Learning Reflection Essay Example | Topics and Well Written Essays - 250 words - 1

Learning Reflection - Essay Example Also, I learned how to manage issues of the healthcare setting, and how imperative healthcare quality and wellbeing is for patients, family, and team member. Health starts with proper management of care. I realized how management is crucial for improving productivity and quality of the health care. The issues blend well with the two program Learning Outcomes I selected. This is because managing is an important step to a proper health care setting. It is also important that as a leader, one must possess the skills necessary for operations. The two Program Learning Outcomes have supported my way of thinking about what could happen or what is expected. There were several case scenarios that were used for me to make a managerial decision. The scenarios gave me the opportunity to use my judgment and make important decisions. Hence, I have been critical on issues needed for quality and safe healthcare practices. The discussion questions gave me the opportunity to read my online classmate thoughts and opinions. In addition, it gave me the opportunity to form my thoughts and opinions about the course of discussion. The course readings and the reading of classmate discussion were valuable as I have been able to offer critical analysis to issues at

Three Positions on Abortion Essay Example | Topics and Well Written Essays - 1000 words - 1

Three Positions on Abortion - Essay Example It does not think that the act of abortion is legitimate under all circumstances. The position considers that the mother and fetus have certain rights. The conflict of rights is created because of the different considerations for the mother, fetus and the society. However, the acceptability of the action depends on the severity of such conditions. For example, if it is feared that there are chances that the fetus will born deformed, moderate position will allow abortion in such cases. The reason behind the acceptance of abortion in this case is that it will cause tremendous pain and suffering to the mother and the fetus itself. The loss or pain cause by giving birth to a child would be greater than the tragedy and loss of abortion. In other words, moderate position on abortion is the rational view of abortion. It requires doing what is best for the mother and the fetus. Hence it is a better alternative to conservative and liberal approaches. The moderate approach strikes a balance be tween liberal and conservative positions. I agree with this position because many a times there are situation when it is necessary to abort the child. People also have a tendency to abuse the abortion. They take it for granted and use it at the cost of rights of the fetus or the child. This harms the sanctity of life. Many people have compared such an act with murder. Since, it has been proven that the fetus gets the life after four months. Unlike liberal approach, the moderate approach will assume that the right of abortion for women should be until four months only. After that abortion should only be allowed if there are severe medical issues, it is feared that the child will be deformed, or in cases of rape and incest. Similarly, the moderate approach is better than conservative approach because it thinks that abortion should not be allowed under any condition. This approach can lead to fatal consequence. For example, if the woman dies in the process of child birth. This would le ad to loss of two lives. Hence, a rational approach in this case would be to allow abortion under certain scenario and let people use the option for the benefit of themselves and the benefit of the entire society. The moderate position on abortion takes into account various ethical frameworks. It takes into account the deontological framework in way that it calls for abortion in cases where the motives of the action are pure. It needs people to weigh the pros and cons of the action before taking the final action. As a result, the motives behind the moderate approach are more often than not pure and hence the deontological framework justifies the decisions taken under deontological framework. Rights-based ethics also justify the moderate position on abortion. Since, a part of women body is involved in the process of child birth, she has a right to abort the child if she want to. If she feels that the entire process of child birth is too painful for her body, or it will cause her stre ss then she can use right based ethics to justify her decision of aborting the fetus. Even consequential ethics allow the parents to abort the fetus. For example, if it is considered that overall standard of living of a family would fall after the birth of another child, the parents can choose to abort the child and this can be justified by using the consequential approach. Similarly, if it is felt that the birth of the child can lead to medical issues for the women or can lead to a deformed child that can cause stress and

