General Theory Of Alcoholism Essays - Psychiatric Diagnosis

General Theory Of Alcoholism There are many theories of alcoholism, and some approaches explain and treat certain alcoholics better than others. One of the common themes throughout the readings is that addicts display a range of personal and situational problems. There is no typical addicted personality or emotional problem (Allen, 1996). Because of these facts, it comes as no surprise that there are also no typical assessment or treatment for these individuals. For instance, a medical/disease model of alcoholism may be more useful to some alcoholics than others. The point is that instead of rigidly applying one model, a counselors goal is to use the models that are most effective to the particular alcoholic in question. A primary thesis is that the way we construe alcoholism highly determines the way we diagnose, treat, and feel about alcoholism. Therefore, it is important for us to clearly and consciously know our own personal views (theories, beliefs, assumptions, expectations) toward drinking and addiction. I believe that each one of us hold theories about alcoholism which may be more or less helpful and/or harmful. For example, if we view an alcoholic only as one who is on skid row, frequently drunk, out of control, and blatantly disruptive and embarrassing, then our theory of alcoholism must be modified for successful assessment and treatment. Although such a view does include some alcoholics, it excludes most of them and therefore precludes helping them. Instead of one alcoholism, I have come to believe that there are many alcoholisms. And as reflected in the referenced readings, instead of one theory, there are many theories and treatments. This is rather frightening to the new MSW! How will I know? Through the years, I have pieced together a general theory of alcoholism. First, alcoholics are more or less obsessed with the thoughts of drinking (manifested in idle thinking, dreams, fantasies, intrusive thoughts, and concrete plans). Alcoholics look forward to drinking, think about and give reasons for not drinking, justify their drinking, lie about and hide their drinking, or think about the comfort of drinking. Simply put: A lot of thought is given to drinking. Furthermore, the promise of drinking in the near future helps alcoholics to relax in the present, and conversely the thought of not being able to drink for an indefinite time evokes anxiety and subtle sadness. Non-alcoholics simple do not think this way. Alcoholics feel compelled to use alcohol as a means of effecting changes in mood, thinking, or over-all well-being. They feel a desire that drives them to use alcohol to achieve contentment, to affect a buzz, to reduce tension, to numb feeling, to forget, to relax, to reward, and to feel better. And, their pleasant feelings reinforce the compulsion to use again. Why are some people compelled to drink alcoholically, while others are not? No one knows for sure. There are many ways to explain alcoholism. Some approaches accent organic/genetic/biochemical factors, others emphasize non-organic/psychogenic/environmental factors, and others try to integrate both nature and nurture. Depending on the person, there can be many reasons (and combinations thereof) to feel compelled to drink such as genetics, biochemistry, habit, stress mismanagement, expectations, environmental pressure, cultural and societal sanctions, etc. One drink can compel some alcoholics to drink until they pass out or get sick. For them, one drink is too many. Other alcoholics feel compelled to drink daily while managing to function without blatant disruption. Others feel compelled to drink only on weekends, during holidays, or at festive occasions. Others seldom drink, but when they do, they drink alcoholically. Many alcoholics feel that they are entitled to drink and that life without alcohol is somehow not right, incomplete, or difficult. Although many alcoholics can abstain, they miss it. Their efforts to abstain, which include intense willpower (white knuckle approach), making great sacrifices, irritability, constant complaints, or dry drunks give evidence of their compulsion. Another of alcoholisms powerful dynamics, which reinforces its obsessive ness and compulsiveness, is the relative certainty and immediacy of its rewards. Unlike the risk and uncertainty of interpersonal fulfillment, alcoholics can safely count on the effects of drinking. Drinking seldom lets them down; it usually gives them what they ask for. Alcoholic effects are easy to come by and occur quickly. There is

Life of a Confederate Soldier essays

Life of a Confederate Soldier essays Did you hear that John, the South made their own government earlier this week. Said Steve King, my younger brother, on our way back home from a swim with some of our slave friends. Yeah, and Jefferson Davis was chosen to be president. I replied, but Im not to sure seceding from the union was to good of an idea. I dont see anything good coming from the South seceding, even if it is constitutional. Im glad we seceded from the union. When the Yankees look at the south all they see is wasted land. They want to get rid of our way of life, which is the backbone of the United States, so that they can industrialize the South and make more money for themselves. Hes right, but I hope it doesnt come to war. The North would be much better prepared, and to many innocent people would die. But chances are it will, and this guy Lincoln wants it to. He said he wants unity for strength, I doubt that, he is no different than the rest of those abolitionist northerners. When we returned home, my life was changed forever. My mom, crying uncontrollably, took my brother and me in her arms, and told us the horrible news. A group of abolitionist, who were trying to start a slave revolt, killed my dad. He was only trying to stop them from taking innocent peoples lives, and despite his courageous efforts his innocent life was taken in a blink of an eye. The next few months were the two of the hardest months of my life. Then it happened, the Confederates attacked Fort Sumter, and the Civil War began. As soon as we could my brother and I told our mom we were going to join the confederates cause in the Civil War. I didnt want it to come to war but, I told my mom and brother, after Dad was killed I have been waiting for an excuse for revenge. My brother felt the same way, and thats why we were surprised when Mom would not let us...

Writing to Attract a Certain Readership

Writing to Attract a Certain Readership The process of writing is more than just knowing how to put words together – its also about knowing how to put words together effectively. Proper grammar, while necessary to achieve a certain level of professionalism and validity to your writing, will only get you so far as a writer. There are also nuances like tone, aesthetic distance, connotation, and style that are necessary considerations if you wish to achieve a particular purpose with your words.ToneTone is the writers attitude toward his or her readers and toward the subject matter, and works the same way in writing as it does in meeting someone for the first time and establishing a connection or rapport with them. Have you ever met someone for the first time and immediately liked that person because of their attitude? Or maybe conversely, you met them and immediately disliked them because their attitude?As humans, we subconsciously pick up on signals others give us through their body language, word choice, articulation , and approach to a topic. Language is a mathematical process in its basic rules of syntax and grammar, but beyond those, it turns into a pure art form that can be manipulated in multiple ways to communicate. Although its more difficult to pick up on a writers tone than it is to pick up on a speakers tone (because we dont hear the inflection and volume of the writers voice), tone is still present, and it is still a subconscious indicator for the audience.This is why it is so important as a writer to consider the tone that comes across in your writing. Measuring that tone against your intent is a crucial step in creating effective writing that will capture your intended audiences attention and achieve the goal you have for your content. If you are selling something, a positive, expert tone is best; if you are writing to persuade your readership to vote for a particular candidate, using the majority of the content to criticize that candidates opponent too often comes across as juvenil e and unprofessional.Aesthetic distanceA writers aesthetic distance is their emotional involvement in their work. As with tone, often it is easier to determine emotional involvement when you can hear the words and inflection; however, it is still present in the written word. In the same sense that a speech can be boring and monotone, showing little to no emotional involvement on behalf of the speaker, written content can take on the same sound, even if that sound is only in the readers head while reading your words.Take the following examples:Product A was released last year and has grown in popularity. Customers have given rave reviews and the online buzz is continuing to spread. Try it today and see what everyone is talking about.I admit – I was skeptical at first. Despite the glowing online reviews of Product A, I didnt expect the exceptional quality, amazing features, and ease of use that I encountered when I tried it for myself. Now, I know it is a product that I not onl y cant live without – its one that I cant wait to share with my friends and family.Now ask yourself which one shows more emotional involvement on behalf of the writer. Its obviously example 2, and beyond showing more emotional involvement, it is also the more interesting paragraph to read. In marketing, this is the type of paragraph that will get and hold a readers attention because it is personal, it is emotionally involved, and the aesthetic distance (or lack thereof) of the author creates a better rapport with the intended audience.ConnotationWe all know that a words connotation is important, especially when it comes to communicating with a wide audience. Just as an author would want to avoid bias and stereotyping in his or her writing, its also equally as important to pay attention to the connotation that words might have to all audiences reading the content. Is there a word that would have a negative connotation to a certain readership? If so, its best to replace that wo rd with something less combative or risky in order to avoid alienating your readership.In the same sense, if you are narrowing your writing to a very specific audience, the connotation of a word can have a big role in this process. This is where buzzwords and jargon are likewise helpful – if you know the words that will get a certain audiences attention, use those words and know the connotation of them before you do. Usually this requires research, but a Google search will generally give you all of the information you need to know about a words connotation and denotation among various audiences.StyleStyle in literary terminology refers to the way a writer expresses a particular thought or idea. It is the concept of how word choice, while crucial, is only one part of the puzzle; a writer should also consider the most effective way to communicate that idea. Should it be through humor? Candor? Persuasion? Again, knowing your audience and knowing which style would be most attract ive to them is important if you want to communicate your message in the most effective way possible.Knowing your audience is everything. Spend the time researching on the front end to do this, and modify your tone, aesthetic distance, connotation, and style to make it happen.

Map of World Hotspots

Map of World Hotspots Most of the worlds  volcanism  occurs on plate boundaries. Hotspot is the name for a center of volcanism that is exceptional. Map of World Hotspots Click the image for the full-size version. Image courtesy Gillian Foulger According to the original theory of hotspots, from 1971, hotspots represent mantle plumes- blobs of rising hot material from the base of the mantle- and make up a fixed framework independent of plate tectonics. Since that time, neither supposition has been confirmed, and the theory has been greatly adjusted. But the concept is simple and appealing, and the majority of specialists are still working inside the hotspot framework. Textbooks still teach it. The minority of specialists seeks to explain hotspots in terms of what I might call advanced plate tectonics: plate fracturing, counterflow in the mantle, melt-producing patches and edge effects. This map shows the hotspots listed in an influential 2003 paper by Vincent Courtillot and colleagues, which ranked them according to a set of five widely accepted criteria. The three sizes of symbols show whether the hotspots had high, medium or low scores against those criteria. Courtillot proposed that the three ranks correspond to an origin at the base of the mantle, the base of the transition zone at 660 kilometers depth, and the base of the lithosphere. There is no consensus on whether that view is valid, but this map is handy for showing the names and locations of the most commonly mentioned hotspots. Some hotspots  have obvious names, like Hawaii, Iceland and Yellowstone, but most are named for obscure ocean islands (Bouvet, Balleny, Ascension), or seafloor features that in turn got their names from famous research ships (Meteor, Vema, Discovery). This map should help you keep up during a talk aimed at specialists.

