American Attitudes about September 11th essays

American Attitudes about September 11th essays Osama Bin Ladin had more than just a plan to harm United States Citizens when he had the world trade centers bombed. He had a grudge with the whole way of life that Americans led. He was disgruntled about our economic strength, our cultural acceptances, and the "materialistic" way of life we led. He thought that by bringing down the world trade centers, our symbol of everything good about America, that he would destroy our lives. However, the opposite effect was produced. The country came together in a wave of patriotism and heroism. Granted, some racism took place against Arab Americans, but for the most part, the whole country came together in a moment that would change lives not only in America, but all over the world. Racism, as defined by Schaefer, is a doctrine that one race is superior. (Schaefer, pg. 506) When the world trade center came down, and the entire country came to a halt and gasped, we realized that the world suddenly changed. We saw scenes of people suffering, dying, and crying out for loved ones, and the heart of America sobbed for them. Everyone in America today, was affected by what happened 09/11/02. Many lost precious loved ones, more lost jobs, and even more lost the feeling that they were safe in the most powerful nation on Earth. We were attacked from more than one angle on that day. The economic consequences of September 11 were that many people lost their source of income across the land. Father's that had to make child support payments were left with no means in which to take care of their children. People who were getting ready for retirement were forced to look at working for another five years to guarantee their pensions. Consumers were afraid to spend money in fear that they would lose their jobs, and not be able to make rent. The economy seemed to come to a halt. However, Bin Laden was wrong. Not only was he wrong about our sprit as a nation, but also about the ...