The post washington consensus development

The post washington consensus development There have been several discussions about whether or not the Washington consensus and the post Washington consensus (alos referred to as the new consensus) approach to development are fundamentally different approaches to development. The World Bank and International Monetary fund critics are quick to say both approaches are the same, and that the Washington consensus was just repackaged and given a new brand, name and identity in the Post Washington consensus development approach. Although it is easy to see how it can be assumed that the underlying fundamentals of the Washington consensus and the post Washington consensus are unchanged because the latter still encompasses the principles of the former that was generally a focus on market reform as the approach for growth and development. However, the fact that the post Washington consensus builds on market reform and includes various other elements ignored by the Washington consensus like institutional reform and good governance whic h are elements that extend the goals of the new consensus and enable it to promote ‘sustainable, egalitarian, and democratic development (Stiglitz 2001:17). These additions and extensive goals therefore make both approaches fundamentally different from one another, even though they both advocate market reform (which is where the similarities end). While the Washington consensus focused on the perfection of the market the post Washington consensus does the exact opposite, it points out market limitations and ways of correcting such limitations (Stiglitz 2001). The purpose of this paper is to illustrate just how different both approaches are by looking at the foundational economic theories they are built on, the components of both approaches and their methodology. The Washington consensus is an approach to development that involves various economic policy prescriptions that are designed to move an economy towards economic growth and development when implemented. They include ten basic polices that create a liberal market and economy. According to Williamson who coined the term and the originator of the list, they include: Macroeconomic stability (restoring fiscal discipline by controlling budget deficit) Redirecting expenditure (reduction of government spending) Tax Reform (involved increasing tax and value added tax.) Financial liberalization Unified Exchange rate (to encourage and ease trade) ‘Replacement of quantitative trade restrictions by Tariffs (trade liberalization) Abolishment of Barriers to entry of foreign direct investments (Liberalizes FDI) ‘Privatization of state owned enterprises (reduce government spending) Deregulation (reduce state interference) ‘Legal system should provide secure property rights (Williamson 2005: 35-42) The policies under the Washington consensus are designed to liberalize various sectors of an economy. They are also directed towards increasing market efficiency, productivity and growth. Not all the policies under the consensus are implemented at the same time and in most cases, there is a lot of mixing and matching done by the governments implementing these policies with a few policies being more popular than others. Williamson (2005: 43) notes that ‘(i)n terms of which reform(s) [policies] were most widely implemented, there have been widespread attempts to tighten fiscal policy, introduce extensive financial and trade liberalization, eliminate restrictions on foreign direct investment, and promote privatization and deregulation. These policies have earned the Washington consensus a bad reputation of increasing poverty because ‘adjustment and stabilization policies tend to depress real wages, as control over money wages is combined with devaluation (Stewart 1991:1849), unemployment coupled with other various adverse effects from such policies on the poor in a country lead to social decay. The failures of such policies are evident in various developing countries like Bolivia, Nigeria, and Zambia (discussed in Adefulu, 1991) whose economies after adopting stabilization and adjustment policies experienced stagnant or slow growth. These countries experienced worse situations than they were in before the implementation of the structural adjustment programme under the Washington consensus policies prescribed by the World Bank and the International monetary fund in the 1980s. The failure of this approach to development gave rise to creation of a new development approach know as the Post Washington consensus which also included some of the policies listed above in relation to its market reform component. However, it focused not just on economic growth through market reforms but also included elements to enhance social growth and welfare and thus encourag es sustainable development. It eased and monitored the effects of the market reform policies on the poor by paying attention to social issues and advocating the creation of safety nets. This new approach addressed areas that had been ignored by the Washington consensus and as a result of this, it provides a better-rounded approach to development. Unlike the Washington consensus: It aims at stabilizing the real economy as well as inflation It tries to improve financial sector regulation, rather than assuming that liberalization is the only game in town It includes competition policy It considers various mechanisms of improving government efficiency, rather than seeking to minimize governments role It focuses on improving human capital formation It seeks to increase the transfer of technology to developing countries. (Williamson, 2005:45) Including these accompanying elements to the market reform policies was based on the recognition that ‘[m]aking markets work requires more than just low inflation; it requires sound financial regulation, competition policy, and policies to facilitate the transfer of technology and to encourage transparency, to cite some fundamental issues neglected by the Washington consensus (Stiglitz, 2001:17). The emphasis placed on trade liberalization, deregulation, and privatization under the Washington consensus approach often lead policymakers to disregard the importance of various factors like competition, which contribute to the effectiveness of a market economy and which may be just as important as economic success (Stiglitz, 2001:20-21). The Washington consensus and Post-Washington consensus not only differ based on their development goals, the economic theories and principles on which they are based upon are from different schools of thought. The former based on the logic of Keynesian economics of liberalization and the mantra of lazzie faire allows the market to stabilize itself with little or more preferably no government intervention. The Washington consensus therefore was founded on the neo-classical economic theory centered on the idea of instrumental rationality (North 1995). Instrumental rationality implies that individuals in the market make decision in such a way that creates a perfect market. Their decisions are made based on factors that offer them maximum utility. Under instrumental rationality it is assumed that ‘values are accepted and given as constant, objective decision of the world as it is can be postulated and.. decision makers computational powers are unlimited (North, 1995:7) thus when an imperfection arises in the market because of this factors, the market will correct the imperfections itself. Therefore, there is no need for government intervention. Under this approach government, interference is seen to disturb the flow of the market and impede its efficiency and growth of the economy. The Post-Washington consensus is however eclectic, drawing from the logic of different economic principles. It draws from both the principles of the new development economics, and the new institutional economics (NIE) which understand and value the role the state plays in the regulation of market functions. New development economics according to Ben Fine (2006) was created to accommodate the shift towards the post Washington Consensus. It extends beyond only economic principles and includes other fields of study like sociology and non-economic factors. It also places emphasis on market imperfections and asymmetrical information amongst parties in a market. In this theory in ‘contrast to economic approach, institutions, customs, as well as economic and social structures are taken seriously rather than presumed to be equivalent to as an â€Å"as if† market situation (Fine, 2006 :8) NIE advocates the significance of institutions, and their importance in solving the problem of transaction costs that may exists in the market due to asymmetrical information. Institutions are an important aspect because they â€Å"are the rules of the game of a society, or, more formally, are the humanly devised constraints that structure human interaction† (North, 1995: 23). They could be formal in the sense of laws created to govern and informal based on norms. The post- Washington consensus as a development approach recognises the fact that markets in developing countries often carry a high cost of transaction, which deters investment and slows down market productivity. Transaction costs arising from asymmetrical information will often lessen confidence in the market and cause insecurity. To remedy the problem institutions are required because; ‘â€Å"efficient institutions lessen insecurity and thereby increase readiness to invest†'(North,1991 in German Fed Ministry, 2004: 7). ‘Over the long term, dynamic growth processes can only be sustained when institutions exist that encourage the growth of productivity and guarantee a high degree of stability, that is, reduce vulnerability to external shocks. (German Fed Ministry, 2004: 7) Another difference between both development approaches is in relation to their view on state intervention in the market. The Washington consensus approach views government intervention as an interference with â€Å"market perfection†. Under this approach, the market will resolve its problems and set the right price, and government or state intervention disrupts this ability and therefore create imperfections and inefficiency. A good illustration is of African countries like Nigeria and Ghana who after independence interfered with the export markets using commission boards and â€Å"monosponies† (singles buyer where there are many sellers) for their agricultural products (discussed in Bates 1981). The boards had an influence on market prices and could afford to be inefficient because the cost of inefficiency could be easily transferred from the states board to the farmers and consumers (Bates 1981). This supports the Neo-liberal view that when states are involved in mark ets, macroeconomic rationality if foregone for their preference of macroeconomic policy instruments. The Washington consensus follows the policy of a non-interventionist state or one with minimal role in markets. The post Washington consensus however, draws from the example of the East Asian countries miracle (which attributes most of its success to state intervention in markets) and promotes the importance of government intervention because of imperfections that already exist within the market. It advocates that the state regulate the market through the creation of institutions, legal framework, and property rights. All of which will solve the problems that exist in an imperfect market like inadequate flow of information and allow proper contracts to be drawn between transacting partners. The government according to the logic of the post Washington consensus ‘should serve as a compliment to markets, undertaking actions that make markets work better and correcting market failu res (Stiglitz, 2001:41). The Washington consensus approach to development as mentioned previously wanted little or no state intervention and disregarded the role of the state. The post Washington consensus approach however, values state role so much so that the approach includes elements designed to better the governance of a developing state in the form of good governance and democracy. Under this new consensus because the state is seen as an important factor for growth and development, it provides for the reform of the state itself. The post Washington consensus recognises the fact that most developing countries are faced with government inefficiency, corruption and bureaucracy. The approach therefore proposes that states should practice good governance, which entails democracy, transparency, and rule of law to mention a few. The post-Washington consensus approach to development considers the practice of good governance as a pre-requisite for sustainable economic growth and development. Under this approach , states role, efficiency or lack thereof and politics is taken into consideration for development purposes, while the Washington consensus approach lacks this attention to governance issues. The disregard for state issues is due to ‘[n]eo-liberalisms skepticism of the state and autonomous exaltation of individual [and the view that] the stateneeds to be extricated from the marketEconomic reforms accordingly take priority over political reforms and civil liberties (Abrahamsen, 2000:30) under the Washington consensus. The post Washington consensus approach to development considers factors outside of economics for instance education and health care. This is another fundamental difference between it and the Washington consensus. The new consensus values the importance of such elements to the development process unlike the Washington consensus that disregards them. Under the new consensus, there is an understanding that development needs to be sustainable and in this regard, it provides for elements that carry it in that direction. Education allows for the development of human capital and the society. If the people are developed, they can move development along by making valuable contributions in the society. According to Stiglitz (2001:46), ‘promoting human capital isa policy that can help promote economic development, equality, participation and democracy. The East Asian countries for instance Japan (Stiglitz, 2001) placed an emphasis on educating its citizens by making basic education compul sory make viable examples of how educating a countrys citizens can contribute to sustainable economic growth and development. Social aspects like education ignored by the Washington consensus is regarded an important element of the post Washington consensus approach. The post Washington consensus approach to development is created in a way that ensures its effects are long-term on the economy as supposed to the short-term effect of the Washington consensus. It achieves this because of its broader goal and dedication to issues outside the realm of economics and the market. According to Stiglitz (2001:68) ‘The new development strategy takes as its core objective development, the transformation of society, this fact and its inclusion of social factors as part of the development agenda ensures that it encourages sustainable development and not only the growth of gross domestic product (GDP). Participation and sense of ownership is another aspect in which both approaches to development have fundamental differences. The Washington consensus approach pays little or no attention to fostering the sense of owner ship instead it reduced state ownership through the heavy promotion of instant privatization. The post Washington consensus on the other hand recognizes that fostering a sense of ownership and participation of developing country governments and its people has an effect on how effective the programs being adopted will be. The government has to implement the development programs that have been recommended by international institutions and if the developing country feel like they are in control and have an opinion about the changes going on in their country they might ensure that the programmes are implemented effectively and not on a superficial level. Lack of proper implementation on part of developing nations government is one explanation offered by the World Bank as a reason for the failure of the structural adjustment programs under the Washington consensus. By including a sense of ownership and encouraging participation, the post Washington agenda ensures that the new approach to development does not face the same problem. The differences between both approaches also extend to how their various components are implemented. For instance, privatization, which is an element of both development strategies as a part of the market reform component of the Washington and Post Washington consensus, has been implemented and understood differently under both approaches. The concept of privatization under the Washington Consensus was to reduce government spending and deficit while removing inefficient state enterprises and creating economic stability. Sale of state owned companies would create revenue and competition between private owners would make enterprises more efficient and more productive therefore it had to be immediate. The post Washington consensus however views privatization as something that has to occur gradually, most importantly after the necessary institutions that would enhance competition has been put in place and not before. The premise for this is that just because public enterprises are made p rivate does not guarantee their efficiency because if the proper institutions were not in place to encourage their efficiency they would not be as productive as expected. The post Washington consensus is however not against privatization, as Stiglitz (2001:38) comments: ‘The Washington consensus is right- privatization is important. The government needs to devote its scarce resources to areas where private sector does not and is not likely to enter. The new consensus is in support of privatizing public enterprises that are unnecessary and can be undertaken by the private sector with institutions to aid its efficiency already in place. Nonetheless, the approaches to privatization under both development programs are different. Both approaches though having a common goal, which is to bring about growth and development, go about it in different ways and have different fundamentals. The Washington consensus approach to development places emphasis on economic growth through increase in GDP levels and market reform. Its fundamental objective is to make market forces more efficient and increase productivity within the economy. This approach is a strong advocate for policies involving deregulation, privatization and stabilization. The post- Washington consensus approach (devised after failure of the previous consensus) on the other hand focuses on development through societal transformation. This approach goes beyond the market approach of the Washington consensus to include broader goals and social factors like health care and education. The new consensus core objective is a more equal, egalitarian and democratic type of development (Stiglitz, 2001:17). The broader goals and objectives pursued under the post-Was hington consensus makes it fundamentally different from the Washington Consensus approach to development. Bibliography Abrahamsen, Rita (2000). Disciplining democracy: development discourse and good governance in Africa. London: Zed books. p23-65. Adefulu, R. A. (1991). African Debt Crisis and the IMF Adjustment Programmes: the Experiences of Ghana, Nigeria and Zambia. In: Renee Prendergast and H.W. Singer Development Perspectives for the 1990s (pp. 37-58). New York: Palgrave Macmillan. Ajit Singh. (1998). Competitive Markets and Economic Development: A commentary on World Bank analyses. In: Phillip Arestis and Malcom Swayer The Polictical Economy of Economic Policies. London: Macmillan Press Ltd.. 60-105. Bates H. Robert. (1981). Polices Towards Cash Crops for Exports. In: Barry and Popkin Markets and states in Tropical Africa: the political basis of agricultural policies. Berkeley: University of California Press. 11-29. Brohman J. (1995). Economism and critical silences in Development Studies: A theoretical critique of neo-liberalism. Third World Quarterly. 16 (2), p297-318. Cammack, Paul. (2004). What the World Bank means by Poverty Reduction. New Left Review. 9 (2), 189-104 Fine, Ben. (2006). The new development economics. In: Ben Fine, Jomo K. S. The new development economics: after the Washington Consensus. 2nd ed. London: Zed Books. p1-20. Fine, Ben. (2001). Neither the Washington nor post Washington consensus: introduction. In: Ben Fine, Costas Lapavitsas, Jonathan Pincus Development policy in the twenty-first century: beyond the post-Washington. New York: Routledge. p4-15. German Federal Ministry for Economic Co-operation and Development. (2004). Post-Washington-Consensus- A Few Thoughts. Available: http://siteresources.worldbank.org/INTEDS05/Resources/PostWashingtonConsensus-englisch-04-2004.pdf. Last accessed 15 January 2010. Gore Charles. (2000). The Rise and Fall of the Washington Consensus as a Paradigm for Developing Countries. World Development. 28 (5), p789-804. Lal Deepak. (1995). Misconceptions of. In: Corbridge, S Development Studies. New York: Arnold. 56-63. Moseley P.. (1991). World Development and International Finanace since 1970. In: Moseley P, J Toye, and Harrigan J Aid and power: the World Bank and policy-based lending. London: Routledge. p3-25. North Douglass. (1995). The new institutional economics and Third World development. In: John Harriss, Janet Hunter, Colin M. Lewis The new institutional economics and Third World development. London: Routledge. p17-26. Stewart Frances. (1991). The Many Faces of Adjustment. World Development. 19 (12), p1847-1864. Stiglitz, Joseph. (2001). More Instruments and Broader Goals: Moving Toward the Post-Washington Consensus. In: Ha-Joon Chang Joseph Stiglitz and the World Bank: the rebel within. 1st ed. New York: Anthem. p17-56. Stiglitz, Joseph. (2001). Towards a new Paradgim for Development:Strategies, Policies, and processes. In: Ha-Joon Chang Joseph Stiglitz and the World Bank: the rebel within. 2nd ed. New York: Anthem. p57-93. Tornquist, O. (2001). The Primacy of Institutions. In: Tornquist Olle Politics and Development. 2nd ed. London: Sage Publications. p86-102. Van Wayenburg Elisa. (2006). From Washington to post washington: illusion of development. In: Ben Fine, Jomo K. S. The new development economics: after the Washington Consensus. 2nd ed. London: Zed Books. p21-45. Williamson, John. (2005). The Washington Consensus as Policy Prescription for Development. In: Timothy BESLEY Roberto Zagha Development Challenges in the 1990s. WashingtonDC: World Bank Oxford University press. 31-57. Williamson J. (1993). Democracy and the Washington Consensus. World Development. 21 (8), p1329-1336. World Bank. (1997). Fostering Markets:Liberalization, Regulation, and Industrial Policy. In: World Bank World Development Report: the state in a changing world. New York: Oxford University Press. p61-75. World Bank. (1994). Moving Towards sound Macro economic policies. In: World Bank Adjustment in Africa: Reforms, Results, and the Road Ahead. New York: Oxford University Press. 43-59 World Bank. (1994). Reforming the Public Sector. In: World Bank Adjustment in Africa: Reforms, Results, and the Road Ahead. New York: Oxford University Press. 99-125 World Bank. (1994). The Road Ahead for Adjustment. In: World Bank Adjustment in Africa: Reforms, Results, and the Road Ahead. New York: Oxford University Press. 181-219.

