Special topics Essay Example | Topics and Well Written Essays - 500 words

Special topics - Essay Example While trying to maintain a balance with justice by providing food and medicine sources, peacekeeping and justice cannot work together in these instances. Bratt writes, â€Å"Although we may find that peace can exist without justice, there will never be justice without peace.† Through his extensive list of examples, Bratt proves this point. Justice is entirely dependent on the creation of peace in a state at war and cannot be executed correctly without peace. Bratt calls upon numerous examples to demonstrate his point. For example, the issue with picking a side to punish in the aftermath of war often encourages groups to keep fighting. The side that is punished is the result of a loss, not necessarily the group that committed the most atrocities. This also brings new challenges to justice seeking missions because supplying food, water, medicine, and even arms only perpetuates the desire to fight. Also, the image of imperialism can be seen through peacekeeping missions, especially with the presence of the Permanent Five many of which were once colonizers of areas with internal strife. Peacekeeping then takes on a whole new image and convolutes the issue between justice and peace even more. Bratt’s argument is convincing even though it advocates administering justice after peace. The question of preserving human life cannot be answered solely through the search for justice, but must be supported by a pact of peace between warring fa ctions within a country. The NIEO or New International Economic Organization was a product of the Second World War and the United Nations first attempt to address the issue of world economic inequality. The General Assembly convened in order to study the world economic problems especially the role of wealthier countries in the development or underdevelopment of smaller and economically inferior nations. The western world’s preoccupation with oil was a deciding force in the change of ideology behind the

Educational Coaches Essay Example for Free

Educational Coaches Essay Educational or instructional coaches – also called â€Å"master teachers† – in elementary and secondary education are facilitators who train other teachers to improve instructional practices and generate higher levels of student achievement (Buly et al, 2004). Specifically, they are trained to serve as support for schools and districts experiencing â€Å"market failure;† i. e. , that have large numbers of students unable to meet state and federal achievement standards (Buly et al, 2004). This document is written as an outline to provide qualitative and quantitative evidence (in economic and real terms) that justifies educational managers (elementary, middle and high school principals, superintendents and school board members) utilizing educational/instructional coaches to achieve the following goals: (1) improving aggregate output through schools’ and districts’ overall level of student achievement on state- and/or federally-mandated testing, and (2) improving micro-level behavior through resource allocation, individual classroom management, implementation of learning strategies and instruction of subject matter. The following is a summary of the main points of this document: †¢ Discussion of what educational/instructional coaches are and their estimated microeconomic impact on students’ and teachers’ performances †¢ Discussion of district and schools’ economic costs and factors including fiscal policy, funding sources, overall output and the impact of budgetary decisions such as hiring educational/instructional coaches †¢ An econometric case study: regression analysis of schools in Duval County Public Schools in Jacksonville, Florida that utilize educational/instructional coaches Definition The field of education, unlike some markets, is not perfectly competitive. Individual buyers (students) and sellers (teachers) do have the ability to significantly influence the cost and quality of education. Consequently, educators continuously strive to make the educational marketplace more efficient and productive; i. e. , they search for methods and tools that improve the process of and environment for learning and address the diverse and changing needs of teachers and students. Unfortunately, the field of education is constrained by limits, and the equitable and efficient distribution of income (state and federal funding) and other resources (teachers) remains an issue that managers (educational administrators such as superintendents, school board members and principals) must address annually. In 1989, an educational organization called the National Center on Education and the Economy (NCEE) developed America’s Choice, a school design model based on high quality instructional materials, technical support and professional development for teachers (NCEE, 2009). Educational/instructional coaches are a central component of America’s Choice (NCEE, 2009). The goal of this paper is to determine whether or not educational managers are making the most fiscally responsible decision when hiring educational/instructional coaches to meet district- and school-based needs. While educational/instructional coaches are an often-used solution in some school districts, managers have other alternatives available to provide support to teachers and students in the classroom. These options utilize different methods of resource allocation. One alternative to â€Å"classroom coaching† is making capital improvements. An example of a capital improvement is upgrading a district’s and/or school’s technological infrastructure. This would involve purchasing computers and/or networks with more memory and larger capacities for data storage and manipulation, increasing the value and useful life of a district’s or school’s technological infrastructure. This could also involve purchasing software such as web-based educational tools for both students and teachers to use. Another option is additional training for teachers through in-service workshops (training provided during the school day) or additional education courses (college and/or university level). A third alternative is realignment of the student-teacher ratio based on aggregate demand; i. e. , the total demand (number of students) for goods (teachers/classes) and services (instruction) in the educational market (classroom). A fourth alternative is awarding financial bonuses to teachers with high or greatly improved student achievement rates. Educational/Instructional Coaches: Their Economic Costs and Factors When evaluating the benefits of using educational/instructional coaches, educational managers must ask themselves, â€Å"What are the accounting and opportunity costs of this decision? † In other words, managers need to determine expenses like salary, benefits, health insurance for the educational/instructional coaches; they also must construct the benefits of other educational options. According to payscale. com, a global, online compensation database, the average salary for K-12 public school teachers in the United States is $42,000 annually for a nine-month school year (Payscale, Inc. , 2009). Educational coaches are often at the top tier for teachers’ salaries and make on average $52,000 each year (Payscale, Inc. , 2009). Thus, the opportunity cost of hiring an educational coach at a school is, on average, $52,000 annually. An educational manager have an additional $52,000 (plus the cost of insurance and benefits) within his/her budget to invest in computer hardware, software, training for existing teachers, or actually hiring a new teacher (thereby reducing the teacher/student ratio). If a school principal hired more than one educational coach – many schools have one for every major academic discipline – the costs would be even greater. Across a school district, the aggregate costs would be much larger. For example, Duval County Public Schools is a school district in Jacksonville, Florida, has 160 schools, and uses America’s Choice, employing educational coaches at all 160 schools (Duval County Public Schools, 2009). At the very least, Duval County Public Schools’ accounting cost for hiring 160 educational coaches would be (on average) approximately 8. 32 million dollars annually, not including benefits and insurance. While educational managers must consider costs, they must also contend with economic factors. There are a wide range of economic factors that affect educational managers’ ability to hire educational coaches. Some of the most important are federal and state government policies, school district management, taxation, and student achievement levels. Before educational managers can make hiring decisions, school districts must meet state and federal approval through accreditation (Duval County Public Schools, 2009). Accreditation is the process by which â€Å"an official body gives authority to something when recognized standards are met† (Lindberg, Ed. , 2004, p. 8). The governing body for public schools in the southern part of the United States is the Southern Association for Colleges and Schools (SACS). In October 2008, SACS awarded Duval County Public Schools full accreditation, which indicates the district complied with meeting state and federal standards for student achievement (Duval County Public Schools, 2009). Schools must be accredited to hire new staff. Thus, the accreditation process was necessary before educational managers could hire educational coaches. Another factor affecting the hiring process is district management. Before principals can finalize hiring any new educators, including educational coaches, the new hires must be approved by the school board (Duval County Public Schools, 2009). The school board is â€Å"a local authority responsible for the provision and maintenance of schools† (Lindberg, Ed. , 2004, p. 1220). In Duval County Public Schools, for example, the school board must vote on whether or not they approve principals hiring educational coaches. Another factor affecting the hiring of educational coaches is funding. Funding for school districts is a fiscal policy issue and comes from a combination of local, state and federal sources (Howell Miller, 1997). Local funding is generally financed by property taxes (Howell Miller, 1997). State financing is generally through sales taxation (Howell Miller, 1997). Both local and state taxation are affected by state policy decisions and voting decisions of the population (Howell Miller, 1997). For example, a governor may issue a proposition to reduce property taxes across a state. If the population votes to accept the tax reduction, the funds available to make hiring decisions are reduced. While federal monies are financed through national income tax, these come to schools and schools districts via an assortment of federally mandated programs, often for at-risk student populations (U. S. Department of Education, 2007). For example, No Child Left Behind (NCLB) is the most recent federal education legislation. Enacted in 2001, NCLB is an initiative of former U. S. President George W. Bush and it authorizes the distribution of educational grants for low-income students, textbooks, professional development for educators and more (U. S. Department of Education, 2007). Often a school’s student population determines how much and if that school can receive federal funding (U. S. Department of Education, 2007) Thus, government policy decisions at the local, state and federal levels affect educational managers’ decisions to hire educational coaches. A final factor that determines whether or not educational managers hire educational coaches is actual student achievement. If a school has a significant number of students not meeting state and federal achievement standards, educational managers seek solutions through options like educational coaches. For example, in Duval County Public Schools, William M. Raines High School has a student population characterized by low-incomes and low test scores (Duval County Public Schools, 2009). The school district also contains Stanton High School, rated

