Case study Coursework Example | Topics and Well Written Essays - 1000 words

Case study - Coursework Example The failure to do this is the reason why Alisi’i cannot gainsay whatever Ed says, since Ed is her boss. Mei can also not speak up for the same reason (Marynissen, 2011, 194). The task maintenance role that Ed plays is managing the financial, health and safety aspect of the project. Alisi’i will have to keep the accounting records of the project as Mike looks for the most pocket-friendly package for the project. Mary represents the clients while Wirimu oversees the process entirely carried through. Mei may help install the heat pumps. The four problems Wirimu is facing are: the big man syndrome in the meeting (as is epitomized by Ed); inordinate balancing of power among the project members; the presence of hardliners; and lack of proper communication. The major problem is the sharp difference in opinion concerning the installation of the heater, as the way to solving extreme temperature variations. The solution is making sure that the members of the project team are equal in authority and calling for a compromise in the team. It is the best decision that Wirimu has allowed the team to email him. This will help the team carry out a consensus to determine the way forward. GameZ new organisational culture can be described as bet your company culture. This is because GameZ is taking on new approaches such as removing Friday evening shouts, appointing three senior employees in a less competitive manner and being emphatic on the organisation’s profitability without factoring unforeseen consequences. The possible reason for Jane’s behaviour may be the detection of performance gap, at the end of the fiscal year. The link between culture and communication is complementary in nature. Organisational culture is relayed through communication, while proper organisational culture fosters democratic dissemination of information hierarchically and horizontally. To develop proper organisational culture, it is

United States Electoral College Essay Example for Free

United States Electoral College Essay The Electoral College, the mechanism for electing the president and the vice-president of the United States which was first put to use in the 1789 presidential election has already outgrown its purpose and should therefore be abolished (National Archives and Records Administration). Formulated by the country’s founders more than two hundred years ago, the system has undoubtedly grown stale and ineffective and no longer â€Å"conform to our modern interpretation of democracy, which is one person, one vote† (Hough). According to the National Archives and Records Administration (NARA), although the term could not be found anywhere in the United States Constitution, it is believed to have been actually conceived by the â€Å"founding fathers as a compromise between the election of a president by Congress and election by popular vote. † The term was coined from the words â€Å"elector† and â€Å"college. † The term â€Å"elector† was used to refer to the German princes who were granted the right to take part in the process of electing the German king who later became the emperor of the Roman Empire while â€Å"college† was taken from the Latin word collegium which means â€Å"a body of persons that act as a unit. † Thus the term â€Å"electoral college† means a group of people chosen to elect the President and the Vice President of the United States of America (NARA). A total of 538 electors handpicked by political parties comprise the present Electoral College. Every state has two electors representing their two senators and another elector for each of their congressional representation. This means that a small state with only one congressional representation owing to the smallness of its population is allocated the minimum number of three electors. In 2004, the four states with the highest number of electors were: California (55), Texas (34), New York (31), and Florida (27) while seven small states (Alaska, Delaware, Montana, North Dakota, South Dakota, Vermont, and Wyoming), and the District of Columbia, had only three electors each (NARA). As congressional representation is determined by the census of population which is taken every ten years, a state’s number of electors could therefore be reduced or increased, without prejudicing the total electors of 538 for the entire country. For instance, based on the 1990 census of population, the state of Arizona was allowed 8 electors for the presidential elections of 1992, 1996, and 2000. After it registered a population increase in 2000, its number of congressional representation and therefore, the number of its electors, was raised to 10 for the presidential elections of 2004, 2008, and 2012 (NARA). In 48 states and the District of Columbia, a presidential candidate who gets the majority of votes in one state is awarded all the electoral votes allocated for that state in a â€Å"winner-take-all† manner. In the states of Maine and Nebraska, meanwhile, proportional voting is practiced. Under this voting system, Maine, which has four electoral votes, gives one vote to the winner in each of its two congressional districts and gives the remaining two votes to whoever gets the majority votes in the entire state (NARA). A simple majority or a minimum of 270 electoral votes is needed to win the U. S. presidency. In case of a tie (269-269 result) in the presidential contest, the Congress of the United States decides the issue while the U. S. Senate conducts the runoff election in case of a deadlock in the vice presidential race. In the history of the presidential election in the country, the congressional runoff was only done twice – in 1800 and in 1824. In the vice presidential race, the United States Senate was called on to decide the issue in 1836 (NARA). This is the first undesirable feature of the Electoral College that many American voters find unacceptable. A tie in the presidential election under this system takes the electoral process away from the hands of the American voters and confers the power to elect the president to a highly partisan congress. In such a scenario, the presidential candidate of the party which controls the House of Representatives would win the presidency regardless of the will of the majority of the American voters. A case in point was the 1824 presidential election. When congress decided on the issue after a deadlock was declared, Andrew Jackson lost the presidency to John Quincy Adams despite garnering a decisive 57. 2% of the popular vote (NARA). Point two against the Electoral College is the fact that the president and the vice president of the United States are not actually chosen by the people but through the electoral votes assigned to the 50 states and the District of Columbia. It is therefore possible for a candidate to win the votes and gain the trust and confidence of the majority of American voters and still lose the presidency – a systemic defect which is tantamount to a disenfranchisement of American voters. This has already happened four times in the political history of the country. The case of Andrew Jackson in 1824 was already discussed earlier in this paper. Another case occurred in 1876 when Rutherford Hayes (R) won the presidency with a single electoral vote majority (185 against Samuel Tilden’s 184) in spite of the fact that only 48. 5% of those who voted went for him while the majority 51. 5% voted for Tilden. Once again, in 1888, Benjamin Harrison (R) won with 233 electoral votes against Grover Cleveland’s (D) 168. However, 90,596 more American voters had chosen Cleveland over Harrison in that election. The most recent case was the 2000 presidential election. President George W. Bush (R) defeated Albert Gore, Jr. , 271 – 266 electoral votes, despite getting only 50,456,062 popular votes (49. 7%) against Al Gore’s 50,996,582 (50. 3%). The official result of that election, in effect, nullified the votes of 540,520 American voters who gave Gore the advantage in popular votes, thereby expressing their preference for Al Gore to be the president of the country (NARA). The Electoral College does not count the votes cast by American voters equally. For instance, in the 2004 election, Wyoming, one of the small states, was allocated three electoral votes. California, on the other hand, whose population was about fifty times larger than Wyoming, only had 54 electoral votes. A simple computation would show us that although California was 50 times as large as Wyoming, its number of electoral votes was only 18 times larger (54/3 = 18). In other words, a vote cast by a voter from Wyoming was given a higher value than the vote cast by a California voter (Bates). Or, expressed another way, one Wyoming voter is equal to 18 California voters. This is plain inequality! Electoral College discourages some voters from participating in the election, thereby resulting to low voter turnout which reduces the credibility of an election. This is true in the case of states which have already been identified as one-party states. For instance in 2004, since California was already expected to vote for the Democratic candidate, chances were that some voters who planned to vote for the Republican standard bearer could have chosen to stay home instead. Indeed, what’s the point of voting when your state is already in the hands of the other party? It would seem as if the votes have already been counted before they were cast (Bates). On the other hand, defenders of the Electoral College claim that under the popular voting, the small states would simply be overwhelmed by the large states and that presidential candidates would tend to overlook them in favor of large states where more votes could be obtained. The opposite had, in fact, been observed during the campaigning which occurred for the 2004 election. Let us return to the example of California, the largest voting state in the country. Because it was already expected to go for the Democratic Party, George W. Bush ignored it in spite of its size and its 54 electoral votes and concentrated instead in the â€Å"swing state of Pennsylvania† which he visited â€Å"more than forty† times. In fact campaigning for the presidency of the United States had always shown candidates spending more time in swing states than in larger states which had already committed to the other side (Bates). Because of its proven ineptness and widespread unacceptability, the Electoral College has been labelled differently by different people. It was likened to â€Å"the vermiform appendix: a useless organ that can cause trouble on occasion† (Abolish the Electoral College? ). It was described by the American Bar Association as â€Å"archaic and ambiguous† when a survey it conducted in 1987 found that 69% of American lawyers wanted the system abolished. The American public have spoken against the system through polls held in 1967 (58%), 1968 (81%), and then again in1981 when 75% of Americans were found to favor its replacement by a popular voting system (NARA). Regardless of the labels, however, the subjugation of the people’s will and the utter disregard for the value of the votes of Americans has rendered the Electoral College unacceptable to the American public. Their disgust and contempt for the system was already shown by the more than 700 proposals for its abolition or modification. They almost succeeded in the U. S. Senate in 1956 when amendments introduced by Republican Senator Karl Mundt (South Dakota) and Texas Democratic Senator Price Daniel won a senate voting with a 48-37 majority. Only their failure to muster the required three-fourths vote of the senate prevented the measures from pushing through (Duchschere). The American people tried again in 1969. Supported by then President Richard Nixon, an amendment was unanimously approved in the House of Representatives only to be stalled in the Senate for almost one year until supporters lost their interest on the measure and it died a natural death. Republican Senator Eastland and Democratic Senator Thurmond, described as â€Å"notorious segregationists† because they had been observed to have â€Å"voted against every civil-rights and voting-rights measure† in the Senate, were responsible for its death (Electoral Justice). Americans now want their votes to be properly counted and their decisions duly respected. As Professor Keyssar aptly put it, Americans today believe that the Electoral College has ceased to mirror America’s â€Å"sense of social equality† (Hough). Hence, it is now time to say goodbye to the antiquated, obsolete Electoral College. The time has arrived to show the civilized world that in the United States of America, every man, every registered voter, has a right to vote and a right to demand that such vote be counted. Works Cited â€Å"Abolish the Electoral College? † Wilson Quarterly. Winter 2001, Vol 25, Issue 1, p. 97. 13 June 2007. http://search. ebscohost. com/login. aspx? direct=truedb=aphAN=4028232site=ehost-live Bates, Nathaniel. â€Å"What Are the Arguments Made in Favor – And Against – the Electoral College? † 26 October 2004. 15 June 2007. http://hnn. us/articles/8163. html Duchschere, Kevin. â€Å"JFK Led Opposition in 1956 Effort to Reform the Electoral College. † Minneapolis Star Tribune. 26 November 2000. 13 June 2007. http://www. freerepublic. com/forum/a3a20ce2a366a. htm Electoral Justice. â€Å"The Electoral College: An Embarassing Vestige of Slavery and Segregation. † 15 June 2007. http://www. iwantmyvote. com/justice/electoral_college/ Hough, Lory. â€Å"Why Do We Still Have The Electoral College? † News Stories. 13 June 2007. http://www. ksg. harvard. edu/news/news/2004/Keyssar_why-electoral_college_102904. htm National Archives and Records Administration (NARA). â€Å"U. S. Electoral College. † 13 June 2007. http://www. archives. gov/federal-register/electoral-college/index. html