The Sea in Beowulf and in Other Anglo-Saxon Poems Essay -- Epic of Beow

The Sea in Beowulf and in Other Anglo-Saxon Poems      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Is the sea mentioned only in Beowulf or is it a common element in all Anglo-Saxon poetry? Is the sea described the same way as in Beowulf? In Beowulf there is one reference after another to the sea. When Scyld died, â€Å"his people caried him to the sea, which was his last request,† where he drifted out into the beyond on a â€Å"death ship.† In the Geat land Beowulf, a â€Å"crafty sailor,† and his men â€Å"shoved the well-braced ship out on the journey they’d dreamed of,† to rescue the Danes from Grendel. â€Å"From far over the sea’s expanse,† the Geats came, â€Å"brave men who come over the sea swells.† In his welcoming speech Hrothgar recalls that the hero’s father â€Å"sought us Danes over the rolling waves,† and his warrior Unferth remembers that the hero â€Å"struggled with Brecca [youthful companion] in the broad sea in a swimming contest †¦ risked his life in the deep water †¦ hugged the sea, gliding through the boiling waves †¦ toiled seven nights in the sea.† A Dane â€Å"was tending to every courtesy† for Beowulf, for â€Å"such in those days could a seafarer expect.† King Hrothgar and Queen Welhtheow gave rich gifts â€Å"to those on the mead-bench who made the sea-journey.† In the Finnburh Episode, Hengest had to spend the winter months with Finn because â€Å"he could not steer his ring-prowed ship on the cold sea.†Ã‚   â€Å"Guthlaf and Oslaf spoke of their grief after the sea-journey.† The Danes carried Hildeburh, the queen of Danish ancestry, â€Å"over the sea.† â€Å"The surging waters† received Beowulf as he swam in pursuit of Grendel’s mother. During the battle Hrothgar and his retinue stared down at the â€Å"turbulent water.† Finally Beowulf returned, â€Å"protector of sailors, strong swimmer, to land.† Hrothgar, i... ... beat across wastes of water: far warmer to me are the Lord’s kindnesses than this life of death lent us on land. . . .   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Seafarer concludes with a rather lengthy prose exhortation to his heareres to fix their hopes on heaven.    The characters in the Old English poem Beowulf certainly delighted in the seas. From this essay it can be appreciated that their attitude toward the sea is both conflictingg with and comparable with that expressed in other Old English poems.    BIBLIOGRAPHY    Alexander, Michael, translator. The Earliest English Poems. New York: Penguin Books, 1991.    Chickering, Howell D.. Beowulf A dual-Language Edition. New York: Anchor Books, 1977.    TheSeafarer. In The Earliest English Poems, translated by Michael Alexander. New York: Penguin Books, 1991.   

Comparative Analysis on Belonging of Romulus

The 1961 novel Revolutionary Road by author Richard Yates links strongly with the autobiographical recount Romulus, My Father, by Raimond Gaita, and in so doing provides a greater understanding of the concept of Belonging. It charts the disintegration of the marriage of Frank and April Wheeler as they struggle against the oppressive conformity of suburban 1950s America. The texts together explore the processes undergone by the individual in their integration to society and it’s inherent cultural groups.Revolutionary Road posits as it’s central idea that life is – entirely and inescapably, not only on the surface but right down to the core of human nature – an act. Every action of the characters in the novel, every single piece of behavior, thought, and reasoning are based on a structure of systematic etiquette. The central protagonist, Frank Wheeler phrases this concept perfectly in the way he describes the speech of his wife as having a â€Å"quality of play-acting, of slightly false intensity, a way of seeming to speak less to him and more to some romantic abstraction†.Though set in the cultural dead-end of the United States in the 1950s, a time when the American dream, entirely achieved, was beginning to ring hollow; it could easily be from any context that could be regarded as a ‘society’ – the text implying a sense of general universality of it’s central posit. The book shows that in any attempt for acceptance, true self expression will be limited – often severely so. Contrastingly, Romulus, My Father appears to espouse an entirely opposite premise: that an honestly of character equates to moral goodness, even in the face of great adversity, and will bring a sense of ful? led connection in life. As Gaita puts is â€Å"Character†¦ was the central moral concept for my father and Hora. † Romulus retains his own identity, despite the barriers it creates in a society that seeks to assimilate; and it is this very attribute that allows him to belong to his family and those he loves. Romulus’s ideals are based entirely on his true feeling, not prescribed to a speci? c formula of action and reaction such as is the case in Revolutionary Road; his values are what make him. Upon further analysis, however, this is no less a conformity to protocol than that of Frank and April.Gaita states that â€Å"the sense given to me by my father and Hora, of the contrast between malleable laws and conventions made by human beings to reconcile and suit their many interests, and the uncompromising authority of morality, always the judge, never merely the servant of our interests†, the perception of his son that certain rules are entirely unbreakable and inarguable is, in itself, a baseless social construct. No real contrast between human convention and morality actually exists. â€Å"Morality was for him as substantially a part of reality as the natural facts of huma n action and motivation. To belittle the feelings of Frank Wheeler as somehow less guiding than Romulus’s is also incorrect, both use feeling based reasoning to choose one of several possible options, open to them as a result of combination of circumstance and the system they take as inarguable, infallible law. Gaita attempts no higher argument for the inherent goodness of his father than his strict obedience and conformist attitude to a moral viewpoint, and makes no further argument for the de? nition of what good is beyond what one perceives to be good.Both are, at root, based on entirely nothing at all – to call one moral and the other etiquette is a farce, both are mere social construct, built by cultural conditioning, to establish and maintain a system of behavior deemed correct for no true reason. They only exist as objectively unchangeable so long as their creators and keepers believe them to be so. So, to avoid the true baselessness of their society and everyth ing the believe in, the protagonists of both texts resort to a method of delusion just as strong as that which they infer to abhor.In Revolutionary Road, Yates uses a technique of not matching the internal dialogue or self-perception of his characters to the events of the plot or speech. Frank Wheeler will often imagine conversations in his head, or prescribe to himself some false grandiosity in his lines – contrasted to a third person narrative voice, which reveals the scene to be usually uneventful and mediocre. April envisions herself â€Å"a whole world of marvelous golden people somewhere†¦ ho made their lives work out the way they wanted without even trying, who never had to make the best of a bad job because it never occurred to them to do anything less then perfectly the ? rst time. Sort of heroic super-people, all of them beautiful and witty and calm and kind, and I always imagined that when I did ? nd them I'd suddenly know that I Belonged among them, that I w as one of them, that I'd been meant to be one of them all along, and everything in the meantime had been a mistake; and they'd know it too. I'd be like the ugly duckling among the swans. †The Wheelers believes in something greater, something more, and that they a worthy part of it; when in reality, such a thing is simply non-existent. All they truly have is the mediocrity of their suburban prison, and the paradox of a world which, with all options open, is so terrifyingly vast that they must cling to the safety and security afforded by familiar protocol. They hold ? rm the excuse that it is necessary and inevitable to ensure societal acceptance, and the vague general assumption that they are somehow different, somehow better or above their surroundings. They are not.All that separates them is their own idea of separation, they do not think themselves to belong, yet in reality ful? ll perfectly the 50s ‘Nuclear Family’ suburban stereotype. They are everything they claim to hate in a way so natural they probably couldn’t have achieved if they’d tried. There is no ‘backup’ to their facade, no face behind the masks they craft, no true identity oppressed by circumstance. All that they have is, as Frank puts it, â€Å"the hopeless emptiness†. This is mirrored in Romulus, but in regards to Raimond’s perception of his father; he sees him not as he is, but as an archetype – some â€Å"romantic abstraction†.The novel is essentially a glori? cation. For Raimond, Romulus is a great man; someone special whose faults could either be excused to someone else’s inadequacy, his madness, or an overextension of his stubborn moralism – him being too good. The events described clearly contradict this, however. Romulus was not remarkable nor extraordinary. He lacked ambition and intelligence (after not succeeding in gaining scholarship he never again pursued any attempts at education, despite the fact that he had suf? ient ability and opportunity – yet in referance to the event, Raimond makes the claim that â€Å"He cried bitterly, not because of lost employment prospects, but because his love of learning would never be ful? lled. †). e wasted his skills in beautiful metalwork ( as the composer puts isâ€Å"He was able to make almost anything to the most exacting standards†, â€Å"his work was unsurpassed in quality and speed†, and My father was not merely skilled, he was a   man of practical genius†) upon the construction of what even his son admits is ugly furniture. e led a lifestyle that perpetuated the isolation that so caused him and those he loved to suffer. In his life he never did a single thing that could be regarded as brilliant that was not to the end of his or Raimond’s continued survival; and though for much of it he lived through great hardship, in the context of humanity it was not especially severe. The greatest in sight to this is found in the ? nal pages of the book, in the speech delivered at Romulus’s funeral, in which Raimond says (in regards to his father) that â€Å"he never intentionally caused suffering to anyone†.It would take a man of enormous stupidity not to realize that to in? ict domestic violence unto his mentally ill wife and young child would cause them signi? cant pain. The composer attempts to portray his father’s wrongs as a product of circumstance, removed from choice or free will; but if such a stance is taken, there is no limit upon extending it to good deeds as well or, even to the very heart of a persona – no line can be drawn between what is merely conditioning and what is one’s true nature.It is ironic that in attempting to portray a man who espoused no greater good than â€Å"real character†, Gaita paints a nearly perfect archetype and ignores or downplays or re-interprets aspects just as real and signi? cant to who his fat her was as those which play to what he seems to want to see. Raimond in his perception of his father and the Wheelers in their perception of themselves seem to assume that, would it not have been for that which life had thrown at them, they could have been something much greater; something truer to themselves or more realizing of their own potential.In reality, they had the whole world at their hands, and as much time at their disposal as any who has lived. They were exactly as they were, and nothing more. It was not circumstance that prohibited the ful? llment of these characters’ potential – this was but a convenient excuse – it was themselves; the sad fact was that neither the Wheelers nor Romulus were actually so brilliant at all.Ergo, from a collective analysis of both texts, it can be concluded that, in the processes undergone by the individual in their integration to society and it’s inherent cultural groups, the conformity to an idealized human ar chetype, though necessary to belong, will inevitably deny individualistic actualization of the true human condition. Through the ideas explored in Revolutionary Road text, strong links can be made with Raimond Gaita’s Romulus, My Father, to provide a signi? cantly furthered understanding of the concept of Belonging.