Wal-marts foreign entry

Wal-marts foreign entry WAL-MARTS FOREIGN ENTRY IN GLOBAL MARKETS The phenomenon of globalization has determined many firms to spread out to overseas markets. The purpose of this paper is to examine the firms strategies for new market entry and the major issues they need to deal with while entering into new foreign markets and Wal-Mart is utilized as an example. During this expansion, some firms succeeded and some failed also. Wal-Marts entry into the foreign market and its operations in the China and U.K where it was successful are examined and it can be inferred that the cultural differences and the political influences play a vital role in selecting entry mode and setting operational strategies. Also, In order to understand the failure in German retail market amongst many, the following influential factors will be considered that Germany has different culture and consumer behaviour, oligopoly market environment, unfavorable legislation and influential labour union. Additionally, this entry and exit of Wal-mart affected, inevitably, other countries and most of the competitors in many aspects. In the domestic market of U.S, Wal-Mart has a considerable success. Since Wal-Mart began international operations in Mexico in 1991, it has violently expanded foreign investments all over the world, including Canada, Latin America, Europe, and the Far East. Wal-Mart expanded its international operations such as in the United Kingdom, South America and China where its going highly successful, whereas in South Korea and German markets its operations were unsuccessful and it was forced to pull out of these markets mainly due to sustained losses in an incompatible culture and highly competitive market. However, Wal-mart failed to position itself when trying to penetrate the German retail market through replicating its US strategies. Initially, firms should have a clear purpose for expanding overseas. Firms tend to go international for many different reasons, for example, firms may be interested in structuring a global brand image, the home market may be saturated, external initiatives to spread the product, or grabbing more market share etc. Prior to entering a particular foreign market, firms need to look upon the consumer purchasing power, market size, entry barriers, political stability and cultural and language differences. Culture plays an essential role in shaping whether a firm can last in a foreign market. Consumers in different cultures may have different attitudes toward the same product and may value things differently. Therefore, international managers should take into account the cultural factor carefully in decision-making. Furthermore, Psychic distance also requires being carefully addressed in the market selection stage. Psychic distance is defined as factors precluding or disturbing the flows of information between firms and markets in terms of differences in culture, language, political systems, levels of industrial development, etc (Johanson and Wiedersheim-Paul, 1975). Theoretically, firms have a tendency to penetrate the psychically close market to moderate risk. Wal-Mart Stores, Inc. (Wal-Mart) is the worlds biggest American retail corporation in the world. Wal-Mart is a company which is renowned for its influence on US government. Wal-Mart has a friendly legislature and government policy in accordance to its company policies and method which indeed helps them to achieve goal such as limiting port security, the elimination of the estate tax, restricting tariff protections and obtaining lucrative subsidies. According to survey Wal-Mart has received 1.2 billion from US government in form of subsidies, grants and fund. Following are few examples that shows how US government helped Wal-Mart in US: More Than $1 Billion from tax-payer funded Subsidies. A May 2004 report analyzed how more than $1 billion from over 244 taxpayer-funded subsidies status, general grants and job training/recruiting funds is received by Wal-Mart. Millions To broaden the Street to its Headquarters. In2005, to broaden Eighth Street in Bentonville which goes to Wal-Marts corporate headquarters, a federal highway bill was signed by President Bush of $35 million. Employing Teens in Unsafe Conditions. An agreement was signed by the Wal-Mart with the Departments Wage and Hours Division about future child labor conditions that the teens aged 16 and 17 are prohibited to participate in activities Negotiating for Weak Enforcement. The conduct of an audit by the (OIG) of the child labor found an agreement among Wal-Mart and the Department of Labor that prove serious collapses in the WHD [Department of Labors Wage and Hour Division] process for approving, developing and negotiating such agreements. These consequences in the WHD gave substantial concessions to Wal-Mart, while entering into an agreement. In the early 1990s, Wal-Mart was enforced to expand its business into the new foreign market due to critical U.S market conditions. Firstly, In the US it faced market saturation. Wal-Mart comes up with 200 new stores each year and this fast expansion results in the short distance between its old stores and new stores. Further, the retail price difference between Wal-Mart and its key competitors has been lessened so consumers had little incentive to go to Wal-Mart. Therefore, rather than summing up the market share from its competitors, the new stores in fact gained the market share from its old stores. Finally, the progress in demand was declining because of the decreasing family sizes in the U.S. (Kim 2008) . Taking into account, all these factors, the international expansion appears as a prior strategy for Wal-Mart to promote its business growth. Wal-Mart initiated to expand internationally in 1991 with the creation of a joint venture with Citra, S.A. de C.V, Mexicos largest retailer. According to the Wal-Mart they promote its growth internationally because â€Å"We need to be the growth of Wal-Mart some day when the United States slows down† (as cited in Molin, 2004). The company feels the international market as a alternate when there was limited growth in the US. After creating a joint venture in 1991, Wal-Mart came out as a large international player and within one and half decade it expanded its operations in globally in many countries. Wal-Mart did not use single strategy to enter in different countries. They decide on the basis of the business, competitive and economic environments that exist in. Wal-Mart made its presence in local markets by first considering the uniqueness of each market, and then by altering its business model to suit that market. After choosing the country like China, the management makes the decision after analyzing the environment that seemed to be positive in China. The China is a country with a history of tremendous level of 1.3 billion population. In China , the governments liberalization initiative and its open policy increased disposable income of consumers because of limited competition offered by similar business models its high constant economic growth and. The retail sale in China is $1.2 trillion in 2007 and the growth of market is expected $ 2.4 trillion by 2020, which indicates that there is a big opportunity for the company. These factors attracted the Wal-Mart company to research and make their presence in China. In 1996,Wal-Mart entered China and it grew slowly. Some people pointed out on its slow growth, but according to me, the strategy of slow growth helps the Company to examine the environment in a completely different culture with regard to US. Wal-Mart had taken up those merchandising and store designs that suits the Chinese consumer requirements best. The company also tries to adopt the local culture and sourced the products from local manufactures who are familiar with the local taste of the people. Company also met the government trade and business guidelines, by adopting such type of the environment it helped the company to grow and launch its expansion plans in China. Wal-Mart is getting involved in the local community such as by participating in CSR- corporate social responsibility .It is also participating in the society by donating the funds and providing the kind support of $ 8 million over the past 13 years. All such awards achieved by the company itself show its achievement in China. Another issue that contributed to Wal-Marts success in China, was labour unionization. At first, Wal-Mart was reluctant to support the idea of unionization, but the constant efforts of All-China Federation of Trade Union led to formation of union amongst Wal-Mart employees, which has contributed positively to its success. Currently, Wal-Mart carries on 7,873 stores worldwide in 15 countries among which 3,615 stores in the foreign countries and remaining in the US. Moreover its international segment gives 24.6% of the companys total revenue in 2009 fiscal year. (Global Market Direct, 2009) However, even with such enhanced international sales, Wal-Marts international division is still far away from its one-third of total sales goal, which it was essentially expected to achieve by 2005. (1999 Annual Report) If we analyze Wal-Marts international business, we will find out a mixed story. It had substantial success in Canada, China, Mexico and the United Kingdom, but it was unsuccessful to place itself in Germany and South Korea. Wal-Mart was leading retailer and employer in US for last decade. There were more than 5000 stores in US itself. This made easier for the firm in structuring a good brand image in spite of offering cheap products. Due to its knowledge, low pricing, strategic resources, geographical presence, strategic investment, product differentiation and managerial excellence, the firm constantly had an upper edge on its competitors and generally drives them out of the business. Further reasons for Wal-Marts success was its elite relations with bureaucrats and government. Government policies usually were in harmony to Wal-Mart business and strategies. Wal-Mart had many weaknesses and pit holes also despite of being worlds no. 1 company. Wal-Mart was always criticized for poor labour practices by labour unions. In US the average salary per hour is $ 13 where as in Wal-Mart the lowest salary rate is US$ 9 per hour. Employees have prolonged working hours around ten hours a day. Further Wal-Mart is charged for adopting the tax avoidance schemes. It has also build a great reputation for destroying small and medium business. Therefore its never greeted in any society. The main weakness of Wal-Mart has been its international operation. It struggled to create a great mark in international market especially in Germany unlike America. It has been losing money from the year it penetrated German market. It has also been found that in some cases those inferior quality products are being sold because of discounted price. As a result consumers who are not price elastic have a preference over other brands. It also bears the huge labour turnover, about 44% employees leave Wal-Mart every year according to the national survey. These were some major weakness that the firm desires to come up in near future for its survival and sustenance. A number of factors that resulted Wal-Marts failure in Germany are such as different corporate culture, political influence, stiff competition and inefficient management and marketing strategies. Firstly, David Wild CEO in 2004, believed that cultural differences between American and German consumers were considerable challenges to Wal-Mart. Debby CEO in 2006 concluded that German shoppers are accustomed to shop at small scale discount stores such as Aldi and Netto that provides a limited range of products with special offers each week and no customer service, unlike US customers. In addition to different corporate culture, the competition has become gradually more intense between Wal-Mart and domestic retailers. The price difference has so lessened that sometimes even Wal-Mart had a higher price than their competitors. Consequently, consumers had little incentive to visit Wal-Mart Germany because of no obvious price advantage. Some other factors that lead to Wal-Marts failure in Germany were, their strategy of acquiring the top competitor did not work, as the German government did its best to ensure the welfare of the domestic players. Also, due to wage restrictions, Wal-Mart could not practice wage bargaining, as it did back in U.S, this was a huge, uncommon expenditure for the company. Its American strategy of restricting employee freedom and forcing them to work extra hours, brought up problems of high labour turnover and a negative image as an employer. Wal-Mart failed to have an effective management at the top level. Its CEOs changed every year,this in an obvious way effected the companys performance. Wal-Mart constantly ignored the strictness of German laws, and was charged heavy penalties for doing so. One of the most challenging thing for Wal-Mart was capturing the market- share. As per German legislation it was illegal to sell products below cost,because of which Wal-Mart could never achieve the à ¢â‚¬ËœLow price leader tag. It is impossible to smoothly run any organization, until there is co-operation between the employees and the employer. Wal-Mart faced a severe labour unrest,which hampered its brand-image. Kay Hafner,CEO of Wal-Mart reduced the wages to cut cost, this negatively influenced individual behaviour , as an anti-union decision. As suggested by Arndt and Knorr, a firm needs to understand the specifications when indulging in global expansion.Out of all the CEOs, only David Wild has been sensitive to cultural difference.He did bring about changes based on this understanding,which had some positive results,yet not profitable enough to impress investors for future investments. Moreover,as per German legislation their were some specific retail related laws,such as, limited legal working hours (80 hours/week) which were way less than the other European countries and had strict rules governing closure on Sundays and holidays. Wal-Mart repeatedly infringement German laws but were able to do away with it mainly because of global presence and influence on the government of US which played a major role in global politics. Some of incidences where the company broke few laws and was able to get away are summed up below:- ‘unfair trade practices such as selling goods below the cost price was prohibited in Germany but Wal-Mart was found violating these laws as it randomly sold some product below cost. German law required a company to disclose it financial statements annually, Wal-Mart seldom did that and was spared without any fine or legal proceedings at number of occasions. Obligatory Deposit Regulationdings law stipulated the retailer to provide deposit-refund-system on few products like metal beverages, cans etc. But Wal-Mart never followed this law. Thus from the above incidences it can be concluded that Wal-Mart used its global influence to refrain from some of the German laws. However, because German culture is quite different from American culture and because of unfamiliarity with the legislation, it would be difficult for Wal-Mart to make marketing and promotion right. And in fact these difficulties had been proved in Wal-Mart Germany. Consequently, rather than choosing Germany as the gateway to Europe, virtually after two years of operating in Germany it had entered in U.K .Even though U.K is not in the Euro zone and its geographic location is less favorable than Germany, it has a similar culture and legal environment as U.S. which makes it easier to operate the companys business and strategies. It has considerable success in the UK market which is called by as a ‘Wal-Mart-ready market[palmer 2005] .Therefore, the lessons learned from from Germany has proven useful for U.K. In the United Kingdom, Wal-Mart operates under its distinct organizational culture ‘the Wal-Mart Way, where executives act as servants and employees are known as ‘associates. Associates are empowered to adapt to local culture and are encouraged to try out new ideas. Consequently, associate cohesiveness is strengthened, and they are willing to work hard to achieve the best results. In addition, satisfying customer needs is always placed as main goal of the company. The company aims to offer British families the things they need at affordable prices, as well as providing superior customer service and convenience. Needless to say, Wal-Mart did face challenges initially even in U.K. The British Planning Policy(PPS6) has clearly limited the construction of huge retail outlets on the outskirts of a town, which was one of its most effective strategy in the U.S According to PPS6,the local governments were required to do so until there was a call for .Wal-Mart responded to this situation by protesting the restrictive policies to the top government officials. Eventually, Wal-Mart acquired an existing retail chain ASDA, and this proved to be fruitful as it served as the best strategic fit between the companies. In the UK, ASDA was the only operator with a consistent non-food offer and Wal-Marts organisational culture had already incorporated into ASDAs management principles before the acquisition taken place. Based on the above examination of Wal-Mart, it can be concluded that Wal-Mart possessed a great influence on the US government and it used its great influence to get various tax reliefs, subsidies etc and when it entered other countries like UK, China and Germany etc, it followed the same policy to influence the government and capitalize on these relationships. Besides that there were few incidences in which the US government helped Wal-Mart in its international operations and having good relations with the foreign government which brings about the companies involvement in global politics, which is the essence of the report. However,while expanding globally Wal-Mart besides carrying all these good relationships still had to confront with the cultural, political and the other economic factors when it entered in the foreign markets because Wal-Mart to be successful only transports its domestic policy to global markets. No such one strategy or model is applicable which is appropriatefor all the markets. Consequently ,Wal-Marts US model cant be consistently applied in other countries, even in UK whose culture is very alike to that of the US. Hence, adaptation to local culture and familiarity with its legislations is a crucial step for Wal-Mart or any firm while entering to the global markets. Therefore, Firms should always make cultural and political considerations as a part of strategic planning, and locating activities in countries that possess these attributes necessary for competing in these activities of foreign entry. REFERENCES IGO Retail Analysis. (2009). â€Å"Company Summary-Introduction: Wal-Mart.† [Online] Available from: http://www.igd.com/analysis/channel/profile_detail.asp?channelid=1channelitemid=27profileid=1541 [Accessedï ¼Å¡2 November 2009] John Robin, Cox Howard, Grazia Letto-Gilles, Grimwade Nigel, Allen Michael, Finn Edward (2002), Global Business strategy. Thomson Ricker (2007) â€Å"Internationalization Theory†, http://www.studentbibliotek.se/doku.php/internationalization_theory Problems in international market, patiporn kitlertphiroj, University college of denver) Landler, M. and Barbaro, M., (2006). â€Å"Wal-Mart finds that its formula doesnt fit every culture.† The New York Times, August2.2.pp.1-3[online] Available from: http://www.nytimes.com/2006/08/02/business/worldbusiness/02walmart.html?_r=1 Wal-Mart (n.d.): 3 Basic Belief Value,[online] Available from: http://walmartstores.com/AboutUs/321.aspx [Assessed: 25 October 2009] Eurofood (1999), Wal-Mart buys Asda in UK retail shock, http://findarticles.com/p/articles/mi_m0DQA/is_1999_June_17/ai_55041044/ Knorr, A. And Arndt, A. (2003), â€Å"Why did Wal-Mart dail in Germany†, available at: http://www.iwim.uni-bremen.de/publikationen/pdf/w024.pdf(accessed November 3, 2009). IGD Analysis (2005): Chinese Wal-Mart chant gets louder. [online] Available from http://www.igd.com/analysis/news/index.asp?nid=2094 [Accessed online: 2 November 2009] Christopherson, S. (2007). â€Å"Barrier to ‘US style lean retailing: the case of Wal-Mart failure in Germany.† Journal of Economic Geography, Vol. 4, No.7, pp.1-19 http://walmartwatch.com/blog/archives/secret_meeting_details_confirmed_wa_mart_lobbied_uk_government/ http://www.politicalaffairs.net/article/articleview/4737/ http://joeg.oxfordjournals.org/cgi/content/full/7/4/451 http://walmartwatch.com/issues/political_influence/ http://www.examiner.com/x-21521-Huntington-County-Political-Buzz-Examiner~y2009m11d28-Wal-Mart-does-again-this-time-in-Canada (http://www.themanagementor.com/kuniverse/kmailers_universe/mktg_kmailers/wal-mart.htm) (http://en.wikipedia.org/wiki/Wal-Mart) http://www.fundinguniverse.com/company-histories/WalMart-Stores-Inc-html)