Patronage and corruption in Elizabethan government Essays

Patronage and corruption in Elizabethan government Essays Patronage and corruption in Elizabethan government Paper Patronage and corruption in Elizabethan government Paper The English government in the 16th century lead and promoted by Queen Elizabeth operated with a system of political patronage and grants of monopoly. These methods were used to organize the governing class as the Queen lacked a civil service, local officials and an army which would allow her to enforce her will; thus Elizabeth had to reward the governing class for her to secure the throne. However, it can be argued that the system was both corrupted and inefficient; many believe Elizabeths regime was marked with cheating, bribery and unjust practices and that it did not operate effectively. On the other hand, it was argued that the system was indeed one of high quality by standards of the historical age; especially when compared to other Western European countries at the time. We also shouldnt judge the operation of Elizabethans government by our modern standards. Source B is a letter dated back in 1595 from the Dean of Durham to Lord Burghley thanking him for his promotion to bishopric. The letter is filled with flattering and obsequious language such as descriptions of Burghley being an especial patron to see, and that he now pleased God and Her Majesty with the extraordinary furtherance. Such a use of language suggests some degree of corruption as the Dean of Durham only got the position because of his pleasing attitude to Lord Burghley and that he isnt the best man for the job. There is also potential for inefficiency as Dean of Durham might not be a good bishop but only one which sucks up to Lord Burghley. Furthermore, the Dean of Durham said he is unworthy of the job; this shows that even he himself does not believe he will do a good job or he is trying to flatter Burghley by degrading himself. The Dean of Durham is also offering to repay his promotion by presenting your Lordship with a hundred pounds in gold. This suggests corruption as the Dean of Durham is paying to buy the position and he only got the promotion because of his wealth; not ability. It shows that the system is inefficient as it allows such actions. Surely, if the Dean of Durham felt that he deserves the position; there will be no need for the gold. On the other hand, the arguments above can be countered. Firstly, the letter is of a friendly and excited tone thus we can see that the two men share a good relationship; which means they will work well together. The Dean of Durham also looks as if he is passionate and ready for the position suggesting he will be efficient with doing his job. As for the giving of the gold; there is no evidence stating Lord Burghley ever asked for and accepted the gold; therefore it is not corruption as there has been no deal between the two prior the promotion. From my knowledge of language, formality and customs of the 16th century, the flattering language can simply be seen as a sign of appreciation and is no more than politeness. The gold giving is no more than a custom of thanking for the promotion; thus, corruption did not occur. I also understand that Lord Burghley was a honest, trusted and highly respected figure and is arguably Elizabeths favorite; thus there is no need and no reason for him to be bribed with a hundred pound of gold. Source C criticizes Elizabethans government for showing certain defects, referring to the system being faulty in that it hands too much power to too few. Wallace MacCaffrey also suggests that the system lacked adequate safeguards which shows that there is little order putting the question of efficiency into doubt. As a result, Lord Burghley had to ceaselessly supervise to stop the worst abuses. This suggests that politicians were corrupted as they lacked self discipline; more worrying, protection waned with the ageing statesmans health and strength. The fact that the system was so dependent on one man shows inefficiency; there is also potential for corruption once Lord Burghley retires. The competition was also too small again suggesting inefficiency due to the lack of participation leading to the limitation of ideas. The governing class tried to increase incomes by any means by exploiting his opportunities. This suggests that the system is inefficient in the first place in that it allows people to abuse it; it also shows that the governing class wasnt accountable or responsible for their actions therefore allowing them to be corrupted. To add to this, I also know that the system at the time was largely based on patronage, meaning if one wanted to rise up the political ladder; one had to do so through some degree of favoritism and corruption. This shows that the system was inefficient and promoted corruption. Reckless competition was also present; this may lead to inefficiency in governing. Giving an example outside the source, the rivalry between Burghley and Leicester in 1570s is a demonstration that aggressive competition was present from the very top of the government. Another example would be the power struggle between Robert Cecil and the Earl of Essex in 1590s which immensely threatened government stability and underlined the systems inefficiency. Quoting historian Keith Randall there was a never ending process of competitive jockeying for position going on. The fact that there were black markets where political influence was brought and sold shows corruptions was present. This is because the inefficient system allowed power to be distributed to the hands of the rich and therefore was not equal. I can further back this point by bringing in my knowledge on the power of politicians at the time. Politicians then had the right to prosecute those who had infringed some act of parliament and they could keep a portion of the fine. Politicians might prosecute simply for the money and that the justice system could be brought off by the wealthy; showing elements of legalized robbery as historian Randell suggests. Furthermore, the courts language was in Norman Court French making law inaccessible and obscure to the general public proving that the justice system was inefficient and unfair that the majority couldnt read the law. This lead to corruption as only the rich and the elite could understand it. Lastly, the writer of Source C states the poverty of the Crown lead to unwise concessions such as grants of monopoly. Elizabeth was inefficient as she only looked at short term benefits whilst ignoring the long term consequences. From my own knowledge, I know that the 1590s to the early 1600s was not a good time for many of the English population. They had just suffered from three consecutive bad harvests and poverty was rife. What monopolies will do is allow prices to be pushed up immensely, leading to inflation. Surely, an efficient governing body will try to lower prices instead of increasing them. At the end of Source C it states that Englishmen were turning away from their bad old habits of conspiracy and treason. However, from my knowledge I can counter the statement by brining in the Earl of Essex who was involved with conspiracies to overthrow Elizabeths regime after he lost his patent on sweet wines in 1600; he was later on executed for treason. This shows that the system of government was corrupted as men like the Earl of Essex placed personal wealth above the country. However, there are arguments that disagree with Elizabeths system of government as being both corrupted and inefficient. First of all, we can see from Source C that Burghley staved off the worst abuses. He continuously and constantly supervised the system of political patronage showing that effective methods were imposed which efficiently prevented corruption. Furthermore, the argument that the Crown made unwise concessions can be countered by stating that the she had to fix short term and immediate challenges first before looking into the long term; this is supported by the fact that Parliament made it hard for Elizabeth to have financial access therefore she did not really have a choice. Also, the idea of handing out monopolies was one which was financially efficient for Elizabeth; as Source C says it offered an increase in income for no outlay. The writer Wallace MacCaffery concludes that high praise must be given for the transformation of Englands politics and that a new political order has been established. This implies that the government was much less corrupt and much more efficient then before; highlighting the improvement and progress of the systems of government as a whole. This can be backed up with some of my own knowledge of the successes of the period. First of all, population doubled in the 16th century therefore Elizabeth entered a period of hardship to lead. Her regime successfully imposed a long lasting and effective means of poor relief which helped ease poverty. Furthermore, social stability was generally enjoyed so as religious and political steadiness. It is also worth noting that under Elizabeths government the Spanish Armada was successfully defeated. It is therefore argued that none of the above accomplishments could have been present without a corruption-free and efficient system of government. Furthermore, although there were individuals like the Earl of Essex; there were many men who served in the genuine interest of their country. The 1800 unpaid volunteers as Justices of Peace was an example; they had to do a lot of traveling and it was an effort consuming position and there was little or no financial gain. Apart from the ideas from the sources, there was a very important element which formed the systems of government. This was the position of the throne and her prerogative powers which helped secure efficiency and solidarity of the country. Elizabeth held on to the powers to call, prorogue and dissolve Parliament, declare war and make peace, appoint and dismiss ministers and judges, determining monarchs marriage and naming a successor. Elizabeth was also careful in not handing too much power away to Privy Council; she would not interfere with the daily running of it so it could run efficiently, however whenever it came to important decisions about the country the Queen would make sure she makes the final call. This made the decision making process efficient as there was only one person making the decisions and disputes were prevented. Furthermore, potential cases of corruption were dismissed as the Queen makes the final decisions so there is no use buying off politicians or advisors. Corruption and inefficiency is also relative to the peoples expectation of government. I know that in the 16th century, the government did not intervene nearly as much as governments do now with social or economical problems. The government was simply expected to keep the realm safe and secure, to help in disasters and to run the finance of the crown and country; it must be said that Elizabeths government did a reasonable job in those areas. To conclude, I cannot agree with the statement that the Elizabethan systems of government were both corrupt and inefficient for three reasons. Firstly, we must understand that 16th century Britain has a very different political structure as to the one we currently have. There were no democratic features such as elections, political parties or the media. This meant that the nature of politics was inevitable to that of favorism you had to get on someones good side if you wanted to excel and advance. Indeed, this would now be what we call corruption, however, back in the time it accepted as standard practices and was part of the social norm. Secondly, the prerogative powers of the Queen provided the system with both fairness and efficiency. Indeed, we will call Elizabeths position as a dictator nowadays but back in the time, a solid leader who held the powers to make the final calls to the most important issues was very much needed. Thirdly, the successes of the period cannot be ignored. Elizabeths regime did have its glorious days such as defeating the Spanish Armada. But most importantly it was the long term stability which citizens enjoyed under Elizabeths government. In contrast to other Western European countries at the time, Britain had excellent social, political and religious stability which is a testimony of the success of a fair, just and efficient system of government.