Peripheral Neuropathy among Patients Living with Diabetes

Peripheral Neuropathy among Patients Living with Diabetes Update on Foot Care: Identifying Early signs of Peripheral Neuropathy among  Patients Living with Diabetes Mellitus Bernice S. Samuel DNP  and  Susan J. Appel, PhD, APRN-BC, CCRN, FAHA Introduction Among those individuals living with diabetes, peripheral neuropathy (PNP) is a major contributor in the development of foot ulcers.1 Even though there has been a decline in recent limb amputations due to advanced management of foot ulcers, 7% of those affected with type 2 diabetes (T2D) will still develop foot ulcers.2 Diabetes-related foot ulcers not only cause further physical disability, they also reduce the quality of life and increase the risks of lower extremity amputations. 3 The CDC 4 reports that 65,700 non-traumatic lower-limb amputations were performed among people living with diabetes. While diabetes is a major cause of complications such as vasculopathies and PNP, foot ulcers are the most easily prevented complications. 5 Therefore, practitioners must be fully apprised of tools and methods used to identify early PNP and prevent foot ulcers. Practitioners should also focus on actively educating the patient and family regarding PNP. Most practitioners are familiar with the Semmes-Weinstein Monofilament testing (SWMT) as the gold standard used in primary care to assess for PNP. Mayfield and Sugarman reported the use of the SWMT as a useful tool in the primary care office for practitioners to assess patients for PNP, but indicated it is not without limitations. 6 Further interventions are needed when there is a loss of sensation detected, such as proper footwear and patient education, to prevent trauma and foot ulcers. 6 Research has shown that practitioners can continue to assess patients with diabetes using the monofilament testing as long as PNP is not present. Once PNP is noted, additional assessment and management techniques are warranted. A yearly thorough foot exam by a podiatrist has been recommended by the American Diabetes Association for those living with diabetes. 7 In addition, persons with diabetes and one or more risk factors need frequent assessments of their feet during routine office visits. 5 Patients with known risk factors for foot ulcers (e.g., poor vision, previous foot ulcers or amputation, monofilament insensitivity, and fungal infections of skin or nails) deserve special attention. 8 When practitioners have available clinical information that can help to predict the development of diabetes- related foot ulcers, patients will have better outcomes. 8 These predictors were found to be helpful in accurately targeting clients at high risks of contracting foot ulcers for preventative interventions. The use of proper footwear such as diabetes specialized shoes with proper diabetes foot insoles has been found to be a protective intervention. Pathophysiology of Foot Ulcers Diabetes related foot lesions occur as a result of two or more risk factors: PNP and peripheral arterial disease (PAD). 9 Diabetes-related PNP is a leading contributor to foot lesions. 10 The presence of PAD increases the risk for foot infections and ulcers among people living with diabetes. 11 Foot lesions are less likely to heal due to vascular insufficiency. 12 Research shows that there are three factors that leads to foot ulcers and infections: foot deformities, PNP, and minor trauma. 13 It is important to understand that the longer an individual lives with elevated blood glucose, the more likely he or she will develop PNP. 2 Long term hyperglycemia can affect the skin and delay wound healing if minor cuts or sores occur on the foot. 14 PNP According to Benbow, 14 PNP can be classified as sensory, autonomic or motor. In sensory system PNP, an individual with diabetes has no feeling of sensation on his or her feet, does not feel hot or cold temperature, and does not feel cuts or trauma to his or her feet. 14 When PNP affects the autonomic system an individual will experience a decrease in sweat, resulting in cracked or fissured skin, dilated dorsal veins and an increase in temperature of their feet. 14 When the motor system is affected by PNP, the patient will be at risk for developing foot deformities such as Charcot foot. 14 Commonly, these patients report symptoms of aches and pains with tingling in their feet when PNP is present. 13 Foot Deformities According to Abad Safdar, 13 foot deformities are the second causative factor that leads to foot ulcers among people living with diabetes. People affected by neuropathy have decreased sensation in their feet, and are more prone to foot deformities. 13 These foot deformities affect the muscles and bones of the foot leading to bony protrusions that put the individual at increased risk for ulceration especially when PNP is present. 13 The correlation of PNP and foot deformities was examined by Soyupek, Ceceli, Suslu, Yorgancioglu, 15 utilizing x-rays. Their study showed that the patients with PNP commonly also have foot deformities such as pes planus, pes cavus, tendon calcifications and osteoporosis. 15 Patients living with type 1 diabetes are particularly at risk for developing Charcot neuropathy that causes destruction of the bones of the foot. 16The resultant bone thinning causes the bones to be fragile and leads to foot deformities. 16 Foot Trauma Abad Safar 13 identify foot trauma as the third factor that can lead to foot ulcers. Foot ulceration occurs when there is breaking of the skin, which leads to impaired healing of the lesion. 12 People affected by PNP have sensory loss of their feet and are unable to identify foot pain, trauma, calluses or injury to their feet. 13 Wearing ill-fitting shoes, calluses, onychomycosis, and foot infections that are not treated are all causes of foot trauma leading to ulceration. Once ulceration occurs due to trauma, the wound becomes infected. Testing Tuning Fork and Neurothesiometer A study by Kà ¤stenbauer, Sauseng, Brath, Abrahamian, Irsigler 17 investigated the effectiveness of the Rydel-Seiffer tuning fork in helping with the detection of diabetes-related neuropathy and compared its ability with that of the electronic neurothesiometer. In this study a 128-Hz tuning fork and a neurothesiometer were used at the bedside. 17 The results of the study showed that vibration perception threshold (VPT) was normal in 1917 individuals and abnormal in about 105 individuals when the tuning fork was used. 17 The participants who had abnormal results were older and also had elevated A1c results. The researchers used the neurothesiometer and the results showed that VPT was 2.5 times higher among patients who had an abnormal tuning fork test. 17 The researchers concluded that the tuning fork had a higher sensitivity and a better predictive value in diagnosing PNP at the bedside. 17 The tuning fork is a reliable instrument in helping to detect PNP in the outpatient setting. It is an appropriate clinical tool that practitioners can utilize either at the bedside or in primary care. Neurometer A double-blinded study by Nather and et al. 18 showed that there were other testing methods that were superior in comparison to the SWMT in detecting PNP. One useful tool was neurometer testing. The neurometer measures readings from rapid current perception threshold (R-CPT) which is derived from the lowest strength of stimulus that the patient could perceive. 18 Three different rates of current signals at levels measuring between 0 and 10 mA were applied by the neurometer to the big toe and ankle. 18 Neurometer testing was found to be highly sensitive as compared to the SWMT. Sensory neuropathy was detected with better accuracy when using the neurometer testing at the big toe and ankle sites in comparison to the SWMT. 18 Studies show that the neurometer is an effective tool that practitioners can use to detect PNP. Temperature guided avoidance therapy Research shows that the best intervention in the prevention of foot ulcers was foot temperature guided avoidance therapy (TGAT). 19 A study by Lavery et al. 20 sought to evaluate the effectiveness of infrared temperature monitoring among individuals at a high risk for diabetes related ulceration and amputations. Patients were placed in a usual therapy group or an enhanced therapy group. 20 The enhanced therapy group had additional tasks such as such as the use of a handheld infrared skin thermometer to measure the temperatures on the bottom of their feet twice a day. 20Participants contacted a nurse if they noted a difference in temperature >4 °F between the left and right foot. 20 The results of the study showed that the enhanced therapy group had notably fewer diabetes related foot complications. 