be reluctant to risk their lives in jobs that do not guarantee their well being after retirement. He further added that firefighters risked their lives on a daily basis in order to save the lives of others (Gustafson, San Diego Pension). Jay Goldstone, who is the chief operating officer of the city, was of the opinion that a lot of nest egg were to be made

Patient Information Sheet and consent form Essay

Patient Information Sheet and consent form - prove ExampleThe results of this audition will give us more specific data regarding your fitness and cardiac health that will be dropd to further customise your pulmonic replacement program.In 2014, every last(predicate) the patients, who participate in pulmonary rehabilitation at the Repatriation General Hospital, will be asked to do this maximum course session cycle test as part of the standard pre pulmonary rehabilitation assessment. Data of this test will be used to further adjust your pulmonary rehabilitation exercises.If you participate in this explore project, there is a 50% chance that you will and a 50% chance that you will non get this maximal exercise cycle test (we will decide this with the help of a calculator program). If you will not be asked to do the maximal exercise cycle test, you will be offered the equal pulmonary rehabilitation program that has been offered in the Repatriation General Hospital until the re st of 2013. Instead of the maximal exercise cycle test, data of the walk test will be used to fit the pulmonary rehabilitation program. Programs without maximal exercise cycle test are offered in most of the centers around Australia.At the conclusion of 2014, we will evaluate, whether the use of the extra maximal cycle test leads to further increase of the effects of pulmonary rehabilitation. If this is the case, the standard use of the maximal exercise cycle test will be continued. If not, we most credibly decide to go back to the previously used pulmonary rehabilitation approach.If you agree to particiate, we will use the measurements that will be done as part of your pulmonary rehabilitation measurements (at the start, by the 8th week, and ratiocination of the program). So, you will be asked to do three sets of measurements before the start of the program, after 8 weeks, and at the end of the program. All measurements include completing a set of questionaires, a walking test, a nd breathing test.You will

Information Communication Technology in the developing countries Essay

Information Communication Technology in the evolution countries - Essay ExampleThis paper pass on discuss countries labeled developing countries in selected areas of the world, such as Ghana in Africa, Vietnam in Asia, Afghanistan in the Middle East, and Ecuador in Latin America and the way in which these countries are trying to develop their technology, economy, and golf-club to meet the demands of a fast-growing global population.In trying to determine how to define a developing as opposed to a genuine country, it is necessary to look at a countrys economy and to question how that economy works. Most developing countries have always been dependent on agriculture, but the boundaries between developed and developing countries are apt to blur at present as a growing middle class in some developing countries have a life-style similar to the more than smashed countries. In the 21st century, information technology and the Internet have created a global economy that has stretch o ut throughout the world. In countries dependent on a local economy with exporting of goods their main cum of income, it is evident that they are becoming more dependent on imports as the population moves away from agriculture. With more education and implementation of electronics and computers offering increased communication for the poorer countries, their economy is improving. However, the bottom line is rising prices in an improved economy. and poverty remains for a percentage of the population who cannot afford the rising prices.This paper allow for study four different areas of the world in which a changing culture is very often affecting their economy-Ghana in Africa, Vietnam in Asia, Afghanistan in the Middle East, and Ecuador in Latin America. In addition, countries moving into a developed category, such as China and Mexico, will be evaluated, with a further discussion of antecedently labeled developing countries such as India, Philippines, Czech Republic, and Ireland, an d finally the present economic difficulties being set about in developed or soused nations, such as the United States. By researching the technological, economical and friendly development of developing countries in terms of the improvements that are being brought about through ICT, the effectiveness of the electronic age for these areas can be determined. In addition, the effort to alleviate poverty, as the line between the wealthy and the poor widens, must be addressed.VIETNAMThe latest buzz word to describe the goal of developing countries is familiarity society. According to Nguyen & Johanson (2007, pp. 1-2)A knowledge society is assumed to have at least two in-chief(postnominal) features information and communications technologies (ICTs)and a critical mass of knowledge which forms the basis of asignificant member of a national society.Vietnam, presently labeled a developing country, could in time become a knowledge society, but changing traditional values have brought abo ut tension and adjustment problems in this ancient culture. In a knowledge society, economic, social and cultural activities combine with government to foster learning. As noted by Nguyen and Johanson,

Strategic management of healthcare organization Research Paper

Strategic management of wellness mete out organization - Research Paper ExampleHealth damages is a hindrance to management of diabetes, normally with dire consequences. Diabetes management costs can be as much as two hundred dollars a month. Adults who are uninsured are less potential to receive care needed for disease management than those with insurance. Meanwhile, those having health insurance have hardships obtaining needed care when there is inadequate coverage.Common place events, most oftentimes, lead to adults losing health insurance. These are divorce and deviate or loss of ones job. Health insurance depends on the applicants employment and family status, state of residence, health status, income, and age. Any change in these f phone numberors often can and will lead to automatic disruption or change in health coverage. On average, two and a half million Americans lose insurance cover every month (Karen et al 88).It is difficult to regain ones health insurance once revo ked (Karen et al 89). Adults suffering from the debilitating disease who apply for health insurance individually are more often than not denied. Many of the victims can not access qualification for Medicare or Medicaid. When there is the availability of impudently coverage, most of the diabetes patients find the coverage to be inadequate or unaffordable. Adequacy, affordability, and access barriers are redundant and give rise layers upon layers of hardships which the diabetics cannot overcome. According to studies, when an individual loses health coverage during a period of sickness, it becomes more difficult for them to regain it as compared to healthy people (Karen et al 90). They thus go for long spells of no insurance, which worsens their situation.Policy makers need to act toward making health insurance adequate, affordable, and available. Presence of options regarding health insurance is not a guarantee for health security. More often than not, policy makers attempt to paper over cracks in the health insurance corpse via the creation of safety net protections, which

Inventory management ratio analysis of Ford and GM Essay

Inventory management symmetry analysis of Ford and GM - Essay fountThe livestock turnover ratio determines the managements readiness in converting the available inventory into sales. A low inventory turnover is a bad sign to a companys process since it indicates that the companys products risk deteriorating. The companys product will diminish in mensurate due to overstaying in the stores. Due to this phenomenon, companies dealing with perishable goods usually have very high inventory turnover (Bull, 78). The second-rate days to sell inventory is a financial measure that gives the willing investors an conception of the duration it takes for converting the available inventory into revenue. Therefore, a companys performance ratio determines management efficiency in converting the stock into sales. In most scenarios a low average days to sell ratio is desirable. This ratio varies between industries. The average days to sell ratio is calculated as the total terms of inventory div ided by cost of sales and the result got from the computation multiplied by 365 days. An average day to sell ratio forms one part of the cash conversion cycle. It represents the conversion raw square into cash. The days sales outstanding and the days payable outstanding are the opposite two stages in the cash conversion cycle. By determining how long a company holds on inventory before selling measures the companys efficiency ratio. The ratio gives the average time it takes for a companys cash to be tied up. The inventory turnover ratio of Ford is 15.9 measure while that of GM is 10.0 times.

Application of Enginerring Principles Coursework

Application of Enginerring Principles - Coursework Example due(p) to centrifugal force, clean mud overflows, and the waste particles (together with some amount of fluid) enters the mesh through the prat government issue of the hydrocyclone. The vibrating mesh further sieves the unwanted particles out, leaving only the pure mud suspension to pass through it. Hence pure mud suspension is obtained. The efficiency of the mud cleaner and the range of sizes of the waste particles that may be sieved out, depends on many factors like cone angle, diameter of the inlet, diameter of overflow pipe, diameter of the bottom outlet of hydrocyclone, the fineness of the mesh, vibration characteristics of the mesh, viscosity and density of the fluid, density and size of the waste particles etc. b) The third components where angular motion is involved be hydrocyclone, pump, drill pipe. Hydrocyclone Here, the centrifugal force that is a characteristic of a system having angular motion is utilized to separate coarser and finer suspended particles. In hydrocyclones, viscous forces are also produced by the angular motion. Because of the difference in densities of the suspended waste particles and the fluid, there will be difference in the centrifugal forces each of these subjected to. This difference in the centrifugal force is trusty for the legal separation of coarser waste particles and finer (required) particles that are suspended in the fluid. ... ncing has to be done properly, bearings give up to be selected properly, lubrication should be taken care of, centrifugal forces (and centrifugal stresses) should be considered while designing the components, blade reactions have to be considered for pumps. Drill pipe Many a times drill pipes rotate and the rotation is greatly responsible for the cutting. But sometimes, even when the rotation of the drill pipe is not the main force behind drilling, a slight rotation of the drilling pipe is necessary for a successful drilling. As with any rotating components (which have angular motion), balancing has to be considered while designing drilling pipes. In addition, buckling should also be taken note of. c) Velocity distribution in a drill pipe during the first stage is effrontery by (cm/s) (1) Differentiating (1) The acceleration, (2) (i) When acceleration is minimum, Hence, from (2), (3) Solving (3), When acceleration is minimum, Hence, Hence, (ii) Assuming that the acceleration is proportional to the velocity during the whole full stop Final velocity in a further 35 second = Final velocity after (20 + 35) second = Final velocity after 55 second = (12%/20)*55 = 33% increase in the velocity (iii) To get the displacement profile for the first stage, integrating (1) Displacement (4) where c is a unbroken The displacement profile is a fourth order polynomial during the first stage. The displacement profile may be obtained by plotting (4) using MATLAB. The profile looks similar to Figure 2. Figure 2. Displace ment Profile for the jump Stage To get the velocity profile for the second stage, acceleration proportional to velocity during the whole stay of the second stage implies that the velocity variation during this stage is exponential. The profile looks similar to Figure 3. Figure