Plan and Design a Small System Project Research Paper

Plan and Design a Small System Project - Research Paper Example ut at the center the System Development Life Cycle is resilient in its testing and implementation in the business, government and industry architecture. Actually, the System Development Life Cycle has been termed as one of the two dominant application development techniques in today’s world together with prototyping. Thus learning about System Development Life Cycle is still very crucial to students of all centuries. This article outlines System Development Life Cycle application in a real world health care environment entailing a core component of a sectional hospital care facility. The article may be used as pedagogical equipment in system analysis and design course, or even in an upper division or graduate course as a scenario of implementation of the System Development Life Cycle in practical application. Several aspects have been discussed that include the entire System Development Life Cycle in health care setup. SDLC has always been part of the information Technology family since the inception of modern digital computers (Wager, Lee, Glaser & Wager, 2009). Systems Analysis and Design course is requisite in various Management Information Systems application programs. Even though such lessons avail an overview of several means of acquiring or developing a software application, at their core such applications still contribute a significant amount of time to System Development Life Cycle as they ought to. As this paper will demonstrate, chronological steps and phases adherence is still an acceptable way of insuring the successful software development. Generally, SDLC has really evolved but at its core it still remains a vast technique used for developing software applications. Early dissertations of the SDLC upheld the arduous delineation of vital steps or stages to adhere to for any type of software development project (Loretz, 2005). The Waterfall Model is one of the common well-recognized forms of development. In this classic architecture, the technique

Juvenile and Adult Courts Essay Example | Topics and Well Written Essays - 1000 words

Juvenile and Adult Courts - Essay Example It was perceived, due to the influence of industrialization and modernization, that the children were corruptible innocents and that their upbringing demanded greater structure as prerequisite to adulthood than that had been previously regarded. Based on the assumptions of the social scientists who suggested that children are not responsible for their actions in the same way as adults since they are not fully developed, the idea of juvenile justice system was emphasized. According to this view, juvenile criminality is a kind of youthful illness, which can be cured by relocating the juvenile to a better family life in a rural setting. Thus, the first court designed specifically to deal with children was established in Chicago one hundred years ago which led to the growth of a separate juvenile justice system nationwide. "Juvenile courts are responsible for dealing with children who are accused of committing two types of offenses: status offenses - violations of laws with which only ch ildren can be charged (e.g., running away from home); and delinquency offenses - acts committed by a child which, if committed by an adult, could result in criminal prosecution." (Young and Gainsborough, 2000, p 2). Significantly, the premise on which the separate juvenile system rests is that children are developmentally different from adults and that more amenable to treatment and rehabilitation to juvenile criminals can be ensured by this system, unlike the adult criminal justice system. Therefore, it is essential to regard the juvenile justice system and the adult criminal justice system as two separate systems of justice founded on different philosophies, even though there are elements of close resemblance in both the systems. In a comparative analysis of the juvenile justice system and the adult criminal justice system, it becomes evident that the juvenile court system has been historically distinct from adult courts and both the systems are founded on divergent philosophies. Whereas the adult criminal justice system emphasizes the punishment of criminals, the juvenile justice system is mainly concerned with the rehabilitation and treatment, along with community protection. Rehabilitation and treatment are not primary goals in the criminal justice system and the guiding principle of this system is that criminal sanctions should be relative to the offense committed. On the contrary, "the juvenile justice process centers on the individual child and takes into account the child's problems and needs, focusing less on punishment than on helping the child to change and so minimize the likelihood of future criminal behavior." (Young and Gainsborough, 2000, p 2). Although there has been an important speculation in the recent years that the clemency within the juvenile justice system is not always the best option for all cases, it is constantly emphasized that there are several momentous differences between the juvenile and adult courts. The terminology used within the juvenile and adult courts offers one of the main differences between the two systems. "For juveniles who are brought into court, the terminology refers to the situation as an 'act of delinquency'. In the adult court the term 'crime' is used. Another difference is the way in which

Erich Korngold Essay Example | Topics and Well Written Essays - 750 words

Erich Korngold - Essay Example Carroll calls him "a remarkable child prodigy composer" and supports this with a quote by Strauss. On the other hand, Palmer does not go overboard with words and maintains balanced critique; he writes of Korngold as continuing "to compose prolifically, and with great success," throughout his teens, and later remarks that his works like Die Kathrin received "less critical acclaim and failed to gain a foothold in the repertory." Thus Palmer's article is quite succinct in praise. While Palmer ends his article with a comment on Korngold's strong points and deficiencies, Carroll end the article on a highly charged note of positive praise, raising Korngold's stature to a "once forgotten classic composer" now regaining his popularity posthumously. An interesting revelation in comparison is that Palmer seems to have almost paraphrased Carroll's words; "and have ensured the renewed and growing interest"as in Carroll's own words it appears as "after decades of neglect, a gradual reawakening of interest.increasingly popular." Now turning to the third article appeared in New Grove's Dictionary of music and musician Carroll seems to have re-written most of the parts of this article from his earlier version. Added to that, he seems to have bettered his chronological references to the works and achievements of Korngold. Also, Carroll's assessment of Korngold's compositions for Hollywood is rather detailed in technicalities. One would strongly fee... Added to that, he seems to have bettered his chronological references to the works and achievements of Korngold. Also, Carroll's assessment of Korngold's compositions for Hollywood is rather detailed in technicalities. As is obvious in Carroll's earlier articles on Korngold, the critic has high praise for the musician and hails him as a composer of "lush" style and praises his music as having "vibrant sensuousness." One would strongly feel that Carroll's intention is to ensure that Korngold is glorified and added to the cannon of world renowned classical composers, while Palmer restrains from overtures of high-flying praise. Palmer's article is more "academic" in nature as the references are acceptable. Though both critics have categories of similarity, like noting Korngold's landmark achievements and his gradual fame, in Hollywood, Palmer does seem more truthful in his article while Carroll's use of positive and superlative adjectives make him seem as being an international cannonizer lobbying for Korngold's position. Conclusion: Based on the representation by Palmer and Carroll in their articles, it is trustworthy to believe Palmer who has tried to represent Korngold's work in words the way a painter paints a picture of nature, the way he sees it, where as Carroll has tried to add some flavor to his