20 The TGAT is an effective method in the detection of PNP where practitioners can assist patients in identifying sensory loss so that foot ulcers and complications can be prevented. Scales for Neuropathy Symptoms The Diabetes Neuropathy Symptom (DNS) score is a valuable tool that can be used to screen for and identify PNP. 21 The scoring is based upon symptoms such as ataxic walking, neuropathic pain, paraesthesia, and/or numbness. The DNS criteria are scored with 1 point each and there is a total of 4 points that can be given. 21 Presence of PNP is present with a score of 1, or more. 21 Similarly, the Diabetic Neuropathy Examination (DNE) is another valuable scoring system that helps to identify PNP. This scoring system consists of a total of eight items: two of the items describe the person’s muscle strength; one item addresses reflexes of the tendon and the other five items address sensation. 21 There is a total of 16 points that can be scored with this system. Any score above 3 points is considered to be abnormal and is PNP. 21 Treatment Educating patients Educational interventions are an important tool in reducing foot ulcers. A randomized controlled trial by Gershater and et al. 22 was designed to investigate the effectiveness of patients learning in groups versus learning on their own with information that is provided to them. The authors sought to understand what types of learning would decrease the incidence of foot ulcers. The study results showed that about 42% of the patients got foot ulcers. 22 Some of the reasons for ulcer development were: stress- related plantar ulcer and trauma. 22 The study showed that education in group sessions among patients who are at increased risk for foot ulcers did not have an effect on whether they would develop ulcers of the foot. 22 It was concluded that sessions conducted within a group educational method may be suitable for patients who have a low risk of getting foot ulcers. The authors of the study suggests that it is important to educate practitioners involved in the patient’s medic al care and also their caregivers regarding improved foot care such as footwear and signs of foot problems. Implications for Practice The conclusive results show the best methods to identify PNP and to prevent foot ulcers was the TGAT, the neurothesiometer and the tuning fork. The TGAT method shows that patients can complete this task at home and alert their practitioner about the results. The TGAT is valuable in showing the results of further neuropathy or damage if patients have a prior history of insensitivity to the SWMT. The SWMT is valuable for practitioners to use in the office setting as this is an inexpensive test. The SWMT is not valid once neuropathy is diagnosed. The practitioner should consider the use of the TGAT at this point and teach the patient how to use an infrared sensitive skin thermometer. The patient should be advised to keep a log book and if the temperature on the designated site is >4 °F, he or she will need to reduce the number of steps taken in the following days and contact their practitioner. The tuning fork was also validated as being highly sensitive in diagnosing PNP and is a goo d test for practitioners to use at the bedside. Certain clinical information about the patient is valuable in predicting future foot ulcers. These predictors were high A1c levels, poor vision, prior history of foot ulcer and/or amputation, monofilament insensitivity, tinea pedis and onychomycosis. The practitioner needs to be aware of these predictors and educate the patient about foot care. Practitioners need to increase monitoring of the patient’s foot at every office visit when these predictors are identified. Education is an important criterion in managing PNP. Patients need to be educated about PNP, foot ulcers, proper fitting shoes and the signs of foot infections. This review of the evidence- based literature revealed that basic SWMT is useful in predicting neuropathy but is not useful in preventing ulcers once neuropathy is diagnosed. There is a common misconception among practitioners that SWMT can be used even when neuropathy is diagnosed. The re-education of practitioners is important with the introduction of new testing methods such as TGAT once neuropathy is already diagnosed. This best practice will help to prevent ulcers among persons affected by diabetes and therefore improve the quality of their life. References Meaney, B. (2012). Diabetic foot care: Prevention is better than cure. Journal Of Renal Care, 3890-98. doi:http://dx.doi.org/10.1111/j.1755-6686.2012.00276.x Eddy, J., Price, T. (2009). Diabetic foot care: Tips and tools to streamline your approach. Journal Of Family Practice, 58(12), 646-653 Dorresteijn, J., Kriegsman, D., Valk, D. (2011). Complex interventions for preventing diabetic foot ulceration. The Cochrane Library. Retrieved from http://www.thecochranelibrary.com Centers for Disease Control and Prevention (2012). Diabetes data and trend. Retrieved from: http://www.cdc.gov/diabetes/statistics/prev/national/figraceethsex.htm Broersma, A. (2004). Preventing amputations in patients with Diabetes and Chronic kidney disease. Nephrology Nursing Journal, 31(1), 53-64. Mayfield, J. A., Sugarman, J. R. (2000). The use of the Semmes-Weinstein Monofilament and other threshold tests for preventing foot ulceration and amputation in persons with diabetes. Journal Of Family Practice, 49(11), S17-S29. American Diabetes Association. (2013). Standards of Medical Care in Diabetes. Diabetes care. Retrieved from http://care.diabetesjournals.org/content/36/Supplement_1/S11.full Boyko, E.J., Ahroni , J.H., Cohen, V., Nelson, K.M., Heagerty, P.J. (2006). Prediction of diabetic foot ulcer occurrence using commonly available clinical information: The Seattle Diabetic Foot Study. Diabetes Care, 29(6):1202-7. Retrieved from: http://care.diabetesjournals.org/content/29/6/1202.full.pdf+html Bakker, K., Apelqvist, J., . Schaper, N. C. (2012). Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism Research and Reviews, 28, 225-231. doi:10.1002/dmrr.2253 Bakker, K., Apelqvist, J., . Schaper, N. C. (2012). Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism Research and Reviews, 28, 225-231. doi:10.1002/dmrr.2253 Jarrett, L. (2013). Prevention and management of neuropathic diabetic foot ulcers. Nursing Standard, 28(7), 55-65. Nagoba, B., Gandhi, R., Wadher, B., Rao, A., Hartalkar, A., Selkar, S. (2010). A simple and effective approach for the treatment of diabetic foot ulcers with different Wagner grades. International Wound Journal, 7(3), 153-158. doi:http://dx.doi.org/10.1111/j.1742- 481X.2010.00666.x Abad, C., . Safdar, N. (2012). From Ulcer to Infection: An Update on Clinical Practice and Adjunctive Treatments of Diabetic Foot Ulcers. Curr Infect Dis Re, 14:540–550. DOI 10.1007/s11908-012-0283-3 Benbow, M. (2012). Diabetic foot ulcers. Journal Of Community Nursing, 26(5), 16 Soyupek, F., Ceceli, E., Suslu, F., Yorgancioglu, R. (2007). Neurologic and radiologic abnormalities of the foot in diabetic patients. Journal Of Back Musculoskeletal Rehabilitation, 20(2/3), 55-60 Holt, P. (2013). Assessment and management of patients with diabetic foot ulcers. Nursing Standard, 27(27), 49-55 Kà ¤stenbauer, T., Sauseng, S., Brath, H., Abrahamian, H., Irsigler, K. (2004). The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometer. Diabetic Medicine, 21(6), 563-567. Nather, A., Keng, W., Aziz, Z., Ong, C., McFeng, B., Lin. C. (2011). Assessment of sensory neuropathy in patients with diabetic foot problems. Diabetic Foot Ankle.2(10). Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/22396819 19. Arad, Y., Fonseca, V., Peters, A., Vinik, A.( 2011). Beyond the monofilament for the insensate diabetic foot: a systematic review of randomized trials to prevent the occurrence of plantar foot ulcers in patients with diabetes. Diabetes Care, 34(4):1041-6. doi: 10.2337/dc10-1666. Lavery, L., Higgins, K., Lanctot, D., Constantinides, G., Zamorano, R., Armstrong, D., Kyriacos, A., Agrawal, M. (2004). Home Monitoring of Foot Skin Temperatures to Prevent Ulceration. Diabetes Care, 27 (11):2642-2647. Meijer, J.W., Bosma, E., Lefrandt, J., Links, T., Smit, A., Stewart, R., Van Der Hoeven, J. (2003). Clinical Diagnosis of Diabetic Polyneuropathy With the Diabetic Neuropathy Symptom and Diabetic Neuropathy Examination Scores Diabetes Care, 26(3), 697-701. Retrieved from: http://care.diabetesjournals.org/ Gershater, M., Pilhammar, E., Apelqvist, J., Alm-Roijer, C,. (2011). Patient education for the prevention of diabetic foot ulcers. European Diabetes Nursing, 8(3), 102-107b. Retrieved from: http://dx.doi.org/10.1002/edn.189