The Struggle to Create Post-Cold War Europe by Mary Sarotte Essay

The Struggle to Create Post- coldness War Europe by Mary Sarotte - Essay eventThe author, Sarotte, has in like manner been able to in effect bring together the flawless descriptions. The author has besides taken into answer for an analysis which is challenging in terms of the creation of the post Cold War order (Dale 2009). present the focus of the earmark has been on German aspect of the overall period. The author has also been able to effectively look into the historical perspective and has also been able to keep track of the events in order of how the events occurred (Sarotte 2010). In the case of most of the geopolitical events, it was found that the 1989 events did not stay in link with the initial omen that had been developed (Sarotte 2010). The book by the author has focused on the reports and bases that flip been focused on the diversify by the statesmen and the other governmental officials. The overall book and the document is very well laid a delegacy and describ ed. The book however does lack new information. The topic of discussion however has been on a whiz topic of Nato expansion which makes a major contribution. There was one underlying question throughout the Cold War which focused on whether the Soviet communism was the cause for the Washington to build up their forces in Europe. The doubt here was whether this has been the cause for the stationed forces or whether it was simply to validate the existence and the presence of Nato (Sarotte 2010). In cartridge clip with the disappearance of the Soviet, the answer to this was clear and evident. The other main question that related to Nato was that of the nuclear weapons. The book has also taken into account the several questions of nuclear weapons and the questions relating to the shadows of the denuclearisation of Germany. The questions of the presence of the US military in Europe have also been gamey. The author has been a little hesitant and unsure of Nato expansion without having a clear idea of the benefits of the expansion (Sarotte 2010). Here there is little attention and positive elements that the author finds in her book slightly Bush and the author has presented Bush to be a very tactful leader who also shows high boldness. There argon two main elements that are found to be missing in the book. Firstly, the way the book has been developed and presented, this could have been written several years ago and the overall analysis as presented in the book, could have been presented in a much more effective manner (Sarotte 2010). There are numerous elements in the book where there have been irrelevant discussions and there has also been a major disconnect in the overall discussion. Here of these one of the examples has been of the marketing strategies discussed in the paper. The second major demarcation of this book is the lack of focus on the corrupt activities of the Chancellor which could have been brought out in a more effective manner. Here these activi ties have a major role in the overall lawsuit as well as the persuasion of the Germans and the unification with the Atlanticist (Dale 2009). As a whole, the book has been well presented and also very thoroughly researched. Here however a lot more positive elements could have been presented in the book to provide a higher level of acceptance and also more recognition to the book as a whole. The author has been able to effectively use all the research to provide a well presented book, with a few tweaks and improvements, the book and

How would Frederickson recalculates the definition of 'self-evident Essay - 1

How would Frederickson recalculates the definition of self-evident truths - Essay ExampleGeorge Frederickson differs that he defined the truths although may get on as self-evident has to be contextualized according the existing order of the day. Civil right which is inherently raw(a) right of man for Locke has to be defined according to the four models of ethnic relations for Frederickson which are hierarchy, acculturation, pluralism and separatism. two Locke and Frederickson may have advocated the emancipation of man but their methods and perspective are different. Both recognized eurocentrism or the perceived superiority of the individuals in America that came from Europe but Frederickson was more benign compared to Locke who was predisposed for ethnic pluralism that is fully inclusive and based on the free choices of individuals to construct their own ethnic identities (642). Locke however sightly like his predecessor Hume reflected the general thinking of the day where the American colored Indians are to be classed with children, idiots and illiterates because of their deprivation of facility to reason (Shohat 88). And Locke defined this to be true and self-evident which needs no justification because it is the graphic order of man. ... These theories define how people differed from each other and how they should interact. a) Hierarchy This type of social relations has been the dominant allele entity in defining truth in the early part of American history. This ethnic relation has claimed rights and privileges that are confined to a particular group and excluding others as unfit to be equal. This type of social race defined the Indian conquests and black enslavement during the colonial period. It holds that people who differed from the old-stock Americans of British origin are inferior. b) absorption Assimilation may be more benign and less racial in the classical maven compared to ethnic hierarchy definition of social relations but it is still h inged on the premise of the superiority, white and unchanging character of the ingroup (Frederickson 635). Thus it follows that the outgroup is inferior and needs to conform to the ingroup through assimilation to achieve equality and stability in society whose truths are defined by the dominant ingroup. c) Pluralism The pluralistic point of view of social relations celebrates the differences among the various groups in society and does not judge a certain ethnic origin to be inferior or obliterate them through assimilation. Truth is not monopolized by the dominant ingroup because ingroups cease to exist in a pluralistic society. It posits that the cultural diversity does not defeat the notion of equal rights and mutual understanding but is in fact desirable to sustain a democratic nation state. The distinction in this theory is not race or color but rather the degree of civilization an individual has attained or how they have evolved from barbarism to being civilized. d)

Child development shot answer Assignment Example | Topics and Well Written Essays - 500 words

Child development shot answer - Assignment deterrent exampleFirst Law For all of the human beings, their traits are heritable and transferred by means of generations. This law indicates that no calculate where the kids are raised some of strong makers in their behavior are the result of heredity. A effected theory is, half of the variation in intelligence, personality and life outcomes is heritable.Second Law Genes affect a persons behavior more than the effect of a person being brought up in the same family. This law relieves that the effect of upbringing on a childs behavior is rough 0% to 10% rests of his traits are all genetics.Answer Their proposed theory of development with genetics is that the genetical traits in any case have an effect on the environment changes and both of them have a direct or through experience impact on 3 geeks of correlations Passive, Evocative and Active. If a child is raised in a tragic environment then chances are that in an evocative environm ent he would start wake negative traits.Q5. List and define the 4 attachments styles assessed in childhood through the Strange Situation. Then fork out an overview of the parenting styles or patterns of caregiving that are thought to foster each of the 4 attachment styles. Describe or explain the social learning, cognitive developmental, and ethological explanation so of how infants form primary attachments.Answer Secure attachment. In this part of attachment the child feels safe, explorative and happy. He trusts the person he is with and knows his needs will be fulfilled. In this case the parents response quickly to the childs need and are always there for him when needed.Avoidant attachment. This type of attachment tells us that the child is not that happy, he does not feel explorative and understands that his needs great power not be met. In this case the parents are usually distant and detached to the child.Ambivalent

Xbis wk5 discussion question Essay Example | Topics and Well Written Essays - 250 words

Xbis wk5 discussion question - Essay ExampleIt has enabled monitoring of employees work and go for of emails enhancing business ethics. In case of research work carried out by a manager to decide on whateverthing, IT use has a great advantage. IT reduces un plasteredty, transform data volumes into manageable levels, while boosting confidence of the results.According to Dursteler, digital dashboards be real time visualisation tools of critical business indicators that help in decision making (Dursteler, 2012). Indicators, therefore, deliberate a snapshot of a family at any given time. The focal point of a company after getting real time information can take action and prevent some results, which could deviate from the expected.A focussing cockpit is a room used by managers to control an operation without flicker from the rest of the team. It was common during the World War II and it has gained importance today where it is used by management to control companies. concern cockp its are needed for two reasons. The first one is effective information supply, which assumes that managers run through a pool of data, most of which cannot be used for decision-making and thus need to be sorted out. instruction presented is standardised to enable better management decisions.Secondly, management cockpits enable effective management collaboration and coherence. Management team is characterised by people from different expertise and background who can tackle a certain task in many different ways. Their coherence influences the entire company to achieve its objectives. Thirdly, managers revisit management issues severally every year enabling better results and correction of goals where

Proposal document Essay Example | Topics and Well Written Essays - 250 words

Proposal document - Essay Exampleadvancement of technology has brought with it additional academic pressures since professors sojourn that students can harness the information highway optimally to enhance the learning process and, concomitantly, expectations have come up insofar as quality of student output is concerned. Currently, there are four hundred unexclusive computer stations at the IUPUI library that provide access to campus electronic resources and to the internet, but they are non connected to the net either locally or wirelessly. In fact, it is not possible to download information on some computers in the library that are not equipped with the necessary software.The Policies One of the variables that wee things difficult is the set of policies imposed at the library. In the IUPUI library, there are four types of computers that students are permitted to mapping with added caveats, as listed belowThe problem is the inability to download data using all computers avail able at the IUPUI library. This is a direct fallout of the library policy as detailed supra. Limiting the types of PCs that may be used for downloading data to only two categories, i.e., PCs with yellow tags and MAC computers, reduces the computer units usable in downloading genuine software in furtherance of their assignments and projects. According to the Help Desk Supervisor, Adam, there are only eighty-six PCs on the third and fourth floors with yellow tags. Although MAC computers can also be used to download data, many students are not be able to use them due to their unfamiliarity with MAC computers.Even with the assurance that MAC computers are fully utilized, the paucity of units available is an impediment that is beyond the control of students needing access to PCs. ready reckoner Information Technology (CIT) major students, like me, are left with no recourse but to buy their own Laptop computers and bring them to the library, which is an undesirable and avoidable stop- gap measure.An analysis has been carried out by me to

Compare and Contrast (Society) Essay Example | Topics and Well Written Essays - 750 words

Comp ar and Contrast (Society) - Essay ExampleShe advocates for individual mirth in a marriage rather than sticking in a marriage for a lifetime because it is what orderliness requires. Slater on the some other hand, analyses the consequence of self think up and its effects on a clement being. She examines the distinctiveness of bulk with lavishly and low self esteem. Society norms in both cases are predictable and easily determined. As Kipsin says when one is married they are expected to exercise obedience, compromise and stay as a couple for a lifetime. She argues that such an expectation from golf-club in the modern world is in some way unrealistic. She argues that modern eff maximizes on submission and minimizes granting imm social unity. She feels that a marriage should be build on freedom and wanting more (755). She feels that marriage is like having a soldier watching over someone completely the time. To her traditional societies allowed household dictators and pe tty tyrants in the private sphere of a family. She believes that love should be subjected to other forms of emotional life than subjugation. To her, a marriage necessitates a sophisticated working acquaintance of the intricacies of mutuality (752). mutuality according to Kipsin id to recognize your partners need and strive to fulfill them. She further says one should meet these needs to the satisfaction of your partner such that you become their desire thus attaining intimacy. She argues that mutuality requires communication so that your partner slew understand your needs, desires and even sensitivities. She contradicts these with traditional societies where marriage was considered a business enterprise between families. Partners who hardly knew severally other get married not because of their mutual interests but because of family interests. Thus, she argues these relationships were not based on love thus expecting them to last a lifetime in unreasonable. She argues that the mai n thing is for one to be quick and if society if a marriage is not working one should leave. She says that one cannot be tied in an unhappy union when she can be happily on her own. Society tends to judge people who are separated or divorced as ill-behaved, but she says this should not be the case thus should be avoided. In addition, she says that one should not be seen as lacking character because she is alone but be given their space. She beholds individualism something that society is against. Society always works as a collective unit where all are inclusive. That is why if one is not married, they begin to question. According to Slater, self esteem is a challenge to many American people. She uses research works by scientists like Baumeister and Emler to analogize her views. She argues that self hold is crucial in the pursuit of contentment. She says that self esteem is not the maim reason why people feel good about themselves but how they relate with others. She uses research work done to analyze high and low self-esteem. She adds that low self esteem is not a dangerous aspect of life. Low self esteem is not the cause of poor academic performance since people with low self esteem tend to do well in life like others and even do better because they fork up harder (859). In discussing her views, Kipsins encounters several challenges that sway from society expectations. Marriage is a respectable institution in society and to gather the courage to argue about it is difficult. Kipsin boldly tackles marriage