Web page wording Essay Example | Topics and Well Written Essays - 750 words

Web page wording - Essay Example g wide-ranging creation services including web design, graphics design creation and implementation of printing , covering wide aspects of advertising, corporate image, branding, and marketing development. With this goal in mind, we’ve produced many aesthetic-appealed designs. Yet, we’ll never compromise on quality and the commitment that we offer to our clients to provide the desired outcome. Thus, we keep moving toward growth and beyond, delivering the simplest yet most fruitful solutions to your marketing communication needs. Additionally, with our assistance, your  website will also potentially rank higher as compared to your competitors bringing in more sales and leads to you! This website comprises of a collection of web pages that are manually connected. Minimal scripting and HTML coding are used for this site. The hypertext or HTML files are then stored on a server, as per the clients requirements. If any changes are made later, the hypertext files are required to be changed, saved and uploaded again to your server. Brochure type website is effective when its only purpose is to act as a display platform for your products or services. This kind of website is idyllic for small organizations, beginners and businesses that have a less diversity of products and services. So if you dont need regular updates for your website, this is the best option for you! Just because your website is static, it doesnt have to be dull and lifeless. We have one of the most creative design team that can deliver stunning websites which catches the attention and keep your visitors clicking on your links. For us every website is a blank new canvas and our designing team with their creativity makes it vibrant and spectacular. CMS stands for Content Management System and Drupal is the best open source application to develop CMS. It is used by some of the biggest sites like The Economist and The White House. If you are in need of Content Management and are looking for Drupal

Cause and Effect on Gasoline Prices Essay Example | Topics and Well Written Essays - 750 words

Cause and Effect on Gasoline Prices - Essay Example   The price of crude oil and how its effect is felt at the pumps is an issue of interest in as far as the price of gasoline gases is concerned. Gasoline is produced from crude oil through distillation process whereby crude oil is heated and fumes captured are converted to various products including gasoline. Thus the cost of extracting crude oil as well as the cost of processing it to produce gasoline will definitely affect the price of its products. For instance, the price of crude constitutes up to half or more of the price of gasoline gallon as suggested by Gupta and Demirbas (73). The rise in the price of crude oil has been driven by the increasing demand for oil globally and the political instability in most of the oil-producing countries according to Gallun (723). Therefore these factors end up directly affecting the price of gasoline. The depreciation of the US dollar when compared to other currencies of other countries contributes to the changes of gasoline gas price. This can be attributed to the fact that when the US dollar changes its value, there is a shift in the demand and costs of countries with different currencies. For instance the dollars depreciation against the Euro by half, the Countries using the Euro pay half more in dollars thus increases the demand. If the Us dollar depreciates, investors in return have to shift their capital there is the rise in price of crude oil gases hence affecting price of Gasoline gas according to Obadia (23). The world wide demand and supply for crude oil affects the price of gasoline gases in different ways. This is because demand and supply of crude oil is influenced by the organization of Petroleum Exporting countries it sets price of oil products produced by its members. This organization also holds the biggest percentage of oil supply in the world and thus it dictates the terms of supply of oil products as suggested by Boyes and Melvin (11). In terms of demand, during the summer there tends be to a lot of gasoline gas demand hence if demand exceeds supply the prices bare likely to rise. It is therefore true that imbalance in supply and demand leads to fluctuation in the price of gasoline gases according to International Monetary Fund (56). For instance if there is fast rise in demand or quick fall in supply due factors such as refinery there may occur a rapid depletion for gasoline gases. The future of oil manufacturing and the contracts made on the future date and price for selling oil in a way affect the price of gasoline gases. On one hand with increasing technology, the future may experience increased demand for gasoline gas compared to the source of this gas and thus prices may end up increasing. On the other hand the increasing alternatives of sources of energy replacing the use of gasoline in future are likely to lead to a decrease in price of the gasoline gases. The future increase in retail gas stations which will still share the market with the existing ones will lead to l ower prices in order to attract customers. Some contracts have been established to decide on the future date and price for selling oil products. For instance a Collar contract is a mini-max strategy assuring producers of oil either a minimum or maximum range of prices for the sale of oil in the future as suggested by Gallup and Frank (221).  Ã‚  

Caterpillars Resilience for Strategic Change Management Process Essay

Caterpillars Resilience for Strategic Change Management Process - Essay Example 1) These above mentioned lines are not only mere scholarly jargon or illusion used by some well known academic scholars but the lines are truly reflecting the core essence of change management. In such context, Zajac, Kraatz & Bresser (2000) pointed out that the question is not about whether an organization is able to change or not rather the focus should be whether the mentioned organization is able to successfully implement the change management mechanism in competitive environment or not. Palaniswamy and Sushil (2003) argued that going for change for organizations is always directed by external factors because no organizations would want to change the existing system equilibrium without any bankable reason. Well, the argument has point because historical analysis of data shows that without the presence of certain reasons or the objective of achieving certain benefits, none of the organizations have invested its financial and non-financial resources to achieve change management (Za jac, Kraatz & Bresser, 2000). ... Caterpillar Inc- Business Dimension Caterpillar Inc or Cat is an American corporation which is global leader in manufacturing, construction and mining equipment, diesel-electric locomotive, industrial gas turbines and diesel and natural gas engines. The company was established in 1925 and at present, headquarter of the company is located in Peoria, Illinois, United States (Caterpillar, 2013a). The engineering giant offers wide range of products ranging from construction and mining equipment (the yellow equipment of the company has become symbolic icon for both industrial and retail consumers), customized industrial gas turbines which can lift heavy loads, natural gas engines which can work in low carbon emission state, remanufacturing services, end to end logistic services and even financial services (Gillett, Fink & Bevington, 2010). As of 2012, Caterpillar Inc has earned revenue of more than US $65 billion from its global business operation while the company has reported asset wort h around US$89 billion (Caterpillar, 2013a). As of 2008, the company has established presence in every continent while total employee base of the company exceeds 0.1 million (Gillett, Fink & Bevington, 2010). Now, the fact is that Caterpillar Inc never targeted retail customers or sell items to end users because from the starting days, the engineering targeted construction and mining companies or the dealers who sell construction equipment to both industrial and retail customers. In such business ideology, Caterpillar Inc has established global dealer distribution network crossing 185 partnerships across countries in Europe, South America, Africa, North

Progressive Movement Essay Example | Topics and Well Written Essays - 1000 words

Progressive Movement - Essay Example A loosely defined movement was formed from the progressive reformers. Progressives were individuals or groups of people who were concerned about the state of society, impacts arising from urbanization and industrialization, poverty, social issues and political corruption (Foner, 2014, p.678). Progressives as businessmen were ambitious to include the laborers and workers for their rights in decision making and economic improvement. Women were part of progressive movement who sought their right of protection of their children from exploitation. Journalists as progressives had exposed the major ills of urban as well as industrial lives with expectations to encourage reforms. Social scientists also took part in progressive era with their beliefs of solving the social problems through the academic research. Middle class individuals were more fearful about the rise of big businesses that could threat their social as well as economic status. Progressivism was defined through currents and tr ends of counterculture, challenges to authorities, cultural liberation and sexual revolution. Other currents and trends include the steps towards the equal rights, civil rights and establishing the women’s organizations.Socialists advocated that economy’s state control and laborers’ voices must be accorded in their decision making. Many civil and political organizations recognized that inequality could threat the democracy, so they considered that political struggle was essential to defend the interests of workers.

Media and war on Terror Essay Example | Topics and Well Written Essays - 250 words

Media and war on Terror - Essay Example The government on the other hand used the media to counter the information and claims distributed by terrorists. Through the media, governments also wages a war of winning the hearts and minds of the people by letting the public know how terrorist organizations are causing havoc in our society. In so doing, they erode public sympathy from the terrorist potential supported. Having said this, media inadvertently becomes an instrument of the tugging parties on the war on terror. Media and terrorism will always have a symbiotic relationship because media will feed on the news created by terrorists. The â€Å"juicy† news that terrorists will provide increases the news agency’s rating while terrorist organization gained media exposure to win public sympathy and support. This kind of set-up inadvertently forms a symbiotic relationship whereby each entity thrives on the existence of the other. Media benefits in either way. When terrorists organization issues a threat, media increases its ratings by sensationalizing it and when government counters to continue our way of life so as to deprive the terrorist of their victory, the media again has something â€Å"juicy† to report to increase its