This Fad?s Gotten Out of Control :: essays research papers fc

In America, 10,250 people died from skin cancer this past year, according to the American Cancer Society. Skin cancer, the most common of all cancers, accounts for nearly all cancers in the United States. Over one million cases are diagnosed in this country each year (Johnnie).   Ã‚  Ã‚  Ã‚  Ã‚  The reason for all of this? UV exposure. America’s value of life is very high, yet many people die just because they are not wise enough to keep out of the sun.   Ã‚  Ã‚  Ã‚  Ã‚  The greatest danger from this problem is faced by teenagers. Studies have shown that among artificial tanners, those who started at an early age are more likely to develop skin cancer. Out of high school-aged girls, 51 percent reported using a commercial tanning bed at least four times in the past year (Perron). The fact of the matter is younger people do not have the foresight to realize that being tan isn’t worth the sometimes fatal after-effects.   Ã‚  Ã‚  Ã‚  Ã‚  The social desirability of a tan is a modern phenomenon, beginning in the 1920’s when the French designer Coco Chanel decreed it as a fashion look. The concept of obtaining a tan without going outdoors became increasingly attractive (Aldige). Today’s media influences everyone, but especially young people, to feel like they need to have that beautiful dark skin color to look good. Teenagers, caring more about their social status and appearance, are looking past the obvious risks of skin cancer. Teenagers ages 12 to 17 are visiting tanning salons in record numbers. This trend presents a huge level of concern, as studies have shown that the risk for skin cancer increases when tanning begins at a younger age. With this fad being so popular, teens are always finding themselves at the tanning salons, becoming nice and crispy.   Ã‚  Ã‚  Ã‚  Ã‚  The best way to keep everyone from this fatal cancer is by completely not allowing teenagers below the age of 18 to ever go to a tanning bed. There have been several other health risks that have been legislated against, such as smoking, drinking, and using seat belts. Why not tanning? We need to make it completely illegal for kids with such delicate skin to go fake-baking. Before the age of 18, teenager’s brains are not mature enough to make wise decisions about something that could greatly affect their lives.   Ã‚  Ã‚  Ã‚  Ã‚  Some would argue that they can still go out in the sun and get skin cancer. Experts agree that sunburns are caused primarily by exposure to UVB rays; however, UVA rays do not burn, but actually may do more harm.

The anesthesia technician & technologist’s manual: All you need to know for study and reference Essay

Improvements of Anesthesia Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   From nineteenth century, there have been important and continuous improvements in the field of medicine in United States, particularly in discovery of microorganisms as the root cause of disease and anesthesia. The improvements have been of great importance in facilitating effective, convenient, and safest methods of treatment. The paper below discusses anesthesia improvements, and importance of its improvement in treatment. Improvements of anesthesia   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The direct use of volatile anesthetics and intense cold were the most important steps in anesthesia in nineteenth century. The steps were used in surgical sites during treatment of traumatic injuries. This was possible by bringing down local temperature of body tissues by the application of salt and ice during the surgeon. However, to estimate the cold projection was extremely complex when using salt and ice. This gave rise to new techniques such as topical application of Dutch oil and vaporization of ether and ethylene chloride by fumigation and spraying. Since then, there was continuous discovery of more anesthetic liquids such as amyl hydrate and vaginal Dutch. Having improved the anesthetic liquids, there was a major challenge in obstruction of sprays used. As a result, there came need to improve the jet, which was possible by designing different systems of nozzles. Almost to the end of the century, some medical practitioners recommend ed the improvements best for surgeon but many individual called for alternative approach, especially in minor surgery (Walter, 2014).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   All the way from 19th century to transition into the twentieth century, there have been many improvements of anesthesia care (Woodworth, 2012). For instance, the common practice discussed above changed by introduction of cocaine around 1884.Later in 1934, the sodium Pentothal was introduced for intravenous anesthetic administration. Despite its many challenges associated with its negative side effects when administered to some patients, it remained the most effective until 1977 when Dr.Brian Kay introduced muscle relaxants and rubber endotracheal tubes. In 1980s, pulse oximetry and end tidal CO2 were introduced that facilitated EKG monitoring. Use of the improvement in medical practice today   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Some of above discussed improvements are still used across the United States. For instance, the improvement of EKG monitoring makes it possible to manage neuromuscular blockade .In addition, the use of muscle relaxants and rubber endotracheal tubes makes it easy for anesthesiologists to monitor the condition of the patient .The monitoring of the patients’ condition primarily involves checking of blood pressure as well as pulse rate. Being able to process EEG measurement, end tidal CO2 and pulse oximetry have made it possible to quantify the depth of anesthesia. The monitoring incorporated with some of discussed advances has led into the best anesthetic practice by improving patient’s safety.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Indisputably, there is significant from the use of advances though some of the anesthetic practices used today for surgery have changed tremendously. Unfortunately, while bringing the changes in transformation of anesthesia surgery, the dramatic change in body knowledge and skills developed from the improvements has resulted to inseparable and complex medical disciplines. Future developments in anesthesia   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Aside from the above important improvements discussed such as introduction of pulse oximeter in aesthesia practices in United States today, there are many cases of mortality and morbidity in anesthesia. It is therefore obvious that the discoveries are not the â€Å"end of the road† but the push to new heights .However, with improved, optimal, and creative anesthetic management evident in United States ,there is hope of continued improvement to develop most safer and effective anesthesia practices while cutting down the pressure from medical economics. This will only be possible if anesthesiologists rise to the challenge. References Walter. (2014). In Encyclopedia Britannica. Retrieved from http://www.britannica.com/EBchecked/topic/482821/puerperal-fever Woodworth, G., & Kirsch, J. (2012).  The anesthesia technician & technologist’s manual: All you need to know for study and reference. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Source document