Strategic Marketing Research Paper Example | Topics and Well Written Essays - 2750 words

Strategic Marketing - Research Paper ExampleBefore acquiring into the issue of knowing whether marketing is a constraint on innovation, we should first get to know and mensurate the basic purpose of strategic marketing. So starting with strategic marketing, it is that sort of marketing which the organizations and companies use in order to create such thinks for the company which should not only be fitted to satisfy the customers need and demands but also increase the productiveness and profitability of the company.Now here it should be noted that productivity depends on the satisfaction and retention of customers of the company. When the customers go forth be satisfied from the products of the company, they will work as a source to attract more customers for the company and as a result, the productivity and the profitability of the company will increase. As we know that when we get a customer, we get one customer, but when we loose that customer, we loose a hundred customers. So , such a marketing plan should be implemented which should not only declare old customers but also should be able to attract more customers.All these methods have a significant importance in marketing of a companys strategic plans. And they have actually proved to be successful for various organizations for the purposes of customer retention and increased productivity and profitability.Tybout and Calkins (2005) found that either organization should typically create and develop a well written strategic marketing plan which should be able to promote the innovative products of any organization. Not only that, it should also be able to relate the implementation strategies regarding those plans. Scott (2007) found that innovation helps an organization in achieving dominance in a competitory market and suitable marketing strategy is always a key towards a successful innovation. Shilbury, et al., (2003) found

Quantitative reasoning Essay Example | Topics and Well Written Essays - 750 words

Quantitative reasoning - Essay ExampleAccording to Thomas Day If indecorous drug reactions were classified as a disease it would rank as the fifth leading wooing of death in the United States. (About Medical C ar for The elder, n.d.) Elderly people eject nearly 30% of all drugs. This group of people takes drugs more than than any other social group. Elderly people have many different problems with their health, thats why they take medicine to relieve hurting in different parts of body. One of the main problems for them is taking medicine. The interaction of drugs is the most dangerous. The average senile person takes nearly three-four prescription medicine at a time. Sometimes people dont understand that there are some side effectuate.The combination of drugs can be very inevitable for effective treatment, but it needs special attention and care. Elderly people are more assured to medicine than young ones are, because of the changes in functions of the organs such as kidney s, liver, etc. If there is too oft medicine in the blood elderly people can face such side effects as memory loss, dizziness, retention of fluids, confusion, internal bleeding, sometimes even death. They are also more levelheaded to particular side effects.Dosage is very important. It must be taken into consideration that the level of dot for young people wont do for older ones. Usual doses and their frequencies are too broad(prenominal) for them. Inappropriate dosage can be dangerous and cause many problems. But there are exceptions when older patient needs a high level of medications, for example, in case when resistance in the cells is being treated.Another problem is inobservance of dosage and its frequency by older people. Some of them take more than it is prescribed trying to recover faster, some neglect taking all necessary medicine in time or refuse to take it at all, some of them have problems with memory or confusion. Thats why it is extremely important for care

Economic Impacts Essay Example for Free

Economic Impacts EssayThe fervour on the World administer Centre in Manhattan had happened on September 11, 2001. The fill out had led to the devastation of numerous buildings and lost of lives. This had greatly alter not provided the citizens of the United States. The incident had also affected the preservation of the country. accord to the enshroud of Mr. George Kahn (2001) , the vice-president and economist of Federal Reserve Bank of Kansas, US economic maturement had already slowed dramatically. Based on the experiences in the division 1996 to 1999, a growth in the GDP has been go through. It is only logical to think that GDP will continue to rise in the next few years. However, hearty GDP has slowed to a 2.8% sum up of growth last year. Un use had moved down from 3.9% in th year 2000 to 4.9% in August.The slowdown in the economy had led to unexpected increase in zero prices and re-evaluation of the prospects for incorporate earnings. Prices in the stock mark et afford been affected, and consumer spending began to slow down. In early September, prices on energy began to stabilize and consumer spending had hold-up. Although manufacturing activity continued to decline but in a s turn away rate as comp ard to what happened in the early part of the year. However, this has all changed later on the attack in September 11. 2001. looney (2002) has used categories to differentiate the different economic impacts of the attack in the United States. His categories were found on both types. First is the nature of the impact and second is the length of time the economy has affected the country. In this paper, the causality would use the length of time the impact has on the economy. These effects would be divided into three split The short-run impact, the intermediate- condition impact and the long-term impact.Short-term impacts of the economy hatful be further categorized into two. These be the immediate short-term direct impact and the imme diate short-term indirect impact. Looney (2002) had enumerated several short-term impacts after the September 11, 2001 attack.For the immediate short-term direct impact, it was say that Lower Manhattan of smart York had lost an forecast of 30% of its office space because of the attack. Reports stated that an estimate of 200,000 were destroyed or relocated out of b ar-assed York City. Estimated cost of destruction of physical assets in businesses amounts to $ 14Billion for private business, $ 1.7Billion for the local and state assets and $ 0.8Billion for federal enterprises. Rescue, cleanup operations and other cost cogitate to these two is approximately $11 Billion. Total direct costs as computed by Looney (2002) in the article, is estimated to be at around $27.2 Billion. However, Mr. Alan Hevesi, had considered other factors that was not included in the article of Robert Looney. Hevesi (2001) considered the lost of human capital which is estimated to be at $11 billion. These a re the lives of the workers who had been killed during the attack. This figure is based on the expected earnings during the persons remaining work life.Indirect short term impacts of the attack are the following Consensus forecast for the GDP growth of the US economy is lowered by 0.5 office points in the year 2001 and 1.2 percentage points in the year 2002. Implied projected cumulative lost from the attack up to the year 2003 is estimated to be half a trillion dollars. Private sector investments went down the said(prenominal) with their inventory levels. The attack had shown the government that an additional investment is needed for the security of the country.It is estimated that an increase of 9.25% in defense team spending was used by the government. Firms such as security and information technology had increase in demand. Federal Reserve had lowered the price of credit and and temporarily liquidated their assets to safeguard the integrity of the financial governance and save businesses from bankruptcy. Aside from the impacts stated above by Looney (2002), Hevesi included factors such as disabilities and combat injury to be at $3Billion, business hoo-ha, training and liability losses to be at $21 Billion, acquit Lost Rents of $ 1.05 Billion from both the damaged and destroyed buildings and Lost wages which amounts to $9.6 BillionIn the medium term, Looney had defined several sectors that had been affected by the attacks. Five areas were highlighted on his report and these are the Insurance, Airlines, touristry and other service industries, Shipping, and Defense.Losses of the Insurance industry are estimated to be at $30 to $58 Billion. These losses are the highest record in the history of the country. Primary insurers have increased their premiums and dropped their coverages for terrorism related risk, this in turn had affected other key industries. Strongest impacts of the redress were seen in the aviation, tourism, transportation, construction an d energy generation sectors. Commercial property and liability insurance rates have been raised by 30% on the average.The terrorist had used airplanes in order to trigger the attack on the World Trade Center and the Pentagon. This had pebibyte in putting the aviation industry in a weak position. An estimate of 20% slack on the service orders had been ecperienced by airlines. Government support and airline passenger traffic was below typical and an estimate of 100,000 layoffs has been announced. Employment opportunities which were normally up in October and November fell by 80,000 or an estimate of 8% from the expected.Another sector that has been greatly affected is the tourism and service sector. These include hotels, tours, automobile rentals, travel agencies, and civilian aircraft manufacturers. As stated by Looney (2002), hotels have reported higher vacancy rates and employment in the sector as a whole fell by 58,000 in October and November. Relative rectitude Values decline d by 15%. Preliminary report of Fiscal Policy Institute in New York (2001) included attendance of people in the Broad room theatres had also decreased..The Shipping sector was in a way affected by the attack, Maritime shipping rates had increased from 5 to 10 percent on average in the two weeks after the attack. Relative stability of freight rates ,despite the decrease in fuel costs and under-utilized capacity of the ships implied that transportation cost had increased because of the attacksDefense sector had experient a significant increase on security-related programs in the budget for the year 2003. An additional budget of $48Billion was proposed for national defense. country of origin security budget was also increased from $20 Billion in 2001 to $38 Billion in 2002. An enhancement on the training of first responders which are the fireman, police and rescue workers were done, total preparation amounted to $8 Billion for domesticated defense spending.The Fiscal Policy Institut e or FPI (2001) included in their report losses on advertising because after the attacks commercial runs on television networks were cut down. FPI (2001) had estimated that there would be a 1,000 reduction in advertising employment and a 3% drop of revenues would be experienced by the advertising sector.Looney (2002), enumerated five effects in the economy. These effects are higher operating(a) costs, higher level of inventories, higher risk premium, Shift of resources t the military defense, and the shift away from globalization.As stated above, several increase in spending for defense had been experienced by the country, and higher insurance premiums were also done in the industry. The attacks and also led to longer wait for time activities because several sectors and consumers are already cautious. These three reasons had led economist to say that higher operating costs maybe experienced by the industries in the country.Since businesses had been interrupted because of the attacks , several companies were not able to resume immediately. Businesses may be requisite to hold larger inventories at scale for fear that their suppliers may not be able to pass around the materials that they needed on time. An evidence on these was shown in the article of Looney wherein the auto industry proceeds was interrupted because availability of components were not immediately shipped out because of the delays in the crossing of the US-Canada Borders.The attack may have lead investors to avoid risking their money in businesses. As a result, higher risk premiums may be passed on to businesses in the form of higher interest rates, and lower equity prices. This could also lead to lower equity prices, business investment lowering and smaller capital stocks.The attack had been a terrorism activity. In response to this issue, the government would most likely divert their attention in strengthening the countrys defense through the military. Many resources may be diverted to militar y use. Research and Development Resources can be also shifted to concentrate on the development of new devices to thwart terrorism activities.Since there had been interruption in the cross-borders of the country, investors may think twice in investing abroad and concentrate on domestic investments. During this time, the anthrax scare is already being shown in the media. Several investors and the government may have taken this into consideration as such higher cost could be experienced because the businesses and the government would closely inspect items going in and out of the country.In the Chicago GSB magazine, the authors have included economic recovery for the country. According to Kevin Murphy, part of the debate team, expected recovery of the economy may occur within 15 months after the attack. Measured loss in the economy is estimated to be at 0.6% of the total asset of the country. Judging from the percentage of economic loss, the percentage shows a very minimal figure. Ga ry S. Becker, another part of the team had also stated that the country had retained basically all the human capital prior to the attack and because of this, the US economy would recover fully.It has been 6 years since the attack of the terrorist in the United States. Prior to the attack the economy of the country is already in the decline stage and this had been accelerated by the attack in the World Trade Center. Although the attack had greatly affected the economy, it is necessary to think on the before bit of the country because that situation had also affected the impact of the attack. The economy of the United States had already recovered since then, however, same security measures are still being by the country to address the issue of terrorism.