Contrasting the Court of Miracles and Notre-Dame Essay -- comparison c

Contrasting the Court of Miracles and Notre-Dame "No one had yet remarked, in the gallery of royal statues..., a strange looking specter who until then had been observing all that passed... All at once, at the moment that the chief executer's two assistants were preparing to execute,... he strided up to the two sub-executioners, knocked them down, carried off the gipsy girl, and leapt at one bound into the church, lifting the girl above his head and cried out in a formidable voice, 'Sanctuary!'" Notre-Dame, an intimidating edifice in the heart of fifteenth century Paris, bears many different faces for those residing in and near it. Quasimodo, the deformed bell ringer dwells in the church after being adopted by the archdeacon, Claude Frollo, when the hunchback was an infant. The empathetic monster lives in complete servitude to Frollo, his savior, and spends his days ringing his beloved bells which repay his altruism by causing him to go deaf. The highly adept archdeacon, Claude Frollo, also resides within the walls of Notre-Dame, and after filling his head with every piece of knowledge he can find, he begins to dedicate his life to alchemy. The two men, besides their relationship and common habitat, have one other item in common. They both have fallen in love with La Esmeralda, a compassionate, orphaned gipsy girl who earns her living on the streets with her fluid dancing and droll tricks her goat, and best friend, Djali performs. Quasimodo's love is pure and fresh and he lives in awe of La Esmeralda after she offers him a drink of water when the townspeople deny him this request while he is being tortured as punishment for the sole crime of being deaf and not understanding the judge. Frollo's... ...ts walls are not as strong as the building. The archdeacon, Claude Frollo, a holy man, gives way to the sin of the flesh and tries to rape as well as kill La Esmeralda. Phoebus, a man who worships God within it's walls, single-handedly could save La Esmeralda's life, but chooses not to because of his own vanity. The entire town closes its eyes to the truth, and condemns an innocent girl to death without any proof, just for the fact that she is different from them. The structures of the Court of Miracles and the Cathedral of Notre-Dame are very different structures. Notre-Dame is a symbol of strength and God while the Court of Miracles represents the filth of the Earth. Yet, as Hugo's theme suggests, one cannot judge places, or men, by their appearances and the Court of Miracles proves to be the stronghold, while Notre-Dame houses the iniquity of the city.