Money or Family Values First Which Way to Go

Money or Family Values First Which Way to Go The fast paced life and major shifts in socioeconomic front witnessed in the 21st century has necessitated major re-alliances and re-alignments of what people consider important for their wellbeing and survival. Advertising We will write a custom essay sample on Money or Family Values First? Which Way to Go specifically for you for only $16.05 $11/page Learn More Principles and philosophies that not so long ago served to preserve the social fabric have been discarded, and their place taken by the inordinate self-directed obsession of monetary and wealth accumulation that is characteristic of most people living in this generation. While money and wealth accumulation are valid indicators of economic progress, the methodologies and strategies that are employed to gain them continues to raise more questions than answers. Today, more than ever before, people have become increasingly obsessed with their work for purposes of accumulating more wealth to an extent t hat family and societal values are relegated to a distant position in the hierarchy of needs perceived to be of importance. It is against this background that this paper purposes to evaluate by comparing and contrasting the various factors and issues that will assist us to understand what, between money and family values, should be of primary importance. It is indeed true that the dream of nearly everyone in this world is to become financially independent and happy, and money is largely viewed as the only silver conduit to financial freedom and enjoyment of life. However, it must be said that this kind of thinking is grounded on misconstrued facts and perceptions that only borders the bizarre. The foremost requirement for individuals aspiring to become financially stable and lead a happy life is to learn how to spend and save the money accrued over their lifetimes and, more importantly, how to invest the financial resources to attain stability. These valuable lessons are best inte rnalized at the family level, and family values play a significant role in molding the principles and perceptions of how young children will utilize their resources later in life depending on what they learn from their parents and older siblings. If the parents are careless with how they spend their money, chances are that the children will internalize that in their value system and will likely become careless spenders later on. As such, family values becomes the epicenter of shaping individual behavior and actions towards the attainment of a certain good, while money assumes the position of facilitating the attainment of a certain good such as that of becoming financially independent.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More Establishing strong family values undoubtedly creates a foundation which permits people, especially young children, to make wise choices on their own. In deed, the values espoused at the family level not only acts as a moral guide to the members of a family, but also functions as the cornerstone of their own conscience. It is primarily the family that functions to instill such values as integrity, respect, forgiveness, self-discipline, and honesty, among others. In the absence of these values, money looses its place in making our lives more fulfilling by virtue of assisting us to meet our needs. Money, in its holistic form and nature, can neither be used to buy the values that are so fundamental to our very own existence such as self-discipline and honesty nor can it be used to buy some states of wellbeing such as happiness and health. For instance, movie celebrities are not only known for their fat wallets and fame, but also for their erratic behaviors such as drug abuse, law-breaking, and high-level divorces. On the contrary, the internalization of good family values into people’s lives allows them the opportunity to use money to enhance the attainment of states of wellbeing that guarantee happiness and health. As such, money assumes a secondary role of making our lives more fulfilling, and may indeed miss out on playing such a role in the absence of good family values. In line with the above, family values helps us discern what is good from the bad, and offers us the opportunity to develop our feelings of self-worth and identity. However, character and self-worth cannot be measured or evaluated in terms of dollars or monetary predisposition. It is true that money can bring security and comfort, but this should not be misconstrued to imply that an individual with lots of money is valued or evaluated using the monetary yardstick. For example, drug lords and bank robbers have a lot of money, but certainly aren’t perceived as people of upright moral values by individuals who know what they do. The fact that society defines people by their actions and behavior, not by their wealth, therefore ass umes a paramount role in this discussion. Certainly, the family is one of the most essential facets of an individual’s life, and the values transferred to the individual by the family institution define his self-worth and identity. As such, it is important to first entrench responsible actions and behavior at the family level before thinking about what money can do to transform lives in ways such as getting a good education, donating to charity, or establishing a business venture.Advertising We will write a custom essay sample on Money or Family Values First? Which Way to Go specifically for you for only $16.05 $11/page Learn More It can be safely agued that family values assists individuals to develop their own world views in ways which money can possibly never achieve. The worldviews that people form are basic to their very own existence since they helps them traverse various life challenges by formulating strategies and frameworks for proper conf lict resolution and coping mechanisms. It is universally agreeable that a weak, negative, or disjointed worldview only serves to occasion more problems that cannot be solved by the financial capability of an individual. For example, Mike Tyson was a great and astute boxer, but his negative worldview arising from his poor upbringing as a child brought him problems with the law enforces that could not be solved by his vast financial resources, resulting in his jailing. This example demonstrates that family values are extremely important in assisting an individual to develop a positive worldview, which inarguably goes a long way to define the capacity of such an individual in developing relationships with others and in conflict resolution. Money and wealth cannot assist an individual in developing good relationships or solving conflicts that are so prevalent in modern society in the absence of family values and, as such, they only assume a secondary role as far as values are concerne d. It is a well known fact that family values are affected by the socioeconomic realities within the family setup, and that money is an important indicator of the socioeconomic status of a family. Indeed, some individuals use this line of thinking to conclude that families with strong economic status have strong family values, implying that money and the wealth it accumulates are the foremost determinants of a family’s capacity to have good family values. However, this is a fallacy that is not only wrong in its interpretation, but has served to instill a misplaced perception that money is everything. In India, for example, the Caste system aligns families with their social economic status, but no evidence has to date been adduced to the effect that families within the lower castes have lesser family values than those in the upper levels of the system. As a matter of fact, it is more rational to argue along the continuum that family values determines the socioeconomic status of individuals since evidence can be adduced to support this argument. For example, children from families which abhor alcoholism and drug abuse are more likely to become successful in life than those reared by alcoholic parents. As such, family values are more important than money All in all, the above discussion has demonstrated why family values must take precedence over monetary considerations. Money is good, but it is not the panacea for leading a prosperous and fulfilling life. However, the capitalistic nature of modern society coupled with misleading media reports and advertisements are entrenching a new angle in our perceptions about what money can do for us to a point where the position of family values in the social matrix is increasingly been threatened by our compulsive love for money. Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More When parents start to worship money, children will have no alternative other than to view money as of primary importance to the values that will help them later in life. This trend should be reversed at all costs.

Peplaus Seven Nursing Roles Social Work Essay Example

Peplaus Seven Nursing Roles Social Work Essay Example Peplaus Seven Nursing Roles Social Work Essay Peplaus Seven Nursing Roles Social Work Essay In this essay I will analyze formal and informal societal webs and how the cognition and apprehension of these are of import to professional carers. Society is made up of an alloy of households and societal webs. The household is the simplest unit of society ; with many different set ups of households. There is the atomic household of female parent, male parent and kids. There is the drawn-out household with grandparents, aunties and uncles. There are besides individual parent households and the reconstituted households with kids from a old relationship life in a new household with step-father, step-mother or step-siblings. Worlds are societal animals and are fond of company, we do non desire to populate and decease entirely. This is why we meet people and do relationships and have kids, so we surround ourselves with friendly relationship, love, household and company. This is supported by the plants of George Peter Murdock, who says that there are four basic maps of the household in society: sexual, generative, educational and economic. Another theoretician, Talcott Parsons believed that the household has two basic maps: the primary socialisation of kids and the stabilisation of grownup personalities of the population of society. I think it is true that the household fulfils these basic maps in society, but these are theories about the atomic household. Some households such as the individual parent household would happen it difficult to run into some of these basic maps, such as the economic system map, supplying for the household, a batch of individual parents are out of work and have to trust on the province to fund their households because employment of the individual parent would non supply adequate income to cover the life costs of the household. For the healthcare professional it is of import to cognize a individual s household and societal background. If they have an penetration into this they are better equipt with relevant information to help the patient s recovery. For illustration, if a patient has a household history of high blood force per unit area or diabetes, they can be prompted to do lifestyle alterations or have trials done to see if they are besides at hazard, therefore forestalling or proroguing unwellness. The healthcare professional has to understand the patient as a individual. A great formative consequence on that individual is their household and societal webs. For case if person has come from a household background of want they might hold a history of hapless diet, doing some diseases associated with hapless nutrition more likely. When we check into infirmary, we are normally asked for inside informations of our following of family, a individual in the household who is willing to be at that place for the patient and assist them in times of demand. This is critical information for the healthcare professional, because if a patient is unable to give inside informations of household history or comes into infirmary as an exigency and is unconscious for illustration, the wellness carer can reach the following of family to inform them of the patient and inquire critical inquiries which may assist forecast and intervention. For case if a individual is brought into infirmary demoing marks of inebriation such as slurring words, the information given by the following of family could be that the patient is a devout Muslim and does non imbibe intoxicant, therefore motivating the carer to look for other possible causes of the symptoms such as shot. The information relayed by friends or household could potentially be lifesav ing. In one manner or another, the huge bulk of people are portion of a societal web. Social webs come in many different signifiers, and modern engineering has developed the societal networking universe dramatically. Most of these webs are informal societal webs, such as friends run intoing one time a hebdomad to play football, or a book nine or your ain close group of friends. Common involvements bring people together to organize societal webs, and they have a intent or grounds for being which are mostly for good causes. Statutory webs are formal and enacted by the province or Torahs. Informal webs are private and between friends or people with commonalties. Sometimes a individual may uncover more about themselves to friends or societal webs than they would to their households, nevertheless people can besides uncover private things to formal webs, for illustration during a therapy session. When a individual confides in a friend their medical job so they may hold valuable information for the wellness attention professional, information which the household may non cognize, for illustration, a adult male who has contracted HIV from a homosexual relationship might non hold told his household that he is cheery and does non desire to state them of his unwellness, but his friend might be cognizant, hence if he were to be in demand of infirmary intervention the healthcare professional would non be able to obtain this information from the household, therefore the importance of informal societal webs to the carer. Each web is different, each has different ends and maps, but their similar purpose is to supply service of some kind, for illustration, to people or animate beings or the disadvantaged. Informal societal webs are of import for us as worlds, because we are societal existences and we feel the demand to portion and confide in people with similar involvements and ideas as ourselves. Informal webs can be of import for a individual s well-being, as it can profit them mentally and emotionally which have close links with physical wellness. If person is entirely and depressed they are more likely to endure physical wellness jobs, such as links to joint strivings, low immune system response, concerns, emphasis, anxiousness, bosom disease and dependences. These wellness jobs put strive on the NHS as these people are more likely to necessitate intervention from physicians, nurses, mental wellness workers and societal services. So the deficiency of societal networking in a individual s life could , in theory, be damaging to their wellness and hence be a immense impact on the lovingness profession, seting excess strain on the demands of the single carer. This is why I think it is of import for carers to cognize and understand the importance of societal webs. In the UK the public assistance province is a formal web which is run by the Government ( another formal web ) with the primary map of supplying services to the population. Formal webs play a really of import portion of society, they regulate the manner in which we live and work together, supplying a platform for regulations and ordinances to be enforced to profit the population. The formal web that is the NHS provides wellness attention professionals with the ability to run in a multi-disciplinary environment, to place, look into and supply wellness solutions. Formal webs particularly benefit the disadvantaged in society, such as aged patients who might necessitate nursing, residential and societal services. Religion is a web of educational and societal stance, which plays the function of learning values and ways of life. Depending on a individual s civilization, their faith can be a monolithic influence in ordering the manner they lead their lives, which sometimes clangs with the medical universe when it comes to intervention, for illustration some faiths ban blood transfusions, abortions and mercy killing. This has a great impact on the professional carer because they will hold to bear in head the patient s spiritual demands and happen an alternate intervention. It is of import for the carer to cognize approximately and understand spiritual ways in the modern twenty-four hours UK because we live in a multi-cultural, multiethnic society and it is of import for patient attention to esteem their beliefs and picks, and to orient their health care around their spiritual patterns and beliefs. Role theory is the sociological survey of function development, concerned with explicating what forces cause people to develop the outlooks of their ain and others behavioursaˆÂ ¦ [ 1 ] Each of us play functions, and each function has its ain set of features. For case, a pupil has texts to read, exams to fix for, but this might non impact their other functions such as female parent or male parent or married woman. Some people can non get by with excessively many functions because sometimes there is excessively much demand on the modern individual. In the yesteryear for illustration, one time a adult female was married with kids in this state, her chief functions were that of married woman and female parent, but presents adult females play more than these two functions. They can for illustration be a married woman, female parent, director, friend and goalkeeper of the ladies football nine. The functions you take on show the sort of individual you are. There is a difference between duties and functions. Society dictates how to act in certain functions, society has developed norms, and each function has norms to stay by. Everyone fits into a function and behaves consequently ; the function can be influenced by many factors such as gender, household, occupation rubric. A individual s place in the household web influences functions such as, the male parent figure is expected to supply. Roles tend to steal our individualism due to the outlooks of the function ; this means that because we are supposed to suit into these functions, society expects of us certain modus operandi. The carer will often handle patients who had a different societal upbringing to themselves. They must be accepting of their patient regardless of their beliefs and cultural beginnings, as carers have certain outlooks to run into. Carers are neer to assume person s socialization procedure to be like their ain, the outlooks placed on the carer by society are norms. Peoples need to be able to divide their functions in society but this is nt ever possible because some functions overlap. For each specific function there is an expected manner to move and act, which is really of import for wellness carers in the UK because they are looked up to and it is really of import for the patient carer relationship that the carer lives up the outlooks of their function. The function of the healthcare professional comes with great duties and responsibilities which aim for the best attention possible of their patients. The duties may be practical things such as doing beds and executing processs, but th ere are besides more interpersonal duties such as speaking to the patient, doing certain that they are cognizant of the client s physical and mental wellness and speaking to the household of the patient to discourse any possible safeguards to keep the patient s wellness in the hereafter. A holistic attack to medical pattern can greatly increase a patient s well-being, by looking at their psychological, societal, physical and religious provinces, and assisting the patient to be comfy and satisfied. It is really of import for the carer to develop a bond with their patient because the carer depends on keeping a high degree of regard from the patient. From this regard comes a trust and comfort between the patient and healthcare professional, where the patient will be more willing to portion information which could give a broader footing for the carer to do informed determinations. If the patient carer relationship is strong the patient will perchance react better to intervention because of the psychological effects of holistic attention. If a wellness attention professional was to of all time interrupt the bond of trust it would be more hard for the carer to give the patient the full benefit of their cognition and intervention. Hildegard Peplau was a nursing theoretician who created nursing theory of interpersonal dealingss, which helped to revolutionise the scholarly work of nurses. She created a theoretical account of seven nursing functions which helped in the development of the humane intervention of patients with mental wellness issues, but besides helped healthcare professionals to develop better curative nursing intercessions. Peplau s Seven Nursing Roles Peplau s Seven Nursing Roles illustrate the dynamic character functions typical to clinical nursing. StrangerA function: Receives the client the same manner one meets a alien in other life state of affairss ; provides an accepting clime that builds trust. ResourceA function: Answers inquiries, interprets clinical intervention informations, gives information. TeachingA function: Gives instructions and provides preparation ; involves analysis and synthesis of the scholar s experience. CounsellingA function: Helps client understand and incorporate the significance of current life fortunes ; provides counsel and encouragement to do alterations. SurrogateA function: Helps client clarify spheres of dependance, mutuality, and independency and Acts of the Apostless on clients behalf as advocator. Active leading: Helps client assume maximal duty for run intoing intervention ends in a reciprocally hearty manner. Technical expertA function: Provides physical attention by exposing clinical accomplishments ; Operates equipment[ 2 ] In decision I have demonstrated how the webs, households and functions affect people and how the cognition and apprehension of these is critical in assisting the healthcare professional dainty the individual as a whole, and non merely the physical symptoms. My personal position is that all of the factors impacting carers in this essay are really of import for them to hold cognition of and understanding, to the extent that I believe every professional in medical specialty and health care should be adequately educated and trained on the importance societal webs, the household and function theory. I think it is indispensable for health care professionals to be of all time cognizant of altering societal and cultural beliefs and ethical motives so that they are better equipped to handle and care for the multi-cultural society we now live in.