Drama Coursework Essay Example for Free

Drama Coursework attemptThe main reason I chose this extract was that there were cardinal female characters in the extract and dickens female actors in the group. I samed the way the relationship between the two characters developed during the extract. At the beginning of the play, there is a professional, quite friendly relationship but by the end, both characters hate each other. I also liked the way my character, Mrs Lyons, descends into madness.When I first started to rehearse this play, I gear up that it was harder than I expected. This is the first serious play I have been involved in, so I comprise it hard to say the lines convincingly and naturally.I suggested that I should talk with a more educated verbalize and that my partner, Becky, should talk with a more common voice to emphasise the social difference between the two characters. I also suggested some ideas for what we should wear.In my coursework I wanted to present a convincing picture of a wealthy, educate d woman who, faced with a extremely distressing, seemingly insurmountable personal problem, sees what looks like a perfect solution, but which ends up driving her to madness. I wanted to initially gain the audiences humanity for her predicament by showing how much she wanted children and to show her as a reasonable person.I considered the second scene the most important as this was when my character discovered that her employee was expecting twins and couldnt afford to assert them both and when the plan for Mrs Lyons to pretend to be pregnant and to keep one of the babies was hatched. In this scene, she promises Mrs Johnstone that the baby give be better off with her, and that Mrs Johnstone will be able to see him every day as she comes to work. However, in the next scene, she breaks that promise by sacking her. I wanted to show that the sacking was do by Mrs Johnstones paranoia. In the final scene I wanted to demonstrate that my characters mental health had deteriorated.I tried to portray that she was wealthy and educated was by talk of the town in an upper-class, educated parlance, and by get dressed in a smart suit. I could have improved my performance by making my accent more pronounced, doing my hair in a more sophisticated way, and wearing some tasteful make-up.In the first scene I tried to gravel her longing for a child by delivering the terminology as if I was completely wrapped up in my problem and as if I was talking to myself rather than anyone in particular. To demonstrate this, when I said the lines about only buying such a big house in the hope of having children, I looked down at the table rather than flavor at my partner because I wanted to make it seem as if Mrs Lyons felt vulnerable because she was creation so open.I concentrated on what I was doing at the time, which was getting something out of my bag, to try and convey that my character was fighting back tears, and didnt want to look at Mrs Johnstone in case she showed her any philanthropy or pity, which might have made her cry. I think I could have emphasised my characters reaction when she found out that Mrs Johnstone was pregnant in a similar way to Kara when she choked back her tea.In the second scene I wanted to show the first signs of my characters madness, when, on learning that Mrs Johnstone is expecting twins, she comes up with the phenomenal idea that she should fake her pregnancy and take one of the babies. I tried to express how she got more emotional by speaking more quickly and by the tone of my voice. I also moved nearly a lot and started to talk more to myself than to my partner as my character got more carried away with her plan.In the third scene, where Mrs Lyons sacks Mrs Johnstone, I started off talking in a very authoritative tone and excludeed shopping centre contact with Becky because the supply teacher explained that when you have a problem with someone, you dont look at them. As the talk develops, and Mrs Johnstone threaten s to take the baby away or tell the police, I wanted to show that Mrs Lyons was manipulating Mrs Johnstone by vie on her superstition and lying to her that shell be locked up if she tells anyone what happens. I showed this by getting mop up up to Becky and talking quite slowly and with a deep voice, in a threatening way. Because I am quite a bit taller than Becky, I was also able to look down on her, which reflected the difference in class between the two characters.I think it was a mistake to avoid mannerisms as compared to some other groups, whose little individual touches made their plays stand out, our performance was quite boring.

In Defence of Harry Flashman Essay Example for Free

In Defence of vex Flash patch EssayIt is intelligible why the first mention of the character of Harry Flash human being the opportunistic philanderer of his Majestys service who lied and cheated his dastard(prenominal) way through the Victorian pages of his fictional memoirs by George MacDonald Fraser is enough to deter the browsing lady, though utmost be it from any hotshot to say it should.Since patterns of book-buying snake across the sexes like a flailing sidewinder, it would be hopeless to say as to where on the shop shelf the batch might lay to rest. Nevertheless, for a series of stories far as well as overlooked for the publics common good, what could the otherwise fairer sex also find to appreciate in a man whose charm seems as fictitious as the women who f altogether for it? To put it more simply can this man to borrow the blurb be all bad?If the name Flashman is shouting forward from the back of your mind, hold up the Lord Flashheart be named as the bothering heckler? Dont think him an unwanted associate, for Blackadders slavering womaniser could be seen as an burlesque of the Flashman persona and certainly close to what Harry himself may have become had he not, by hand and boot of queen and empire, been thrown into the Flemingesque scenarios he haphazardly emerged from, some the wiser and better-shaped.Unlike the all-consuming debauchery of his comedic counterpart, Harrys lechery is merely a tempered impetus punctuating his desire for the English comforts that makes for the only form of patriotism youll see in him, if you can call it patriotism the patriotism of Bond it most certainly is not. What differs Harry from James is awareness, and when fetching stock, the idiom trumps the ammo. It would be daft to credit Harrys decision making with the weighing of political consequence, however that would be a laughable excuse something he doesnt begin to admit.Its fear that has his mind running back to the delighted English riff-raff and the spread of beds that await. Though isnt to think with your legs the best strategy for the reporter? Reluctant maybe, Harry is a better reporter than he is a soldier. This cowardice kept him alive til a time when he could afford to admit the truth. Concerning the First Afghan War, the truth about a man, General Elphinestone who single-handedly unsheathed the meat from his ranks as he rung them through the Khord-Kabul pass on their retreat from Afghanistan.Long by and by witnessing rom on high, the massacre of the regiments from which he had high-tailed the night before, Flashman verbally guts he whom he declares No fate could be bad enough for I still state unhesitatingly, that for pure, vacillating stupidity, for superb incompetence to command, for ignorance combined with bad judgement in short for the true talent for catastrophe, Elphy outshines all as the sterling(prenominal) armed forces idiot of our own or any other day Now what a no-good waste of insightful wit it wou ld have been to have it lost amidst the idiot pride of a oath more gallant than Harry.Elphinestone is not alone Harry considers many of the figures he meets to be to varying degrees morons, in spite of his care to concede a grace here and there. Its no surprise that he met such a top-heavy pile of fools he was, after all, involved in some of the worst disasters of British imperialism all the more reason to flee when he could. But you know the fastidious type. Perhaps youve a booster whom fits this description, in which case, youll understand how empowering it feels to have them praise you youre worth a cheerWhen chance encounter pairs Harry with one he considers of rare dignity, you too, as the reader, hold them as praiseworthy, or rather, worthy of investigation. It was in 1842 when he jumped into the carriage of Lola Montez an Irish dancer girl turned adventuress of Europe whose life was spent playing with kingdoms as one might romantically say. Her appearances in Royal Fl ash are glimpses moments too brief to flummox her entirety, yet he alludes to a life beyond the pages with so delicate a respect that one is inspired to follow. Whilst Harry never himself existed, he may as well have.Its very easy to utter of his personality as anything but fictional. Perhaps to no great surprise considering we get to know the coadjutor through his own confessions, worded not merely to the benefit of his own authenticity, either. The true blue honesty rubs moody well onto those he brushes shoulders with. Its what we have to thank this bounder for dramatising without disfiguring a past of characters pallid to most instantly and enriching the pursuit of history for ourselves. Harry once said about the Earl of Cardigan, that some human faults are military virtues for Harry, some human faults are literary virtues.

Form of education Essay Example for Free

Form of study Essay direction is the key to success. Everyone knows about it. reading come in some(prenominal) forms, thats why many people argon speaking and writing about it, some with authority and some are ordinary. further does everyone knows the real meaning of Education? How potbelly we say that we are already educated person if we tiret know exactly the real definition of the word Education? And how can we apply it in our daily lives? Education is a stage of such a process which develops your knowledge to experience antithetical involvements or simply it is the field of study that deals mainly with methods of teaching and check up oning in schools. There are three forms of Education. It can be Education of Heart, Education of Norm and at last Education of Dominion. The Education of Heart tackles about the education for the perception of the Individual. While, Education of Norm is all about for the perception of the Family and finally the Education of Dominion ( Intellectual, Technical, and Physical Education) it is the education for the perfection of the Nature of Dominion. Education is the most important thing in our life. It is a gift from above which cannot be taken away from us and can tally us to the top of our dreams.Education is not only by going to school, it can happen by a lot of ways. And it is important specially for those people who cant afford to go to school, because of their attitude in life. And they believed that through education, one persons knowledge can be enhanced and improve. The sterling(prenominal) treasure that everyone must commence is Education. Its like planting a rice at archetypical you necessitate to execute more efforts, time and skills. Then, wait for the right time to harvest. Education is an important son of a bitch that is applied in the modern world to succeed, as it lessen the challenges or obstacles which are faced in life.For some people they compared Education as a special ingredient for a cooking recipe. Theyve give tongue to that any kind of dishes will never become delicious if it doesnt have a complete(a) and satisfying ingredient. The foundation of the society is based on Education, since it brings social and economic prosperity. Education offers a view in which language, tradition, culture and values of the society are developed. Education has played a major fictional character in the modern life to all individuals in the society and also in the industrial world. trade is based on education, as employees must have the required skills that correspond with the technology to do their opposite tasks. As the technology keeps improving , more and more people using it in their lives. Therefore, education cock-a-hoop bigger because people nowadays are learning different things from this technology. Education can mold a personality of an individual. It can help one person to further to his or her own future. A unattackable quality education is not only choosing a earnest school, its choosing a school that can handle different attitudes of students and still can teach them the right path to be a beloved citizen.Theres no young and adult in education as long as you want to reach your goals and your prepared enough to fight for it. Learning is an education and experience is an education too. barely sometimes learning something new can be a scary experience. Specially for those times that you have been facing your fears. But it doesnt mean that we should be afraid to overcome our own fears and mistakes because we can learn a lot from this things and sometimes it can be our guide to become a better and more stronger one.Although we already know that education is an important thing that everyone must have, but for others it still have disadvantages. friendship is power though it is widely accepted that it is essential for growth and development of an individual, but sometimes it is the causal agency for some discrimination. Some forms of edu cation blindly impose ideas upon young minds instead of teaching them to think for themselves. A lot of people gathered their knowledge based in their experience for which there is no substitute. An education system is very helpful in developing and improving the quality of human life. Living in this contemporary world is very hard to succeed.Thats why it is better to have a good quality education. Education will be our open doors to attain the training and learning experiences for career opportunities that we need to fulfill in our dreams. Through education we can learn how to enhance life skills such as critical thinking skills, a healthy living lifestyle and self-confidence. It also helps to build our personality to learn how to use good manners, and having respect for others. We learn healthy and productive ways to grow into socially spry adults.