Native Americans in the United States Essay Example for Free

Native Americans in the United States Essay Based on the ethnic groups (Table 1: Appendix), several beneficial values that helped to shape the United States lifestyle can be described (Holland, 2006). In particular, the brief summaries have given the clear picture of Multiculturalism in the United States in relation to the origin. The United States, for that matter, is captured as a multicultural society that is open to all people with different backgrounds. From an early time, several groups started moving into the region due to various reasons, which allowed for the development of a culturally diverse society. Hence, the United States substantially benefited from the cultural diversity as improved workforce was available for the various work scenarios. Despite the obvious benefits of multiculturalism in the society, some negative forms such as racism, stereotypes, prejudice, and discrimination flourished over several years (Holland, 2006). In the recent past, for example, several ethnic groups such as the African American, Hispanic, and Indian Americans have continually suffered racism, discrimination, and being depicted in certain stereotypes. Firstly, segregation between the Whites and Blacks was a key characteristic of the population before the rise of the civil rights during the 1950s and over (Holland, 2006). Workplaces, schools, commuter busses, and residential areas were segregated between the two groups until in 1954 when segregation in schools was banned. As a result, people started integrating on a multicultural perspective, which led to the realization of better performances and solutions for the workplaces. Besides the significant leap ahead, other factors such as prejudice and stereotyping still exist at the current date. For instance, the African American and Hispanic groups have been stereotyped in the villainous characters such as gangsters, robbers and the like for several decades (Holland, 2006). Such beliefs have existed for several years and are even a common occurrence in media the same way. Hand in hand, prejudice has also resulted from the occurrences. Therefore, prejudice and stereotypes are a normal situation in the culturally diverse environment of the United States. However, the multicultural nature of the country’s population resulted in some positive factors such as creation of a multicultural workforce that can meet the requirements of the target population in an effective manner (Kenyon, 2005). In connection to that, all the ethnic groups in the American landscape are subject to some positive, as well as, negative aspects of the cultural diversity. As a result, prejudice, stereotypes, racism, and discrimination that were once extremely high have considerably low effects on the modern and socially active populations. In conclusion, the United States still leads with regards to the benefits of cultural diversity among its people. Table 1: Multicultural Matrix and Analysis Worksheet. Part I: Matrix What is the group’s history in the United States? What is the group’s population in the United States? What are some attitudes and customs people of this group may practice? What is something you admire about this group’s people, lifestyle, or society? 1. The African American Several African American people are linked to a history of slavery since their ancestors were brought in the United States as slaves. This happened first during the 1600s-1700s, and where they assisted English colonialists to get American independence. Later, prominent leaders such as Martin Luther King, Jr. helped to change discrimination against Blacks. As a result, a breakthrough into the rampant segregation between the whites and blacks reduced. The African American has an approximate population of about 37 million forming about 13 percent of the total population of the United States. The African Americans are characterized by the practice of several cultural activities depicted in their music, art, and lifestyle. As such, they form a significant part of the USA as their culture substantially influenced the American culture. I appreciate the African American lifestyle and their music such as Hip-hop and reggae music. Additionally, I love their celebrations such as the Black history celebrations in which they remember their historic past. 2. The Hispanic and Latino American The Spanish became among the first settlers, before Europeans, to settle in some areas of America such as Florida and California. Several people of this group speak the English language only and have adopted the European-American Culture. On average, the Latino and Hispanic population in the United States is approximately 16 percent of the whole population. This accounts to almost 50 million people. The Hispanics are depicted as religious people who believe in helping one another. Families may be nuclear or extended, and the father is the final decision maker in the family setting, while the mother is the home care taker. However, all family members are expected to assist in the effective functioning of the setting. I love Hispanic music and their musicians such as Ricky Martin and Jenifer Lopez. Additionally, their Mexican foods are an excellent appetizer that I always cannot ignore. 3. The Indian American The Indian American officially became legal citizen in the United States in 1946. The Indians immigrated into the United States via other countries such as Jamaica, South Africa, and United Kingdom among other countries. The Indian population in America is reasonably low at approximately 0. 89 percent of the whole population. As such, this reflects to about 2. 5 million people. The Indian Americans have a strict cultural background and adhere to strict rule on religion, culture, and food among several other practices. Their religions are diverse and may include Hinduism, Islamism, Christianity, and Buddhism. I value the cultural practices of Indians especially those practicing Hinduism as they have fascinating ideas. One example is the caste system, where once in a low or high case system; one is destined to remain right there. 4. The American Asian Asians of the Chinese background came into the United States due to mainly conflicts from their countries. One situation was the Vietnam War, which led to massive migration of the affected into the USA. In the 1970s and 1980s, therefore, was time for the largest Asian migration into the United States. The Americans Asian account for about 5 percent of the United States’ population. As a result of cultural diversity, the American Asians are exposed to several challenges. I admire the Chinese way of life that comprises of fun in the form of art and craft. Additionally, I find pleasure watching some of their movies and appreciate the Yoga. 5. The Native Americans The Native Americans were the original settlers of the United States of America. Relevant sources indicate that they enabled undetectable communication during the World War II using their native language. As pertains to name, the Native Americans are recognized as the first settlers of the United States. However, they account for a small population percentage of about 1 percent. The Native Americans culture show dissimilar practices in all other nations. In particular, those living on reservations show dissimilar cultures from the ones not living on reservations; however, some similarities may exist in their heritage and traditions. The Native Americans fascinate me with their incredible lifestyle such as them living in tepees and their spiritualism. 6. The Bahamian American The Bahamian American migrated into the United States from the Caribbean during the late 19th century in search for job offers in the agricultural sector. The Bahamian American has an extremely low population of about 40,000 people. Hence, it accounts for approximately 0. 01 percent of the whole population. Bahamian Americans preserved their cultural heritage; hence, have a distinguished way of living and culture. The Bahamian way of living and cultural heritage provides an excellent measure of modern living from historical setting. Their cultural practices are engaging. Part II: Analysis Basing on the above listed ethnic groups, several beneficial values that helped to shape the United States lifestyle can be described. In particular, the brief summaries have given the clear picture of Multiculturalism in the United States in relation to the origin. The United States, for that matter, is captured as a multicultural society that is open to all people with different backgrounds. From an early time, several groups started moving into the region due to various reasons, which allowed for the development of a culturally diverse society. Hence, the United States substantially benefited from the cultural diversity as improved workforce was available for the various work scenarios. Despite the obvious benefits of multiculturalism in the society, some negative forms such as racism, stereotypes, prejudice, and discrimination flourished over several years. In the recent past, for example, several ethnic groups such as the African American, Hispanic, and Indian Americans have continually suffered racism, discrimination, and being depicted in certain stereotypes. Firstly, segregation between the Whites and Blacks was a key characteristic of the population before the rise of the civil rights during the 1950s and over. Workplaces, schools, commuter busses, and residential areas were segregated between the two groups until in 1954 when segregation in schools was banned. As a result, people started integrating on a multicultural perspective, which led to the realization of better performances and solutions for the workplaces. Besides the significant leap ahead, other factors such as prejudice and stereotyping still exist at the current date. For instance, the African American and Hispanic groups have been stereotyped in the villainous characters such as gangsters, robbers and the like for several decades. Such beliefs have existed for several years and are even a common occurrence in media the same way. Hand in hand, prejudice has also resulted from the occurrences. Therefore, prejudice and stereotypes are a normal situation in the culturally diverse environment of the United States. However, the multicultural nature of the country’s population resulted in some positive factors such as creation of a multicultural workforce that can meet the requirements of the target population in an effective manner. In connection to that, all the ethnic groups in the American landscape are subject to some positive, as well as, negative aspects of the cultural diversity. As a result, prejudice, stereotypes, racism, and discrimination that were once extremely high have considerably low effects on the modern and socially active populations. In conclusion, the United States still leads with regards to the benefits of cultural diversity among its people. Part III: Sources Holland, C. (2006). Ethnic and Religious Diversity in Central America: An Historical Perspective. Retrieved November 12, 2011 from the Prolades Website: http://www. prolades. com/Ethnic_Religious_Diversity_CAM-Holland. pdf Kenyon, A. (2005). The Importance of Diversity in the Workplace. Retrieved November 11, 2011 from the Leading Today Website: http://www. leading today. org/Onmag/2005%20Archives/may05/ak-may05. html Reference List Holland, C. (2006). Ethnic and Religious Diversity in Central America: An Historical Perspective Retrieved November 12, 2011 from the Prolades Website: http://www. prolades. com/Ethnic_Religious_Diversity_CAM-Holland. pdf Kenyon, A. (2005). The Importance of Diversity in the Workplace Retrieved November 11, 2011 from the Leading Today Website: http://www. leading today. org/Onmag/2005%20Archives/may05/ak-may05. html