Gulf Oil Spill Essay Example

Gulf Oil Spill Essay Example Gulf Oil Spill Essay Gulf Oil Spill Essay Seunghwan Lee Professor Poe En 102 11/08/2010 Causes and Effects of Gulf Oil Disaster As the situation of environment is becoming worse than ever these days, the explosion of Deepwater Horizon ship has been making things the worst with the enormous damages since this incident happened on April 20th 2010. This disastrous accident happened under the 2nd biggest oil company BP’s poor responsibility. According to this accident, about 30 laborers died or got deadly hurt then the ship started to sink down couple days after the exploding. As an unofficial said that it was spilling out 35,000 to 60,000 gallons of oil for a day from the borehole in deep sea. (â€Å"Oil estimate raised to 35,000-60,000 barrels a day†) In fact, however, it was hard to estimate how speedy the oil was spilling since it started to spill out from too deep. This problem brought controversy nowadays since the police were not even sure how big this trouble was. This disaster is still causing the end of marine animals, fishing industries, tourism and even wild animals’ place to live by marine pollutions. Although the situation is not easy to bear, if people know what exact causes and effects of this accident, there must be the way to be closed for solution. The BP’s efforts to resolve is not actually seemed that it’s able to cover the seriousness of this accident any soon since it’s like uncountable costs would be charged to clean up the oil and restore the damage. Furthermore, some experts predict that more than 100 years will be needed to make it up. However, these days, BP is putting efforts to burn up the oil on the sea. That indicates they try to cover their fault step by step. Figure 1. : This is how the BP is burning up the oil which is flowing on the sea. now all holes are blocked but 560millions of oil already spilled out (Bourne). Nevertheless the BP’s efforts, there still are many reasons that lead this problem stuck. One case of it is the â€Å"Not Me† Blame-shifting between BP and Halliburton. Since BP is claiming that what Halliburton did was too unstable and Halliburton is claiming that they have tested enough times to make sure that it is safe, both companies are teasing themselves to shift the responsibilities to each other without knowing that it makes the progress of resolving slower than they planned. Halliburton is an oil company that has failed few times to block the holes with cement then it caused more spilled oil than BP expected. After all, BP became to be responsible for the most of cleaning up cost under the law. Also some contractors had to face the rest of costs; those contractors include Transocean, the rigs operator; Halliburton, the company responsible for cementing the well; and Cameron International, the maker of the blowout preventer, a device designed to shut off a well. Krauss and Elisabeth) (â€Å"The Latest Gulf Outrage†) Although many people cancelled their vacations due to the spill, hotels close to the coasts of Louisiana, Mississippi and Alabama reported dramatic increases in business during the first half of May 2010. However, the increase was likely due to the influx of people who had come to work with oil removal efforts. Jim Hutchinson, assistant secretary for the Louisiana Office of Tourism, called the occupancy numbers misleading, but not surpr ising. Because of the oil slick, the hotels are completely full of people dealing with that problem, he said. Then added Theyre certainly not coming here as tourists. People arent sport fishing, they arent buying fuel at the marinas, and they arent staying at the little hotels on the coast and eating at the restaurants. (Reed) As it sounds like, this disaster took the beauty of nature which helps people to rest. It is also caused of health consequences. As of May 29, ten oil spill clean-up workers had been admitted to West Jefferson Medical Center in Marrero, Louisiana. Two of the cleanup workers had to have hard time suffering from symptoms of dehydration. At a press briefing about the May 26 medical evacuation of seven crewmembers from Vessels of Opportunity working in the Breton Sound area, Coast Guard Captain Meredith Austin, Unified Command Deputy Incident Commander in Houma, LA, said that air monitoring done in advance of beginning work showed no volatile organic compounds above limits of concern. No respiratory protection was issued, Austin said because air ratings were taken and there were no values found to be at an unsafe level, prior to us sending them in there. (Elizabeth) Figure 2. This is the Picture of damaged bird which shows how serious the situation is (Witt). The Political Buzz Examiner Ryan Witt reports that even though 70% of spilled oil has burned, the remaining 30% of oil left on the sea still 5 times larger than the last biggest oil spill Exxon Valdez. As the picture shows that what the animals go through is not any kind of game for the companies that are responsible on it. No one can even sure that how hugely people have been destroying the environment according to Witt’s comment of â€Å"There may be much less environmental damage that was previously anticipated, or there may be much more, that we simply do not know yet. All the scientists agree that more studies and research will have to be done to see what the long-term environmental impacts of the spill are. † (Witt) Same happens for the fishes. For instance, six months into the BP oil spill, satellite data from the European Space Agency says that 20 percent of juvenile bluefin tuna have been killed by BP’s oil spill and more than half of blue fin tuna is died by the sea pollution in the past 30 years. Blue fin tuna has been banned fishing since it has been declining too much but this once people’s mistake reduced the 20% of valuable lives. This can be described as tragedy. Including oiled blue fin tuna, for polluted fishing industry harm estimated cost about $2. 5 billion. McDermott) BP has done unforgivable tragedy way too far. No matter how hard they try to clean the ocean up, it’s mostly like impossible to make things right at this point. In the other word, BP has become a terrible murderer that killed uncountable lives and environments. Unfortunately, furthermore, they were harmed more than ever by themselves either. There actually is no way to fix this situation up. However, to think positively, if they turn their mind as it was big lesson to not make the same happen again, it could be the big opportunity to step up. It might be too cruel to give the BP lessons from this incident but, no matter how huge the fault is, it’s always better to get a moral after the error. â€Å"Oil estimate raised to 35,000-60,000 barrels a day† CNN 16 June. 2010. Web. 8 Nov. 2010. Bourne, Joel K. Jr. †Is Another Deepwater Disaster Inevitable? † National Geographic, Oct. 2010. Web. 8 Nov. 2010. The Latest Gulf Outrage. New York Times 29 Oct. 2010: A30(L). The New York Times. Web. 8 Nov. 2010. Reed, Travis. Spill hasnt yet emptied hotels on Gulf Coast. The Sun News. Associated Press. 5 May. 2010. Web. 8 Nov. 2010. Elizabeth, Grossman. BP Lies about Air Toxicity as Gulf Workers Are Hospitalized. The Faster Times. 1 June. 2010. Web. 8 Nov. 2010. Witt, Ryan. â€Å"NOAA Report on Gulf Oil Spill Draws Criticism for Many Assumptions. † Examiner. com. 5 Oct. 2010. Web. 8 Nov. 2010. McDermott, Matthew. â€Å"One-Fifth Of Juvenile Atlantic Bluefin Tuna Killed by BP Oil Spill† Treehugger. 20 Oct. 2010. Web. 8 Nov. 2010 Krauss, Clifford, and Elisabeth, Rosenthal. The price and who pays: updates from the Gulf. New York Times 13 May 2010: A18(L). The New York Times. Web. 8 Nov. 2010.