Practices in Project Management Essay

Abstract The St. Dismas Medical Center (SDMC) Assisted Living Facility (ALF) Project was authorized to create a new service line to counteract a decline of inpatient activity. The project objectives are to build 100 light- and heavy-assist units in a standalone residential facility with a sheltered connection to SDMC by late-July 2001 and within an $11 million budget. The particular deliverables, constraints, assumptions, exclusions, and work breakdown structure are outlined in the Project Scope Statement. Brainstorming and scenario analysis will be used in the risk strategy, while cost-benefit analysis will be the primary tool in project quality management. A project work list and milestone schedule illustrates the critical path for the 102-week construction phase. And, the $10 million budget is detailed by activity and quarter to reconcile the multiple cost perspectives of team members. Project monitoring will primarily use earned value metrics along with the Gantt chart and budget. Data will be analyzed and reported weekly to the team, and significant deviations from the plan are subject to the control strategy; milestone status reporting and meeting with the Board of Trustees and submission of change requests to get the plan back on track. The plan will conduct a formal closeout process to include an audit, closeout meetings, a final report, closeout meetings, and record archival. Project Purpose and Justification Over the past few months, there has been a steady decline of the inpatient population at St. Dismas Medical Center (SDMC) due to the increased usage of seatbelts and bicycle/motorcycle helmets. A planning retreat was held to  identify business opportunities and a solution was proposed to build an assisted living facility on the St. Dismas campus. The purpose of the project is to plan and implement Assisted Living Facility (ALF) as authorized by the Board of Trustees in May 1999. The project is being completed in order to create a new service line to take advantage of the opportunity presented by the shortage of medically-focused and highly specialized facilities available throughout the country and a growing geriatric population. We project that the ALF, the for-profit subsidiary of SDMC, will bring in a net income between $9,000 and $12,000 per unit and a net cash flow of about $1,500,000 annually. Both outpatient referrals and inpatient population are expected to increase. Furthermore, we hope that the project will have an added benefit of strengthening the organizational focus on reimbursable preventive and wellness programs for healthier aging community. Project Requirements The ALF Project Steering Committee has identified several actions and processes that need to be met, including: facility design and construction; operational needs for food services, housekeeping, and staffing; development of operational policy and procedures; creation of an operating budget; creation of payroll and accounting systems; characterization and set up of telecommunications and information system needs; preliminary marketing plans, with community and staff communications plans; development of medical assessment tools for incoming residents; designation of clinical services offerings; development of an organizational structure; identification of government regulations and industry standards. Primary Project Objectives The primary project objectives of the ALF Project are as follows: The cost objective is to fall in between $8.5 to $11 million for the construction of the facility. The time objective was to complete construction and open by July 2000, but was later revised to a duration of two years, with completion by late July 2001. The scope objectives are to build a standalone residential facility with a sheltered connection to SDMC that can access the  cafeteria and hospital services, containing 100 units that accommodate up to 150 single and couple residents with 15 to 30 â€Å"heavy-assisted† units and the remaining units â€Å"light-assisted†. Assumptions and Constraints The following is assumed: Project funds will be released in a timely manner. Project team members and resources will be available as needed. Contractors will have the skills and experience needed to complete the project. The constraints are as follows: The construction cannot begin until after the November 1999 city elections. The facility needs to open by late July 2001. Operational and administrative policies, procedures, and systems need to be created and regulations and standards need identification. High-Level Risks As with all projects, there is a risk of running over budget, over schedule, and/or falling short on scope. There are several high-level risks for the ALF project. One particular area of concern was the short seven-month time period for the complex construction project, but that has been extended about another year. Further, the organizational complexity is high with the number of people involved across many functions and the decision-making body being the Board of Trustees. This complexity may lead to delays in decision-making. The project is also much larger than SDMC has handled in the past with only one team member having construction experience. The operational and administrative regulations and standards for construction and healthcare industries will be complex and have not yet been identified. Construction projects have a strong potential to impact the local ecology which will add a risk factor to the project. Further, weather poses a high-level risk to the project and may negatively impact the schedule by delaying supply deliveries and construction work. Major Project Milestones Major project milestones include: 1. Facility design and construction 2. Identification of operational needs 3. Project and operating budget development 4. Creation of payroll and accounting systems 5. Define telecommunications needs and system setup 6. Define information systems and system setup 7. Creation of a preliminary marketing plan and communications package 8. Organize major ground breaking event 9. Clinical Services 10. Design of assessment tool for incoming residents 11. Identification of demands for clinical services 12. Development of facility’s management structure 13. Identification of governmental regulations and industry standards Preliminary Budget Estimate The preliminary budget estimate for the completed project is between $8.5 and $11 million, which includes the land purchase, facility construction, facility furnishings, and construction of the sheltered connection from the assisted living facility to the Medical Center. Key Stakeholders Illustrated below is the key stakeholder analysis matrix, which demonstrates the key stakeholders, their levels of power and interest, and an engagement plan. The matrix is followed by a communications chart that outlines stakeholders, their responsibilities, and their communication needs. The project scope is to build a standalone residential facility for the purpose of providing assisted living services to up to 150 single and couple residents. The product will also include a sheltered connective structure that provides access to St. Dismas Medical Center’s cafeteria and hospital services. The facility will contain 100 residential units with 15 – 30of those units that accommodate residents that need heavy assistance and the remaining units categorized as â€Å"light-assisted†. The cost to construct the facility should fall within $8.5 to $11 million range. Acceptance of the project requires that construction may not begin until after city elections in November 1999 and the facility must open to the public by late July 2001. Project Constraints The construction cannot begin until after the November 1999 city elections. The facility needs to open by late July 2001. Operational and administrative policies, procedures, and systems need to be created and regulations and standards need identification. The budget cap is $11 million. Project Assumptions There are several assumptions that may also impact the implementation of the project if they prove to be false (Project Management Institute, 2013): Project funds will be released in a timely manner. Project team members and resources will be available as needed. Contractors will have the skills and experience needed to complete the project. Project Deliverables facility design and construction; operational needs for food services, housekeeping, and staffing; development of operational policy and procedures; creation of an operating budget; creation of payroll and accounting systems; characterization and set up of telecommunications and information system needs; preliminary marketing plans, with community and staff communications plans; development of medical assessment tools for incoming residents; designation of clinical services offerings; development of an organizational structure; identification of government regulations and industry standards. Project Exclusions Items that are not included in the scope include: design and construction of a parking lot or garage design, construction, and furnishings of patient entertainment and activity areas design, construction, and furnishings of exercise and fitness areas design and development of landscaping, walking paths, and gardening areas design, construction, and furnishings of private visiting areas design, construction, and furnishings of salon and barber services area design, construction, and furnishings of dining area Project Risk and Quality Management Strategy Project Risk Strategy The project team has held a brainstorming session with a group of consultants in several relevant areas of expertise to identify an exhaustive list of risks by questioning what could go wrong with tasks. The scenario analysis method has also been utilized to identify, analyze, and prioritize risks from high-to-low impact. This method entails utilizing critical thinking skills to realize events that may likely impact the project (Mantel, Meredith, Shafer, & Sutton, 2011). Additionally, the work breakdown structure (WBS) and project profile were scrutinized to further identify highly probable risks as suggested by Mantel et al. (2011). The following highly probable risks have been identified: Bad weather Inadequate staffing Inadequate budget Project management team inexperience Regulatory and industry requirements Cost estimation errors Complex