Narrative of the Life of Frederick Douglass

Advanced Academic Writing The wide attention of critics to Hemingway â€Å"Indian Camp† can be attributed in compare two secondary sources: â€Å"Hemingway Primitivism and Indian Camp† by Jeffrey Meyers, and â€Å"Dangerous Families and Intimate Harm in Hemingway Indian Camp† by Lisa Tyler. Both Meyers and Tyler explore the theme of masculinity and Hemingway biography. The story introduces the theme of masculinity in the context of giving birth in anIndian camp. Although childbirth typically concern women, Hemingway turns it into a male-dominated situation and shifts the focus to DRP. Adams, who performs a Cesarean operation, and to the husband's suicide. Both Tyler and Meyers examine this masculine focus of a typically female endeavor-?childbirth. Tyler refers to DRP. Adams role as the person who passes on values and shape perceptions of masculinity and especially how to respond to a women suffering to his son- Nick.Meyers, on the other hand, refers to the India n husband who feels responsible for the male sexual behavior during the birthing that contaminates his wife and â€Å"cannot bear this defilement of his wife's purity â€Å", therefore follows his primitive values and customs and â€Å"punishes himself for the violation of taboo†. Both secondary sources cite Hemingway biography. Tyler uses Hemingway biography in order to demonstrate how Hemingway own relationship with his father extends to the interactions between Nick Adams and his father. Narrative of the Life of Frederick Douglass

Methamphetamine essays

Methamphetamine essays In the last decade, methamphetamine use has dramatically increased throughout the United States. This growing epidemic raises concerns for a variety of reasons. First, methamphetamine is extremely addictive and often leads to compulsive use. Secondly, this is particularly problematic because as the abuse problem continues to rise, a growing body of research is demonstrating a wide range of neurotoxic effects that can result from the drug. Methamphetamine administration in laboratory animals has been proven to cause profound and long-lasting toxicity of the brain, most notably to dopamine terminals (Volkow, et al. 2001, p. 377). Recent studies have confirmed that methamphetamine abuse exerts similar effects on dopaminergic systems in humans as well, in addition to other structures of the brain. Dopamine is an essential neurotransmitter that plays a role in memory, mood, and motor coordination (Imaging Studies, 2001, p. 12). Damage to dopamine-related structures is linked to numerous l ong-term consequences, including memory impairment, motor deficits, mood disorders, psychiatric symptoms, anxiety problems, and increased aggressive tendencies. In a recent study conducted by Volkow and her colleagues, certain brain areas of methamphetamine users were compared to a control group using positron emission tomography (PET). All of the users met the DSM-IV criteria for dependence on the substance. Their length of abstinence from the drug ranged from 2 weeks to 35 months, and none had a prior history of drug addiction. The comparison group consisted of healthy volunteers with no past history of drug use. The focus of this study was to assess memory and motor impairments due to dopamine transporter reductions in methamphetamine abusers. Researchers were also interested in determining whether the drug produced any significant effect on portions of the brain not innervated by dopamine. A similar study was conducted by Sekine and his...

Should Frank Lloyd Wright essays

Should Frank Lloyd Wright essays Frank Lloyd Wright was born on June 8th, 1867 in Wisconsin. His heritage was Welsh. His fathers name was William Carey Wright; his occupation was a musician and a preacher of his faith, Unitarian. His mothers name was Anna Lloyd Jones; her occupation was a schoolteacher. It was said that his mother placed pictures of great buildings on the walls of his nursery in order to train him to become an architect. He spent most of is life on his Uncles farm near Spring Green, Wisconsin. Frank briefly studied civil engineering at the University of Wisconsin in Madison. When Frank was twenty years old, he moved to Chicago. After he moved there, he got his first job in an Architectural Firm of J. Lyman Silsbee, he worked there for about a year. In 1887, he got a job as a draftsman for Adler and Sullivan; here he eventually became chief draftsman and residential design. Under Sullivan he began to develop his architectural ideas. In 1889 he married his first wife Catherine Tobin. After awhile of developing his own ideas he started to design bootlegged homes which meant that he was going against the firms policy of moonlighting. When the firm found out what Frank was doing, he was fired. These were the start of Wrights low, sheltering rooflines, the prominence of the central fireplace and destruction of the box open floor plans. In 1893, Wright started his own firm; he first worked out of the Schiller Building (designed by Adler and Sullivan). Then he moved into a studio which was built onto his home in Oak Park. Oak Park was an affluent suburb of Chicago, which was located to the west of centercity. From 1893 to 1901, about 49 building designed by Wright were built. This period was brought together by concepts of prairie house ideas. In 1909 he developed and refined his prairie style. He founded the Prairie School of architecture. His art of this early produ...

An Analysis of the Rampant Food Waste America Produce

An Analysis of the Rampant Food Waste America Produce In my opinion the relationship between America and food is horrendous. Yes, throughout the states and different regions of America there are many takes on food, transforming it into creative and tasteful dishes. Maybe garnished with a sprig of some fancy tree that you’re not going to eat because who eats that junk? So, like many other foods, the garnish is thrown out and wasted. The wastefulness of our modern society branches out all through industries such as fast food, markets, and restaurants.Countless times fast food restaurants dump out food that was not sold: burgers, fries, chicken nuggets. All this food which was still edible is discarded. To think we could have still used this food or given it to someone who needed it, but rather kept it from them and took away the chance of anyone using it seems monstrous, but hey, that’s America. Everything revolves around some form of profit, so theres no time to get rid of that food for free. On the other side of fast food restaurants, there are the top of the line restaurants who work more on the aesthetic side of their food rather than the quality and taste which begins to create a sort of expectation from the people. We want our food to be flawless, and satisfy our eyes. There can be no burnt pieces of meat, no discolored pieces of ripe fruit, nothing that we see as flawed, and if it is, then its thrown out and wasted. So as we have the fast food restaurants literally just throwing out food, we have our top of the line restaurants shaping how we view good and bad food which ultimately leads us to also end up throwing out food. Not only do these top of the line restaurants influence how we view good food, but the agribusinesses as well, such as Walmart. We walk into a store and see an extreme abundance of colorful fruits and vegetables yet that does not phase us, although a majority of those fruits and vegetable wont be bought because of some small flaw which doesnt really affect anything about them. We take this abundance of food for granted and rather than actually having the thought of buying food for our own sustenance, we have the thought of buying the best looking fruit. So instead of buying those 5 apples which all have flaws, we choose not to buy them and ultimately they get wasted, just like so many other foods that we take for granted in America.

Essay - Aristotle and Plato -ethics Example | Topics and Well Written Essays - 1000 words

- Aristotle and Plato -ethics - Essay Example the Cave, he presented the idea that people are living in a world of forms, within which the ideas that were called truths were mere projections of the reality. For that matter, he considered that the ethical way of life for man was to achieve goodness which he defied as the level of understanding the real nature of things. This he stated can be done through education (Plato 453). Aristotle on the other hand presented in the work The Aim of Man his main ideas on ethics. According to him, ethics is a form of practical science, thus he was known for his experiential approach in ethics (Aristotle 691). Based on the views of Plato or Aristotle then, one’s way of life is more ethical and practical that another when one does not only think of one’s own goodness but contribute to the goodness of the society and the state. Through the course of the discussion then, both the views of the two philosophers will be discussed. The differences between Aristotle and Plato can be presented on different points. The first one is in relation to the manner of achieving an ethical life. Aristotle viewed that ethics was more practical and experiential while Plato viewed that it is more theoretical. Aristotle presented a view on ethics that is more practical and experiential. For that matter, based on his view, one’s life can be more ethical if it is more experiential. This means that a person needs to primarily focus on his or her function in the society to have an ethical life. Aristotle indicated that a man needs to be â€Å"rational and exercise his reason, not just possess it† because this is what separates him from other animals (Aristotle 700). He believed that goodness can be defined as a state wherein a particular entity maximizes its potentials and skills (Aristotle 694). One example that can be given is the profession. If a person is good in a certain field of study such as arts, he or she needs to pursue that field. In this manner, life is more ethical

Human resource development in multinational companies Essay

Human resource development in multinational companies - Essay Example To cope up with the competition, they are required to plan and implement strategies to develop the company’s human resources. In today’s globalized environment, it has become difficult for the managers to completely eliminate the threats that globalization has brought. Multinational companies face many of such difficulties in acquiring efficient staff in other countries. Multinational companies aim to build up their brand name and reputation. They need to provide the same quality and facilities in every country they are working in. However, the human resources available in different countries bring different challenges for them. They need to develop a plan to accumulate a workforce which could perfectly carry out the job the company aims to achieve. The concept of repatriation and expatriation is also worth mentioning here as the human resource development program must consider these concepts. As an expatriate gets the assigned work done in the other country and moves b ack to the host country, he faces the adjustment problems all over again. A complete and viable HRD strategy must also take in to account these workers who are sent abroad while working permanently in some multinational organization. Objective: The aim of this paper is to identify the key challenges faced by senior managers in today’s globalized business environment in achieving competent human resources. The paper also focuses on the researches made in this regard. In addition it provides recommendations to lessen or eliminate the difficulties in human resource development and reduce the employee turnover rate in the organizations. The study is designed in such a manner that would help in achieving the objective successfully. In the first step it provides a brief introduction about multinational organizations and their place in today’s business world. In the next step it

To what extent would you agree with the view that the protagonist of Essay

To what extent would you agree with the view that the protagonist of Poe's stories is language itself, and the structure of the tale is its hero discuss with r - Essay Example This internal battle causes Wilson to go insane and eventually attempt to murder a man who looks and acts just like him because he believes that this will reacquire his identity for him. Each of these stories has a protagonist that can be representative of language as a whole because each of them is battling against other forces who are trying to regulate their language. Dupin does not wish to be bound by the conventional rules of investigation, just like many do not like to be bound by the conventional rules of language, so he becomes an innovator in his field, which leads to him solving the crime. Wilson, on the other hand, believes that his own person language is being threatened and so he acts violently in order to protect it. Each of these characters represent language because language, while constantly evolving, must also be protected from external factors, otherwise we will all eventually end up speaking and writing exactly alike. In the story ‘The Murders in the Rue Morgue,’ by Edgar Allan Poe, the protagonist is an expert detective named C Auguste Dupin. Poe is often credited with creating the genre of detective fiction that is present today, as he â€Å"introduced three common motifs of detective fiction: the wrongly suspected man, the crime in the locked room, and the solution by unexpected means. Dupin solved the crime by reading the evidence better than the police did and by noticing clues that they had neglected, thus highlighting the importance of inference and observation†1. This story’s use of language focuses on both Dupin and the narrator, who is an overly sympathetic figure and does not believe that Dupin can do any wrong. Dupin forms the plot of this story around his belief that the Paris police department has not done all that it can do to solve this crime. He uses his power of observation to recognize clues at the crime scene

Rhetorical Analysis Essay Example | Topics and Well Written Essays - 750 words - 11

Rhetorical Analysis - Essay Example The author achieves this by employing superior common ground, detached diction, and an academic tone to place the reader on a scholarly level observing an ancient disciplinary measures practice. The author in his book wrote about the Panopticon under the title â€Å"Panopticism† where he metaphorically alludes to the way authority takes charge and control of the people. He uses the seventeenth century order and case scenario to show the reader how people’s respect for the ones in power comes from their fear of the authority as opposed to the authority’s actual strength. The order was formulated at a time when the plague rose, and it functioned to separate people one by one from the eldest to the youngest, in terms of towns, classes, as well as individuals. This in terms of rule and authority was the ideal method of running a city. Having isolated everyone to quarters and giving orders to be followed, which the people feared to break for the consequences that would follow. The common ground for â€Å"Panopticism† is surveillance or the watchful eye of the law or authority instilling conditional obedience in its subjects through rule of fear. Theoretically speaking, the Panopticon is a building constructed in the shape of a circle with holding cells in multiple rings, built in a storey form. A tower is erected in the center of the rings in order to observe the prisoner’s activity. Each cell has sufficient room for holding one person and is partitioned by a wall from the next to deter prisoners from seeing each other as well as eliminate chances for mob action. The front side is blocked with bars while the back has a window to let in light so that the prisoner cannot hide. The author uses this model/theory to prove the effect of using fear to quarantine people and make them very submissive to authority. The people in the text were ordered to stay indoors, and none was to leave on pain of death. The syndics were given authority over