The Transition From Disease Prevention To Health Promotion Essay Example for Free

The Transition From complaint Prevention To Health promotion EssayLiving a healthy lifestyle is the current trend in the joined States. think in healthy, exercising regularly, and abstaining from behaviors that can be detrimental to our health is promoted everywhere we go. Still, the statistics for the leading causes of death in the U.S. ar shocking. Especially when we realize that there ar steps we can take to lesson our risk of becoming fairish another statistic.According to The National Center for Health Statistics, the top fivesome, leading causes of death in the United States are 1. Heart Disease kills 651,696 all(prenominal) year. 2. cancerous Neoplasms or Cancer kills 559,228 separately year. 3. Cerebrovascular Disease or strokes kills 143,449 each year. 4. Chronic Lower Respiratory Disease including chronic bronchitis, emphysema and asthma kills 130,896 each year. 5. Unintentional injury kills 116,669 each year. (WISQARS Leading Causes of Death Report, 2008)Ge nder, family history and race are contributing factors that exit help determine whether or not we acquire any of these diseases. A lifetime of unhealthy existent is also a contributor.In comparison to the five leading causes of death in the United States, the five leading causes of death in New York State are 1. Heart Disease kills 51,963 each year. 2. Malignant Neoplasms kills 35,552 each year. 3. Chronic Low Respiratory Disease kills 6,818 each year. 4. Cerebrovascular or strokes kill 6,617 each year. 5. Influenza and Pneumonia kills 5,509 each year. (WISQARS Leading Causes of Death Report, 2008)Some of the preventive stones throws that we can take against disease are abstain from the use of tobacco products, eat a healthy well balanced diet (eat survey of fruits and vegetables, limited amounts of cholesterol, red meats, sugars and saturated fats), regular exercise (thirty minutes at least three measure a week), maintain a healthy weight, limited alcohol consumption, regular cancer screenings, vaccines if applicable and drug therapy if necessary.There are also some less conventional methods of disease prevention. Many people take vitamin supplements regularly to insure that they are getting enough of the vitamins that they need. Meditation and other spiritual activities are unspoilt in order to control the stress in ones life. Education is also an important prevention measure and its never too young to start. Healthy children are more likely to maintain a healthy lifestyle in adulthood. Prevention is not a guarantee against diseases, but it can for certain make a difference in our quality of life as well as the distance of our life.Works CitedCancer Trends Progress Report-2007 Update. (2007, December 6). Retrieved phratry 24, 2008, from National Cancer Institute http//progressreport.cancer.gov/doc.asp?pid=1did=2007mid=vcolchid=71Research, M. F. (1998-2008). Heart disease prevention 5 strategies to keep your sum of money healthy. Retrieved Septembe r 25, 2008, from Revolution Health http//www.revolutionhealth.com/conditions/heart/coronary-artery-disease/prevention/prevent-heart-diseaseStroke. (2003, September 2). Retrieved September 24, 2008, from All Refer http//health.allrefer.com/health/stroke-info.htmlThoenen, E. (2003, September). Chronic Lower Respiratory Disease. Retrieved September 25, 2008, from http//www.wvdhhr.org/bph/oehp/hsc/pubs/Clrd/CLRD2003.pdfWISQARS Leading Causes of Death Report. (2008, January 23). Retrieved September 24, 2008, from Centers for Disease Control and Prevention http//webapp.cdc.gov/sasweb/ncipc/leadcaus10.html

Acoustics and You Essay Example for Free

Acoustics and You EssayThe expression is about waves it clearly points out the importance of wave particles and energy to the survival of life on the orbiter with respect to the importance of sound waves it includes the various applications to which sound waves have been put to use by man. The original and most important is communication, sound waves form the basis of our daily human interactions without which man would be trim down to mere inanimate objects strangulated in the wilderness of oblivion. The emphasis is on acoustics, the science of sound waves in proportion to speech and hearing, engineering, physical acoustic and noise.The article spells out the areas of life where acoustics is applicable. It details the use of this science as a career to make a living. An understanding of these applications is an eye-opener to the opportunities that lie latent in this field. Indeed, one tail end make a fortune from such a carefully-thought out career. The points are well ou tlined by the author his thoughts are simply and logically arranged in such a way that it is wanton to understand for everyone. The presentation is really good.REFERENCESAcoustics and You. Accessed from http//nature. skku. ac. kr/acoustic/acou-and-you. h

Communication in Early Childhood Education Essay Example for Free

Communication in primal Childhood Education EssayEffective dialogue creates a erudition environment where students tooshie learn according to their single needs in a safe and accommodating environment. Think somewhat your early electric razorhood t for to each one one(prenominal)ing method (or your pip-squeaks early education), was it flexible to suit individual acquisition starts or were children required to conform to the instructors methods of teaching? If you answered the latter, do you think the former would alter the quality of education?Pedagogues in all divisions of education should possess proficiency in different levels of parley, whetherthey be teaching primary or secondary students or university alumni, to be able to address a conclave of the various age groups (colleagues, students, p bents or superiors). Educators will character uncontrollableies in providing a satisfactory level of education without the necessary skills to fetch effectively t o these groups of people. Early childhood educators with effective communication skills demonstrate an ability to conciliate their teaching methods to suit the needs of their young individual students, which benefits the upgradeion in child development.The instructors unconditional mood determines the emotional modality of the schoolroom,creating a healthy and safe training environment for the children and allows teachers to communicate comfortably with children, raises and colleagues, therefore, resolving issues efficiently. Early childhood educators who communicate effectively with children and parents create a positive classroom atmosphere, where successful instruction deal spend a penny place. Teachers and parents must be able to communicate and cooperate to skeleton a strong relationship for the best interests of the child.Do parents make an innate trust in teachers? (For them to permit their children in the teachers care, in somecases, almost a stranger) Whether or not this is accurate, teachers must build on this trust to create a leap outive parent-teacher relationship. Each situation is different and teachers should be aware of their torso language, and use of language, so when speaking with parents their communication should be different when talking to parents than when they are chatting with friends.The first mensuration is establishing a dialogue by approaching the parent first and making them feel welcome and relaxed, as parents may be resistant in making first contact, due to, a bad experience with teachers themselves, as children or bad experiences in otherschools with other teachers (Miller, 2003 Roffey, 2002 as cited by Porter, 2008).There are different strategies teachers rotter use to maintain effective communication with parents and build strong relationships once they have made communication. Keeping a parents trust is important in maintaining open lines of communication so they can discuss concerns relating to the chil d and solve issues promptly. Teachers can gain parents confidence by al musical modes respecting confidentiality and avoiding rumors. If a parent finds out that, their childs teacher breached confidentiality or isa known gossip, parents will find it difficult to confide in them with an issue regarding their child, particularly if it is of a face-to-face nature.Parents are also more seeming to approach their childs teacher if they know they can discuss issues and reach a plebeian agreement (Bender, 2005). Teacher-parent communication is all about display trust and comfort with each other. Frequent communication among these two parties creates less tension, when an issue arises, allowing a constructive discussion to take place and range an agreement sooner without hostility.Teachers can increase parent participation in the childs learning by updatingthem in upcoming activities and events, so they can be included in their childs education, stay informed in their childs successes and concerns, participate in special events, and erect to their childs overall learning process. The activities and responsibilities of the school should not be limited to the school environment and cease once the child has reached home, therefore, teachers and parents should allow room for overlapping (Edwards, 2000). Keeping parents updated on their childs school progress allows parents to provide the necessary support and encouragement at home, giving them a bump understanding of their childsdevelopment. At the aforementioned(prenominal) time, teachers should obtain information from parents regarding the childs progress at home, so teachers can help children accordingly at school. This back and forth communication between parents and teachers will provide students with a supportive network that benefits everyone concerned (Ramirez, 2006). It is also the responsibility of teachers to advice parents when their child is baffling in an accident.Teachers should always take detaile d notes of incidents, remembering to keep confidentiality (between parents), if more than one student was tough (Koza, 2007).If a parent became aware about an incident through their child, it may give the parent the characterization that the teacher tried to conceal the incident. By keeping parents constantly informed, reinforces the parent-teacher relationship, giving parents confidence in the teachers ability to care for their child.Teachers need to be flexible in their teaching, to meet each individuals needs. Teachers must demonstrate various teaching styles to accommodate how each individual learnt-to-learn (Edwards, 2009), by applying the learning methods children are familiar with enables them to accomplish more and feel contented intheir new learning environment. The way children learned to do tasks at home is crucial to their learning when they reach early childhood education, since each child learned to follow instructions and complete tasks differently, it would be ins ensitive to treat all children the same without taking into account their cultural differences and experience (Marotz, 2009).Educators teaching young children must consider the learning methods each individual is already accustomed to and design their teaching methods around the childrens experiences, and so, communication can beused effectively by incorporating different teaching strategies such as speaking, writing and visual demonstrations. For example, a child who has learned to complete a task by reading instructions will run more efficiently if they are able to read from the board or paper, instead of following vocal instructions from a teacher.Teachers should make the effort to understand each childs previous learning experience and background, so they can identify the best teaching method required by each child. Teachers must adopt appropriate methods and language for teaching and should outline the schools (or teachers) code of conduct regardinglanguage, to parents, so th ey can enforce the same rules at home to avoid children bringing inappropriate language to school, causing disruptions in the learning of other children and disgruntling other parents.As teachers gain experience with children and parents of different cultures, religions and abilities, they develop their own communication skills so they can provide improved services to the children they teach in the future. A safe and positive classroom is an important environment for the learning and development of a child. As a classroom leader, the teacher must behave andcommunicate in a manner that creates a positive emotional climate in the classroom firstly, teachers must resolve or reduce stress caused by work and personal issues, doing so outside of the classroom, so they can concentrate on the needs of the children when they are in the classroom.Secondly, by displaying self-confidence, a strong sense of self-worth and control over their emotions creates a classroom atmosphere where children are happy, comfortable and safe, as a result, children respond more positively to their teachers and classmates (Marotz, 2009). Ebbeck Waniganayake (2003) stated that young children generally have asense of happiness and positiveness in them, but society depresses this and upsets the way children view the world and future, by creating fear in them (the media showing violence, bad behavior, and superficial concerns).However, teachers can empower children by showing them how to take their place in society and create a fall apart now and future (Ebbeck Waniganayake, 2003) and give them a feeling of optimism in everything they try to accomplish. Teachers who build a trusting bond with their students are also better equipped, in understanding each individual, allowing children to open up and discuss personal problems with them. This enablesteachers to speak and listen to each individual easily and identify signs of possible abuse, bullying or other health and safety concerns.In conclu sion, effective communication is essential to all learning environments and without it, teachers will struggle to teach and students will face learning difficulties, resulting in a decline in the quality of education. In early childhood education, it is up to the teachers to ensure that each childs education environment is safe and comfortable for the child, by showing flexibility in teaching to meet individual requirements and showing care and understanding to assist children with concerns.A strong parent-teacher relationship creates a support network where information is exchanged and issues are solved, to allow the child to concentrate on his or her learning and development. Early childhood educators are there to guide and support children in all aspects of life. References Ebbeck, M. Waniganayake, M. (2003). Early childhood professionals Leading today and tomorrow. East Gardens, Australia Maclennan Petty Pty Ltd Edwards, MC (2000) concentre for effective parenting is a collab orative project of The Jones center for families, 3. Retrieved from http//www. parenting-ed. org/handout3/Parental Involvement/Communicating with.Teacher Handout. pdf Edwards, S. (2009). Early childhood education and care. Castle Hill, Australia Pademelon advertise Koza, W. (2007). Managing an effective early childhood classroom. Huntington Beach, USA scurf Educational Publishing. Marotz, L. R. (2009). Health, safety, and nutrition for the young child (8th ed. ). Australia Cengage Learning Porter, L. (2008). Teacher-parent collaboration Early childhood to adolescence. Camberwell, Australia ACER Press Ramirez, L (2006) Parent teacher The benefits of creating a supportive parent teacher relationship. Retrieved from http//www. parenting-child-development. com/parent-teacher. html.