National Institute For Health And Clinical Excellence Nursing Essay

National Institute For Health And Clinical Excellence Nursing Essay This essay will critically appraise and evaluate the evidence that underpins Occupational Therapy practice within a hospice setting and specifically an implemented intervention with reference to a case study. Inherent within this will be a critical analysis for the rationale and clinical reasoning behind employing that intervention, including the legislation and political drivers that govern and influence the intervention, the OT practice, and the setting, along with and in relation to the wider context of the service. The case study focussed upon within this essay, surrounds Mrs A (pseudo name used), a lady in her early 60s, diagnosed with an inoperable breast carcinoma with bone metastases. Initially Mrs A had difficulty accepting her deteriorating condition, resulting in her presenting with severe fatigue and loss of occupational identity and engagement in her life-long passion of drawing, despite trialling pharmaceutical treatments. This along with her low mood levels and preferred aim to stay with her family in her home meant she was referred to community palliative care OT (Appendix-slide 4, 5). The World Health Organisation (WHO) (2012) defines palliative care as the physical, psychosocial and spiritual approach that improves quality of life of the patient and their families associated with a life limiting illness. This concept is re-iterated within palliative care policies and a prominent piece of legislation within this specialist field is the End of Life Care Strategy (Great Britain. Department of Health (GB.DoH), 2008). Although published in 2008, it has developed from other integrated publications, such as the National Health Service (NHS) End of Life Care Programme (2007) and is the first national and comprehensive framework aimed at promoting high quality care for all individuals that are approaching end of life. It also provides a basis for health and social care services to build upon and the core concepts of all health professionals duty of care whilst supporting patient and their carers. The philosophy of palliative care differs in focus from the medical model of health care, with its core focus on quality of life and meaningfulness; consequently it fits well alongside OT core principles and paradigms of holistic and patient centred practice (Lucey, 2012; Othero, 2010). Although OT intervention with patients with palliative care needs is not a new concept, there is little evidence that supports this area of practice (American Occupational Therapy Association (AOTA), 2008; Cooper, 2006). However the Improving Outcomes in Breast Cancer document acknowledges the important role and key concerns for OTs, assisting patients in sustaining their independence, autonomy and empowering the maintenance of control over own health decisions (NICE, 2002). Additionally the Route to Success in End of Life Care Achieving Quality for Occupational Therapy (College of Occupational Therapist (COT), 2011) and the National Service Framework for Older People (2001) provides a framework for OTs to work within. These are alongside other ethical and legal principles and professional codes of conduct, such as Code of Ethics and Professional Conduct (COT, 2010) and the Professional Standards for Occupational Therapy Practice (COT, 2007). Intrinsic within the core values of OT, are the concepts of the occupational nature of individuals and that occupation has the capability to influence health, a key area within the care of Mrs A (Turner, Foster and Johnson, 2002). Wilcock (2006) suggested that occupation is a basic human need found across the life span through doing, being, becoming and belonging, and the importance of occupational engagement in palliative care has been found in numerous research studies (Burkhardt et al, 2011; Lyons et al, 2002). Vrkljan and Miller-Polgar (2001) provided evidence for the value of breast cancer patients participating in meaningful occupations in order to enhance wellbeing at the end of life. In accordance to these principles Mrs A is experiencing occupational deprivation due to her inability to engage in drawing, however the age of this study restricts its application to todays contemporary practices. According to Ahlberg et al (2003) cancer-related fatigue (CRF) is the most commonly reported symptom associated with cancer and its treatment, preventing engagement in occupations, usual functioning and infringement on quality of life (Cooper, 2006). Classified as a distressing, subjective and persistent sense of exhaustion or tiredness, fatigue can be experienced during or after treatment by 70%-100% of cancer patients (Stone and Minton, 2008) (Appendix-slide 6). Only recognised as an official diagnosis by the International Classification of Diseases (ICD-10) in 1998, its impacts on everyday occupations are subjective and no two individuals experience the CRF in the same way, making standardised assessments difficult. The impacts of fatigue outreach the individual concerned, increasing duties and responsibilities of carers, friends and family, therefore, it is an imperative OT role to assist, support and educate these individuals in the management of fatigue in a way that is constru ctive to them (Kealey and McIntryre, 2005). These are evident points within the case of Mrs A as she felt she had lost ability to engage in her artistic passion (La Cour et al, 2007; Townsend and Polatajko, 2007). Alongside policies and legislation, the application of the compensatory frame of reference and the Model of Human Occupation (MOHO) informs and directs OT practice (Turpin and Iwama, 2011; Kielhofner, 2008). The compensatory frame of reference applies to Mrs A as it aims to maximise her independence and enhance her quality of life. This is achieved by focusing on the management of her symptoms rather than the proactive treatment and cause, a notion that is synonymous with the values of palliative care. Being a practical approach it provides a basis for the fatigue management as it assists with the understanding of the concepts and an alternative method of participating in an activity, however this lack evidence (Duncan, 2011). Although the biomechanical frame of reference addresses occupational performance limitations through concepts of strength and endurance, aspects such as energy conservation could also be teamed with the compensatory frame of reference as a method of increasing the applicability to Mrs As situation and minimising the impacts of her fatigue levels on her occupational engagement (Duncan, 2011; Curtin, Molineux and Supyk-Mellson, 2010) (Appendix-slide 12). Again, similar to the philosophy of palliative care, the MOHO models holistic approach is centred on Mrs As needs (Kielhofner, 2008). Despite the MOHO model having an expansive evidence base and reportedly being the most extensively applied occupation based model in OT practice, there is little evidence base for its application within palliative care and CRF (Lee et al, 2008). Additionally, the models terminology can inhibit inter-professional working (IPW) within the multi-disciplinary team (MDT), therefore it was not applied in its entirety within the setting and