Critical evaluation Essay Example | Topics and Well Written Essays - 1500 words

Critical evaluation - Essay Example t supplementary facts that were expected from the implementation of the smoke-free legislation, as they acknowledge, â€Å"Our study is part of a comprehensive evaluation of Scotland’s smoke-free legislation† (Haw & Gruer, 2007: 549). The researchers successfully deal with the comprehensiveness of the topic of their study. Though previous researches on the air quality of the public places of Scotland refer to the subsequent impact of the smoke-free legislation, their acute limitation was that they do not tell much about the impacts on the private places. Haw and Gruer’s comprehensive approach to the research topic pertinently includes the exposure of the non-smokers in the private places. Such comprehensive approach to the changes in exposure aids the readers to achieve an overall picture of the change in exposure. Another thing is remarkable that the researchers are more concerned to prove the consistency of the findings of their paper with other studies than to clarify the concepts of â€Å"exposure to second-hand smoke† (Haw & Gruer, 2007: 549) and the parameters of â€Å"change† that they are dealing in the paper. Significantly their paper lacks any efficient literature review that could have clarified the outline of their research topic and other related concept. Also it lacks a sufficient literature review to support its methodology and other approaches to the research topic. Haw and Gruer do not tell anything about ethical approval by any ethic committee. Also they do not describe the maintenance of ethical issues for the paper. As to research method, Haw and Gruer chose the cross-sectional approach for their research. But the flaw within their methodological approach is that though in the first place they chose the cross-sectional method, they used longitudinal data also. Though they expressed the aim of the study as â€Å"to measure change in adult non-smokers’ exposure to secondhand smoke in public and private places after smoke-free legislation was

My history as a reader and writer in Russian and in English Essay

My history as a reader and writer in Russian and in English - Essay Example Writing is an art that requires one to have passion and willingness to counter the challenges that relate to the rules of good writing. My experience in reading and Writing in college is quite different from that of high school. In high school, most of the writing involved simple compositions and summaries. In college reading and writing requires deep analysis of the contents and the interpretation of those contents. Learning a new language is quite challenging but I am determined to perfect my new skills within the shortest time possible. My strengths in this new language are the commitment I have in my studies through regular practice to enhance my speaking and writing skills. I am also good at recalling facts and materials learned which enhances my performance in English and Russian languages. My weakness is the poor mastery of new phrases, especially in the new language. To counter this weakness, I am working hard by reading many articles and noting everything that I read in my notebook. The main goals for this course are to improve my analytical skills, which will enable me to be an excellent creative writer in the future. I also want to improve my usage of verbs especially the correct use of verb tenses, which will enable me to write the high-quality grammar. I also want to organize my work very well and compete with some of the world’s renowned writers in creative and imaginative writing. Reading and writing in the two different languages will help me communicate with more people and make many friends who have similar interests.

Critical evaluation Essay Example | Topics and Well Written Essays - 1500 words

Critical evaluation - Essay Example t supplementary facts that were expected from the implementation of the smoke-free legislation, as they acknowledge, â€Å"Our study is part of a comprehensive evaluation of Scotland’s smoke-free legislation† (Haw & Gruer, 2007: 549). The researchers successfully deal with the comprehensiveness of the topic of their study. Though previous researches on the air quality of the public places of Scotland refer to the subsequent impact of the smoke-free legislation, their acute limitation was that they do not tell much about the impacts on the private places. Haw and Gruer’s comprehensive approach to the research topic pertinently includes the exposure of the non-smokers in the private places. Such comprehensive approach to the changes in exposure aids the readers to achieve an overall picture of the change in exposure. Another thing is remarkable that the researchers are more concerned to prove the consistency of the findings of their paper with other studies than to clarify the concepts of â€Å"exposure to second-hand smoke† (Haw & Gruer, 2007: 549) and the parameters of â€Å"change† that they are dealing in the paper. Significantly their paper lacks any efficient literature review that could have clarified the outline of their research topic and other related concept. Also it lacks a sufficient literature review to support its methodology and other approaches to the research topic. Haw and Gruer do not tell anything about ethical approval by any ethic committee. Also they do not describe the maintenance of ethical issues for the paper. As to research method, Haw and Gruer chose the cross-sectional approach for their research. But the flaw within their methodological approach is that though in the first place they chose the cross-sectional method, they used longitudinal data also. Though they expressed the aim of the study as â€Å"to measure change in adult non-smokers’ exposure to secondhand smoke in public and private places after smoke-free legislation was

Reporting Practices and Ethics Essay Example for Free

Reporting Practices and Ethics Essay Introduction Reporting practices and ethical standards are the most important building blocks that are needed to build a successful health care organization or any business. These reporting practices and ethical standards prove to be the upmost important practices in any health care organization. When reviewing all the variables and factors, one considers the principals listed in the generally accepted accounting principles. There are several factors to consider and inforce these principles in an organization. To successfully implement generally accepted accounting principles and execute corporate compliance, an organization should consider in order for building a successful organization; ethics, fraud and abuse are all key components for maintaining a successful health care or business organization. A successful organization cannot be successful unless they integrate and implement the four elements for financial management. In order to implement and execute the four element of financial management for a successful organization, the four elements should be implemented and carried out in full on a daily basis for every procedure and operation within the organization. Controlling, planning, organizing, and decision making are the four components every business and/or health care organization should adopt. The four elements are the keys to every good business ethics and standards to maintain a successful organization. Four Elements of Financial Management The planning stage of the four elements of financial management proves this stage, is vital to set goals for a healthcare organization end to end with its execution of this stage and the other four elements. The next element of financial management is the controlling stage and in this important stage the organization must set goals for their organization and that each goal is executed and carried out. A perfect example of how an administrator /director/ manager in a healthcare organization can control their  organization is to conduct audits of the department they oversee. Decision making is defined as the overall performance of the other three elements and determination on wither or not the overall performance of the other elements. The success of this can be measured Decision making in conjunction with the other elements and the overall performance and success of other 3 elements ultimately determines decision making elements. Examples, if the organization exceeds the funds budgeted and find they are over budget, the decision making element comes in to play to review these items over budget and make an action plan to correct and/or prevent in the future. The four components are a vitally in financial management there are also other important principals and standards. The Generally accepted accounting principles and general financial ethical standards along with corporate compliance, ethics, or fraud and abuse are equally important separately and combined. The four functions of management help the facilities function properly and give the management the opportunity to resolve any issue or obstacle that may present as well as the opportunity to growth and make them better to perform and utilized the resources around them. Management is responsible for beginning the process for procedure or task at hand and sustaining the actual method of internal control that is set by the organization. It is important that management/ administrator/ director to oversee and maintain the budget control. The manager/admin/director overseeing the budget should be knowledgeable of how to control the budget and in order to maintain budget control, they should regulate to increase productivity and be familiar with assets, financial reporting and account summary. Every cooptation or health care organization is necessitate to meet the satisfactory operational needs, consequently cash management function helps any organization begin to create a set of policies and procedures to ensure that federal funds are not withdraw unreasonable from the organization and payments are made properly to the programs (Ethics and Compliances May 1994). According to Ethical Behavior by Companies Benefit Society and Business (November 13, 2010), when applying ethical business practices, says that business should ensure that the production of its services should be environmentally ecological and every human involve in the production should not be dangerous or harmful for them. Ethical practices involve the strong financial reporting as well as consideration  for the social and environmental impact of the business. Audit reports help the organizations know the financial condition of the organization for Health Care or any other business as well as the result of the organization’s day to day internal operations. Audits are helpful when following the practices of financial reporting practices of the organization can serve as a checks and balances and a great tool for capturing financial data, if management checks the financial audit reports often. Financial reports explain in detail how the organization is doing and prevents negative numbers on the company because it records any procedure and activity that happens in the organization (Ethics and Compliances. May 1994). According to American College of Physicians (Snyder. 2012), the environment for the delivery of health care continues to change. Sites of care are shifting, with more care provided in ambulatory settings while the intensity of inpatient care increases. Generally Accepted Accounting Principals â€Å"The phrase â€Å"generally accepted accounting principles† is a technical account term that encompasses the conventions, rules, and procedures necessary to define accepted accounting practice at a particular time. Generally accepted accounting principles (GAAP) are concerned with the measurement of economic activity, the timed when such measurements are to be made and recorded, the disclosures surrounding this activity, and the preparation and presentation of summarized economic information in the form of financial statements (Bragg, 2012). Generally accepted accounting principles also known as GAAP to understand the definition better, GAAP are guidelines that one should follow when trying to establish proper financial documents and reports. With these guidelines to follow, it was easier to maintain the financial reporting’s for all fields, including healthcare. The generally accepted accounting principles were held in the highest regard. The guidelines of the GAAP have had a high authority when it came to determining financial practices in healthcare. The GAAP influence has dwindled if not stopped. It was stated that it was not required for hospitals, nursing homes or any kind of healthcare facility to adhere to the GAAP (Taebel 1995). It has been documented that the guidelines of the GAAP has caused facilities to lose money, even though they knew what was best about recognizing costs. It has  been suggested that is not required to make decisions based off of the general accepted accounting principles. Capital costs are reimbursed according to a prospective payment system; providers are being paid a predetermined amount regardless of GAAP issues (Taebel, 1995). Conclusion There are countless of different ways that we can touch bases on to understand the importance of a cohesive financial department. It is essential to its success to be ethically compliant and to follow through with policy and procedure. It is up to the financial managers to execute and enforce proper guidelines. In conclusion, there are four elements of the financial structure that is the basis for a financial departments success which are planning, controlling, organizing and decision making. With this information we were able to understand and summarize more in depth the importance of generally accepted accounting principles and general financial ethical standards. Finally, we were able to view examples in those respecting terms and gain understanding from them. By compiling all of these elements together can guarantee a solid financial department in any healthcare facility. References American College of Physicians (2010) Ethics in Practice: Managed Care and the Changing Health Care Environment. Retrieved 11/13/2010 from http://www.annals.org/content/ Bragg, Steven M. Wiley GAAP 2012: Interpretation and Application of Generally Accepted Accounting Principles (10th Edition). Hoboken, NJ, USA: John Wiley Sons, 2011. ProQuest ebrary. Web1 May 2015. Ethics and Compliances Retrieved 11/13/2010 from http://www.miamivalleyhospital.org/mvhdefault.aspx?id=12746 (May 1994) Snyder L, for the American College of Physicians Ethics, Professionalism, and Human Rights Committee. American College of Physicians Ethics Manual: Sixth Edition. Ann Intern Med. 2012;156:73-104. doi:10.7326/0003-4819-156-1-201201031-00001 Taebel, S.W. (1995, October). Supreme Court ruling reduces GAAPs authority in Medicare cases. Healthcare Financial Management, 49(10)