organizational structure and decision-making process Broad set of stakeholders that have yet to weigh in on the project Environmental impact from construction Project communication and coordination issues Inadequate deliverables (e.g. parking garage) Inadequate time schedule The strategy for handling risks is to develop a risk response plan as advised by Mantel et al. (2011). The risk response plan will include contingency plans to handle events that do happen, with more than one contingency plan and supporting logic charts developed for high-impact risk. Furthermore, risk identification and response planning will be ongoing through the project duration. Project Quality Management Strategy The ALF project quality management strategy is to follow the Project Management Institute (PMI) (2013) guidelines: identify quality requirements, document compliance levels of quality requirements, perform quality assurance auditing, and control quality by taking action to address poor quality measurements. Inevitably changes will have to be made to manage events or unsatisfactory quality results. The ALF Project change management strategy is to include provisions in the original contract to accommodate change as suggested by Mantel et al. (2011). An integrated change control process will be created and implemented, as advised by PMI (2013) to reduce project risks through holistic analysis of proposed changes. This process will outline how change requests will be reviewed, approved or denied, and how those changes will impact other aspects of the project (policies, documents, plans, etc.) (Project Management Institute, 2013). Two tools that will be used to manage quality are: cost-benefit analysis, which compares the cost of the proposed change to the expected benefit. cause-and-effect diagrams which utilizes the question  Ã¢â‚¬Å"why† to discover the root cause of a problem in order to correct it. Cost-benefit analysis will be useful in presenting problems and their possible changes to the decision-making body in order for them to fully assess their options and identify the solution that best suits their requirements. The cause-and-effect diagram will be beneficial in recognizing the true problem that needs to be addressed. Finding a solution for the root cause will help the team avoid unnecessary costs, time, efforts, and rework in addressing the wrong issues. Construction Phase Milestone Schedule Below is the work list and milestone schedule for the construction phase of the St. Dismas Assisted Living Facility project. The critical path (B-C-D-E-F-G-H-I-K-L-O-P-S-T) is illustrated in green on the milestone schedule. The project is scheduled to be completed in 102 weeks, just shy of two years. The assumptions for this schedule are the following: The milestone schedule will be approved by the Board of Trustees. The project will begin in August 1999 after action plans are submitted. Project funds will be released in a timely manner. Project team members and resources will be available as needed. Contractors will have the skills and experience needed to complete the project. Project Budget Below are the summary-level budget and detailed budget for the St. Dismas ALF Project. The assumption from examining the provided cost information chart is that the Chief Operating Officer and the Construction Project Manager provided the estimates for the facility design and construction activities of the ALF project, and upper management dictated the administrative and contingency budgets, and both did so honestly. Bottom-up budgeting utilizes the work breakdown structure in a way that cost estimates of each activity are completed by the team members responsible for carrying out those tasks, while top-down budgeting produces estimates based on the judgments and experiences of top managers (Mantel et al., 2011). The combination use in this project of top-down and bottom-up budgeting is ideal, according to Mantel et al. (2011). The advantage of top-down budgeting is that it generally has a high degree of accuracy, although it can include considerable miscalculations for low-level act ivities; bottom-up budgeting is opposite in that it provides accuracy for low-level activities and the possibility of considerable miscalculations for high-cost activities (Mantel et al., 2011). The detailed budget is also divided by task and expected quarter of expenditure to address the multiple perspectives of cost between the project manager (PM), the accountant, and the controller. Mantel et al. (2011) point out that the PM is concerned with commitments made against the budget, accountants track costs as they are incurred, and controllers are responsible for the organization’s cash flow. Dividing costs by activity and quarter allow all three parties to understand their relationship to the project. In this budget, the bulk of the detail outlines only one deliverable from the project’s scope statement and work breakdown structure—facility design and construction. The other deliverables are clumped into the central and direct administrative costs categories. Although the budget may sufficiently cover the costs of the labor that needs to go into the other deliverables (identifying needs and regulations, and developing plans, systems, and budgets), it may insufficiently cover the costs for other aspects of some of the deliverables, such as setting up  telecommunications and information systems, and organizing a major ground-breaking event. Furthermore, consideration should be given to the fact that project exclusions from the Project Scope Statement, such as design and construction of a parking area and activity and entertainment areas, are not factored into this budget. The current budget totals $10,000,000, which is still $1,000,000 under the original estimated budget and leaves some room to add deliverables if necessary. Project Summary Budget Project Monitor and Control Strategy The ALF Project monitor and control strategy is as follows. The project team will continuously monitor schedule progress via the Gantt chart and monitor budget progress via the detailed budget. Monitoring these will give the team a comparison of the time period against the actual plan. However, the team will utilize earned value (EV) metrics to not only compare the current situation with the plan, but also consider the actual progress at the point of evaluation (Mantel at al., 2011). The data from these control tools will be collected and analyzed weekly and reported to the team on a weekly basis as stated in the communication chart. The project management team will assess if any deviations from the plan are significant enough to employ control measures. If the project management team feels that intervention is  necessary, data (including the project milestone status report), assessments, and suggestions will be communicated with the Board of Trustees, and change requests will be s ubmitted with the aim to reduce the differences between the plan and the actual circumstances. Earned value metrics is the ALF Project preferred monitoring tool for the purposes of monitoring and controlling. Earned value metrics allow the team to compare the plan with the actual progress at any given point in the project, to see how efficiently our schedule and costs are being maintained, and providing an estimate of cost if the project is continued at the current rate (Mantel et al., 2011). Utilizing a go/no-go control, such as the milestone status report, allows us to compare the project output (using milestones as checkpoints) to the existing standard, assess what are needs are in terms of physical assets, human resources, and/or finances for particular tasks, and employ the necessary steps to meet those needs in order to get the project schedule, budget, and/or scope aligned with the plan (Mantel et al., 2011). Project Closeout The ALF Project will conduct a formal project closeout primarily to â€Å"help the organization improve its project management skills on future project† (Mantel et al., 2011, p. 273). The formal project closeout will allow SDMC to understand project mistakes, accomplishments, performance, and project team and management efficiencies and deficiencies, and document these in the organizational knowledge base. Furthermore, a formal close out deals with all those involved in the project in a way that has positive impact on morale and trust. The organization and the project managers show they are reliable when they finish what they start, communicate to each department that it is time to finalize their project activities, and deal with project staff and their reassignments in a tactful manner. The project closeout will follow the suggestion of Mantel et al. (2011). After the project manager ensures that all project work is complete, the project must go through the project acceptance phase. Acceptance needs to be gained from the Board of Trustees, and project management team, and officially recorded. A detailed audit will be performed to assess the progress and performance of the project’s plan through examination of â€Å"its methodology and procedures, its records, properties, inventories, budgets, expenditures, progress, and so  on† (Mantel et al., 2011, p. 275). Audit findings as well as the complete project history will be written in a final report. The final report will include the project failures, successes, and lessons learned. The final report will also document the project activities and management techniques, the location of the organization’s assets, and recommendations for improvement. The final report will be distributed to stakeholders upon completion. Closeout meetings with contractors and department heads (financial, legal, purchasing, organizational, facility, etc.) will be head to notify them of project termination, provide direction to clear the project activities in which they are responsible, and address final issues. A closeout meeting with project personnel will be conducted to address reassignments and stress, and provide closure. Finally, the project books will be closed, organizational assets will be updated, and records will be archived. References Mantel, S., Meredith, J., Shafer, S., & Sutton, M. (2011). Project Management in Practice (4th ed). Hoboken: John Wiley & Sons. Project Management Institute. (2013). A Guide to the Project Management Body of Knowledge (PMBOK ® guide) (5th ed). Newtown Square: PMI Publications.