the practice with Mrs A (Melton, Forsyth, Freeth, 2010). Furthermore, MOHO lacks the idea of spirituality, a contemporary concept within both OT and palliative care literature (GB. DoH, 2010; Belcham, 2004), and an aspect that is central within the Canadian Model of Occupational Performance and Engagement (Polatajko, Townsend and Craik, 2007). Nevertheless, the MOHO model provides understanding of Mrs As motivation for eng agement in occupation (Lee et al, 2008) and according to Kielhofner (2008) it addresses Mrs As volition, habituation, performance capacity, values, roles, culture and her occupational identity. These are all key areas that her CRF had impacted on and it aided identification of her difficulties and direction for intervention (Costa and Othero, 2012) (Appendix-slides 7-11). In order to assist Mrs A with her difficulties and implement an intervention, environmental and fatigue assessments were conducted indicating occupational imbalance, within her lack participation of drawing and fulfilment of her occupational identity (Whiteford and Hocking, 2012; Mackenzie and OToole, 2011; Creek, 2003). Being non-standardised both assessments lacked the underpinning reasoning for the application and meant that outcome measures would be more difficult to certify the effectiveness of the intervention, in terms of its effects on Mrs As quality of life (McColl, 2010). However it enabled the practice to be patient centred, qualitative and more flexible with no formal structure, which is imperative within the nature of end of life care and ensures interventions are meaningful to Mrs A (Fawcett, 2007). Completion of the assessments also supported the formulation of her aims, which were to manage her fatigue level in order to regain engagement in her former self, and partic ipate in drawing for her husbands Christmas present, therefore justifying the implementation of fatigue management intervention (Appendix-slide 14). Due to the nature of the service, assessments and initial conversations needed to be completed within a short amount of time, yet were aided by the fact that they took place within her home environment with her family present. Research has supported this concept as it provides a personalised and caring therapeutic environment (Meyers, 2010; Brazil et al, 2005), additionally achieving a patients preferred place of care has been highlighted as prominent need within national drivers. However in these circumstances interference from carers and family members or resistance to OT interventions as already in preferred place of care periodically inhibited full engagement in intervention (AOTA, 2008). Lowrie (2006) and Halkett et al (2005) reported that fatigue management, compromising of energy saving, adaptation of role, activity planning and prioritising techniques, is a commonly recommended intervention for and sought after by cancer sufferers in order to maximise quality of life (Hawthorne, 2010; The National Comprehensive Cancer Network (NCCN), 2009). Although Saarik and Hartleys (2010) study comprised of a four week programme based in a hospice day care, as opposed to within the community, it concluded patients reporting decreased fatigue levels, increased ability to cope and improved functioning post receiving fatigue management. Furthermore the NCCN (2009) has recognised the importance of CRF management and has guidelines recommending that integrative non-pharmacological interventions, including fatigue management are implemented with all individuals undergoing cancer treatment, not only palliative patients. Though its importance is highly acknowledged there are multiple studies indicating that cancer patients are not receiving the fatigue management intervention in order to meet their needs (Purcell et al, 2010). A study conducted in the United Kingdom, supports this concept, as only 14% of the 1370 of the participants with mixed diagnosis reported receiving fatigue management (Stone et al, 2003). Similarly in an American study of 814 participants, 23% suffering from CRF received management intervention (Henry et al, 2008). However extrapolation of the findings for this American studies small sample size would reduce its validity within the worldwide population and there may also be evidence of cultural nor m differences. Attributable to its recent development, the intervention lacks clarity and a structured evidence base, which is fundamental in assuring a rationale and clinical reasoning for its use within practice (Lowrie, 2006; Wratton et al, 2004). Additionally there is insufficient robust evidence and investigation into the interventions efficiency; however this does not certify the ineffectiveness of the intervention (Duncan, 2011). Alternatively the benefits of the fatigue management include that even minimal changes have positive impacts, its simple applicability and that it is highly patient centred, thus is tailored to Mrs As individual situation (Ream, Richardson and Alexander-Dann, 2006). Overall, literature, although limited, has found that fatigue management intervention has yielded positive outcomes for cancer patients where other conventional interventions have failed, justifying its application with Mrs A. As with many contemporary interventions, further research is required in order to secure effective clinical intervention and management of CRF (Mustian et al, 2007). This coincides with Bannigan et als (2008) statement of further development, which highlights research into the effectiveness of OT interventions is now a priority for OTs. While it is a common opinion that traditional rehabilitation based interventions generate few improvements in physical functioning and suggested as an unethical intervention for palliative patients, research has shown that it is appropriate at many points during the disease trajectory, improving self-efficacy, control and identity, therefore applicable to Mrs A (Guo and Shin, 2005; Eva, 2001). Engagement in occupations reportedly assisting with an individuals ability to connect with the purpose in life and enhancing spiritual wellbeing, quality of life and ability to cope with their situation (AOTA, 2008; Prince-Paul, 2008; Jacques and Hasselkus, 2004). The role of OTs in palliative care rehabilitation has been supported through national guidelines and literature; with NICE (2004) recommending and that all patients should receive a planned rehabilitation approach, including continuous assessment, goal-setting, care planning, intervention and evaluation to prevent loss of identity and poor quality of life. Despite this there is little guidance on how this is delivered in practice, resulting in settings lacking the right rehabilitation approach and consequently the case study setting displaying an absence of comprehensive evidence for its occurrence (Eva et al, 2009; National Council for Palliative Care (NCPC), 2006). Set within a community hospice setting the service provided to Mrs A was governed by the Care Quality Commission, equivalent to the NHS. However unlike the NHS, being an independent charity the hospice has a short organisational hierarchy, therefore limited layers of bureaucracy between the patients and their families, the health professionals and the leadership team. This means that the practice is