Probation and Parole Research Paper Example | Topics and Well Written Essays - 750 words

Probation and Parole - Research Paper Example Probation is usually exercised on criminals who have committed a capital offence. Both Parole and Probation are a method of reducing the overcrowding in jails by releasing them in normal society but at the same time monitoring for their behaviors. History of Parole and Probation The system of parole was introduced by Brockway Zebulon in order to facilitate more space in the overcrowded prisons. Parole provided the incentive for offenders to win their way out of prison by adopting good behavior towards inmates and wardens. Parole was introduced as the good time statute by the Department of Justice in 1867. This statute granted the power in the hands of the warden who was responsible for recommending prisoners for parole and later monitoring these prisoners. Probation was introduced in the US law by John Augustus in order to monitor the release of offenders that still pose a threat to the society, even after serving their prison sentence in full. Augustus ‘was the first to provid e ball for defendants under the authority of Boston Police Court in 1841’ (Clear, Cole and Reisig, 187). Probations are extension to the prison sentence and were adopted by most states in 1879. Rights According to law, every individual on parole and probation is allowed to exercise certain rights. These rights are granted to the individual through the law and could only be revoked in certain conditions. Under parole and probation, the individual has the right of freedom to move. However, this freedom of movement is restricted to areas within the place specified by the individual as his residence city or state. The probationer also has to report on a weekly basis to the probationary officer to give an account of his weekly activities. In case, the probationer commits any offense, he has the right to receive notification from the court and arrange for his defense council. The probationer also has the right to speak in front of the hearing council to plead on his own behalf. Rev ocation Both parole and probation could be revoked at any time if the officer in charge believes that the individual has committed any offense or gone against the conditions of the parole or probation. In most cases, the parole and probation officer has the authority to hold the offender in custody if he has sufficient belief that the offender poses an immediate threat of society. Certain cases with respect to revocation have brought changes in existing laws. The Morrissey v. Brewer in 1972 is one such case. This case gave the parolee certain rights when being considered for revocation. Under these rights, the parolee has the right to written notice before considered for revocation and evidence and laws violated must be identified beforehand. The Parolee also has the right to question the evidence and the witnesses presented for the case. Another case is The Pennsylvania v Scott (1998), which bars the use of evidence that has been collected without a search warrant from the paroleeà ¢â‚¬â„¢s residence. Revocation laws were also updated after Gagnon v. Scarpelli (1973). This allowed probationers the right to hearing in case of being charged for any offense and the right to hire a lawyer for the hearing council (Alarid, Cromwell and Carmen, 148). Release on Parole and Probation There are certain general conditions for Parolees and Probationers released on

A world without words reflection Coursework Example | Topics and Well Written Essays - 250 words

A world without words reflection - Coursework Example Unfortunately it’s the doctors’ or rather clinicians’ views that are reflected which paints this children as dormant and damaged. Both clinicians and direct care staff are involved in the social construction process of these children but programs by clinicians are not adequate for their needs since they do not know them well or on a close personal level. Though the direct-care staff reports are more accurate, no one has ever considered these children as children first1. Like the use of electric shock to deter a kid from stealing food from other children’s’ plate is crude and an animal like training2. After reading through this article, we learn that choices made by these children should be considered when designing rehabilitation programmes for them because through this one understands these children’s life, challenges, choices and preferences and thus one is able to help them

Defining Marketing Paper Essay Example | Topics and Well Written Essays - 1000 words

Defining Marketing Paper - Essay Example However, with the little background that I gained, I have learned that marketing encompasses a wide array of activities aside from selling products and services. In fact, marketing is a lot more complicated than it seems. It starts at determining the needs of customers and creating a product together with the proper strategies to bring it to them. Now, my definition of marketing is the satisfaction of customer needs through the provision of products and services at a profit. The definition of marketing varies from organization to organization. The Chartered Institute of Marketing (CIM 2007) defined marketing as the â€Å"management process responsible for identifying, anticipating, and satisfying customer requirements profitably.† This is a very broad definition of marketing. It highlights three important aspects that marketing accomplishes. First, it recognizes the purpose of business organizations to design products which satisfy customer requirements. Marketing does not just involve offering any goods and services but business organizations should strive to offer those which offer customer value. Second, it stresses the aim of business organizations to generate profit from its operations. Thus, the definition of CIM involves assessing the marketing strategy which will be mutually beneficial for customers and companies. Business organizations as this definition implies are profit maximizing entities. Lastly, this definition highlight that marke ting is not just about providing the current needs by â€Å"anticipating† the future requirements of the markets. In summary, the CIM’s definition of marketing balances the satisfaction of customer and profit maximizing goal of business organizations. According to the American Marketing Association (AMA 2007), â€Å"marketing is the process of planning and executing the conception, pricing, promotion, and distribution of ideas, goods, and services to

Intellectual property Essay Example | Topics and Well Written Essays - 500 words

Intellectual property - Essay Example Erik Sherman in his article in The Chief Executive states that securing intellectual property is the only way to stay on the rapidly developing marketplace these days. The companies that do not have time or money for licensing their inventions end up bankrupts very soon nowadays, as the ideas that are not patented or copyrighted are soon plagiarized by the competitors, who spare neither trouble nor expense to get the legal rights on the invention. Thus, in some time, the company may even be sued for using its own invention. In addition, selling the rights to use the intellectual property may become a very good source of profit, especially for the small companies. The Ambient Devices, a company, producing consumer electronics can be brought as an example here, as today it gets 15% of its income just from granting other companies the rights to use its intellectual property, and the managers hope that in the next year this number may grow to the 50%. Andrea. L. Foster, the author of Who Should Own Science emphasizes the importance of sharing the scientific and technology data in order to make the research process more effective. Unfortunately, he forgets about thousands of companies who build their business and research strategies grounding on the existing system of licensing the intellectual property.

Heat capacity Lab Report Example | Topics and Well Written Essays - 750 words

Heat capacity - Lab Report Example The heat energy that is lost by the hotter object is absorbed by the object with the lower temperature. Calculating specific heat capacities involves the use of a calorimeter and a known mass of water. The calorimeter is designed in such a way that heat is not lost to or gained from the surrounding air (Laider). Since no heat is lost, then it can be safely assumed that heat lost or gained by the object inside the calorimeter is the same as the heat lost or gained by the water contained in the calorimeter. A known mass of water was heated using an electrical heating wire. The initial and final temperatures of the water were measured and recorded, as well as the current, voltage and the time that the electric switch was turned on. For liquid nitrogen, a known amount of heat was applied to liquid nitrogen. The quantity of liquid nitrogen that boiled away was measured by finding the difference between the initial and final masses. The flask with the liquid nitrogen was placed on a balance and the electrical heater lowered into the liquid nitrogen. The vaporization rate of the liquid nitrogen was measured after every ten seconds and recorded. Temperature (T) was plotted against time. The change in temperature was then used in the calculation of Cwater. (IVT)/ ΔT was plotted against the mass of water. The slope of the curve was found to be Cwater: From (IVT)/ ΔT, the value of IVT can be calculated by replacing ΔT in the equation (IVT)/ ΔT with the value in the table that corresponds to ΔT and then solving for (IVT). This gives a value of 50240.1601. The specific heat capacity of water of successfully determined, along with the latent heat of vaporization for liquid nitrogen. The measured and calculated results may have errors because of the possibility that experimental errors occurred during heat transfer to the surrounding and also not taking the

Microbiology Essay Example | Topics and Well Written Essays - 500 words - 2

Microbiology - Essay Example Nevertheless, not all the ways of the virus transmission have been fully defined and studied by the scientists. This virus is dangerous for human health and it causes much more deaths in comparison with other infectious diseases. The uniqueness of this virus and its main difference from Staphylococcus epidermis is the following: the cytoplasmic site of virus transmission and extension leads to enzymes encoding, especially those for macromolecular precursor pool regulation or for biosynthetic processes (Knipe, 2007). A morphogenesis of this virus is too complex and genomes of this virus encode the majority of proteins that interact with host processes at different levels (e.g. the cellular and systemic levels). Unlike Variola virus, Staphylococcus epidermidis  is a â€Å"gram-positive, coagulase-negative cocci that is a part of our normal flora† (Knipe, 2007). Within nosocomial environment, this pathogen has an ability to spread quickly among other non-infected humans. Nevert heless, unlike Variola virus, it is transmitted by means of foreign body infections. Staphylococcus epidermis is a facultative anaerobe and humans and warm-blooded animals are hosts for this infection. It should be also note that in spite of a non-pathogenic nature of S.

Intellectual property Essay Example | Topics and Well Written Essays - 500 words

Intellectual property - Essay Example Erik Sherman in his article in The Chief Executive states that securing intellectual property is the only way to stay on the rapidly developing marketplace these days. The companies that do not have time or money for licensing their inventions end up bankrupts very soon nowadays, as the ideas that are not patented or copyrighted are soon plagiarized by the competitors, who spare neither trouble nor expense to get the legal rights on the invention. Thus, in some time, the company may even be sued for using its own invention. In addition, selling the rights to use the intellectual property may become a very good source of profit, especially for the small companies. The Ambient Devices, a company, producing consumer electronics can be brought as an example here, as today it gets 15% of its income just from granting other companies the rights to use its intellectual property, and the managers hope that in the next year this number may grow to the 50%. Andrea. L. Foster, the author of Who Should Own Science emphasizes the importance of sharing the scientific and technology data in order to make the research process more effective. Unfortunately, he forgets about thousands of companies who build their business and research strategies grounding on the existing system of licensing the intellectual property.

Microbiology Essay Example | Topics and Well Written Essays - 500 words - 2

Microbiology - Essay Example Nevertheless, not all the ways of the virus transmission have been fully defined and studied by the scientists. This virus is dangerous for human health and it causes much more deaths in comparison with other infectious diseases. The uniqueness of this virus and its main difference from Staphylococcus epidermis is the following: the cytoplasmic site of virus transmission and extension leads to enzymes encoding, especially those for macromolecular precursor pool regulation or for biosynthetic processes (Knipe, 2007). A morphogenesis of this virus is too complex and genomes of this virus encode the majority of proteins that interact with host processes at different levels (e.g. the cellular and systemic levels). Unlike Variola virus, Staphylococcus epidermidis  is a â€Å"gram-positive, coagulase-negative cocci that is a part of our normal flora† (Knipe, 2007). Within nosocomial environment, this pathogen has an ability to spread quickly among other non-infected humans. Nevert heless, unlike Variola virus, it is transmitted by means of foreign body infections. Staphylococcus epidermis is a facultative anaerobe and humans and warm-blooded animals are hosts for this infection. It should be also note that in spite of a non-pathogenic nature of S.