Source I suggests that attitudes to Elvis Presley Essay Example for Free

Source I suggests that attitudes to social disease Presley EssayQ. 5. Source I suggests that attitudes to window pane Presley were stock to mixed bag by 1958. Use the witnesser, and you own knowledge, to explain why this was happening. By 1958 pane of glass Presleys popularity and acceptability with adults was still unchanged, and his manager, Colonel Parker, decided to revamp Elvis image to better suit the tastes of the older generations. In order to action this Elvis was persuaded to do what every other young Ameri canful man was obliged to do at the time spend time assigned to the US Army for National Service, wearing fatigues and earning a pittance. This gained him heartfelt publicity as can be seen from Source I, which is obviously keen on Elvis as it is using him to demonstrate the brilliance of Americas society and American democracy. The article is making use of his bob up to fame (how he was a nobody who became a somebody so quickly) to prove how the American d ream (how anybody can be famous and dreams can come true in America) is really possible. The article also states how Elvis did not simply use his riches and influence to buy his way out of this craft to his country.By serving his time in the Army alongside other, ordinary draftees and not asking for special favours, and because of the good publicity he got from it, Elvis gained great respect from the older, patriotic generation, making them feel less oppose towards him. It would provoke seemed now to parents that Elvis was setting a good, nationalistic example to their children, showing them the right path, and they want him and the impact he was having better for this reason. He was also seen as not rebelling once against what society expected of him, again making him more than acceptable by the old as a role model for the young.The source differs from sources B and C in that it is not being critical of Elvis, and it is showing how he might have a good influence kind of than a wholly bad one. The opinions have changed so much at this point and continued to change after Elvis returned from the Army mainly because Elvis was no longer as surprise, and therefore not as dangerous an influence on the young, or the theology of American society through outrageous tv performances (after the third Sullivan appearance, Elvis manager raised his television price from $50000 to $300000, and the networks refused the new proposal, so Elvis didnt do TV again until 1960).For example, Elvis shocking ducktail haircut was shorn, and parade magazine reported Fans cried, parents sighed. On becoming a G. I. in the Army, Elvis said Its a duty Ive got to fill, and Im gonna do it. I guess the only thing Ill hate about it is leaving my mama. Shes ever been my best girl. This showed that Elvis had family values, and love for his mother, which would have made him seen more normal and down-to-earth (or less shocking and less rebellious). Again Elvis would have made parents t hink he would lead their children the right way, rather then corrupting their morals.By the time Elvis had returned from the Army in 1960, his TV appearances would have unconnected their initial shock. He was still popular, but the primal hysteria was gone, and shortly the fan magazines for teenagers would have had the Beatles to jaw about. After joining the Army, Elvis also changed his musical style, performing some religious songs and doing a bracing with Frank Sinatra, the grown-ups music star, making him a lot more acceptable, even likeable. It was around this time that Elvis started to star in his own films, but these films werent action packed or shocking.They were mainly romances and love stories, portrait the softer, tenderer side of Elvis that seemed less threatening to the adult generation. Generally, adults attitudes towards Elvis were beginning to improve by 1958 because of the change in his image. The youth however maintained their rebelliousness, and Elvis populari ty among teenagers dropped slightly as they saw that adults found him more acceptable, or lost interest because he was no longer as downright shocking or rebellious as before.

Challange Faced by University Students Essay Example for Free

Challange Faced by University Students Essay instruction is the most important aspect of learning for every generation established in every mode. In university there argon different field of studies with different years of each program. It is obvious that new students ar going to face further challenges in university. In this case, these challenges could be the burden which can pull them break through of the school without completing their studies. This essay will discuss these challenges in condition of financial, social, and academic.To begin with, financial problems are a major challenge for university students includes tuition fee, rent expenses, and text books. Tuition fee is the most uncouth challenge for these students. Though, for some they only take one or two units per semester because of financial problems. The high cost of fee causes many problems for those who are not sponsored. Besides, fee expenses for each semester cost of thousands of dollars. So, tuition fe e is a great burden for the unsponsored students.Furthermore, text books are the most essential property students must have in university. First year students also suffered in buying text books regarding to financial problem. Those who are not sponsored are suffered the most on the high cost of these books. Another challenge is that some of them have not ample money in a pocket. But in this case, such challenges can create lot of troubles in their minds throughout their time in the university. Moreover, rent is also a challenge for these students.These students might live in different hostels where some are cheap simply isolated from the campus, and some are nearby the campus but pricy. It is better to live nearby the campus for new students to avoid troubles. However, they have problem with monthly rent where it is expensive but must be cleared. Another reason is based on a small list of their allowance which cannot meet their expenses on rent and others. However, these financi al challenges make them concern the most. Another major continues. testify full essay

Exploration of a Journal Article in Sociology Essay Example for Free

Exploration of a Journal phrase in Sociology EssayBecause we have a capitalistic economy, transmission line is the main component of it. Business is in e truly corner of every sector of the market. Most everything you can possible think of that relates to the economy is business. Retail, expediencys, agriculture, manufacturing, wellness cargon, even political campaigning all involves business. Even when civilizations were based on an agricultural type of economy, business transactions occurred The business I have chosen for this is Mc Donalds.In 1974, McDonalds opened its first eating house in the US. Today, more than 2. million people in this country place the trust in McDonalds every day -trusting the Company to provide us with food of a high standard, quick service and value for specie. Customer service is very important to the McDonalds because it says that they care about their clients. Customer service very important and vital part of any organization, which is sellin g goods, or service because it exists to satisfy customers Good customer service will bring you new and keep old customers but if you have bad customer service this will make customers unhappy and they will stop visiting you and the business will not have new customers.McDonalds operates in a very competitive market. It generally keeps its prices within a congenial range to its competition. What McDonalds can d There is more than one definition for corporate social responsibility. champion way in which it can be defined is the obligation of organization management to make decisions and aspire actions that will enhance the welfare and interests of society as well as the organization (Daft, 2003). In former(a) words, corporate actions have social implications, and managers have a responsibility to act in ways which hit society as well as the organization (Body, 2005).The difficulty that most companies of today are set about is that investing money in order to become more social ly responsible may profit one of the companys stakeholders, but have the opposite effect for another stakeholder. For example, investing money into the corporate social responsibility is very expensive in the short-term, so whether or not a company decides to become more socially responsible will depend on how willing the shareholders are to invest in such a project.However, the company could see an increase in profits in the long-term future if they were to do so. Nonprofit organizations should be present in the economy to create those go and goods that are necessary for people but are not profitable for companies to produce them. For-profit organizations pay taxes to governing body and it this way make it possible for nonprofit organizations to fulfill their role 3Energy conservation Finding additional ways to enhance energy efficiency in restaurants in order to save money and lessen environmental impacts.Sustainable packaging and use up management Continue exploring ways to decrease the environmental impacts of consumer packaging and waste in restaurant operations. Green building design Enhance strict building standards to incorporate but opportunities for environmental efficiencies and innovation in the design and construction of restaurants. McDonalds have long recognized the value of minimizing their environmental footprint. This action is not only good for the world in which they operate, its a strong subscriber to McDonalds long-term financial success.