Preventing accidents to children Essay

One of the hazards in the nursery is wires. To minimize the risk of children tripping over wires, wires should be tidied away out of the areas where the children are to prevent them from tripping up over them. Also, cable management systems such as cord covers could be used to cover the wires which make it less likely that the children could trip over them. The Healthy Working Lives website advises to ‘try to place equipment to avoid cables crossing pedestrian routes and use cable guards to cover cables where required’ (Healthy Working Lives, 2013). Slips/ Trips and fall is another hazard in a nursery and to minimise it so that service users are not at risk you can make sure that such hazards are put onto a side where it is not in the way of children. For e.g. if toys are in the walkway then tidy them away to a side. The Safety and Health website says that to prevent slips trips and falls you should ‘clean up spills immediately. If a spill can’t be cleaned up right away, place â€Å"wet floor† warning signs for workers. Keeps walkways and hallways free of debris, clutter and obstacles. Keep filing cabinets and desk drawers shut when not in use. Cover cables or cords in walkways. Replace burnt-out light bulbs promptly. Consider installing abrasive floor mats or replacing worn flooring. Encourage workers to wear comfortable, properly fitted shoes’. (Safety and Health, 2016) Another hazard in a nursery Weather/ Room temperature. To minimise the risk of children professionals and other in the setting suffering from hyper/hypothermia the nursery should ensure that the setting is suitable for service users to be in. This can be done by nursery staff making sure that the setting has an appropriate temperature for e.g. if its cold outside then they should ensure that the nursery is nice and warm for the service users’ and others who work or maybe visiting the nursery. If the temperature outside is too hot then The Nursery World advises to ‘avoid physical activities on very hot days to minimise the risks of heat stress, heat exhaustion and heatstroke.’ (Nursery World, 2015) Hazardous substances – cleaning products, beach etc. is one of the major hazards in a nursery as the harms and severity are very critical. In order to minimise the risk of this hazard substances and cleaning products should be placed out of children’s reach or placed in a locked cleaning cupboard. The Health and Safety Executive website advises to ‘Use good work techniques that avoid or minimise contact with harmful substances and minimise leaks and spills. Store cleaning products safely.’ (The Health and Safety Executive, No Date) In a nursery Doors/ stairs is also another hazard. In order to ensure that no service users are harmed by this hazard and the risk of potentially being harmed to be reduced the nursery should place some control measure to prevent them and they could be things such as door-slam stoppers or jammer. The Safe Kid website advises to fit hinges with protection strips ‘these devices cover the hinge where the door is joined to the wall. They are a long strip of plastic, easily fitted, that bend with the door when it opens, preventing children from slotting their fingers in.’ (Safe Kids, 2015) Open windows can be hazardous for service users as well as other people in the setting. The risk can also be very severe for this the nursery should try to minimise the risk of children being harmed. This can be done by placing some barriers such as gates around the window so children can jump out, this can also help safeguarding as no intruders will be able to enter. The Baby Centre website advises to ‘fit locks to prevent your child from opening them from the bottom. Fix low windows so that they don’t open more than 12.5cm.’ (Baby Centre, 2017) Faulty electrical equipment’s are another hazard in a nursery. This hazards has an overall rating of 12 but it can severely affect service users, professionals and others in the setting. In order to minimise this risk all electrical equipment’s should be regularly tested, any electric’s that are broken or can be hazardous to people should be disposed of or put out of use. This is supported by The Nursery World website that says ‘All electrical and gas equipment to be maintained and subject to annual inspections. The service histories of appliances should be recorded in a log book.’ (Nursery World, 2017) Medication or drugs lying around in the nursery is another hazard. To minimise professionals should keep an eye on service users to ensure that they don’t do anything that could place them in harm. This can be done by professionals making sure that the setting is safe for the children. Any medication that are in the premises should be authorised by the nursery nurse or it should be a prescribed by doctors. These medication should be kept by professionals and given to service users as prescribed. The Kids Health website advises to ‘Store all medicines, prescription and non-prescription, out of sight and out of reach of children, preferably in a locked cabinet. Even items that seem harmless, such as mouthwash, can be extremely dangerous if ingested in large quantities by children. Just because cabinets are up high doesn’t mean kids can’t get their hands on what’s in them, they’ll climb up (using the toilet and countertops) to get to items in the medicine cabinet.’ (The kids Health, 2017) Climbing frames/ broken toys can also be hazard in a nursery as service users can be harmed during playtime or when doing activities. To minimise this risk the nursery should make sure that all their equipment’s have a risk assessment done, make sure that the toys in the nursery aren’t harmful to the children, broken toys can be a hazard as service users may fall of them and gets hurt or it may drop on them depending on what toy it is. When children are playing on the climbing frames a professional should keep an eye on them or help them on this activity as they may fall from it and get injured. Toys with sharp edges should be avoided and the nursery should have age-appropriate toys. The safe Kids website says that ‘Useful points to consider include what to look for when buying toys, understanding safety marks and labelling, ensure that the right safety checks have been carried out, and considerations when giving and receiving used toys.’ (Safe Kids, 2011) Another potential hazard in a nursery is the event of a fire. If the nursery have control measures in place then the likelihood of a fire can be reduced. Control measure could be equipment’s that may cause a fire being checked and tested regularly, cookers and gas check should also be up to date and recorded on a logbook. The Kids Health website supports this by saying that making sure all electrical appliances are tested, making sure that wires are in good condition and sockets are safe to use. Fire alarms, fire doors etc. should be installed in the case of a fire and the Safety website says that the three P’s are recommended, they are: †¢ ‘PREPARE – Reduce the risk of fires by eliminating hazards. †¢ PRACTICE – Practice a fire evacuation plan and general fire safety practices. †¢ PREVENT – The Unthinkable’

George Washington Could Not Afford To End Slavery Essays - Slavery

George Washington Could Not Afford To End Slavery Essays - Slavery George Washington Could Not Afford To End Slavery subject = U.S. History title = George Washington Could Not Afford To End Slavery George Washington Could Not Afford To End Slavery In his writings, George Washington felt very strongly that slavery was an institution that needed to be eliminated from American society. However, there were several circumstances that arose following the American Revolution that would prevent Washington from actively pursuing the elimination of slavery during his lifetime. It is certainly plausible that George Washington's personal economic short-comings, forefront in the setting of conflicting political agendas and the nation's revolutionary climate, prevented this founding father from actively pursuing the nationwide emancipation of slaves. Prior and during the American Revolution, little was written by Washington on his feelings about slavery. In the last year of the war and thereafter, more attention was spent by Washington on the issue of slavery. On February 5, 1783, Washington received a letter from Marquis de Lafayette, whom Washington considered both a friend and a son, that stated, "Let us unite in purchasing a small estate, where we may try the experiment to free the negroes, and use them only as tenants. Such an example as yours might render it a general practice..." (Sparks v.3, p.547). It is doubtful that Lafayette would have proposed this idea unless he knew that Washington had strong views on seeing the elimination of slavery. Washington wrote back to Lafayette on April 5, "The scheme... to encourage the emancipation of the black people of this Country from that state of Bondage in which. they are held, is a striking evidence of the benevolence of your Heart. I shall be happy to join you is so laudable a work..." (Fitzpatrick v.26, p.300). Unfortunately, Washington was still in charge of the American troops, and would be so until December, so he thought it would be best to "...defer going into a detail of the business, 'till I have the pleasure of seeing you" (Fitzpatrick v.26, p.300). However, when Washington finally did return home in December, he found himself in such great debt that even noble experiments like the one that Lafayette had proposed, had to took a back seat to getting Washington's financial situation in order. Lafayette went on with his plan alone, buying land in the French colony of Cayenne (Sparks v.4, p.110). Washington was still very supportive of this plan despite his inability to participate, and on May 10, 1786, he wrote to Lafayette, "[Y]our late purchase of an estate in the colony of Cayenne, with a view of emancipating the slaves on it, is a generous and noble proof of your humanity" (Fitzpatrick v.28, p.424). Washington hoped that the American people would have similar ideas and feelings on slavery, but he realized that this hope was very unlikely to be realized. He writes to Lafayette in the same letter, "Would to God a like spirit would diffuse itself generally into the minds of the people of this country; but I despair of seeing it" (Fitzpatrick v.28, p.424). While Washington believed that the slaves needed to be freed, he also thought that the process should be a slow and gradual one. He felt that to release the slaves all at once would, "[B]e productive of much inconvenience and mischief..." (Fitzpatrick v.28, p.242). There would be a mass of former slaves in America who did not have the skills needed to survive. Many of them may have had to resort to stealing in order to feed themselves. It would also be very inconvenient for the slave holders who depended so greatly upon their slave work force. To eliminate such a work force would devastate many Americans, mostly Southerners, who relied heavily on slave-labor. In numerous letters, Washington stresses his desire to see Legislative authority enact a plan that would slowly and gradually free the slaves. In a letter to Robert Morris on April 12, 1786, Washington writes, "I can only say that there is not a man living who wishes more sincerely than I do, to see a plan adopted for the abolition of [slavery]...by Legislative authority..." (Fitzpatrick v.28, p.408). He also writes on September 9, 1786, to John Mercer that, "I never mean...to possess another slave by purchase; it being my first wishes to see some plan adopted, by which slavery in this country may be abolished by slow, sure, and imperceptible degrees" (Fitzpatrick v.29, p.5). Much later in his life, Washington is still echoing this same message when he writes on August 4,