The Personal Statement Instruction Essay Example for Free

The Personal Statement Instruction Essay Question 1 Focus: Academic Preparation Question: What is your intended major? Discuss how your interest in the field developed and describe any experience you have had in the field such as volunteer work, internships and employment, participation in student organizations and activities and what you have gained from your involvement. My early academic requirements such as grammar school and middle school years were spent studying in China. I never wavered in my commitment to do my best academically because in China, if you do not have good grades in school, your future would not be bright. My middle school education was finished in the United States. After, I went on to attend four years of high school.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   After High School, I enrolled in general courses at Pasadena City College. I am an average student with average grades but a burning passion to learn and draw. I joined various school activities that allow me to hone my architectural skills. I have almost completed all the general courses that I have to take. I am hoping to be able to attend more advanced classes and hone my skills further at your university. I am a very patient person who has the determination to succeed in the field that I have chosen. I have been developing my portfolio of architectural designs over a number of years now. I have also been an active member of various clubs and organizations in Pasadena City College where my design skills are often put to good use. Question 2 Focus: Potential to Contribute Question: Tell us about a talent, experience, contribution or personal quality you will bring to the University of California. *   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   I am a friendly person by nature. This is why I would like to be an active participant in school events and politics. I was raised with strong convictions and beliefs about life peoples rights. It is my wish to help the world become united in friendship. I would like to develop my leadership abilities by joining school civic groups and the student council. The school has a large campus and there is always work to be done. I would like to make sure that the student body is always an active participant in the programs that the school has designed to help build character and confidence in a person. College is the happiest time in a students life. I fully intend to enjoy my campus life to the fullest and bring my closest friends and classmates along for the life-changing ride. During my first few weeks at the new school, I expect that I will be joining social activities that will help me blend in with the student body.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   I want to join in the civic efforts of the university. I would like to join Habitat for Humanity and help build homes in various parts of the United States. I will continue attending workshops and seminars as well that relate to fine arts and architectural designing. I believe that these seminars help me towards gaining a better understanding of the work that I want to do in the future. I am a highly imaginative person. I always want to be kept abreast of the latest design trends and future concepts. So I will want to spend every spare moment I have gaining the knowledge that I will need. I would like to start an architecture organization on campus. The main objective of this club will be to gather the architecture students and even those students who are not enrolled in architecture but have a love for design and concepts and give them an avenue in which to have a free exchange of ideas. We can have weekend outings where in we can tour the city and visit various architectural landmarks. Perhaps even attend seminars as a group as well. I have had encouraging feedback from the seminar and workshop conductors. They give me the courage and will to go on and see this dream through to the end. I know that the line of study I have chosen is in an area where one has to always be up to date and thinking ahead. This is why I will excel in this field. I am a highly imaginative person and I believe my concepts are far ahead of its time. I have a very keen interest in urban design and architecture. It is my ambition to become a highly competent and popular urban designer or architect known for excellence worldwide. Question 3 Focus: Open-Ended Question Question: Is there anything you would like us to know about you or your academic record that you have not had the opportunity to describe elsewhere in this application? *   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   I am Dong Chen. I am currently enrolled as an architectural student at Pasadena City College. I have been living in the United States for a large number of years now. I came to the United States by way of China where I was born and partially raised. My parents value education highly even though they themselves are not university graduates. My brother and I will be the first two in our family to graduate with college degrees.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   My family moved to the United States when I was still an adolescent. They have political reasons for the move. Mother and father wanted my brother and I to have a good future so they insisted on us going to good schools They were able to afford our education, a simple apartment and some amenities in life for the family. Mother works as a rank and file employee at a printing factory while father works a chef.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   My brother is based in San Diego. He has already finished college. He attended university classes at the University of California San Diego. He graduated with a major in Computer Science. He is currently completing his Masters Degree as a student in Cal-State-San Diego.   He is my role model and I always pattern my life after his.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Once I become a student at this university, I will make sure that the chance that has been given to me will not be wasted. I will strive to excel in my field and make sure that I am always at the service of the school and the student body. I can be an adviser to the new Chinese students who are still adjusting to their new life in the USA.