not governed by such tight and mandatory restrictions and can be creative and adaptive to meet Mrs As needs. Although consequently, it is not so economically and fundamentally secure as a larger organisation like the NHS. Regardless of this it is imperative that service integration between the hospice and the NHS occurs and maintained to benefit Mrs As care. Furthermore, the small size of the organisation impacts upon its culture and enables opportunities for health professionals to undertake and be involved in service improvement and quality assurance activities, which attribute to both professional and personal achievements, furthering the quality of care provisions. Also, issues that are raised are rapidly and effectively examined by the directors with the patients needs central to all actions, instead of cost savings. Despite this, the importance of cost implications remain closely examined as being an independent charity, it is not funded by the NHS and crucial fundraising ensures availability of all resources, yet this can be difficult and precarious especially within todays economic climate. Due to the nature of Oncology and Palliative care being complex and demanding, many health professionals from differing disciplines have to work collaboratively in order to combine expertise and create a service effectively integrated to resolve Mrs As key areas of need, whilst making resources go further (Atkinson, Jones and Lamont, 2007; NCPC, 2006). According to NICE (2002) an integrated MDT and the occurrence of effective IPW is imperative to ensure seamless continuity of care, supportive and timely response to patients needs (WHO, 2012). Although the MDT within the setting for the case study lacked a dietician, therefore this role was split between all other health professionals, occasionally causing some duplicated information or gaps within service provision, being potentially detrimental to Mrs As health and wellbeing (Infante, 2006). Central to the idea of effective IPW is communication and due to the nature of the community setting, this can be made more challenging, with many health professionals on visits when their input is needed (Infante, 2006). This is exaggerated by many of the health professionals within the team working part-time hours. In order to overcome this and instil effective and efficient practice each day, a mandatory multi-disciplinary meeting occurred for all health professionals to discuss patients within their care. Overall the OT presence within the MDT team was well respected, other health professionals identified and recognised the core OT philosophy, which is indicative with end of life care in literature, and replicated in the reasoning for Mrs As referral. This concept was also readily recognised by the directors and replicated within the OT budget. However, regardless of this the OT practice and patient service was restricted due to limited OT professional hours, with recent audits indicating that organisational OT targets were not being met and highlighting the increased need for more OT hours within the caseload. Conversely, despite receiving a late initial phone call, Mrs As level of care showed no evidence of this occurrence, although it could have severely impacted upon her if she required additional input. Furthermore there was evidence of professional tribalism, as some protective professional relationships were formed, restricting effective IPW and efficiency of her care between t he MDT (Armstrong, 2007). Improved quality of life and engagement in meaningful occupations are primary outcomes of all OT intervention within palliative care (AOTA, 2008). In summary, the outcome measures used within the setting were limited, non-standardised, and based on patient feedback (Appendix-slide 18). Yet qualitative and centred around Mrs As the fulfilment of her occupational need and aims, by completing a drawing for her husband and remaining within her home. In addition to this, the fatigue management techniques were found to be transferable to everyday activities, thus Mrs A reporting improvements in her overall occupational participation, quality of life and consequently her wellbeing, therefore further justifying its use as an intervention (Cooper and Littlechild, 2004). Nevertheless within palliative care the importance of timeliness and an awareness of disease progression are crucial for both Mrs A and the OT, as it is evitable that Mrs A will develop further occupational deficits due to dis ease progression; therefore outcomes are short term and future positive or negative outcomes may not be a direct cause of the intervention (COT-HIV/AIDs, Oncology and Palliative Care Education, 2004). This may be fundamental in terms of patient satisfaction as to whether these aims are achieved and then lost again, or not achieved at all. In line with the importance of timeliness, is the concept that earlier referral to OT services would have restricted the degree of fatigue that Mrs A presented with and also the greater the impact of the fatigue management could have had on her quality of life. McLaughlin and Kaluzny (2006) recognised that patient feedback as an outcome measure is a fundamental part of quality and service improvements within care. Despite originally being a debatable concept, patient feedback has now become so well acknowledged that it has formed an essential part of health planning documents (Darzi, 2008). However due to this, it does not conclusively show financial benefits of the OT service, yet presents the importance of patient choice, quality of life and patient led care. Therefore a standardised outcome measure that could have been implemented to provide structure and improve OT practice whilst acting as an assessment, is the Model of Human Occupation Screening Tool (MOHOST). Implementing this tool would also embed the MOHO model framework further into the OT practice (Kielhofner, 2008). Being observational it wouldnt require input from Mrs A, therefore will not exacerbate her fatigue levels, although only gives the OTs perception of her difficulties . Additionally the Quality of Life questionnaire and the Fatigue Impact Scale, although not OT specific, could be implemented to provide clear areas of focus and as an outcome measure, as these are key elements of the purpose of OT intervention and palliative care settings (Pearson, Todd and Futcher, 2007). Utilising these assessments tools within OT practice would demonstrate both the benefits and the cost effectiveness of the OT intervention, crucial elements within a charity run organisation. To conclude, the role of an OT within palliative care is diverse and challenging, although ideally positioned to assist Mrs A in maximizing her quality of life and achieving her aim of drawing her husbands Christmas present (Kealey and McIntyre, 2005; Vockins, 2004). Achievement of this surrounds addressing her fatigue difficulties in a holistic, ethical and patient centred way, whilst having specialist knowledge of disease related problems within contemporary evidence based practice (Berger, 2009; Steultjens et al, 2004), a notion that has been acknowledged by both professional bodies and researchers (Oertli, 2007; National Breast Cancer Centre and National Cancer Control Intitiative, 2003).