Importance Of Needs Assessment In Nursing Practice Nursing Essay

Importance Of Needs Assessment In Nursing Practice Nursing Essay Confidentiality and anonymity must be maintained at all times to protect the identity of the service user, carers, families, healthcare settings and other professionals involved. Any breach of confidentiality will result in an automatic fail. This essay will discuss the importance of needs assessment in nursing practice. In relation to case study 2 about a 68 years old Afro Caribbean retired bus driver male called Carl, who has being married for 45 years with 5 grown up children and 8 grand children. He smokes 20 a day and enjoys nightcap before sleep. His latest vital signs observation are respiratory 20 rpm, blood pressure 168/105, pulse 92bpm, Spo2 95% and BMI 32kg/m2 and he is on statin, betablocker, aspirin, frusemide medication. Currently his wife has notice Carl seems to have forgetfulness, he couldnt remember his way home from the super market and keep losing items. He is getting frustrated and taking it on his wife and grand children, especially when he cannot read them a story. This essay will discuss the importance of needs assessment in nursing practice. It will identify a service users needs base on a scenario and the appropriate assessment tools required for his care. And from the tools identified, one will be prioritised and apply on his condition. Finally the essay will summarise the experience of using the assessment tool and how it will help in future learning. Patients assessment is the collection of data about an individuals health state that identifies and defines patient problems in order for solutions to be planned and implemented in line with their preferences (Roper el at 2000 p 124). Therefore, a clear idea about health is important because this determines which assessment data should be collected. The world Health Organisation (WHO) (2001) defines health as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Whiles this is a broad definition, it implies that the nursing approach to health care is holistic in nature and therefore health assessments should reflect that philosophy with it focus on the whole person and their context. Nurses are obliged to take in to consideration patients physical, emotional, spiritual, social and intellectual needs when making an assessment (Department of Health 2004). ` Therefore, when nurses are conducting health assessment on a person it may requires acknowledgement of techniques of collecting and analysing subjective data which is what the person says about them selfs during history taking. And objectives data which is what nurses observe by inspecting, percussion, palpating, and auscultation during physical examination (Department of Health 2003). Potter and Berry (2005) argue that if inaccurate, incomplete or inappropriate data is recorded then the overall care of the patient may be affected, including wrong diagnosis and even wrong treatment. NMC (2002), code of professional conduct, urged all nurses to work in a professional manner and abide by the policies set out by the trust they work in. it suggest that the recording or documentation of information is essential and any deviation could lead to potential consequences for the individual if their standards are not met. The purpose of health assessment is to make judgement or diagnosis because all health treatments and decisions are based on the data gathered during assessment; it is paramount that the assessment is factual and complete, providing the foundation for clinical decision making (RCN, 2007). This gathered information provides a comprehensive description of the patient. It focuses on the patients needs at that moment in time and possible needs that may need to be addressed in the future (NMC, 2007). Its a fair and accurate account of the individual and their life. Overall assessment is a way of delving deeper into a patients illness and preventing more problems from arising. In relation to case study 2 about a 68 years old Afro Caribbean retired bus driver male called Carl, who has being married for 45 years with 5 grown up children and 8 grand children. He smokes 20 a day and enjoys nightcap before sleep. His latest vital signs observation are respiratory 20 rpm, blood pressure 168/105, pulse 92bpm, Spo2 95% and BMI 32kg/m2 and he is on statin, betablocker, aspirin, frusemide medication. Currently his wife has notice Carl seems to have forgetfulness, he couldnt remember his way home from the super market and keep losing items. He is getting frustrated and taking it on his wife and grand children, especially when he cannot read them a story. Newson (2001) suggests that, for a process to commence a model of assessment is utilised and this model needs to be holistic in all aspects of patients needs. Therefore proper attention needs to be paid to the biological, psychological and social situations of the patient. It is important that the health assessment includes a thorough examination of the patients activities of daily living (Department of Health, 2002) .The twelve activities of daily living (ADL) are communication, safe environment, breathing, eating and drinking, elimination, washing and dressing, temperature, death and dying, mobility, working and playing, sexuality and sleep (Roper, Logan and Tierney model 1985). Although, the Roper Logan Tierney model has being criticized for the use of activities of living as a simple checklist and emphasis only on the physical aspect of patient care( Reed and Robins 1991). This contrasts with Newton (1991) who suggests that the description of the Roper Logan Tierney model (1985) have been varied over the years and describe the model as a system model. Also Pearson (1983) describes it as a systems/development-based model incorporating certain concepts of Dorothy Orems model and the conceptual framework of Hendersons model (Henderson, 1969). It is important to remember that all ADLs about our individual life activities are interlink and when one or more activities is affected due to illness then most of the activities can become compromised. (REF) After a thorough nursing assessment, the ADLs that are appropriate to meet Carls needs are communication breathing, eating and drinking, elimination, safe environment, mobility, working and playing. Communication is essential for building nurse patient relationship (Robinson, 2002). For Carl due to his state of forgetfulness, memory loos, out of character behaviour and frustration especially when he cannot read for his grand children, he may need referral to see opticians for eye check, and the MMSE tool can be use to assess his state of dementia. Breathing is the first sign every health professional look for during patient assessment. Being able to breathe normally ensures that we can attempt other activities without any difficulties for example running. For Carl his breathing can be affected by smoking for 20 pack years as well as his higher BMI can cause shortness of breath. Referral to the NHS stop smoking service or radiographs for chest x-ray to check for infection will be essential. Also regular vital signs check up and the use of the peak flow meter for checking oxygen level in the lungs or nebuliser will help. Ensuring adequate hydration and nutrition is essential if health is to be maintained and in Carls case he has a higher BMI and he is in a state of confusion. There is a difference between dying from nutrition and dying with nutrition. And in Carls case he is dying with nutrition as being over nourished with higher cholesterol level. Fanning H, (2003) suggests that Dehydration as well as UTI can contribute to his state of confusion. Both the (MUST) tool and the (MMSE) tool for assessment of possible dementia can be used (NICE 2012). Referrals can be made by nurses for Carl to see the dietician and also physiotherapist for physical exercise regime and dipstick for UTI. Elimination is very important, and in Carls situation review of his medications will be important since some may cause constipation or frequent urination e.g. furosemide. Higher BMI as a result of being Obese as well as chronic chest problems and constipation can cause urinary incontinent (Kamm, MA1998). Also In male, disease of the prostate may lead to the obstruction of the flow of urine (Abrams el at 2002). The Bristol stool chart can be use to assess constipation, the dipstick tool can also be used to check for infection or UTIs and the fluid balance chart can be use to assess for dehydration by checking input over output. Mobility can be a problem since Carl has a history of forgetfulness and the need to urinate frequently. Fear of not being able to find his way home, been incontinence in public and even fear of falling in a new environment may but him off from mobilising. Human assistance will be needed as well as the assessment of risk of fall. Carl may need assessment on Working and playing since he is retired, have memory impairment and get upset when he cannot read for his grand children. Socialisation seems impossible for him now due to his condition. Referral to psychologists for self worth exercise and also going to day centres to meet other people will help. According to the RCN (2004), nurses will always need an assessment tool to guide their daily nursing practice in terms of their professional accountability and responsibility. For any tool to be effective it must be integrated into daily activity as a standalone initiative it is unlikely to have a significant impact. In Carls condition the as human beings the capacity to sustain life is dependent on our ability to address biological needs including breathing, maintaining blood flow to all our major organs, eating and drinking, elimination waste, protecting ourselfes from injury or disease, exerciseing and resting. All these activities can be monitored through nursing observations of patient in our care, enabling us to decide whether any intervention is necessary to help them maintain their vital functions. In order to make accurate observations we need to learn the correct techniques and how to use relevant equipment. To appreciate the significance of the observations, we need a good understanding of relevant anatomy and physiology, and how to distinguish normal from abnormal functioning. We then have to decide whether our observation require further action, which might include double checking results, increasing the frequency of observations, reporting changes to the clinical managers, Universal Screening Tool (MUST) will be appropriate for his health. The reason being that, been over weight or having a higher BMIcontribute to a whole range of health problems such as heart conditions, high blood pressure, type 2 diabetes, stroke, sleep apnoea, cancer, gallstone, weak pelvic muscles and osteoarthritis (Department of Health, 2004). Heart disease for instance, is one of the most widespread main health risks of being overweight. Being overweight increases the probability of heart malfunction and blood circulation problems and may result in congestive heart failure (Miller el at 2006). He continued that, losing weight in this situation may not only avoid the above-mentioned ailments but as well assist normalize blood pressure, cholesterol levels and triglyceride and diminish inflammation in the body. According to Elia, (2003) MUST is a screening tool that has been devised for application to all adult patients across all health care settings. Malnutrition adversely affects physical and psychological function (Elisa, 2000; Stratton et al. 2003b) and impairs patients recovery from disease and injury, thereby increasing morbidity and mortality. BMI (body mass index) is an easy, inexpensive method of predicting the percentage of your body weight that is due to fat mass. BMI is found by dividing your weight (in lbs.) by your height squared (in inches) and then multiplying by 703. In adults, a BMI below 18.5 is considered underweight, 18.6 to 24.9 is considered healthy, 25.0 to 29.9 is considered overweight and above 30.0 is considered obese. Respiratory function has been studied extensively in relation to BMI. For those with lung diseases, including emphysema, chronic bronchitis, asthma, and interstitial and vascular lung diseases, respiratory function is moderately to severely compromised. This compromise can be exacerbated by being overweight or having a BMI over 25.0. However, even in those with normal airway function, high BMI can impair respiratory function. Obesity and Chronic Obstructive Pulmonary Diseases (COPD) Chronic Obstructive Pulmonary Diseases include emphysema, chronic bronchitis and asthma. COPD causes a decrease in elastic recoil of the lungs so that excess air becomes trapped in the chest. This stretches the muscles involved in respiration and compromises their function. The respiratory muscles must then work harder even at rest, increasing oxygen demand on an already taxed respiratory system. At a certain point during physical activity, COPD patients reach a level when increased effort does not further increase the amount of air that they can expire. Having a high BMI means having more weight for your muscles to support during mobility. Thus, if you have COPD, the level at which increased effort no longer provides an increase in expiration comes much faster since you are working harder to support your own weight. In addition, having a high BMI means having more weight on the chest for the respiratory muscles to work against. Sponsored Links Lose 2 Stone in 4 Weeks?Mom reveals the shocking truth  About the UKs hottest dietwww.constant-fitness.com/diet Underweight and COPD Although a high BMI can further impair respiration in those with COPD, once COPD progresses to a severe level, weight loss becomes problematic. Because of lower oxygen levels in the blood, blood becomes shunted from the abdomen into the heart and lungs. This causes malnutrition because the gut is not getting enough blood flow to properly digest foods. Additionally, severe impairment of the lungs causes the respiratory muscles to work so much harder that metabolism greatly increases, even at rest. Typically, severe COPD patients who are underweight have a worse prognosis than those who are overweight because they are essentially starving. High BMI in Healthy Individuals According to a 2005 study by Jones et. al., high BMI can severely impact respiratory function even in non-diseased individuals. The study found that both Functional Residual Capacitythe volume of air in your lungs after passive exhalationand Expiratory Reserve Volumethe volume of air you can expire after passively exhalingdecreased exponentially as BMI increased. Subjects who were morbidly obese were actually breathing close to their Residual Volumesthe amount of air in your lungs after forced exhalation. Another 2005 study by Medarov et. al. Supports Jones findings and also found that Total Lung Capacitythe maximum amount of air you can inhaledecreased with increasing BMI. According to the American College of Sports Medicine, being overweight has mechanical effects on respiration, due to increased weight on the chest wall and diaphragm. Being overweight also causes an increase in energy use at the same workload compared to a leaner person, so the respiratory muscles fatigue at lower intensities in heavier people. These effects may contribute to the decreases in Functional Residual Capacity, Expiratory Reserve Volume and Total Lung Capacity. Lung Diseases Caused by Obesity There are two types of lung disease for which