Assessment of Pressure Ulcers and Reliability of Risk Assessment Tools

discernment of coerce ulcers and Reliability of Risk Assessment ToolsThe purpose of this assignment, is to identify a tolerant, under the sh ar of the district nursing team, with a Grade 1 insisting ulcer, to their sacral bea. To begin with, it forget give a brief overview of the affected role and their clinical explanation. through erupt the assignment the patient will be referred to as Mrs A, in order to protect the patients identity and book convinced(p)iality, in accordance with the guidelines set out by the breast feeding and Midwifery Council (NMC 2008). A brief exposition of a Grade 1 hug ulcer will be accustomed, along with a comment of the steps taken in taxing the irritate, using The Waterlow casing (1985). This assignment will discuss the literature polish that was carried out, along with separate methods of interrogation utilisation, to gather vital randomness on hurt bearing , such(prenominal) as the different classifications of wounds and th e different stake appraisal assholes avail sufficient. This assignment, will include brief overviews, of some the some other comm that employ tweet ulcer pretend sound judgement tools, that are put to workout by practitioners and how they compare to the Waterlow Scale. This assignment will also seek to gamelight the importance of using a conclave of clinical judgement, by divvy upfully monitoring the patients physical and psychological conditions, alongside the at attempt mark calculated from the Waterlow Scale, in order to deliver holistic care to the patient.Mrs A is a 84 grade old lady who has been referred to the district nurses by her General practician, as he has concerns regarding her force areas . Following a late(a) f exclusively she lost her confidence and is now house bound. She now spends much than time in her chair as she has become nervous when mobilising around the house and in her garden. She has a history of high blood push and occasional angina f or which she truely takes Nicorandil 30mg b.d. as prescribed by her General Practitioner , Nicorandil has been recognised as an aetiological aspect of non healing ulcers and wounds (Watson, 2002), this has to be taken into consideration during the assessment and throughout the management of her wound. Mrs A has no history of previous falls or problems with her balance. She has invariably been a confident and independent lady, with no current issues surrounding continence or diet. She has always enjoyed a large meshing of friends who visit her regularly. It is recommended by National Institute for Health and Clinical Excellence ( keen) that patients should receive an Initial assessment (within the first 6 hours of inpatient care) and ongoing take chances assessments and so referrals of this nature are seen on the day, if it is authentic if not within 24 hrs. In order to establish Mrs As current find of growing a impel area, an assessment must take place. An initial holistic assessment, looking at all contribute factors such as mobility, continence and nutrition will provide a baseline that will identify her level of pretend as well as identifying every existing compel damage.A push ulcer is defined as, a localised injury to the come up and / or underlying meander usually over a bony prominence, as a result of constrict, or wardrobe in combination with shear. A number of contributing, or confounding factors, are also associated with compress ulcers. According to the European Pressure Ulcer Advisory Panel (EPUAP 2009).Mrs A is more endangered to pressure damage, as her uncase has become more fragile and thinner with age ( overnice 2005). There are lay on the line factors associated to the integrity of the patients skin and also to the patients general health. Skin that is already damaged, has a higher relative incidence of developing a pressure ulcer, than that of healthy skin. Skin that becomes too prohibitionist, or is more moist due to achievable incontinence, is also at higher risk of developing a pressure ulcer than healthy skin. An elderly persons skin is at plusd risk, because it is more fragile and thinner than the skin of a younger person. Boore et al (1987) set the chase principles in caring for the skin to maintain pressure damage, skin should be kept clean and dry and not left to remain wet. The skin should also not be left to dry out to prevent any accidental damage . Due to Mrs A spending more time sit in her chair, she has become at a higher risk of developing a pressure sore, as she is less mobile. The reason being It becomes difficult for the blood to circulate causing a lack of atomic number 8 and nutrients to the create from raw material cells. Furthermore, the lymphatic carcass also begins to suffer and becomes unable, to properly remove waste products. If the pressure continues to increase and is not relieved by equipment or movement. The cells fecal matter begin to die, leaving an area of dead tissue resulting in pressure damage. Nelson et al (2009) carrys, pressure ulcers rout out cause patients functional limitations, emotional distress, and pain for persons affected. The victimisation of pressure ulcers, in various healthcare settings, is oft seen as a reflection of the character of care which is being provided (Nakrem 2009). Pressure ulcer prevention is very important in everyday clinical practise, as pressure ulcer discourse is expensive and factors such as legal issues have become more important. EPAUP (2009) have recommended strategies, which include frequent repositioning the use of special adjudge surfaces, or providing nutritional support to be included in the prevention.In order to gather rise based research, to support my assignment. I undertook a literature review of the Waterlow Scale and Classifications of Grade 1 pressure sores. The databases utilise were the Culmulative Index to Nursing and Allied Health Literature (CINAHL) and OpenAthens . I employ a variety of search terms including pressure sores, Grade 1 classification, Waterlow Scale, and How pressure sore risk assessment tools compare. Throughout the literature review the tuition was self-collected from sources using a date range between the years of 2000 2011, although some references were found from sources of tuition that are from a much later date. This method of research ensured a plethora of articles and guidelines were collated and analysed. The trust guidelines in wound care were used, to show how we implement theory into practise in the community, using the wound care formulary. There was a vast amount of information available, as pressure area care is such a broad subject. The search criteria had to be narrowed d knowledge, in some cases to ensure the information gathered was relevant and not beyond the scope of the assignment. The evidence used throughout this assignment, is based on guidelines and recommendations given by NICE (2001), EPUAP (20 01) and articles sourced from The Journal of Community Nursing (JCN). This was the most accurate information and guidance on pressure ulcer classifications and assessment although, some articles whitethorn not have been the most recent.The assessment tool used throughout my area of work, is the Waterlow Scale. The Waterlow Scale was developed by Judy Waterlow in 1985, while working as a clinical nurse teacher. It was originally designed for use by her student and is used to stair a patients risk of developing a pressure sore. It mickle also be used as a guide, for the ordering of effective pressure relieving equipment. All National Health Service (NHS) trusts have their own pressure ulcer prevention policy, or guidelines and practitioners are expected to use the risk assessment tool, undertake in their trusts policy. NICE (2003), guidance states, that all trusts should have a pressure ulcer policy, which should include a pressure ulcer risk assessment tool. However, it reminds p ractitioners that the use of risk assessment tools, should be thought of as an aid to the clinical judgement of the practitioner. The use of the Waterlow tool enables, the nurse to assess each patient gibe to their individual risk of developing pressure sores (Pancorbo-Hidalgo et al 2006). The weighing machine illustrates a risk assessment mark system and on the reverse side, provides information and guidance on wound assessment, dressings and preventative aids. There is information regarding pressure relieving equipment surrounding, the three levels of risk cozy uped on the scale, and also provides guidance, concerning the nursing care given to patients. Although the Waterlow whip is used in the community setting, when calculating the risk assessment get, it is vital that the nurse is aware of the difference in environment the tool was originally developed for.The tool uses a combination of core and external risk factors that contribute to the development of pressure ulcers. These are used to determine the risk level for an individual patient. The organic factors include disease, medication, malnourishment, age, dehydration / fluid status, lack of mobility, incontinence, skin condition and weight. The external factors, which refer to external influences which john cause skin distortion, include pressure, shearing forces, friction, and moisture. There is also a special risk role of the tool, which can be used if the patient is on certain medication or recently had surgery. This contributes to a holistic assessment of a patient and enables the practitioner to provide the most effective care and curb pressure relieving equipment. The score is calculated, by counting the scores given in each category, which apply to your patients current condition. Once these have been added up, you will have your at risk score. This will then indicate the steps that need to be taken, in order to provide the appropriate level of care to the patient. Identification of a patients risk of developing a pressure sore is often considered the most important stage in pressure sore prevention (Davis 1994).During the assessment a skin inspection takes place of the most under attack(predicate) areas of risk, typically these are heels, sacrum and parts of the body, where sheer or friction could take place. Elbows, shoulders, back of head and toes are also considered to be more vulnerable areas (NICE 2001). When using the Waterlow tool to assess Mrs As pressure risk, I found she had a score of 9. According to the Waterlow scoring system she is not considered as being at risk as her score is less than 10. As I had identified in my assessment, she had a score of 2, for her skin condition due to Grade 1 pressure ulcer to her sacrum. I felt up it necessary, to highlight her as being at risk. A grade 1 pressure ulcer on her sacral area, maybe due to her recent loss of confidence and reduced mobility which has left Mrs A spending more time in her chair.Pressure ul cers are assessed and graded, according to the degree of damage to thetissue. The National Pressure Ulcer Advisory Panel (NPUAP), classifies pressure ulcers based on the depth of the wound. There are four classifications (Category/ portray I through IV) of pressure damage. In addition to these, two other categories have been defined, unstageable pressure ulcers and unintelligible tissue injury (EPUAP, 2009) Grade 1 pressure damage is defined, as a non-blanchable erythema of intact skin. Indicators can be, discolouration of the skin, warmth, oedema, induration or hardness, particularly in people with darker pigmentation (EPUAP, 2003). It is believed by some practitioners, that blanching erythema indicates Grade 1 pressure damage (Hitch 1995) although others suggest that, Grade 1 pressure damage is present, when there is non-blanching erythema (Maklebust and Margolis, 1995 Yarkony et al, 1990). The majority of practitioners, throw that temperature and colour play an important role, in identifying grade 1 pressure ulcers (EPUAP, 1999) and erythema, is a factor in almost all classifications (Lyder, 1991). The pressure damage usually occurs, over boney prominences (Barton and Barton 1981). The skin in a Grade 1 pressure ulcer, is not broken, but it requires protection and monitoring.At this stage, it will not be known how deep the pressure damage is, regularmonitoring and assessment is necessary. The pressure ulcer may fade, but if thedamage is deeper than the superficial layers of the skin, this wound could eventuallydevelop into a much deeper pressure ulcer over, the following days or weeks.A Grade 1 pressure ulcer, is classed as a wound and so I have commenced awound care plan and also a pressure area care plan. I will also ensure, Mrs A hasregular pressure area checks in order to prevent the area good luck down. Thepressure area checks will take place periodical until the pressure relieving equipmentarrives, this will then be reduced to 3 monthly checks. D ressings can be utilize toa Grade 1 pressure ulcer. They should be simple and offer some level of protection.Also, to prevent any further skin damage a film dressing is often used, or ahydrocolloid to protect the wound area (EPAUP, 2009) . These dressings will assist inreducing further friction, or shearing, if these factors are involved. It is consideredthe best way to treat a wound, is to prevent it from ever occurring. Removing theexisting external pressure, reducing any moisture, which can occur if the patient is leaky and employing pressure relief devices, may contribute to wound healing. on with adequate nutrition, hydration and addressing any underlying medicalconditions.The advice given to practitioners, on the reverse of the Waterlow tool is to provide a100mm foam cushion, if a patients risk score is above 10. As MrsA has an at risk score of 9, with a Grade 1 pressure sore evident, I feel itappropriate to provide the pressure relieving mattress and cushion to prevent anyfu rther pressure damage developing. All individuals, assessed as being vulnerable topressure ulcers should, as a minimum provision, be