Organizational Leadership versus Management Essay -- Leader Manager es

When in a leadership role I don’t like to consider myself as a boss, but a mentor. I don’t want my employees to see me as a boss but as a guide for further learning and success. Today’s managers are not leaders, they are people in charge and nothing more. They don’t necessarily have the skills to lead, don’t get me wrong they may be a very good manager. However, they are only managing and not setting an example as a leader for the employees of an organization. An organization has the greatest chance of being successful when all of the employees work toward achieving its goals. Since leadership involves the exercise of influence by one person over others, the quality of leadership exhibited by supervisors is a critical determinant of organizational success. Supervisors study leadership in order to influence the actions of employees toward the achievement of the goals of the organization. Supervisors can learn about leadership through research. One of the reading assignments said leadership studies can be classified as trait, behavioral, contingency, and transformational. Earliest theories assumed that the primary source of leadership effectiveness lay in the personal traits of the leaders themselves. Yet, traits alone cannot explain leadership effectiveness. Later research focused on what the leader actually did when dealing with employees. These behavioral theories of leadership would explain the relationship between what the leaders did and how the employees reacted, bot...

What Makes You Who You Are

The perennial debate about nature and nurture–which is the more potent shaper of the human essence? –is perennially rekindled. It flared up again in the London Observer of Feb. 11, 2001. REVEALED: THE SECRET OF HUMAN BEHAVIOR, read the banner headline. ENVIRONMENT, NOT GENES, KEY TO OUR ACTS. The source of the story was Craig Venter, the self-made man of genes who had built a private company to read the full sequence of the human genome in competition with an international consortium funded by taxes and charities.That sequence–a string of 3 billion letters, composed in a four-letter alphabet, containing the complete recipe for building and running a human body–was to be published the very next day (the competition ended in an arranged tie). The first analysis of it had revealed that there were just 30,000 genes in it, not the 100,000 that many had been estimating until a few months before. Details had already been circulated to journalists under embargo. B ut Venter, by speaking to a reporter at a biotechnology conference in France on Feb. , had effectively broken the embargo. Not for the first time in the increasingly bitter rivalry over the genome project, Venter's version of the story would hit the headlines before his rivals'. â€Å"We simply do not have enough genes for this idea of biological determinism to be right,† Venter told the Observer. â€Å"The wonderful diversity of the human species is not hard-wired in our genetic code. Our environments are critical. † In truth, the number of human genes changed nothing.Venter's remarks concealed two whopping nonsequiturs: that fewer genes implied more environmental influences and that 30,000 genes were too few to explain human nature, whereas 100,000 would have been enough. As one scientist put it to me a few weeks later, just 33 genes, each coming in two varieties (on or off), would be enough to make every human being in the world unique. There are more than 10 billio n combinations that could come from flipping a coin 33 times, so 30,000 does not seem such a small number after all.Besides, if fewer genes meant more free will, fruit flies would be freer than we are, bacteria freer still and viruses the John Stuart Mill of biology. Fortunately, there was no need to reassure the population with such sophisticated calculations. People did not weep at the humiliating news that our genome has only about twice as many genes as a worm's. Nothing had been hung on the number 100,000, which was just a bad guess. But the human genome project–and the decades of research that preceded it–did force a much more nuanced understanding of how genes work.In the early days, scientists detailed how genes encode the various proteins that make up the cells in our bodies. Their more sophisticated and ultimately more satisfying discovery–that gene expression can be modified by experience–has been gradually emerging since the 1980s. Only now is it dawning on scientists what a big and general idea it implies: that learning itself consists of nothing more than switching genes on and off. The more we lift the lid on the genome, the more vulnerable to experience genes appear to be.

King Kalakaua essays

King Kalakaua essays King Kalakaua was elected by the legislature in hawaii in 1874. He was so popular in the election because the sugar growers in Hawaii would benefit from him signing the reciprocity treaty if he became king. The treaty would allow them to export and import goods (mainly rice and sugar) tax free in Hawaii. The Hawaiian League was formed in 1887 composed of elite business men and sugar growers of missionary descent. Its primary goal was to eliminate the monarchy by further reducing the kings power. They desired an American democracy so badly that they forced the king to appoint a new cabinet consisting of members from the Hawaiian League. In that same year, Kalakaua adopted the Bayonet constitution because Lorrin Thurston , grandson of American missionaries, was the backbone for the revolution against the Hawaiian Monarchy. Lorrin and other American missionaries had a goal to (in their words) reform the monarchy. Thurston had a vision to change the Government of Hawaii into a democracy to protect and preserve the ways of the Hawaiians from other countrys invasions. The league had a vision that they would allow the king to remain in his current power except being limited to a new constitution of their making. Dethroning him would be a last resort, and only if he refused to comply. Many Hawaiian League members belonged to a volunter militia, the Honolulu Rifles, which was officially in service to the Hawaiian government, but was secretly the league's military arm. The league formed a military arm to protect themselves from any people who might damage the well being of the people in the league. Thurston desired justice from some of the ways of the Hawaiian people. They traded and freely smoked opium, had a corrupted government system because of it, drank and danced hula. Kalakaua was compelled to accept a new Cabinet composed of league members, who presented their constitution ...