obesity is a primary cause. The first is Obesity Hypoventilation Syndrome, also known as Pickwickian Syndrome. Obesity Hypoventilation Syndrome involves chronic hypoxemiatoo little oxygen in the bloodand hypercapniatoo much carbon dioxide in the blood. The second lung disease obesity can cause is Obstructive Sleep Apnea. This disease involves periodic airway collapse and increased airway resistance during sleep. As both of these diseases progress, pulmonary hypertension may occur and eventually cause cor pulmonalefailure of the right side of the heart. Domino Effect Because high BMI decreases lung function in both diseased and healthy individuals, an unfortunate domino effect often occurs. Since being overweight makes it harder to breathe, those with respiratory problems may become less physically active. Decreased physical activity causes your muscles, including your respiratory muscles, to weaken and break down, which in turn makes breathing even more difficult. A downward spiral begins, in which inactivity begets further respiratory problems and respiratory problems beget more inactivity Read more:  http://www.livestrong.com/article/84685-bmi-respiratory-function/#ixzz2I54s1yvb The Health Risks of Overweight and Obesity Dr Jeremy Sims  MB BS MSc MRCGP FRIPH FRSH PGDipHI DipNH MRNT Obesity isnt just a cosmetic problem; its very much a health problem as well. You may be reading this today because you are, or have been, very unhappy about your physical appearance. However, losing weight isnt just about looking good, it is about feeling good; its about being healthy and living a productive and comfortable life. Above all, it is about avoiding the terrible health consequences of carrying around excessive weight. The growing evidence shows that if you are overweight you are more likely to develop health problems, such as heart disease, stroke,  diabetes, certain types ofcancer, gout (joint pain caused by excess uric acid), and gallbladder disease. Being overweight can also cause problems such as sleep apnoea (interrupted breathing during sleep) and osteoarthritis (wearing away of the joints); and the more overweight you are, the more likely you are to have these health problems. In comparison, healthy and steady Weight Loss can help improve the harmful effects of being overweight. The latest studies show that by losing as little as 10 to 20 pounds you can dramatically improve your overall health status, whilst significantly diminishing your risk of disease. The Risks To Your Health Heart Disease and Stroke Heart disease and stroke are the leading causes of death and disability for both men and women in the Western World. Overweight people are more likely to have high blood pressure, a major risk factor for heart disease and stroke, than people who are not overweight. Very high blood levels of  cholesterol  and triglycerides (blood fats) can also lead to heart disease and often are linked to obesity. Being overweight also contributes to angina (chest pain caused by decreased oxygen to the heart) and sudden death from heart disease or stroke without any signs or symptoms. The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. See dietitian, Juliette Kellows  Healthy Heart Diet  feature. Reducing your weight by 10 percent can decrease your risk of developing heart disease by improving how your heart works, reducing your blood pressure, and reducing the levels of blood cholesterol and triglycerides. Diabetes Noninsulin-dependent diabetes mellitus (type 2 diabetes) is the most common type of diabetes in the Western World. Type 2 diabetes reduces your bodys ability to control blood sugar. It is a major cause of early death, heart disease, kidney disease, stroke, and blindness. Statistically, overweight people are twice as likely to develop type 2 diabetes as people who are not overweight. You can reduce your risk of developing this type of diabetes by both losing weight and by increasing your physical activity. Furthermore, if you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels. If you use medicine to control your blood sugar, Weight Loss and physical activity may make it possible for your family doctor to decrease the amount of medication you need Mohammed, MA (2009) Improving accuracy and efficiency of early warning scores in acute care. British Journal of Nursing. 18(1) 18-24 This article is a report on an experimental study to compare the effectiveness of hand held early warning computer system with the traditional pen and paper method Article 2. Johnstone C, Rattray J and Myers L (2007) Physiological risk factors, early warning systems. British Association of Critical Care Nursing. 12(5) 220-231 This article is a general article that provides background information on the topic of why early warning systems can improve patient care Article 3. Hughes LL (2009) Implementing a patient assessment framework in acute care Nursing Standard 24(3) 35-39 This article describes a service improvement initiative to improve patient assessment using an early warning score system over a4 month period at a Hospital in Birmingham Artcicle 6 Wheatley I (2006) The nurses practice of taking level 1 patient observations. Intensive Critical Care Nurse 22(2) 115-21 This was a survey conducted to discover the nurses practices of taking clinical observations in acute settings. It uses an observation data collecting tool (words 470) Read more:  http://www.ukessays.com/essays/nursing/examining-use-of-early-warning-scores-in-assessment-nursing-essay.php#ixzz2I5R87ePn Read more:  http://www.ukessays.com/essays/nursing/examining-use-of-early-warning-scores-in-assessment-nursing-essay.php#ixzz2I5QcaLAr Weight-control Information Network.  Do You Know The Health Risks Of Being Overweight?. Nov. 2004. U.S. Dept. of Health and Human Services. 23 Oct 2006 Diabetes Statistics.  Total Prevalence of Diabetes Pre-diabetes. 2005. American Diabetes Association. 23 Oct 2006 The Nutrition Source.  Healthy Weight. 2006. Harvard School of Public Health. 25 Oct 2006 Obesity causes many of the most common diseases in the world. Being overweight can cause insulin resistance, which leads to Type II Diabetes. A diet high in fat and lack of exercise causes cardiovascular disease and congestive heart failure. Excess weight can cause sleep apnea and respiratory illnesses. Many top scientists believe the increase of average weight directly corresponds to the increase of cancer cases, including kidney, breast, colon and prostate cancers. Read more:  Effects of Being Overweight | eHow.com  http://www.ehow.com/about_4596213_effects-being-overweight.html#ixzz2I57jKX6t Advances in the recording of vital signs make it possible for nurses to monitor patients continuously, be it their heart function, arterial blood pressure, central venous pressure or oxygen saturations. The recordings generated by this equipment must be interpreted according to the patient and in conjunction with other observations. The concern is that nurses may become too reliant on using technology to carry out assessment. Burman et al (2002) describe how staff who are used to equipment can feel insecure assessing patients without this equipment to validate their findings. Within the competencies are skills such as venepuncture, cannulation, arterial blood gases (obtaining and analysing), and recording and obtaining ECGs. Docherty (2003) identifies the recording and interpretation of the 12-lead ECG as being pivotal in the assessment and management of patients who are experiencing chest pain. This is further supported by Harvey (2004) who discusses the assessment and management of patients suffering from angina. However, it is further complemented by accurate physical assessment of the patient. Basic is a term that is frequently used to describe blood pressure, pulse, respiratory rate and temperature. However, I would argue that this undervalues these observations. Breakell (2004) identifies respiratory rate as one of the most important signs and yet one of the most frequently omitted clinical observations. Carberry (2002) also found this to be a problem in clinical practice. The objective of observation is to monitor patients progress, thus ensuring the prompt detection of adverse events or delays in recovery (Stevenson, 2004). Respiratory rate is pivotal to assessment. Many scoring systems incorporate respiratory rate, such as: APACHE Acute Physiology and Chronic Health Evaluation Score; SIRS Systemic Inflammatory Response Score; Assessment tools Neiderhauser and Arnold (2004) identify the importance of assessing the health risk status of patients, and the indications for intervention. A wide variety of assessment tools are in use to facilitate assessment and ensure the reliability of the process. For example the EWAS/MEWS tool can be use to check vital signs and avoid patients deterioration. EWAS is use for the assessment of unwell hospital patients, using 5 simple physiological parameters, mental response, pulse rate, systolic blood pressure, respiratory rate and temperature. It scoring system can be calculated at the patients bedside, using a simple and inexpensive equipment to measure any parameters. Of all the parameters respiratory rate is said to be the most sensitive indicatory of a patients physiological well being. Breakell (2004) identifies respiratory rate as one of the most important signs and yet one of the most frequently omitted clinical observations. Carberry (2002) also found this to be a problem in clinical practice. This is logical because respiratory rate reflects not only respiratory function as in hypoxia or hypercapnia, but cardiovascular statusas in pulmonary oedema, and metabolic imbalance such as that seen in diabetic ketoacidosis (DKA)( REF). Department of Health (1999b) Making a Difference: Strengthening the Contribution of Nurses, Midwives and Health Visitors. DH, London the health problems that stem from being overweight go way beyond the ones we usually hear about, like diabetes and heart disease. Being overweight can also affect a persons joints, breathing, sleep, mood, and energy levels. So being overweight can impact a persons entire quality of life. Dangers of being Overweight Some of the dangers of being overweight include developing: High Blood Pressure:  When you have excess body fat, your body retains sodium. When your body retains sodium, blood volume increases and blood pressure rises. High blood pressure causes your heart to work harder, which is dangerous for the heart. Diabetes:  Obesity is the leading cause of type 2 diabetes. Excess fat makes your body resistant to insulin. When your body is resistant to insulin, your cells cant get the energy they need. Stroke Abnormal blood fats:  A diet high in saturated fats increases the level of LDL (bad) cholesterol. Osteoarthritis:  Excess weight adds pressure to joints and wears away at the cartilage that protects them. Sleep apnea:  The more overweight a person is, the greater more severe the sleep apnea will be. Cancer:  Men and women who are overweight have a higher risk of developing many different kinds of cancer. Gallstones:  Gallstones are more common in people who are overweight. The connection between gallstones and weight is unclear. Weak Pelvic Muscles Physical Discomfort: As fat accumulates, it crowds the space occupied by yourorgans. People who are overweight may have difficulty breathing, walking or sitting. Heart disease is 1 of the most widespread main health risks of being overweight. Being overweight to a great extent increases the probability of heart malfunction and blood circulation problems and may result in congestive heart failure, heart attack, angina (chest pains), abrupt cardiac arrest or unequal heartbeat. Weight loss in this situation may not only avoid the above-mentioned ailments but as well assist normalize blood pressure, cholesterol levels and triglyceride and diminish inflammation in the body. Cancer is one of the foremost causes of death in the United States, and is frequently a result from fat cells that affect cell growth and multiply beyond capacity. Colon, esophagus, and the kidney are the most affected regions of the body. Being obese has also contributed to uterine as well as postmenopausal breast cancer in females. Sleep apnea, Osteoarthritis plus other Health Difficulties In sleep apnea the sufferer experiences short lapses of breaths during nighttime. This in turn makes the person tired right through the day, making it hard for him to concentrate on work. In some cases, heart failure has also been noted in patients suffering from this ailment. The lapse of breath happens due to the increased size of the cells of the neck, obstructing the windpipe at certain intervals. Dropping weight may decrease the size of the neck and diminish the pressure on the windpipe and make breathing easy. Osteoarthritis is another health risk of being overweight. In this particular ailment, the joint bone and the tissue that protects joints (cartilage), wear away. The joint bone of numerous parts of the body like the hip, knees, plus lower back are the main targets of Osteoarthritis. Being overweight places a lot of heaviness on the joints, which might lead to this condition in the long run. Dropping  weight  will let down the  body fat  and lessen the aches and pains. Excess fat accumulates in the liver cells and causes the organ to inflate, leading to injuries. This results in Fatty Liver diseases. This disease can lead to severe liver injury, built-up of scar tissue that blocks the proper blood flow to the liver (cirrhosis), and complete liver breakdown. It is relatively similar to alcoholic liver damage but does not inevitably mean that it cannot affect those who do not consume alcohol. Taking communication for instance, it is essential for building nurse patient relationship (Robinson 2002). It is important, for example for nurses to know during assessment whether a patient can hear, understands the language in which a question is being asked or can answer by speaking or sing language. And if they cannot hear, do they wear hearing aids, if so in which ear. Language barrier can be a major problem during assessment, but interpreters, family and friends can contribute and help. However, very often accurate information will not be given, preventing full assessment of patients needs. The use of braill and flashy lights is also important during assessment for patients who are blind or deaf. Newton (1991) suggests that descriptions of the Roper, Logan and Tierney model (1985) have been varied over the years. The model has been described as a system model (Aggleton Chalmers, 1987), as a model that incorporates multiple theories (Thibodeau, 1983) and as an activities of living model based on human needs (McFarlane, 1980). Farmer (1986) has described it as having a functional approach. Pearson (1983) describes it as a systems/development-based model incorporating certain concepts of Dorothy Orems model and the conceptual framework of Hendersons model (Henderson, 1969). It seems fair to suggest that the Roper, Logan and Tierney model has had criticism over time. Indeed, the model has been criticized for the use of the activities of living as a simple checklist (Reed Robbins 1991), the emphasis on solely the physical aspects of patient care (Minshull et al 1986, Walsh 1989), and the simplicity of the model (Walsh 1991). Bellman (1996) suggests that the first two problems indicate an inappropriate introduction and implementation of the model in practice. We have done nursing assessment and for Carl the ADLs that are a