Practice Nurses Role in Treating Chlamydia

Practice Nurses Role in Treating Chlamydia The practice nurses role in treating chlamydia and improving the sexual health of the nation Introduction Chlamydia treatment has been the focus of considerable research interest in the past few years. A huge proportion of what used to be called NSU, or was even undiagnosed non-specific pathology, is now recognised as being due to the chlamydia pathogen. It has now achieved the unenviable status of being considered responsible (numerically) for the greatest amount of sexually transmitted disease in the UK today (Duncan 1998) Given the fact that it is now therefore recognised as being a major contributing factor in the overall picture of sexual health, we must examine ways in which the NHS is set up to tackle the problem. (HPA 2003) As with many health related issues such as this there are a number of subsidiary issues that must be considered in relation to the main theme. These include the role of the screening process in trying to contain the prevalence of chlamydial infection, the practice nurse’s role in that screening process, the current thoughts on the treatment of chlamydia and the practice nurse’s role in not only the treatment, but also the partner tracing activity that is vital to try to stop the spread of the disease. (Fenton et al 2001) The practice nurse is generally ideally placed within the primary healthcare team to act as a central liaison point for many of these activities If we start by considering the whole issue of screening. On one level, one could be forgiven for thinking that the issues relating to screening are actually rather simple. We know that many cases of chlamydia are actually asymptomatic (see on). Given the fact that it can cause considerable damage and is eminently treatable, why not screen for it and get rid of it? Sadly, it is not as simple as that. (Simms et al 1996) The National Institute for Clinical Excellence (NICE) has set up the National Chlamydia Screening Programme (NCSP). It quotes its rationale for doing so as: Genital Chlamydia trachomatis is the commonest Sexually Transmitted Infection (STI) in England Genital chlamydial infection is an important reproductive health problem ~ 10-30% of infected women develop pelvic inflammatory disease (PID). A significant proportion of cases, particularly amongst women, are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID. Screening for genital chlamydia infection may reduce PID and ectopic pregnancy. The study itself was exemplary in design with an entry cohort of nearly 8,000 patients. The authors considered the efficacy of several different methods of screening and then compared the results of the programmes against the costs of allowing the disease to continue untreated in the community and these include all the sequelae of infertility, pelvic inflammatory disease and ectopic pregnancy in women together with the complications that can occur in the male partners (infertility again) and prostatitis. (Berry et al 1995) The paper even covered the incidence of both pneumonia and eye infections in their children. The structure of the study was quite comprehensive insofar as it compared the results of four separate groups One group received no screening at all, a second group were screened if they exhibited mucopurulent cervicitis, the third group included all women who were less than 30 yrs. old and the last group was all women irrespective of symptoms. The actual screening tool was the Polymerase chain reaction (PCR) which is a very specific and sensitive antibody based test. It was performed on either urine or direct cervical samples. (Barlow et al 2001) The study protocol then called for all positive testing patients to receive treatment with doxycycline for seven days. The analysis section of the paper is both long and complex. We shall therefore condense our examination of this part of the study into an examination of the results. The overall treatment costs of treating all of the medical complications of chlamydial infection was calculated as $676,000. Each of the positive screening strategies produced a significant reduction in the expected cost of complications that was greater than the cost of the actual screening exercise. A condensation of the tabulated results is shown here: Screening method Screening costs ($) Medical costs ($) Total cost ($) Number of PID cases PID cases prevented No screening 676,000 676,000 152 CDC criteria 55,000 390,000 446,000 88 64 Women 75,000 297,000 372,000 67 85 Universal screening 120,000 270,000 391,000 61 91 The results need little explanation, as it can be clearly seen that both the costings and the number of cases prevented argue strongly for a case for screening. The only point of contention is the decision on the population that the health care system will fund for screening. Overall, the authors state that their regime reduced the incidence and prevalence of pelvic inflammatory disease by 60% when compared to the unscreened group. The other significant factor was that, taking all groups as an average, they noted a total healthcare saving of about $50 per woman screened, and this clearly does not take any account of any associated comorbidity, pain and suffering that is caused by the chlamydia infection A further corollary can be drawn from the results. The authors went on to provide an impressive statistical analysis of the comparative costs of different community groups with different rates of prevalence. Of great importance to our considerations here was the fact that the authors concluded that the cost of screening was cost effective when the incidence of infection in a population of asymptomatic women was above 1.1%. when the incidence rose above 11% then they found that the screening of all women and their partners became the most effective strategy. To some extent, this study can be considered the â€Å"gold standard† for most of the studies in this area. It is well conceived, meticulously executed and well and thoughtfully analysed to give meaningful results which are of great practical importance. Despite such comments it should be noted that there are a number of negative points to be considered in this particular study. The universal treatment constant was the seven day doxocycline treatment. We should note (as the authors did) that there is therefore a potential for non-compliance with the whole seven day regime, and this may introduce a potential source of bias in the figures(Haddix et al.1995). We can also point to other studies that have addressed this particular problem with a one dose treatment regime (azithromycin). It is fair to note that despite the potential for bias, extrapolation to these other studies does not appear to show significant differences in the overall results (Lea et al 1997) The issue of screening, although covered reasonably comprehensively in the last paper, certainly as far as matters of cost are concerned, is examined further in the paper by (Duncan et al. 2001). This paper approaches the issues from a different perspective. It includes the issues of male screening And takes an overview of the Public Health issues from a sociological viewpoint, which makes it, (in our examination of the current literature), almost unique. We should note that we have already addressed the issues faced by the NCSP, but the other major public document in this area is the report commissioned by the Chief Medical Officer (CMO 1998). It is instructional to discuss the recommendations of this group as they differ significantly from the screening criteria used in the previous paper. The recommended groups for screening here are the following: Everyone with symptoms of chlamydia infection, All those attending genitourinary medicine clinics, Women seeking termination of pregnancy.1 Opportunistic screening of young sexually active women under 25 years Women over 25 with a new sexual partner or two or more sexual partners in the past year. In the context of our considerations here, we should note that the advisory group identified the optimum sites for screening as the primary healthcare team (family planning clinic) as well as the usual GUM clinics. (Stokes 1997) The Duncan paper is particularly well written and a major point that comes from it is in sharp contrast to that found in the Howell study. One of the criteria that they suggest for screening males in the population is that women may find that being screened has connotations of being dirty and unattractive A positive result is said to be associated with promiscuity. The authors suggest that not screening men not only fosters gender inequalities but it reduces the Public Health impact on the Man’s responsibilities for sexual health. (Pierpoint et al 2000) There is no argument that this is a valid point, but the paper does not produce any evidence to show that male screening has a positive impact on the cost-effectiveness of the screening procedure. (Stephenson et al 2000) The paper does however, contrast these statements with the accepted fact that women are actually easier to target than men, as they are generally heavier health care users than men in the major at risk age range. (Oakeshott et al 1998) The paper points to the need to tackle the issues of sexual inequality, as it could be considered that the screening programmes may have less than the desired effect if they are perceived by women to be little more than surveillance of their particular sexual habits. It draws a clear analogy between a women only screening programme for chlamydia and the well established women only cervical cytology screening clinics. The paper quotes (Holgate et al 1998) in the comment: The potentially adverse consequences of sexual intercourse a private event can be surveyed and treated through screening services a publicly based and funded system . It is women who transcend this private, public dichotomy and find their lives scrutinised in a manner alien to men . The focus is commonly upon women both as transmitters and contractors of relevant viruses as both those whose cervixes are surveyed and whose sexual activity comes under surveillance. The paper then has a long middle section which, as a critical analysis, is little more than a diatribe against women being singled out for screening. It is fair to say that all of the arguments put forward are valid, to a degree, but are presented with a strongly feminist viewpoint, which is both understandable and worthy of merit form a sociological standpoint. The arguments are not however, convincing from a scientific, financial or practical perspective. The conclusions of the paper are entirely justified in calling for a greater understanding of the woman’s point of view when organising and running screening clinics, in order to broaden their appeal to the target groups. (Santer et al 2000) With specific reference to the role of the nurse in the primary healthcare team screening for chlamydia we can now turn and examine an excellent paper by Grun (et al 1997) which looked at two different methods of screening for chlamydia in a nurse run primary healthcare setting. The study set out to try to accurately determine the prevalence of chlamydia in the North London area using the ligase chain reaction (LCR) technique which is similar to the PCR mentioned earlier. (Butt et al 2001) This particular study used the rather labour intensive cervical scrape method for sampling, which had the added benefit that cervical cytology could be assessed at the same time. The paper is quite detailed in its description of its method and appears to be rigorous in its execution. It is worthy of our consideration here because of it’s direct relevance to our prime consideration. The results and conclusions of the paper make for interesting reading One of the more significant conclusions was that, on the basis of their findings, if there was a policy of simply screening all women aged 25 and all women who had had two or more partners in the past year, they would have detected 20 out of a possible 23 positive chlamydia infections in their cohort. The authors make a salient comment that including other screening criteria such as marital status (which has been suggested by other authors [Lossick JG, et al 1996]), would have made no statistically significant impact on their detection rate. They also make the comment, in line with the other authors we have examined, that selective screening appears to be more cost effective than universal screening, although the actual cost implications were not specifically considered in this paper. In contrast to the Howell paper, it suggests that screening become a viable tool when the community prevalence rate approaches 5% The fourth paper to be reviewed is the more recent paper by Adams (et al 2004). This paper takes a more general overview of the whole issue of chlamydia in the UK. This is effectively a meta analysis of nineteen different papers (selected from 357 studies) which report the incidence of chlamydia as tested by the PCT method on urine samples. This is significant as it is the first meta analysis to be carried out on UK data. (Armitage et al 2001) The results are extremely detailed and many are only of marginal relevance to our considerations here. We shall restrict our comments to those aspects that are specifically relevant. Firstly, the authors comment on the current prevalence of 8.1% of the population testing positive in the under 20 age group, progressively diminishing to 1.4% in the over 30 group. The significance of this is that it is very much lower than other studies. For example studies set in GUM clinics put the prevalence in the under 20 age group in the region of 17% and antenatal clinics at about 12%. (Piementa et al 2003) This may therefore have relevance in targeting of specific at risk groups. It should be noted that this study gave no data with regard to the incidence of chlamydia in the male population. (Dixon et al 2002) Our comments made earlier about the asymptomatic nature of the bulk of the infections, is borne out in the fact that only 8% of those tested and found to be positive, actually volunteered that they had any genital symptoms (of any sort). Another important consequence of this study is the fact that it highlights the comparatively high detection rate to be found in attenders at primary healthcare team premises. This shows a gap in the reasoning and recommendations of the National Sexual Health and HIV Strategy for England (D of H 2002) which currently suggests targeting GUM clinics and family planning centres as prime sites for screening centres. Following on from the reasoning expounded in the last paper, we can look at a provocatively entitled article by Kufeji (et al 2003)† Who is being tested for genital chlamydia in primary care?† The paper makes the point that we already have enough evidence to clearly identify the target populations that are the most likely to give a good yield as far as screening is concerned (viz. the most â€Å"at risk† groups). The raison d’à ªtre of this paper was to compare the characteristics of the actual groups screened with the characteristics which we know to be representative of the groups most likely to be at risk. The corollary of this reasoning being that if the two groups do not match then all the calculations made about the cost effectiveness of a selective screening process do not hold water. (Kinn et al 2000) The most striking feature of this paper is the fact that we know (Adams et al 2004) that the maximum age incidence for chlamydia is in the sexually active under 20 age group and the incidence rapidly decreases with age to the over 30 age group. Kufeji and his co-workers found that the majority of the tests done (63%) were done on the over 25 yr. age group where we would expect the results to be positive only in about 1.5% of the population. Adams’ findings were confirmed with a positive rate of 13.3% found in the under 20 yr. olds tested. The paper also point to the fact that the practices studied had a comparatively high healthcare staff to patient ratio. In the practices where the ratio was lower, even less opportunistic testing was done. (Shefras et al 2002) This correlates to the finding that the Townsend score ( of social deprivation) correlated highly with both a reduction in the amount of testing and an increase in the prevalence of chlamydia. In the words of the authors the study points to the fact that screening programmes for chlamydia in primary healthcare settings suffer from â€Å"a selection bias and social desirability bias, and they do not aim to provide complete descriptive information on testing patterns across a population.† It should be noted that this particular study was not just on a small sample. The authors took as their entry cohort all of the 119 General Practices in Nottingham which collected a total of over 7,000 samples. The authors note that the number of tests done in General Practice is increasing at about 35% per year. It follows that if a significant number of these are inappropriately targeted, this has profound implications for the related costings of the exercise. One other salient point in this study was the fact that only 1 in 40 tests were done on men. (Chernesky et al 1999) The last major paper that we shall review in this section is the paper by Cassell (et al 2003) this deals with the thorny issue of partner notification when screening turns up a positive result. Hitherto contact tracing had largely been in the realms of the GUM contact tracing nurse. With the expansion of the screening role into the realms of General Practice and other clinics, the contact tracing role has also expanded and may well have lost some of it’s efficiency due to both a lack of skill, time and resources. (D of H 2002). Cassell and her colleagues have tried to investigate the extent to which this perceived reduction in contact tracing may be responsible for the relentless increase in the overall incidence of chlamydia. (Radia et al 2001). The study was done by postal questionnaire to all GPs in Nottinghamshire. They got a 56% response rate. Arguably the most significant finding of the study was the fact that 86% of respondents considered that chlamydia testing was part of the remit of the primary healthcare team, while only 40% considered that partner notification was a primary healthcare team role. The rationale for this was, that most of the non-contact tracing respondents felt that it was their role to inform the patient that they should inform their partners. Given the fact that we have evidence from the Duncan paper that women tend to equate a positive test with promiscuity and being â€Å"dirty†, it is perhaps not surprising that a substantial number of partners do not get told. If you add to this number the unknown number of chlamydia infections that may have come from clandestine or extramarital liaisons, then this number may be higher still. This is clearly both hypothesis and conjecture but it would seem to be dictated by common sense. The paper goes into considerable detail about the reasons why different primary healthcare teams have different practices, but rather worryingly a surprising 20% treat chlamydia with a dose of antibiotic which is less than the currently recommended therapeutic level recommended by the Central Audit Group for Genitourinary Medicine, (Stokes et al 1997) The difficulty of a postal questionnaire study is that there is an intrinsic bias in the study design. It is quite conceivable that the 56% of primary healthcare teams who responded were the ones who may have been sufficiently motivated to be positive about matters to do with chlamydia and may therefore have been better informed that those who did not respond. In the words of the authors â€Å"our study probably over-represents primary healthcare teams already testing for chlamydia and may exaggerate the extent of good practice.† The paradox outlined by this study is that while the majority of GPs and their teams are already willing to assume the mantle of diagnosing and managing chlamydial infection, the same majority agree that contact tracing is the main difficulty in managing these patients. The study made enquiries relating to the presence of follow up strategies which were designed to minimise the risk of further infection and found that there was â€Å"very little evidence to be found† other than by putting the onus on the patient to tell their partners. It follows from this observation, and the authors put it quite succinctly: If testing in primary care continues to increase without adequate support for partner notification, much of the resource used in testing women will be wasted. (Griffiths et al 2002) If we accept the premise that an increasing amount of chlamydia screening will be done in General Practice in the future, it is likely that an increasing proportion will fall to the practice nurse or the family planning nurse specialist. (Stokes et al 2000). If this is the case, then it is common sense to maximise the benefit of chlamydia screening by supporting the healthcare professionals with time and resources to perform proper contact tracing to minimise the risk of re-infection. (EHC 1999) Conclusions In this review we have selected six primary papers which each represent a significant contribution to the evidence base in our knowledge of the rationale for screening and treatment of chlamydia infection. (Sackett 1996) From our examinations it is clear that there is a considerable disparity in the figures pertaining to the prevalence of chlamydia infection in the community. The paper by Adams (Adams et al 2004) gives us a partial rationale for this and that is that studies done in different areas of health care practice will yield different results because they have a different clientele. It is not, perhaps, surprising that a study done in a GUM clinic will report different prevalences than a study done in a General Practice setting. The common factor that runs through all of the papers examined is the fact that it is rare to find that men are screened. Generally the figures suggest about 2-5% of men are screened when compared to the number of women. There is no evidence to suggest that they have lower infection rates than women and, according to Duncan (et al 2001), there are a number of very good sociological reasons why men should be screened as frequently as women. The fact of the matter is that women are subject to screening with much greater frequency than men and therefore bear the brunt of both the indignity and the responsibility. There is no doubt however, that the case for screening and treatment and contact tracing is made on both economic and health grounds. It is equally clear that the practice nurse has a central role in the efficient administration of all of these vectors to varying degrees. The advent of nurse prescribing (Legge 1997) will make the practice nurse as valuable in this area as they already are in both the screening and contact tracing roles. The only concern here is that according to Kufeji (et al 2003) we are collectively targeting the wrong population in terms of efficacy and efficiency. References Adams EJ , A Charlett, W J Edmunds, and G Hughes 2004 Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies Sex. Transm. Inf., October 1, 2004; 80(5): 354 362. Armitage P, Berry G, Matthews J. 2001 Statistical methods in medical research. Malden, MA, 2001. 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