Chemical Composition of Table Salt

Chemical Composition of Table Salt Table salt is one of the most common household chemicals. Table salt is 97 percent to 99 percent  sodium chloride, NaCl.  Pure sodium chloride is an ionic crystal solid. However, other compounds are present in table salt, depending on its source or additives that may be included before packaging.  In its pure form, sodium chloride is white. Table salt may be white or may have a faint purple or blue tinge from impurities. Sea salt may be dull brown or gray. Unpurified rock salt may occur in any color, depending on its chemistry. Where Does Salt Come From? One of the main sources of table salt is the mineral halite or rock salt. Halite is mined. The minerals in mined salt give it a chemical composition and flavor unique to its origin. Rock salt commonly is purified, since halite occurs with other minerals, including some that are considered toxic. Native rock salt is sold for human consumption, but the chemical composition is not constant and there may be health risks from some of the impurities, which can be up to 15 percent of the mass of the product. Another common source of table salt is evaporated sea water. Sea salt consists mainly of sodium chloride, with trace amounts of magnesium and calcium chlorides and sulfates, algae, sediments, and bacteria. These substances impart a complex flavor to sea salt. Depending on its source, sea salt may contain pollutants found associated with the water source. Also, additives may be mixed in with sea salt, mainly to make it flow more freely. Whether the salt source is halite or the sea, the products contain comparable amounts of sodium, by weight. In other words, one cannot be used in place of the other to lower dietary sodium. Additives to Salt Natural salt already contains a variety of chemicals. When it is processed into table salt, it may also contain additives. One of the most common additives is  iodine in the form of potassium iodide, sodium iodide, or sodium iodate. Iodized salt may contain dextrose (a sugar) to stabilize the iodine. Iodine deficiency is considered the biggest preventable cause of mental retardation. Salt is iodized to help prevent cretinism in children as well as hypothyroidism and goiter in adults. In some countries, iodine is routinely added to salt (iodized salt) and products that do not contain this additive may be labeled uniodized salt, Uniodized salt has not had any chemicals removed from it; rather, this means supplemental iodine has not been added. Another common additive to table salt is sodium fluoride. Fluoride is added to help prevent tooth decay. This additive is more common in countries that dont fluoridate water. Doubly-fortified salt contains iron salts and iodide. Ferrous fumarate is the usual source of iron, which is added to help prevent iron-deficiency  anemia. Another additive may be folic acid (vitamin B9). Folic acid or folicin is added to help prevent neural tube defects and anemia in developing infants. This type of salt may be used by pregnant women to help prevent common birth defects. Folicin-enriched salt has a yellowish color from the vitamin. Anti-caking agents may be added to salt to prevent the grains from sticking together. Any of the following chemicals are common: Calcium aluminosilicateCalcium carbonateCalcium silicateFatty acid salts (acid salts)Magnesium carbonateMagnesium oxideSilicon dioxideSodium aluminosilicateSodium ferrocyanide or yellow prussiate of sodaTricalcium phosphate

Is Hamlet a Tragic Hero Essay Example | Topics and Well Written Essays - 500 words

Is Hamlet a Tragic Hero - Essay Example According to Aristotle, there are six major elements required to make up a tragic hero – three character elements and three behavioral elements. To begin with, the hero must have a noble stature. He must also have excessive pride in some aspect of his being. Finally, he has to have a tragic flaw, usually something related to his source of pride. These three character traits combined lead the character to his or her downfall through a three-step process that comprises the behavioral aspect of Aristotle’s definition. This process begins with a mistake in judgment or action that will eventually cause the hero’s ruin. The second event is when the hero realizes where he made his mistake. The final event is the reversal of fortunes the hero experiences as a result of his mistake (â€Å"Aristotle†, 1998). With this definition in hand, it is easy to see how Shakespeare’s character Hamlet fits within this definition. Hamlet meets all three of the character requirements to be defined as a tragic hero. He is noble first because he is truly of noble blood being the only son of the reigning king and queen and second because he is dedicated to doing the right thing. Although everyone else has come out of mourning less than two months after King Hamlet’s death in honor of the new royal couple, Hamlet is accused of wearing black to seem more upset than the others, showing that he is still mourning the death of the old king which was only proper this early after he died. A lot of his inability to act throughout the play is based on this insistence that he act correctly rather than allowing himself to be fooled by the devil. Hamlet’s pride is in his intellectual abilities. However, his fatal flaw is in allowing himself to analyze a situation too much, which slows his actions considerably and provides his uncle with the knowledge that Hamlet suspects his actions. Hamlet also meets all of the behavioral requirements of Aristotle’s definition of

Environmental Economics Essay Example | Topics and Well Written Essays - 750 words - 2

Environmental Economics - Essay Example The article, Food Waste Is Becoming Serious Economic and Environmental Issue, Report Says, was authored by Ron Nixon and published in The New York Times on February 25, 2015. The article provides research findings on the huge impact of food waste on the economy and the environment. The figures used include United States wasting food valued at $162 billion and amounting to 60 million metric tons and that 1/3 of food produced globally is not consumed but end up as waste costing $400 billion annually. A reduction in food waste, according to the article of between 20 and 50 percent by 20130 would result in saving of between $120 and $300 billion annually (Ron, Par. 4). The article projects an increase of food waste cost to $600 billion if the problem is not tamed and links the contribution of food waste to climate change owing to the use of fertilizer, water, and land in vast amounts in food production (Ron, Par. 8). Food waste relates to global change through the decomposition in landfi lls resulting in the production of methane amounting to 3.3 billion metric tons in a yearly (Ron, Par. 9). That is 7% of world’s greenhouse gas emission only surpassed by China and the United States, depicted the high global warming effects it results and the cost in millions of food waste. The article then provides measures being taken to combat the issue of food waste including the provision of grants to consumers and local businesses and non-profits for recycling of food waste to compost in Hennepin County, Minnesota. Clarifying expiration dates, sale of small amounts of food, donation of excess food, and changing manufacturing processes are some of the measures being taken to reduce food waste. Economics plays an important role in the food waste problem where there is a demand for food with 870 million people going hungry while food is wasted in industrialized countries. The concepts of the scarcity of resources and distribution of wealth and resources globally