The Salem Witch Trials Essay examples -- American History Witch Witche

The Salem Witch Trials The Salem Witchcraft trials in Massachusetts during 1692 resulted in nineteen innocent men and women being hanged, one man pressed to death, and in the deaths of more than seventeen who died in jail. It all began at the end of 1691 when a few girls in the town began to experiment with magic by gathering around a crystal ball to try to find the answer to questions such as "what trade their sweet harts should be of ". This conjuring took place in the Parris household where a woman named Tituba, an Indian slave, headed the rituals. Soon after they had begun to practice these rituals, girls who had been involved, including the Master Parris' daughter and niece, became sick. They had constant fits, twitched, cried, made odd noises, and huddled in corners. The family called in doctors, and they were treated for many illnesses. Nothing helped. Many weeks later after running out of reasons for their strange behavior, all of their symptoms seemed to lead to one belief, "The evil hand is upon them." They were possessed by the Devil. At first the families of the children could not find anyone to accuse for being the witch responsible for possessing the children. Then, late in February of 1692, Parris' neighbor, Mary Sibley recommended that Parris' slaves, Tituba and John Indian, should work a spell to try to find the culprits. Even after trying this solution the girls' condition worsened, and the people responsible still had not been found. The girls began to see hazy shadows and believed that these shadows were of the people who had done this to them. After more and more children became victims of this, the hunting for the witches who were to blame for the girls' sickness began to get more serious.... ...time, credibility of an accusation was not checked thoroughly, instead the person accused was simply locked up in jail until their trial time came. Even then, if they did not confess to being guilty, they were punished sometimes even killed. Although the law is innocent until proven guilty, and had been practiced before the trials, in the case of the witchcraft trials, the accused witches were guilty until proven innocent. Not many were given the chance to prove themselves to be innocent. Bibliography 1. Guilley Ellen, Witches and Witchcraft (New York: Facts on File, 1989), 152. 2. Wilson, Lori Lee, The Salem Witch Trials (Minneapolis: Lerner Publishing Company, 1997) 3. Hoffer Peter, The Salem Witchcraft Trials: A Legal History (Kansas: University Press of Kansas, 1997), 212. 4. Zeinert, Karen. The Salem Witchcraft Trials, (New York: F. Watts, 1989),

Movie: Wolfgang Amadeus Mozart Essay -- essays research papers

Movie: Wolfgang Amadeus Mozart   Ã‚  Ã‚  Ã‚  Ã‚  The movie takes place in Vienna, Austria in the 1700's. The film begins with the attempted suicide of Antonio Salieri, a court composer of the Austrian Emperor. He is placed in a mental asylum where a priest visits and asks for his confession. Salieri claims to have caused the death of Mozart. The rest of the movie is a narration by the court composer, mostly in flashbacks, of how he caused this death.   Ã‚  Ã‚  Ã‚  Ã‚  Salieri recounts that while he was playing games as a boy Mozart was playing music for the King. At the age of four, Mozart composed his first concerto, at seven, his first symphony, and at twelve, his first opera. He was considered a child prodigy. Salieri wished to become a famous composer, like his idol. However, his father would not allow this. He didn't want his son to be a ‘trained monkey, on tour around Europe performing tricks like a circus'. Salieri prayed to God and what he considered a miracle happened: his father dies and he was able to pursue his musical studies. He eventually became a popular musician and teacher in the Emperor's court. When he heard Mozart was coming to Vienna from Salzburg, he eagerly sought him out. He finally found him at a party, way from the other guests, acting like a silly animal, chasing a young woman. However, as soon as he heard his music starting without him, he changed into a serious musician, rushing to take his place as conductor. Salieri noticed that Mozart conducted without notes. Although he recognized that Mozart was a ‘giggling, dirty-minded creature', he was also able to see the genius in him. He couldn't understand why God had chosen a ‘obscene child to be his instrument'. At another time, Mozart's wife presents to Salieri some of his work in an attempt to get him a job as a teacher. Salieri sees that the music sheets have no corrections and no notes. Mozart simply composed from his head onto paper. It is then that Salieri is overwhelmed by his brilliance. He realized that God has given to Mozart the skills and genius that he has always prayed for, and all he gave to Salieri is the ability to recognize it. It is at this point that he turned away from God and set out to ruin Mozart.   Ã‚  Ã‚  Ã‚  Ã‚  Salieri then describes what Mozart was like. Mozart drank too much, he partied all day and composed all ni... ...live to suffer. As the movie ends, Salieri is being wheeled through a room of mentally ill patients and this is where he will spend his remaining days.   Ã‚  Ã‚  Ã‚  Ã‚  I think that Hollywood may have over-exaggerated Mozart's behaviour. In my reading there is no evidence that he was like this. I wonder if Salieri really hated or was jealous of Mozart. Did Salieri really plan to kill the composer? The World Book Encyclopedia states that Mozart did try to earn money by teaching pupils. There is no mention of any abnormal behavior.   Ã‚  Ã‚  Ã‚  Ã‚  Whether the movie is true or false, I think the movie tries to show that genius is next to madness. A person may excel in one subject, yet the growth of the other parts of his behavior may be stunted. The movie also points out that jealousy brings misery. Salieri was well paid and popular, had a high position, and had respect from other people. Yet he remained unhappy and even ruined his life, all over the fact that another musician was better than he. Finally, it's a great tragedy that Mozart died so young and penniless.   Ã‚  Ã‚  Ã‚  Ã‚  The movie was well acted, and the music was beautiful to hear.

Happy Teacher

â€Å"HAPPY TEACHER† A Narrative Report on Practice Teaching 2011- 2012 Maria Regina D. Gile My parents would always tell me how I dreamed of becoming a teacher in the future. I would usually be found holding a book and a pen, scribbling some notes and cutting off sheets of paper. A chalk and a board was my favourite, they would say, with matching pointing stick. I guess ever since, I find teachers so majestic and powerful and smart that made me want to be one. That was BEFORE not until now. Not today. I want to become a fashion designer, an interior designer, anything that has to do with the Arts. I love anything related to it.Colours, pegs, pencils, paintbrushes, everything. That is what I want. But you see, not all that we want, we get. This is what I want but I’m taking up what I don’t want. BS Education. Well for one it’s because a lot of people look at it as a low profession. Second, monetarily speaking, it does not tantamount to all the works to be done and efforts exerted. And lastly, my patience level? Err. Below Average. I cannot tolerate slow learners, or mentally challenged ones, or whatever you call them. I just am not comfortable with that. But fate brought me here. God brought me here. Although hard to accept, I had to.The first few years of me being an Education Student went quite well. I got high satisfactory grades, loved by teachers and gained friends. Everything was going well. I could get used to this, I thought to myself. Four years and I still haven’t shifted. Cool. And in my fourth year, the â€Å"total defining moment† has finally arrived; and that is to Practice Teaching- in an unfamiliar environment- just us- no back- up. Oh great, I thought. I better ready myself. I cannot back out! THIS IS A REQUIREMENT! I NEED TO DO IT IN ORDER TO GRADUATE! And so i did. I entered the room sheepishly with all eyes on me.Not to mention the slight murmurs children made and slight laughs. Boom- boom- boom! My heart went. I was assigned to Grade 1 students. I can do this. So in the first few weeks, i observed and supervised classes but not really went to the act of teaching. Children would usually approach me, asking me to open their biscuits, punch straws on their juices and fix their belts. It felt good and that was quite odd. I never opened myself to this perspective. Days went on and I realized i have memorized their names in just a week. I would usually call out their names to tell them to keep quiet, to fall in line and to fix their things.I’m lovin’ this i thought. What even made me realize i could be in this profession is when students started giving me cute little heart shaped papers telling me how much they love me and how beautiful i am. These kids really know how to appreciate every small little thing! My presence, they say, makes them feel safe and that they never want me to go away. Isn’t that sweet? Until finally i realized, i could be a teacher. I love kids, i love how they express their gratitude, i love the classroom setting! It makes me feel confident and safe and everything! And from that moment, i realized i wanted to become a Grade- school teacher.Not because i am enforced in this course but because i want it. Yes, i want to become a teacher. My â€Å"realization† was even strengthened when i started teaching. At first i was extremely nervous and uneasy because i do not know what to expect. Will they listen to me? Will they learn from me? Can they adapt to my strategy? All of these questions kept running in my mind until one student approached me and gave me a hug. I needed that. I instantly felt at ease. It felt like home. So i went on. The night before my teaching, i practiced and prepared myself very well. From the motivation, presentation, lesson proper and all.I didn’t want to fail. I need to impress my students, my critic teacher. So going back, when i started talking in front, i find myself getting more energetic and excited. i love talking and this profession allows me to maximize my mouth muscles! Great! The kids started listening attentively, actively participated and they are getting excited too! With this, i even thought, i am a great teacher! I can arouse their interest, they are listening and my critic teacher is smiling! It feels good and rewarding, honestly. All the things i have learned, i integrated, all the strategies taught, i applied and i said to myself this is gonna be fun!And so, i always prepared lessons even two days before and thought of different ways to motivate my students. I injected humor in my discussions that made the class lively, games to challenge the students, and riddles and more. It was fulfilling to see those timid students before were actively reciting and are motivated by me. I got so attached to all of them easily, taking care of them as if my own children. They’re my little angels! And everyday i look forward to see them despite the ted ious works and deadlines. I know that becoming a teacher isn’t easy. It requires a lot of patience and hard work and passion.And i am thankful to God for bringing me here. If i didn’t give it a try, i wouldn’t have seen the beauty of this profession. Thanks to St. Paul too, for this practice teaching. It exposed me to an environment i would probably be dealing with for the rest of my life and through this Pauline Education, not only has it moulded me as a professional but a teacher with a heart and values. Finally, with the practice teaching i have experienced, it served as an eye- opener that becoming a teacher is not bad at all. It is a fulfilling profession not only academically or professionally but a food for the soul.