Effective Leadership And Management Styles

Effective Leadership And Management Styles According to Ward S (2010) Leadership is the art of motivating a group of people to act in a specific way towards achievement of a common goal. A leader therefore is a person who has a combination of skills and personality that will make people want to follow his or her direction. The leader should have the ability to manage all the resources under his or her disposal. Successful leadership as a discipline involves communicating, supervising and inspiring people under his or her leadership. On the other hand, Management is the organization and co-ordination of the activities of an enterprise in accordance with certain policies and achievement of certain pre-defined objectives. As a discipline, it involves formulation of policies, organizing, planning, controlling and directing firms resources towards achievement of the policy objectives. According to Reh .J. (2010) a manager is a person who plans and directs the work of other individuals by monitoring their work and taking corrective action when necessary. Skills are the capacities and abilities obtained through deliberate and sustained efforts to carry out complex activities or job functions. It involves use of ideas (cognitive skills), interacting with people (interpersonal skills) and doing things (technical skills). Qualities are the attributes that define the degree of excellence. Something of quality is that which is free from deficiencies and ineffectiveness. Knowledge is the expertise acquired by a person through education or practice. Ability is the acquired or natural capacity, competence or talent that enables an individual to perform a particular job or task successfully any time. This paper will analyze the specific skills, knowledge, qualities and abilities that an individual will need to develop to become an effective leader and manager. MAIN BODY There is an argument that there is a difference between a leader and a manager. Indeed it is true that all leaders must be managers first but not all managers are leaders. There are several theories put forward to distinguish between leaders and followers. According to Cherry K (2010) there are several leadership theories. These include: Great man theory: It postulates that great leaders are born and not made. Leaders in this group are heroic, mythic and their destiny is to rise to leadership whenever needed. Trait theory: This theory assumes that people inherit certain traits and qualities that enable them to be best suited for leadership. The theory identifies particular personality and behavioral characteristics which are common for all leaders. Contingency theories: This theory focuses on variables related to the environment that determine the leadership style to be used in different situations. Thus leadership styles will have to be changed according to the situation. Success therefore depends on various variables like the situation in question, the qualities of followers, number of variables and leadership style. Situational theories: Leaders will choose leadership styles depending on the situation. Different leadership styles may be more appropriate for certain decision making than others. Behavioral theory: This theory is based on the belief that great leaders are made and not born. According to the theory people can learn to be leaders through observing and learning. Participative theory: In this style the output of others is taken into account in decision .Leaders will therefore encourage participation and contribution of the group members and make the members to feel more relevant and committed to the decision making process. Management theory: This theory is based on the system of reward and punishment. In this case, when employees succeed, they are rewarded and when they fail they are punished. The role of the manager is thought to be focused on supervision, organization and group performance. Relationship theory: This theory focuses on the connection between followers and leaders. Leaders motivate and inspire followers by helping the group members to see the importance of the task. Leaders in this group will have high moral standards because they are focused on performance of group members and they want everyone to fulfill his or her potential. Effective leadership An effective leader must have followers because the essence of leadership is to convince people to act the way you want. Therefore, a leader must have the ability to convince people to pull people towards his direction. This will entail good communication in order to explain goals clearly to the followers. This will bring about better results because the followers understand the goals to be achieved well. According to Walker .C.A. (2005) effective leadership must be built on a solid foundation which is in turn dependent on the qualities of integrity and humility. He goes further and defines integrity as firmness of character, honesty, uprightness, sincerity and good moral character. Integrity not only influences the goals that leaders chose but also the type of followers that they get. It means therefore that, high integrity builds trust, honor, respect and loyalty among followers. Humility on the other hand, has the effect of avoiding arrogance in the work place and also allows you to share glory and celebrate success with followers. Thus, to be successful as a leader, you should build your personal and organizational code of conduct on humility and integrity. According to White B. (2010), a good leader has several qualities that characterize him or her. These qualities can be summarized as: Availability: A leader should be available and in touch with the people he leads. This means that he should be sensitive to the needs of people and respond in time. Maintaining good relationship: Successful business leaders know the importance of good relationships. They will therefore prioritize on minimizing conflict and lack of harmony. Self motivation and development: Successful leaders will do anything acceptable to ensure that their skills and knowledge base is kept on track because they know the importance of personal and professional development. They therefore set and use goals for motivating themselves and others. Appropriate use of authority: Good leaders use their authority with wisdom and sensitivity to different circumstances. Authority should therefore not be used in gratifying or promoting oneself or even controlling or dominating others. Understanding of group dynamics: Successful leaders are good at using both the strengths and weaknesses of a group to achieve the best results. They also have the ability of bringing groups together by leading them without conflict and minimizing harmony. Having incentives and building team spirit: A result orientated leader will give his juniors incentives in order to improve their performance and maintain quality results. According to Burger (2004), there are certain abilities that a good leader should have several vital abilities. According to him, leaders are born leaders and develop according to their environment and education. Management on the other hand, can be learnt and obtained by sufficient training, education and acquiring additional skills. Leaders are necessary to drive the vision home and making sure that the drive stays alive in the hearts of the staff, members and contributors. The abilities which are very critical for leaders are: Encouraging workers to be creative and contribute: This is achieved by setting guidelines and encouraging them to participate at their level. People are individuals: Understand the strengths and weaknesses of the members of your group, listen to their fears and encourage them to achieve their aspirations. Lead by example: A leader should have the ability to build up a team to support him or her and this means that the leader should first volunteer. Therefore the example that is set by the individual is followed by the rest of the team. Effective Management According to Francis M (2007) the quality of a manager and effective management styles determine the culture of the organization, productivity of its staff and the ultimate success of the organization. As such a manager should striver to use the best Management styles. A manager should have the ability to direct supervise, encourage, inspire and co-ordinate and as a result facilitate action and guide change. In doing this the manager should develop his qualities and those of others. Managers use planning, Organizational and communication skills. There are certain other skills which must be possessed by effective managers. These skills are: Creative problem solving skills-A good manager should have the ability to describe and analyze a problem critically. During the analysis, there is need for a good manager to identify the causes of the problems in question and identify the best options and the best courses of action to take. The manager should then implement and evaluate the effectiveness and efficiency of his actions. Communication Skills-A good manager should be able to listen to the juniors and any other ideas from that may be of importance to the organization. He should also be able to make good presentations, give feedback on issues relating to running of the business and be able to write good reports. Conflict management skills.-The manager should have the ability to identify the sources of conflict in the organization and understand the personal style of conflict resolution. He should also develop the best strategy of dealing with the conflict and promote positive conflict in the organization. Negotiation Skills -The ideal manager should develop rational thinking in negotiation. By doing so, he will avoid various mistakes in negotiation and develop an effective skill in negotiation that assists both parties. Self-awareness and improvement-The manager should understand the importance of emotions in work and self-development. In addition, the manager should attempt to understand the importance of self-motivation and how to effectively manage self-learning and change. Successful managers must have certain qualities which should be able to define them. They should therefore be: Enthusiastic: This means that the manager should always be positive about everything because it helps to motivate those under them. Enthusiastic managers are committed to their goals because they express this through their optimism. Good communicator: The best managers who have good communication skills support individual and team achievements by creating guidelines for accomplishing tasks and career advancement for team members. Competence: Managers should have the ability to successfully lead others by having a past winning track record. A competent manager has expertise in management skills which enables him to inspire encourage, challenge and model. Ability to delegate: The way a manager checks and controls the work of others demonstrates his ability to delegate. A good manager should leave the other team members to participate in the work actively. Help employees set goals: Talking to employees assists in enabling them to understand the overall goals of the business. The manager should then help them to set individual goals which are geared towards achieving the long term business goals. Positively talking with employees and allowing them to participate in goal setting will motivate the workers to work harder. Effective management styles Managers are those people who can make the most out of their employees through their inspiration. According to the tutor2u business site (2010) Managers use different types of management styles according to the preference of the individual manager. These management styles are discussed below: Autocratic management style: There is close supervision and control of employees and all decisions are made by the manager. Workers are not trusted. They are just given orders which they are expected to follow to the latter. It means that in this style communication is one way. This style is very important when dealing with large number of semi-skilled workers who can not make certain decisions on their own. It may also be appropriate in time of crisis when fast decisions must be made. Paternalistic management style: Managers using this style give more importance to the social needs and view of workers. Decisions are therefore made in the best interests of workers. In addition, managers consult employees over issues and they listen to their feedback and opinions. Democratic Management style: Managers using this style trust their employees and will delegate to them some of the duties and encourage them to make some decisions. This requires two way communication and listening to employees advice. This means that the managers should encourage democratic discussion groups which form the basis of useful ideas. This style is only effective when decisions are made based on the major views of most workers. According to Vercillo K. (2010), there are ten traits that an effective business manager should have. These are: Self motivation: The manager should understand the goals of the business and develop individual strategies for achieving the goals. As such, he should be capable of doing the job with minimum supervision. Great customer service skills: An effective manager should be effective in dealing with customers and /or clients. He should thus be effective in handling problems which may occur with the customers. This means that the manager should be capable of making even the difficult customers happy in order to retain the customer and ensure business growth. Be a team player: The manager should be interested in making the business to grow. This means he should be ready to work with a team of people for the improvement of the overall business. Conflict resolution abilities: The manager should serve as a middleman between the lower employees and the company. He should therefore make an effort to solve any disputes that may arise between employees themselves or employees and the management. Knowledge of the industry: The manager should be able to answer all questions asked by customers, clients and even staff members. The manager should not only have advanced or specialized experience in the fields but should also have a thirst for more knowledge about the industry. CONCLUSION Although there are some people who still argue that leaders are the same as managers, there are some differences between the two concepts which can not be ignored. Managers have subordinates unless the title is honorary. This means that managers are paid to get things done and can therefore be said to be subordinates of other people. On the other hand, leaders have followers and it therefore means that when somebody is leading, he or she has to give up formal authoritative control because leading is majorly about voluntary work. There are however some attributes that must be possessed by both managers and leaders. For instance both the leader and the manager must have good communication skills to be able to clarify issues for attainment of overall best results. According to Clemmer J (1996), both management and leadership are important for a high performing organization. It is therefore important to understand the similarities and differences between the two concepts. This will help us to balance and improve the two roles. It is for instance important to understand that you can only lead people and manage people. According to Kotelnikov V (2001), leaders strive to seize opportunities and amplify strengths while managers avert threats and reduce weaknesses. As the old proverb says, leadership is doing the right thing while management is doing things right. However you should not dwell so much on the differences because both roles are required for corporate growth since the risk of leadership creates opportunities while the strictness of management turns them into tangible results. It means therefore, to be successful in business one must be both a good leader and manager because you will have to get followers who can easily listen to you and put the set goals into action .Proper management of organizational resources will minimize losses and in the long run maximize the value of the firm. Excessive use of managerial authority may deter the workers from doing their work well because they will be executing their duties with fear. The managers should thus device good communication mechanisms that will ensure that they are able to understand the fears of the workers and in turn help solve their problems in time. In conclusion, good management and leadership skills should be used effectively for the betterment of the organization because the two are inseparable and in most organizations leaders are the managers.