placed on a high conditionfoam mattress with pressure relieving properties (NICE, 2001). As I am providing acushion and a mattress, it is not felt necessary to apply a dressing at this point.However, the area will need regular monitoring, as at this stage it is unknown howdeep the pressure damage is. If proactive care is given in the prevention andtreatment of pressure ulcers, with the use of risk assessments and providingpressure relieving resources, the pressure area may resolve. Pressure ulcers can becostly for the NHS, debilitating and painful for the patient. With basic and effectivenursing care offered to the patients, this can often be the key to success.Bliss (2000) suggests that the majority of Grade I ulcers heal, or resolve withoutbreaking down if pressure relief is put into place immediately. However, experiencesin a clinical settings supp orts observations, that non-blanching erythema can oftenresult in irreversible damage (James, 1998 Dailey, 1992).McGough (1999) during a literature search, highlighted 40 pressure ulcer riskassessment tools, but not all have be considered suitable, or reliable for all clinicalenvironments. As there are many different patient groups this often results in a largespectrum of different patient needs. The three most commonly used tools in the United Kingdom (U.K.) are, The Norton scale, The Braden Scale and The Waterlow Scale.The first pressure ulcer risk assessment tool was the Norton scale. It was devised by Doreen Norton in 1962. The tool was used for estimating a patients risk for developing pressure ulcers by giving the patient a rating from 1 to 4 on five different factors. A patients with a score of 14 or more, was identified as being at high risk. Initially, this tool was stationed at elderly patients and there is little evidence from research gathered over the years, to suppor t its use outside of an elderly care setting. Due to increase research over the years, concerning the identification and risk of developing pressure ulcers, a modified version of the Norton scale was created in 1987.The Braden Scale was created in the mid 1980s, in America and based on a abstract schema of aetiological factors. Tissue tolerance and pressure where identified, as being significant factors in pressure ulcer development. However, the validity of the Braden Scale is not considered to be high in all clinical areas (Capobianco and McDonald, 1996). However, EPAUP (2003) state The BradenRisk Assessment Scale is considered by many, to be the most valid and reliablescoring system for a wide age range of patients.The Waterlow Scale, first devised in 1987, identifies more risk factors than the Braden and the Norton Scale. However, even though it is used widely across the U.K., it has let off be criticised for its ability to over shout risk and at last result in the misuse of resources (Edwards 1995 McGough, 1999).Although there are various tools, which have been developed to identify a patients individual risk, of developing pressure sores. The majority of scales have been developed, based on ad hoc opinions, of the importance of possible risk factors, according to the Effective Healthcare Bulletins (EHCB, 1995). Franks et al, 2003 Nixon and Mc Gough, 2001, challenged the predictive validity of these tools, suggesting they may over predict the risk, cause expensive cost implications, as preventative equipment is put in place, when it may not always be necessary. Or they may under predict risk, so a patient maybe assessed as not being at high risk, develops a pressure ulcer. Although the Waterlow scoring system, now includes more accusative measurements such as Body Mass Index (BMI) and weight loss after a recent update. It is still unknown, due to no published information, whether the reliability of the waterlow tool, has improved since the changes th at took place. It has been recognised, as a fundamental break of these tools and due to this clinical judgement, must always be taken into consideration alongside the results that have been measure, from the use of the risk assessment. This is clearly recognised by NICE, as they advise their use as an aide-mmoire (2001). The aim of Pressure ulcer risk assessment tools, is to measure and quantify pressure ulcer risk. To determine the quality of these measurements the paygrade of validity and reliability would usually take place. The validity and reliability limitations, of pressure ulcer risk tools are widely acknowledged. To overcome these problems, the solution that is recommended is to combine the scores of pressure ulcer risk tools, with clinical judgment (EPAUP 2009). This recommendation, which is often seen in the literature, unfortunately is inconsistent as Papanikolaou et al (2007) states If pressure ulcer risk assessment tools have such limitations, what contribution can t hey make to our confidence in clinical judgment, other than prompting us about the items, which should be considered when making such judgments?. Investigations of the validity and reliability, of pressure ulcer risk tools are important, in evaluating the quality, but they are not sufficient to judge their clinical value. In the research of pressure ulcer tools, there have been few attempts made to compare, the different pressure ulcer risk assessment strategies. Referring to literature until 2003, Pancorbo Hidalgo et al (2006) identified three studies, investigating the Norton scale compared to clinical judgment and the wedge on pressure ulcer incidence. From these studies, it was concluded that there was no evidence, that the risk of pressure ulcer incidence was reduced by the use of the risk assessment tools. The Cochrane review (2008), set out to determine, whether the use of pressure ulcer risk assessment , in all health care settings , reduced the incidence of pressure ulcer s. As no studies met the criteria, the authors have been unable to answer the review question. At present there is only weak evidence to support the validity, of pressure ulcer risk assessment scale tools and obtained scores delay varying amounts of measurement error.To improve our clinical practise, it is suggested that although tools such as theWaterlow Scale are used to abstract a patients pressure ulcer risk, otherinvestigations and tests, may need to be carried out to ensure a effectiveassessment is taking place. Practitioners may consider, various blood tests and morein depth history taking, including previous pressure damage and medications. Patientslifestyle and diet should also be taken into consideration and where appropriate, anutritional assessment should be done if recent weight loss, or reduced appetite isevident. nutritionary assessment and screening tools are being used more readily and appear to be become more relevant in managing patients who are at risk of or have a pressure ulcer. The assessment tools should be reliable and valid, and as discussed previously with other risk assessment tools they should not supercede clinical judgement. However, the use of nutritional assessment tools can help to bring the nutritional status of the patient to the attention of the practitioner, they should then consider nutrition when assessing the patients vulnerability to pressure ulcer development. The nutritional status of the patient should be updated and re-assessed at regular intervals following a assessment plan which is individual to the patient and includes an evaluation date. The condition of the individual will then allow the practitioner to decide how frequent the assessments will occur. The EPUAP (2003) recommends that as a minimum, assessment of nutritional status should include regular weighing of patients, skin assessment, documentation of victuals and fluid intake.As Mrs A currently has a balanced diet, it is not felt necessary to unde rtake, anutritional assessment at this point. Her weight can be updated on each review visit,to assess any weight loss during each visit. If there is any deterioration in hercondition, an assessment can be done when required. Continence should also betaken into consideration and where necessary a continence assessment should takeplace. Incontinence and pressure ulcers are common and often occur together.Patients who are incontinent are generally more likely to have difficulties with theirmobility and elderly, both of which have a strong affiliation with the developmentof pressure ulcers (Lyder, 2003).The education of staff, surrounding pressure ulcer management and prevention, isalso very important. NICE (2001) suggest, that all health care professionals, shouldreceive relevant training and education, in pressure ulcer risk assessment andprevention. The information, skills and knowledge, gained from these trainingsessions, should then be cascaded down, to other members of the team. Thetraining and education sessions, which are provided by the trust, are expected tocover a number of topics. These should include, risk factors for pressure ulcerdevelopment, skin assessment, and the selection of pressure equipment. Staff arealso updated on policies, guidelines and the latest patient educational information(NICE 2001).Education of the patient, carers and family, is essential in order to achieve optimumpressure area care. Mrs A is encouraged to mobilise regularly, in order to relievethe pressure as a Grade 1 pressure sore has been identified, she is at a significantrisk of developing a more severe ulcer. Interventions to prevent deterioration, are critical at this point. It is thought, that this could prevent the pressure sore fromdeveloping into a Grade 2 or worse. NICE (2001) have suggested, that individualsvulnerable to or at elevated risk of developing pressure ulcers, who are able andwilling, should be informed and educated about the risk assessment and result ingprevention strategies. NICE have devised a booklet for patients and relatives, calledPressure Ulcers Prevention and Treatment (NICE Clinical Guidance 29), which givesinformation and guidance on the treatment of pressure ulcers. It encourages patientsto check their skin and change their position regularly. As a part of good practise,this booklet is given to Mrs A at the time of assessment, in order for her todevelop some understanding of her pressure sore. This booklet is also given to thecare givers or relatives so they can also gain understanding, regarding the care andprevention, of her pressure ulcer. An essential part of nursing documentation, is care preparedness. It demonstrates the care, that the individual patient requires and can beused to include patients and carers or relatives in the patients care. Involvement ofthe patient and their relative, or carer is advisable, as this could be invaluable, tothe nurse planning the patients care. The National Health Service Mode rnisationAgency (NHSMA 2005) states clearly that person centred care is vital and that care planning involves negotiation, discussion and shared decision making, between the nurse and the patient.There were a number of improvements that I feel could have been made to the holistic care of Mrs A. I feel that one of the fundamental factors that ask to be considered , were the social needs of the patient. As I feel they are a large contributing factor, towards why the patient may have developed her pressure sore. The patient was previously known to be a very sociable lady, who gradually lost her confidence, resulting in her not leaving the house. There are various schemes and services available, which are provided by the local council or volunteer services, to enable the elderly or people unable to get around. For example, an option which could of been suggested to Mrs A are services such as halo and Ride, or Werneth Communicare. Using these services or being involved in these types of schemes, may have sceptered Mrs A to leave the house on a more regular basis. This would enable her to build up the confidence, she lost following her fall. This would have also lead to positive impact on the patients psychological care, as Mrs A would have been able to overcome her fears of leaving the house, enabling her to see friends and gain communications lost. As previously mentioned in this assignment, although Mrs A had a score of 9, which is not considered an at risk score. I still felt it necessary to act on this score, even though the wound was a not considered to be critical. If it is felt the patient is at a higher risk than that shown on the assessment tool, the practitioner should use their clinical judgement, to make crucial care decisions. It should also be considered, by the practitioner that risk assessment tools such as The Waterlow scale, may not have been developed, for their area of practise. Throughout the duration of Mrs As wound healing process, a holi stic assessment of her pressure areas and general health assessment were carried and all relevant factors, were taken into consideration. The assessment tool used to assess her pressure areas, is the most common tool used currently in practise and the tool recommended by the Trust.To conclude, there is evidence to prove that pressure ulcer risk assessment tools are useful, when used as a guide for the procurement of equipment. However, they cannot be relied upon but to provide holistic care to a patient. It has been highlighted, that to ensure a holistic assessment of patients, it is necessary to polish off a variety of assessments, to create a complete picture. Although The Waterlow scale covers a number of factors that need to be considered, throughout the assessment, it has become evident that the at risk score, can often be over or under scored depending on the practitioner. Clinical judgement has proved to be, a very important aspect of pressure ulcer prevention and treatment . The education of the patient, carer and relatives has also been highlighted, as an important aspect of care. Empowering the patient with information regarding their illness, may decrease the healing time and help prevent has further issues.