The Weather Underground Review

The Weather Underground Review During the Vietnam War, a radical protest group rose up on the campus of the University of Michigan. Weathermen, as they became called in everyday vernacular, were actually nothing like weathermen at all – they protested, rioted, bombed, and broke people out of jail, to mention a few of their actions. The name was formally changed to Weather Underground Organization a year after the founding, and their acts of terror followed shortly after.Earlier in the semester, a documentary about the Environmental Liberation Front was viewed. In this documentary, titled If a Tree Falls, a radical protest organization rises up to confront environmental issues. In this essay I will compare and contrast the two. The Weather underground Organization was formed in order to protest the United State Government's intervention in Vietnam, although it expanded to an array of other issues as time passed. The Civil Rights Movement became another catalyst for protest, as the notion of â€Å"black power† was not something very appealing to the members.Bill Areas, a prominent leader of the group, owned because he was upset with the war in Vietnam and wanted to do something about it. The group was nonviolent towards people and to this day says that they never killed an innocent person. Three of their members died when a bomb they were making exploded, but that was all. They bombed mostly government buildings and some banks, with notable attacks being done on the United States Capitol building, The Pentagon, and the New York Police Department.These attacks were all done to send a message of fear to the people in power in an effort to make them change their ways. To justify the actions of the group, Bill Areas was quoted saying, â€Å"Large numbers of people are broken from the notion that the system is working for people, that the system is just or humane or peaceful. † The United States government reaching peace with Vietnam toward the mi ddle of the sass was the reason for the organization going out of style, as they had no Issue left to protest.The Environmental Liberation Front was formed after a group of people became upset with how government policies were favorable for businesses looking to expand and remove forestry. Within the group, which only served o protest, there was a small cell that turned to arson in order to perpetuate their views. The leader, Daniel McGowan, organized various attacks on businesses and corporations that were cutting down trees. One of the better- known attacks was at a Colorado ski resort that resulted in hundreds Of thousands of dollars in destruction.The group was also nonviolent toward people, having never claimed a life. The Environmental Liberation Front leaders that were purporting the violent attacks were captured and arrested by United States Federal officials and tried in court in the last couple of years. Both of these organizations have many things in common; beginning wit h them being categorized as terrorist organizations. The terrorist organizations were founded in response to a public issue that they felt was not receiving enough attention and quickly turned to violence to get their message sent to the people in power.Both Bill Areas and Daniel McGowan were strong leaders with a substantial following of people, too. The attacks carried out by the organizations were also very meticulously planned out as to not kill any civilians, which would have seen the reaction from the government and police be much more significant. Their targets were similar then, in that regard, as it was entirely buildings that were bombed. The Weather Underground Organization's reason for formation and action was due to the Vietnam War, which they strongly opposed.The reason that the Environmental Liberation Front's formation was entirely different; it was completely related to the destruction Of trees by businesses. Therefore, their targets differed in scope. The Weather u nderground Organization almost exclusively bombed government buildings, with some banks added in. To the contrary, The Environmental Liberation Front targeted businesses that cutting own forests for their personal benefit. The organizations both differed in how they faded out.The end of the Vietnam War saw the Weather underground Organization lose it's relevance while the arrests of leaders in the Environmental Liberation Front caused it to cease its violent attacks. The class defines a terrorist act as something that has political motives, involves violence or the threat of violence against noncombatants, intends to have far-reaching psychological repercussions, and is perpetrated by people who believe they are altruists. The Weather Underground Organization had al the makings of a terrorist organization based on this four-part definition.The motives of the group were entirely political; it was created in response to the United States Government authorizing involvement in the Vietn am War and also grew in scope during the Civil Rights Movement. Without the political catalysts to get the organization started, it would not have been formed in the first place. Violence was found throughout the organization, as their attacks involved bombs on buildings, as well as freeing a person from prison. The threat of violence continued in the wake of attacks, as people ere constantly worried that their building was next.Moreover, the victims were noncombatants, as they were simply working for the government. The psychological repercussions were intended to be far reaching -? to the executive branch of the United States Government. They intended to influence the government at all levels to change their ways. Finally, the perpetrators were acting as if they were altruists. Clearly they felt that the Vietnam War was wrong and that, by their actions, they were going to make things right. During the Vietnam War, a radical protest group rose up on the amass of the University of M ichigan.