Classical Criminology Essay -- Crime Deviance Psychology Essays

Classical Criminology The classical school of criminology was around in the eighteenth century. It came abount in a time when the previous dominent spiritual look at defining crime and criminal behaviour was being challenged by a newer naturalistic approach of the social contract theorists. The classical school was the established ideas of monarchs, fedual lords and the fathers of the church. The main pioneers of the classical school were Cesar Beccaria ( 1738-1974) from Italy and Jeremy Bantham from Britain (1948-1832). From them writing their theories in the eighteenth century they established the essential components of the rational actor model. They both shared the idea that crime and criminal behaviour could be understood and controlled by human nature. The classical school was not intrested in studying crime and criminals, it got its theorys from law making and legal processing. The new ideas of '' enlightenment'' philoshefers were Montisque, Rasseau, Voltaire, Thomas Aquins and Locke. The fundermental principles of the classical school are made up of four main things. These are, free will, rationality, self-intrest and responsibility. Free will - People thought that god made people commit the crime, the classical school thought that people are not forced into commiting crimes. They believe that its our choice to behave in a criminal or non criminal way. We have a range of choices, and it is up to us if we want to break the law. Rationality,- This is where we think about each pro and con of each action we take, and we think about what we are doing. Self-intrest.- The classical school believed that we were all born s... ...present the state. In proportion to all this, the law must specify the relationship between law and the punishment given. The Punishment must come very soon and as quick as possible after the crime has been commited. The judge's and the jurys administer the law and punishment and interprate the law. Beccaria's theorys have a huge impact on modern criminal law. The idea of free will is built into many legal codes. Jermy Bantham was a philoshopher and a leading disciple of Beccaria. He too thought that human nature had some place in people becoming criminals. He too was a believer in that people would commit crime to minimalise pain and maximise pleasure. Bantham believed that it was incorect up-bringing that caused people to commit crime. Works Cited Roger Hopkins Burke. An Introduction to Criminological Theory

Tennessee Williams The Glass Menagerie :: Free Essay Writer

Tennessee William's The Glass Menagerie Reality is merely an illusion, albeit a very persistent one. -- Albert Einstein. The most important theme in The Glass Menagerie is the difficulty people have in accepting and relating to reality. As a result of their inability to overcome this difficulty, the characters withdraw into a private world of illusion to find the comfort they can’t find in real life. Out of the three Wingfield family members, Laura probably is the one living furthest away from reality. There are several symbols in the play that represent that in some way. Her glass collection that she carefully takes care of, is the imaginary world she lives in to escape the real live where she doesn’t finish high school, fails typing class, and doesn’t have any â€Å"gentlemen callers† like her mother expects her to. Another symbol for Laura’s personality is â€Å"Blue Roses†, the nickname Jim gives her in high school. Blue roses are, although beautiful, not real and can’t be found in nature, what refers to Laura’s uniqueness but also to her very own, special beauty that lies beyond her differentness and inability to live in reality. Overall, Laura is a very important character, because the whole story is basically about her (Tom tells us) and she also is the one who is most concerned with the play’s theme of withdrawing fr om reality. At first sight Tom seems to be the only one in the Wingfield family who is capable of functioning in the real world, interacting with strangers, and holding down a job to finance his mother and sister. But he also, withdraws into his illusions to abscond the never-ending conflicts with his mother and his frustration about his monotone, meaningless life. During the play, Tom often mentions â€Å"the movies† he’s going to all the time, which represent his attempt to escape all this and to give him the illusion of adventure. The same goes for the fire escape to where Tom often withdraws whenever the â€Å"fire† of conflict and arguing with Amanda gets to hot. Tom's attitude toward his sister puzzles the reader, since even though he clearly cares for her, he is frequently indifferent and even cruel. Not once in the play does he behave kindly or lovingly toward Laura, not even when he knocks down her glass menagerie. Laura on the other side is the only character who, despite the selfishness that characterizes the Wingfield family, never does anything to hurt anyone else.

Treadway Tire Company Case Study

Introduction: Treadway Tire Company, a major supplier of tires in North America, is experiencing high turnover rates of foremen in their manufacturing plant in Lima, Ohio. Moral issues and dissatisfactions of line-foremen segment are infecting the entire plant. Background: Lima plant employ 970 hourly employees and 150 salaried employees . It operates 24 hours a day, seven days a week, with four rotating shifts. Lately the plant is faced with variety of challenges due to the rising cost of raw materials. Problem: High turnover and low productivity were due to stressful work environment, lack of training, morale and hiring problems.Foremen had too many responsibilities yet lack of authority and respect. Lack of communication within the plant. Opportunities: Lama Plant has a great opportunity to enhance work environment and upgrade workers skills to increase productivity. Recommendations: Eliminate dissatisfaction by: – Reducing work hours, and offering a periodic training progr am to upgrade personal skills and knowledge required. – Guide foremen and hourly workers through different work process, so as to understand what their responsibilities are and were that fit in the companies’ overall picture. Develop better communication system between foremen, hourly workers and, managers. Then, managers should motivate foremen by showing them some respect and appreciation, allowing them more authority, and involving them in decisions regarding their subordinates. Conclusion: Considering the recommendations above Lima plant will recognize a significant decrease in foremen turnover as well as increase in morale and it could become Treadway’s number one plant for productivity and its lowest cost producer in North America.

My Review on Matchstick Men Essay

Matchstick men means a kind of person who can have others buy his things, even just a box of matchsticks, with his excellent deception and eloquence. Therefore, they are also called cheaters or con artists. In the film Matchstick Men, the main character Roy was such kind of an outstanding con artist who always cheated others. With his partner Frank, he made a lot of bucks. Whereas, he suffered from odd disease which gave him many pain. Things get to a turning point when a daughter called Angela came into his life. Roy gave deep love to her and gradually overcame his illness. As a result, he wanted to give up cheating others and be a responsible father. Nevertheless, after an accident, Angela killed someone that was cheated by them and Roy decided to sacrifice himself to protect his daughter. In the end, however, Roy found that all of this turned out to be a fraud which was directed by Frank. Ironically, he lost all his money that was also earned by cheating. What a joke! An excellent con artist though he was, Roy was cheated by his partner. And it really makes me realize the importance of communicating with others. Imagine the situation that when Roy heard he had a 14-year-old daughter, if he could phone his ex-wife and talk about it, perhaps the fraud could be debunked. However, Roy was afraid of talking with his ex-wife and failed to face the past, as a result, that gave cheaters a good opportunity to continue their plan. Besides, the movie also shows me the power of love. Before the appearance of Angela, Roy had serious illness and heavily relied on pills. It was the love to his daughter that cured him. He no longer ate pills and could eat pizza with his daughter on the carpet without caring about the clearness. In fact, he enjoyed time staying with her and had the happiest time in his life. So at the end of the movie, when Roy met the false ‘daughter’, though he was angry, he didn’t choose to revenge but to forgive her. Love made a difference on him and changed his life. Another point I want to express is that misfortune may turn out to be an actual fortune. On the one hand, Roy was cheated and lost all of his money. From this aspect, he was absolutely unfortunate. However, during that period, he earned happiness and lightened his illness. After that he gave up cheating others and began a totally new life as a salesman. Money is important but compared with love, health and happiness, money is nothing. Though life deprived Roy of his money, he got love, happiness and health instead. Hence, when life is tough for us, we should see it from different aspects. Although we may lose something, we can also gain other things more important instead.