Operations Management and Csr Essay

Why are operations the most vulnerable sector of any company when considering CSR? I. Introduction As globalization continues, the earth’s natural processes transform local problems into international issues along with the development of international commercial activities. Few communities are being left untouched by major environmental issues and social problems. As one of the most active and influential elements of the human society, the business world has been required, for several decades, to shoulder more responsibility by their consumers and society in general. The concept of corporate social responsibility (CSR) draws more and more attention from all sectors of society, and is considered as an issue that we cannot afford to ignore. As we take into account the increasingly serious environmental problems and social issues such as inequitable growth, corporate social responsibility can no longer be used as a slogan or a tool of self-glorification, but rather as a pressing task for all companies, who contribute to these problems. In a day and age when technology allows us to be informed in real time, strategies such as â€Å"green-washing† may only accelerate the deterioration of a company’s image. Consequently, the CSR should be treated as an issue that can be solved only by creating synergies between several functions within a company. From establishing product concepts or services to manufacturing, from delivering goods to recycling waste, every single step of the process may have an enormous impact on whether a company decides to become socially responsible. For this reason operations management is at the core of the CSR discussion, given that it involves the design and control of the production process. Though the principles of operations management and that of CSR have factors in common, such as reducing waste and energy saving, the traditional vision of cutting cost as more as possible conflict with the spirit of sharing value with all shareholders, making operations management the most vulnerable function when considering CSR. The objective for operations managers, increasing profits with less resource, can be quite affected by the value of corporate social responsibility. In this essay, we try to respond the question: Why are operations the most vulnerable sector of any company when considering CSR? After presenting several main concepts and the background of this problematic, we will give three reasons to answer the question above with analysis and examples. Finally, we will put forward our proposals and previsions then come to a conclusion. II. Concepts and background 1. Corporate social responsibility Corporate social responsibility (CSR) is a concept firstly raised by Andrew Carnegie (1835-1919) and developed in the USA. According to him, a businessman should, first of all, accumulate his capital, and then distribute his fortune to society. As he said: â€Å"Man who dies rich dies disgraced†¦If you want to be happy, set a goal that commands your thoughts, liberates your energy and inspires your hopes.† (Banerjee, 2007) After this initial definition, the concept of CSR drew more attention from both academic circles and the business world in the second half of the twentieth century. According to Howard R. Bowen, enterprises should make and practice the policies that aim to create values desired by the society (Bowen, 1953). On the contrary, Milton Friedman insisted that the only duty of corporations is to augment the fortune for their shareholders. Is his article on the New York Times in 1970, he said: â€Å"The social responsibility of business is to make profit.† Since the first decade of the twenty first century Concern from governments and appeals from non-government organizations put this issue under the spot light. In 2001, the European Commission defines the CSR as â€Å"the voluntary integration of social, environmental firms in their business operations and their relationships with all internal and external stakeholders (†¦) in order to fully comply with applicable legal requirements, invest in human capital and respect its environment (ecology and territory)† (European Commission, 2001). Moreover, we can observe a combination of concepts from corporate social responsibility and sustainable development. 2. Operations management Operations management is the activity of managing the resources which produce and deliver products and services. A close relation with products and main services makes the operations function central to all kinds of organizations. It is one of the three cores of business, with the marketing (including sales) function, and the product / service development. Rather than an isolated island within a company, the operations function is involved in a high degree of interaction with others. For example, it has to keep in touch with product development function to assure that the firm has the capabilities to manufacture the design of a new product. For the same reason, there is a synergy between operations function and marketing that helps match the sales power with production. (Nigel Slack et al., 2010) The importance of this integrated way of working has been known for long time, but it is the development of information system that makes it possible. Thanks to systems like Electronic Data Interchange (EDI) and Enterprise Resource Planning (ERP), companies can, on one hand, facilitate the communication with their partners and suppliers, and promote the collaboration among functions. In order to compete in an ever-changing global economy, enterprises make an emphasis on the efficiency and productivity of their manufacturing process, aiming to maximize advantages on price, quality, as well as satisfaction of costumers. The important role of operations management in the company, and the influence it exerts to other echelons of the value chain, make it crucial for managers to consider when they think about environmental and social issues. 3. Background: evolutions on global market During the last three decades, we can observe that two elements are changing rapidly in the business world, the continuous development of international trade and production, and the wide use of the Internet. We cannot talk about CSR or operations management without considering these issues. International trade and production Once a business reaches a certain economic level, it usually aspires to reach an international level (Czinkota & Ronkainen, 2004). This sort of ambition will lead to a series of actions and changes in the strategy of the operations functions. For instance, problems in adaptation to the economic environment and culture in the target country, may cause repercussions on materials sourcing or the integration of products. Even a change of format or packaging requires coordination between the marketing department and the operations function. At the same time, trans-national delivery demands a higher degree of reliability and efficiency from the supply chain, demanding significant improvements of operations management. On the other hand, more and more multinationals locate their facilities in third world countries, raising environmental and social problems in the host country. While they benefit form relatively low cost of raw material, energy and labor, these industrial giants leave behind high levels of pollution ad cause a scarcity in resources (DeTienne & Lewis, 2005). Globalization has not eliminated the inequality between countries, but rather has aggravated the problem. Wider use of Internet First, the explosion of e-commerce has profoundly altered the way we do business. Especially when we talk about selling online, satisfaction of customers is no longer determined only by products themselves, but also deeply influenced by the performance of supply chain, manifesting mainly by issues of delivery and after sale service (Lannoo & Ankri, 2007). Whether taking care of these tasks internally, or outsourcing to third-party companies, companies and their operations function will be faced with unprecedented challenges and risks. Second, the Internet serves as a tool for all members of the society to be informed, to understand and even monitor a company. In many countries like France, annual reports of listed companies are now required to include a CSR report. Along with economic performances of these firms, their contribution to communities and the environment is also be available on their official web sites. In this case, managers have to take more voluntary and effective acti ons to fulfill their promises to the public. III. Major reasons for vulnerability 1. Outside pressures There is no doubt that some of companies give priority to value creation for all shareholders such as the Body Shop. However, in reality, most companies make an effort to achieve their CSR goals largely because of increasing pressures from all sectors of society. Some of these requirements are focusing on the production process and delivery of goods, and thus put tremendous stress on the operations function. First of all, we could compare Traditional and Modern views of Corporate Social Responsibility applied to Operational Management. Within the company, operational management works as an integration of several functions such as: Engineering or Manufacturing (Inventory, Planning, Material Flow, Quality etc.), Distribution (Suppliers, Transport), accounting etc.; with interrelated operations such as: Finance, Human Resources, Marketing and etc. This can be applied to any type of organization, regardless of its sector (Manufacturing, HealthCare, Wholesaling, Retail, Banking etc.) Modern CSR approach creates vulnerabilities to Operational Management because even seemingly insignificant change or disturbance in one participant (function) can influence whole loop of Supply Chain, which can therefore negatively influence company’s behavior in regards to Social Corporate Responsibility and even affect the goals for efficient Operations Management. There are eight possible competitive priorities (goals), which fall into four groups: In the event of such disturbance, most of companies tend to forget their tactics and strategies regarding CSR/ long-term or sustainability goals and use to short-term solutions, no matter what the price to the environment, society, employees, consumers or stakeholders. We have concluded that most important vulnerabilities within the Organization are: * New concepts and re-design (products and services) It is quite clear that creation of new concepts and re-design of products/services is crucial for every company. The first step or designing, creating new or modifying product is generating ideas which furthermore need to be properly tested, feasibility study conducted, no matter how great the ideas seems to be. The process is lengthy and complicated: Therefore, the re-design itself can become CSR problem due to: * Waste Management, additional energy consumption, recyclability * Social impact of the product and Customer Safety * Layoffs (employees and suppliers) in case of restructuring or failure. For example, Michelin has failed to launch its run-flat PAX tire, which could be driven while being damaged, at highway speeds, for a hundred miles or more. Unfortunately, in order to use these tires, the under-body of the cars would need to be redesigned, new equipment and new skills would need to be acquired by the mechanics. As Michelin failed to analyze complete consumption chain of this new concept, the production line had to be discontinued. This was not only a commercial fail, but looking from the CSR point of view, it also had negative social impact such as layoffs, the time and resources used up for R&D, Marketing and other operations which could have been used for more efficient and value-added products. (Harvard Business Review 2007) * Transportation/ Logistics The location of the headquarters/warehouse and any other business unit has an important impact on Operations management and is one of the most vulnerable points when considering CSR. Transportation can have significant environmental impact: business flights, employee commuting and the movement of goods may cause emissions and leaks, including air pollutants, greenhouse gases and water pollution. As transportation is unavoidable for a manufacturing firm, operations management helps to reduce the impact, however due to complexity of the interrelated operations it can become vulnerable. For example, Company A is a supplier of Raw Materials; Company B is a customer, which needs Raw Materials to manufacture goods. In the event of a raw material production delay in Company A, scheduled standard delivery might need to be re-scheduled to a special express dedicated delivery to the Company B because, let’s say, due to this delay and bad planning Company B will have a production stop. Such delivery would be considered inefficient, as it is costly, fuel inefficient, increases pollution, pressurizes truck driver, moving from standard procedures to special procedures, additional pressure and stress for employees from both companies etc. One may argue, that the production stop would cause more negative impact than the rushed delivery, however it is difficult to weight the impact, there is the need to address root causes. If the planning and security stock from both sides was well managed, the express delivery would not have been necessary. To conclude, no matter how efficient Logistics processes are created within the company, human error is unavoidable; therefore Operations Management becomes vulnerable when considering CSR. * Waste and Recycle One of the most tragic examples of an operational failure is Chernobyl disaster in 1986, polluting and creating toxicity and waste problems. Not only companies need to manage the basic production safety and reduce accident rate, but they also need to recycle as much possible, manage day-to-day waste safely and create lean product life cycle. However, these processes are subject to vulnerability when considering SCR as there could be a graver damage made by conducting these operations. Recycling Companies such as HP who organize the recycling of the old cartridges or companies such as Nespresso who collect used coffee capsules, shows a great example of how to reduce the environmental impact of its products. However as great as it might appear, many other aspects need to be taken into consideration, for example supply chain system needs to be created to collect and transport these used items, special environmentally friendly bags or boxes for the pick-up point’s needs to be produced. Remembering Michelin case, where it failed to analyses it’s complete consumption chain, HP and Nespresso had to find a way to encourage consumer to bring back their empty cartridges and capsules. In their cases, it is successful, however it is vulnerable and could become a failure if the participation level of consumer is low. Waste Most significant waste issue is well noticeable in chemical industry or any other industry where waste is hazardous or is non-recyclable or non-reusable. The solution would be to improve the operation processes and to avoid unnecessary waste, however this is proven to be impossible due to human error and especially in chemical industry where chemical reactions can create unusable waste. The hazardous waste management is controlled by the legislation and will be discussed later on in the essay. Not only materials are considered to be waste, but also energy and labor waste – companies try to be more efficient by implementing just-in-time and lean process, however there is a clear vulnerability when considering CSR: at what price do company’s adopt their just in time principles? Overcrowded and polluted roads would be most direct negative impacts, but there are also other social impacts, which will be discussed in more detail in â€Å"organization evolution† section. * Organizational evolution Performance Measure There is no doubt that Performance Measure is highly important in Operational Management as well as for any other part of the business, however measuring and setting standards have negative social consequences, especially for the employees. Reduction of costs and prices, increasing customer experience, quality conformance, the speed of delivery, reliability of delivery could cause serious stress and working hour’s fluctuations for the employees. An example of the employee struggle to meet the set performance level is making data look better than it is by leaving out certain information, some company’s set high un-reasonable standards or in some quarters the performance cannot be met due to external factors causing stress. Continuous Improvement Kaizen is a Japanese system promoting Continuous Improvement or in other worlds never ending journey of improvements. There are many approaches such as the Deming Cycle (Plan, Do, Act, Check), tools and techniques to conduct the Continuous Improvement process. The benefits for efficiency and profit are unquestionable, however when considering CSR we can find many vulnerabilities. A good example of Continuous Improvement is Business Process re-engineering (BPR) which is a way of reconfiguration of processes in an appropriate level to provide highest value to the customers and improving critical areas. However again, at what cost when considering CSR? As BPR requires organizational change which requires changes in staff attitudes and could possibly result in loss of positions for many, reduction of responsibilities for others, the fear for Hire and Fire. Also, as tasks become more efficient, they also become more repetitive and less challenging. (T.Hill 2005) To summarize: Main social considerations of operations management decisions 2. Outside Partners As the world continues to expand we are starting to understand the consequences that our development has not only on the environment but also on society. Due to this new consciousness we have seen the emergence of different attempts to confront these environmental and social issues. Corporate Social Responsibility or CSR is one of the most commonly used concepts within the business world. Historically CSR has been only partially integrated as a philanthropic effort. Little by little the environmental issues caused by everyday operations of a company have also integrated the concept of CSR. With this change in definition, companies have actively trying to reduce their impact on the environment and society. As an essential function of a company, Operations Managements is constantly affected by these decisions. If, for example, a company decides to reduce their packaging it will be the operations department that will have to manage this change. Suppliers When we consider the impacts on Operations Management when integrating CSR to a company, we must go farther and analyze the impact on all outside partners such as suppliers. When we decide to integrate a CSR action, especially within the manufacturing process we need our suppliers to integrate the same change on their process. As customers begin to become more conscientious about environmental and societal issues they are demanding companies to make many changes. Within the clothing industry this green movement was reflected by customers asking for organically grown cotton to be used in the manufacturing of products such as Nike. In this kind of situation we see how the responsibility immediately falls on the supplier to change their process. This sort of sudden changes leaves the operations function of a company quite vulnerable, as they have to trust that their suppliers will be able to change their process without increasing costs. When there is a synergy between a manufacture and its suppliers such changes can be made with collaborations. A great example of this is how the company Esquel managed to give their customer the organic cotton they needed by managing their whole supplier chain. Instead of just demanding their own suppliers to supply the needed product they worked with 1st and 2nd tier suppliers and built a sustainable procurement chain (H. Lee 2010). In the last few years we have seen how many manufacturing companies who have simply demanded certain changes to their suppliers, but do not think about make an effort to assist in this change, and most importantly they do not control the whole procurement chain. This was the case of Mattel who made it clear to its 1st tier suppliers that no lead paint could be used when manufacturing its products, yet it never thought of auditing its 2nd tier suppliers or furthermore the outsourced production its main supplier had. This type of opaque supply chain makes operations very vulnerable and can cause, like in Mattel’s case severe financial repercussions (N. Sun 2007). The new shared-value concept developed by Porter and Kramer has introduced the idea that by collaborating with all the actors in a value chain we can create value while still respecting CSR. A company that has been able to smoothly transition into this new shared-value concept is Toyota. The deep relation that exists between Toyota and its manufacturers has allowed them to naturally apply changes that create a win-win situation for them and its suppliers. The Toyota company culture naturally includes the idea of shared-value and has a long-term mentality (Spear Bowen 1999).