Mrs. Thomas: Holistic End of Life Care

Governors university Scenario A brief synopsis of the scenario explored in this paper will be forthcoming so the following observations and detail will have context. The key points in the scenario explored for Mrs.. Thomas, her husband and family are as follows. Mrs.. Thomas is a candidate for palliative care; In specifically hospice If she Is given a prognosis of six months or less. She has suffered breast cancer twice In the past year.A year ago she had a right mastectomy with removal of five auxiliary lymph nodes, with chemotherapy and radiation. Six months ago she had a second mastectomy on her left breast, followed by chemotherapy and radiation. After said treatment it was discovered that the cancer had metastasis's to her lungs and further surgery is not a feasible option. She has not been taking her pain medication as she does not want to procure an addiction problem. Her pain has Increased and she spends most of the time In bed crying.She had to leave her job, but has a small stipend via disability. She and her husband, a police officer, are struggling to make ends meet financially Her husband suffers from chronic depression that is being managed by medication, but he is resorting to take his medication often. He is a supportive and able caregiver however, he Is showing signs of caregiver strain and Job stress. In response Mrs.. Thomas Is worried that he Is becoming classical because of the circumstances of her condition and this In turn Is causing her further suffering. Core family support Is minimal.Mrs.. Thomas' close female relatives are dead from the very disease that is killing her. Because she is sick, she and her husband no longer socialize; she does not seek help from her female friends. Her sons live far away, and call often but they do not come to see her. Mrs.. Thomas is saddened that her sons are not here, but Quality of Life and Health Promotion This nurse believes that quality of life is defined individually for each patient. Each individ ual is unique and how they perceive life and what their life circumstances are define what is needed for end of life care.Quality of life during a time when aggressive treatment is no longer possible needs to be focused on comfort and support of the patient, caregivers and family. This nurse believes comfort (quality of life) includes the right to be free from pain, unless the patient chooses to experience main in trade for mental clarity. It includes the right to not participate in aggressive treatment or in clinical trials if the patient has no wish to do so. Quality of life to this nurse is helping the patient to do the best with the situation in life in which the patient finds themselves.It includes helping the patient with what he or she perceives as unfinished business and helping the patient conclude this business to the extent possible. Holistic end of life care includes care of all aspects of the patient (physical, social and spiritual) and care for those who love the one d ying?the family. The family is whatever blood or non-blood ties this entails; whatever â€Å"shape† of family the patient has at this time. This nurse believes that holistic end of life care encompasses not only physical comfort for the patient but promotion of healthy interactions for the patient with those who love and comfort them.These sensitivities are the goals of this nurse and if applied diligently may provide the best outcomes for the patient in this time of life. Strategies Four holistic nursing goals to begin to improve quality of life for Mrs.. Thomas, her husband and family are the nursing diagnoses: Pain Management, Addressing Anticipatory Grieving and Situational Low Self-Esteem, as well as, Altered Family Processes. First one must establish a rapport with the patient. By providing an open nonjudgmental conversation the nurse can encourage an open and realistic dialogue about what Mrs..Thomas is feeling. By reviewing past life experiences one can get to know th e patient and what interests her and establish trust. This trust is of most importance as all nursing care success depends on creating a team effort with the patient. Family involvement in this time needs to be proactive to help Mrs.. Thomas' mental state and via this her physical functional ability. Nurseries) A beginning conversation with Mrs.. Thomas needs to be about the importance of pain relief. By bringing the patient to an understanding of how this relief of pain will benefit those around her, Mrs..Thomas may be more likely to try the medication for said relief. This may be the initial hook with which one can get her to take said medication. The nurse must determine a comprehensive pain history, including frequency, duration and intensity using a scale dependent upon the patient's perception of pain throughout her life span. Zero pain for no pain; ten for the worst pain ever. This call gives the nurse a baseline from which to assess pain management. Her pain has been increas ing for the last six months and this nurse would designate that as chronic pain, perhaps with acute episodes.Also, the nurse must ask about and continue to monitor when said pain is occurring, as well as where and how much. Morning or when? Identifying precipitating factors of pain will help in its long term management. (Nurseries) Pain is what the patient says it is; we as nurses need to accept that premise. Within the realm of pain lie both physical and emotional response. Because Mrs.. Thomas is no longer seeking aggressive cancer treatment, he â€Å"variations of aggressive treatment† pain control will not be discussed.However, as her disease progresses it is most likely that her pain will increase. Which brings up another point?reluctance of the patient to report pain because of fear that the disease is worse or that the pain is deserved somehow. The nurse must also be aware of unmanageable side effects (like hallucination) which if experienced must be dealt with in a ma tter of fact fashion and by trying another medication regime. To address pain management with Mrs.. Thomas one must address her fear of addiction. By talking with Mrs..Thomas openly and honestly about the need for pain relief, it is hoped that she is lead to the conclusion that pain management and pain medication abuse are two different things. At the end of life, pain medication addiction is not an issue. This idea needs to be gently but openly professed. One could point to the relief of stress for her husband if she is not in pain; as well as the physical benefit (and hence mental benefit) of remaining pain free. If she remains pain free she will be more able to take care of herself and her activities of daily living.She will be able to live in this time instead of living in dread of each day. Once she is taking said pain medication it must be monitored, adjusted and changed as needed for optimal effect and to support the ability to participate in activities of daily living to the fullest as possible. Also discussing non-pharmacological comfort measures like massage and diversionary activities like music is in order. What does Mrs.. Thomas respond to; what does she like? What kinds of non-pharmacological pain intervention has worked for her in the past?Ask questions so that she can verbalize these things to help herself. Being able to relax will help her focus her attention. Encouragement of stress management skills and complimentary therapies (relaxation techniques, biofeedback, LAUGHTER, music, aromatherapy, acupressure, acupuncture and touch are a few) helps the patient to actively participate and enhances a sense of control. Heat and cold may also help by decreasing muscle spasms and inflammation. Pain makes stress, stress makes stiff muscles and increases self-focus which, unfortunately, increases pain.As the nurse interacts with the patient it is important that the patient comes up with ideas about care and becomes a proactive member of their healthcar e team. (Nurseries) Mrs.. Thomas is also suffering, â€Å"Anticipatory Grieving. This is related to loss of her physiological health and change in lifestyle. It is interconnected to the knowledge that she is going to die, for real, and most likely soon. This nursing diagnosis is needed because of her change in social activity level, her reluctance to tell her sons that she needs them?now.It is evidenced by her denial that she does need them and help and support in general from her friends. (Nurseries) Outcomes that are desired include the patient being able to feel her feelings and express them. By doing this she will hopefully come to the place where she is able to take one day t a time and continue her normal activities; even planning for the future. Being able to admit that she is dying, understanding and verbalizing the process is a beginning is done, she must feel supported in her grief work. One must beware of debilitating depression, the like of which is indicated by the sce nario.To address this the nurse must be frank and direct in asking questions about the patient's mind state. (Nurseries) Frequent visiting by the nursing team and care providers, family and social support of friends can help relieve feelings of isolation and abandonment. Her ones need to be contacted with a â€Å"for your information† talk about coming to see their mom (and dad) and possibly who could be of help with caregivers as it is needed. Mr.. Thomas is also a source to find out about who may be able to help with this care this, as well.The nursing diagnosis, â€Å"Situational Low Self-Esteem† is related to how Mrs.. Thomas feels about her disfiguring surgeries and subsequent treatment side effects (aliped, muscle wasting, and more) as well as feelings of self-doubt and lack of control in her life. It is about the doubt about being accepted by others–of still eyeing a human in the world. It is also about her anxiety and fear of her disease process. This is evidenced by her not taking responsibility for self-care (not taking pain medication; crying in bed all day. ) Acceptance of her situation is an outcome that is looked for.She needs to be able to develop mechanisms to cope with her problems and set realistic goals. What coping skills has she used in the past? She needs to be able to participate in her own life by learning to adapt. The nurse can help her through this process by asking proactive questions about how she feels and perceives her world. By getting her to voice where she's at, she will also perhaps start to voice how she can manage. (Nurseries) This diagnosis ties in with the aforementioned, â€Å"Anticipatory Grieving† diagnosis. By defining diagnosis and disease process beginning problem solving can occur.By anticipating what can happen, some measure of control can be taken. By working with Mrs.. Thomas and planning how daily activities can be managed, adaptation can occur. (Nurseries) Discussion about her roles in life, as a worker, spouse, and mother and problem solving about how to accomplish her goals for these roles may help reduce problems that interfere tit her self-esteem. It may help her to see how she can cluster activities at home to conserve energy but be productive. It may help her to be more able to reach out to those who love her for inclusion and support.The nurse must acknowledge troubles she is experiencing and validate the patient's reality; this opens the door to the patient being able to seek measures that are necessary to cope, like counseling, and support groups. The nurse should readily be able to supply information about said resources so as to facilitate the patient in procuring more support. If Mrs.. Thomas is n hospice the social worker of the interdisciplinary team can help facilitate and direct this work; but the nurse must always continue it during her visits. Holistic Nursing Plan Amongst personal revelation the nurse must explore who may be able to help Mrs ..Thomas with her activities of daily living. Her husband is doing the Job, but he is suffering from care giver strain and could use some help. It may be that the people she has cut herself off from socially miss her and would love the chance to be able to help in some way. Caregivers avenues and their affordability need to be explored before they are needed. These interactions; providing pain control, helping with grief and esteem issues, and helping the patient to discover what will work best to live disease state progresses, but before it is needed, preparation for a lesser level of self-care must be addressed.Medicare provides a â€Å"compassionate allowance† for hospice care for those of any age with a metastasis cancer with a prognosis of six months or less. She needs to apply for this care in the beginning of the nursing visits if she qualifies. To receive hospice care via Medicare she must be eligible for Medicare Part â€Å"A†, be certified as terminally ill a nd then apply for hospice care. This care would be in her home. By signing an election of benefits Mrs.. Thomas would be choosing hospice care in lieu of routine Medicare-covered benefits.Hospice would pay for pain medications and those required by her terminal diagnosis, as well as services included in the palliative plan of care. Often the hospice doctor confers with the patient's primary doctor and others on the hospice interdisciplinary team are included. (â€Å"Your Medicare benefits,† 2014) Hospice of Kits County provides an interdisciplinary team consisting of the doctor, the patient's primary provider and nurse practitioners, sitting nursing care, a medical social worker, a chaplain, a home health aide. Also provided are complementary services, which include massage and music therapies.Volunteers are also enlisted to help with such things as grocery shopping and the like or simply for company. These persons come to the patient's home for service. Hospice care differs with regional coverage. Durable medical equipment is also covered, so if Mrs.. Thomas is in need of a hospital bed, oxygen, bedside commode, wheel chair and so on, it will be provided at no cost to her family via Medicare coverage. Grief and loss counseling is also provided. â€Å"Hospice of kits,† ) Providers for home care must be explored as Mrs.. Thomas declines.Often the expense precludes coverage of duties in this way. Exploration of service providers and means of payment need to be explored as a way to cover Mrs.. Thomas' needs as she declines. Medicare covers the cost of a short term inpatient care in a Medicare approved hospice facility, or nursing home if the caregiver is suffering from caregiver strain (for up to five days) or if it is determined by the hospice physician that symptoms must be managed in an inpatient setting. Because Mrs.. Thomas has no Eng term care health insurance this care could be instrumental in providing for her final days. â€Å"Your Medicar e benefits,† 2014) The fourth nursing diagnosis, â€Å"Altered Family Processes† must be addressed for the holistic health of Mrs.. Thomas. This holistic care includes her husband as well as Mrs.. Thomas' sons and families. Situational crises can develop when a family member has a long term illness. There is a change in roles in caring for a parent and an anticipated loss of said parent. (Nurseries) Those involved need to learn to express feelings freely and demonstrate individual involvement. This individual involvement must include a problem solving process that promotes suitable solutions for the situation.Mrs.. Thomas' sons need to be contacted and requested to attend a family conference. If they are unable (because of finances or schedule) to attend then this could be accomplished via phone. They must understand the need of their mother to see them in person and will hopefully comply. The reality of the situation must be broached to them in a caring way. It may be that the Thomas' or Mrs.. Thomas can go and stay with them for more available for care and support of their mother. Speaking with family members in a caring, respectful manner and providing information both written and spoken helps promote feelings of empathy.It stimulates individual feelings of value and capability in ability to handle the present situation. In answering questions and providing information one can empower Mrs.. Thomas' loved ones. Identifying patterns of communication and interaction between family members is an important nursing intervention. It provides information about how active said communication is. It can also identify what problems may exist that interfere with the family in helping the patient and what problems there are in adjusting to the prognosis.Role expectations must be explored and how each individual sees the situation, in sharing these thoughts the family can promote understanding within its unit. Assessing the way members are expending their ene rgy with which to deal with the situation is needed so as to provide guidance in positive focus for the well-being of patient. Acknowledging the difficulty of the prognosis, as well as, encouraging appropriate expressions of anger helps resolution in the stages of grieving. The nurse must remain centered.Stressing the importance f continuing dialogue that is open and honest between the family members helps communication to remain open and thus facilitates problem resolution. Mr.. Thomas must be educated by the community health nurse as with regards to how anti- depressants need to maintain a certain blood level to be effective. If he is not taking them regularly this will not happen. To help achieve this goal, a pill box with days on it can be set up; perhaps an alarm set to the same time each day enlisted, so that he can remember to take his medication and thus be better able to function at this time.To provide holistic nursing care to Mrs.. Thomas her needs as a person must be add ressed. Physical, social and spiritual realms must be explored. Plans of action to provide for her physical care and the demise of her abilities must be explored; help must be sought out from the aforementioned sources. Method must be applied via nursing diagnosis and indications of said diagnosis. Desired outcomes must be planned, as well as nursing interventions to work toward these outcomes. Mrs.. Thomas must be approached with honesty and treated as a human being, with a life, in her time of need.