Partnership Law Assignment The WritePass Journal

Partnership Law Assignment Introduction and Issues Partnership Law Assignment Introduction and IssuesAppointment of Tina and / or HelenExpulsion of JuliaArbitration ClauseLiability of Michael as AgentConclusions and SummaryBibliographyRelated Introduction and Issues The facts presented here indicate that a partnership has been set up between three individuals and that there is a partnership agreement in place to deal with the operation of the business. Several factual situations have arisen and this will require the partners to look at the agreement entered into between the parties, as well the statutory provisions that are contained within the Partnership Act 1890 (PA). When looking at the situations being presented here, it is recognised that there is a partnership agreement in place and this would need to be seen in its entirety, in order to advise fully. Based on the above, this discussion will look at the facts presented and the extract of the agreement, alongside the statutory provisions, in order to determine ultimately the way in which the various issues raised can be dealt with. This will depend on a combination of the statutory provisions and anything that may be in a partnership agreement. As the partnership agreement has not been see n, the basis of this advice is that the partnership agreement is in keeping with the statutory and common law provisions. Four key issues have been identified and will be discussed in turn. Firstly, there are queries in relation to the potential appointment of either Tina or Helen, both of whom are related to Andrea and for slightly different reasons she wishes them to be included in the partnership. Secondly, there is a question in relation to the potential expulsion of Julia from the partnership. Thirdly, a suggested arbitration clause has been requested and is contained below. Finally, there is the query of the liability of Michael to the supplier and his relationship with the partnership and the supplier, i.e. whether he was acting as an agent. Therefore the supplier could legitimately bring an action against the partnership for the money owed or the question as to whether Michael would be liable personally. Appointment of Tina and / or Helen There are duties placed upon partners by virtue of their entering into partnership arrangements. These are stated in the Partnership Act 1890. Firstly, there is the duty to act in the utmost good faith towards the other partners. Secondly, there is a duty for the partners not to make a personal profit and not to place themselves in a position when the interest conflicts with their duty. As there are three partners within the current partnership arrangements, a majority i.e. two of the partners would be able to agree the inclusion of another partner. In principle, therefore, if Catherine remains unhappy about the proposition, she alone could not block this appointment. It is however argued, particularly in the case of Tina, that Andrea is acting in breach of her fiduciary duties to the partnership by attempting to include Tina, simply so that the partnership could remain within her family, in the future. There is a strong argument that putting Tina forward is a conflict of interest and therefore should not be allowed by virtue of the Partnership Act. Therefore, Catherine could present this argument, even if she remains in a minority. The position in relation to Helen is somewhat more complex, as it could be argued to be in the partnerships best interests to recruit a much needed bookkeeper who is suitably qualified. As it would seem that Andrea and Julia would vote in favour of including Tina and Helen in the partnership, it would then be up to Catherine to argue that Andrea is acting in breach of her duties. It would be considerably easier for Catherine to prove this in the case of Tina who seemingly has no purpose in the partnership save as to further Andrea’s interests. In reality, however, it would be necessary to look at the provisions of the partnership agreements, in order to ascertain what would happen in the event of a dispute. The ultimate sanction for a partnership that is no longer tenable is the winding up of the partnership and this may not be desirable to any of the partners (section 26). In that case, consideration should be given to any arbitration of the possibility or the opportunity of one party to buy another out. It is not clear what provisions are contained within the partnership agreement for this and therefore the rules established in the Partnership Act 1890 prevailed on the partnership, with the danger of being wound up, if no agreement can be reached. It is also noted that, in accordance with clause 20, a notice of expulsion could be issued upon Andrea stating that she has breached her duties as a partner within the partnership. Although Catherine is unhappy with their actions, there is no indication that Julia is insufficiently unhappy that she is likely to be willing to pursue this route, although it does present a potential option in the event that both Catherine and Julia feel sufficiently strongly that Andrea is breaching her duties, in attempting to ensure that the partnership stays within her family, in the future. Expulsion of Julia Firstly, it is noted that, in accordance with section 25 of the 1890 Act, there is no immediate right for the majority to expel a fellow partner within the partnership. Therefore, it is necessary for Andrea and Catherine to look at the provisions of the partnership agreement, in order to ascertain whether or not they have any legitimate way to expel Julia, based on recent events. An alternative would be to look at the dissolution of the partnership and there are certain conditions within the Act which allow for this, although at this stage it is not perceived to be the desirable route and instead both Andrea and Catherine are looking towards the clauses within the partnership agreement, in order to expel Julia. An extract of the partnership agreement, namely clause 20, has been provided and it is recognised that there may be additional clauses within the agreement which have not been seen that could impact on the advice given. However, for the purposes of providing this advice, claus e 20 will be looked at. It is possible for the remaining partners to provide a notice in writing to the partner who is in breach of clause 20, terminating their position within the partnership, if the partner acts in a way that is a breach of their duties, or if they have acted in a way that is contrary to good faith between the partners, such notice may be provided. In this case, Julia has been convicted of a criminal offence namely drunk and disorderly behaviour, with a recognition that Julia is undergoing difficult personal circumstances. The question here would therefore be whether this conviction is such that it breaches one of the partnership duties, or creates a situation where it cannot be said that Julia is acting in good faith, going forwards. It is suggested that, due to Julia’s current level of distress, there is a strong argument that the necessary good faith between the partners has irretrievably been eroded and that clause 20 is then utilised in order to expel Julia from the partnership. In the alternative to taking a litigious approach and given Julia’s existing unhappiness with the attempted changes from Andrea, a form of settlement may be possible, or arbitration to resolve the situation. It is unclear as to whether these situations are dealt with within the partnership agreement and further investigation is necess ary to prevent a potential dissolution or battle in relation to the expulsion of Julia. It is, however, concluded that the actions of Julia are sufficiently severe that they could be used in order to expel her. Arbitration Clause As evident above, it would be advisable for the partnership agreement to have some form of dispute resolution mechanism in place. A suggested wording for such arbitration or dispute resolution mechanism is as follows: â€Å"Except as otherwise provided, any dispute arising out of or in connection with this agreement, including any question regarding its existence, validity or termination, or the legal relationships established by this agreement, shall be referred to and finally resolved by arbitration under the Rules of the London Court of International Arbitration, which Rules are deemed to be incorporated by reference into this clause. (a) The number of arbitrators shall be one. (b) The seat, or legal place, of arbitration shall be London. (c) The language to be used in the arbitral proceedings shall be English. (d) The governing law of the contract shall be the substantive law of England and Wales. 33.2 This clause shall be without prejudice to the rights of any party to seek any injunctive or similar relief from the courts to protect its intellectual property rights, confidentiality obligations, restrictions on the activities of any Partner or former Partner or other rights of any description.† This offers a dispute resolution mechanism that is both certain and efficient in dealing with such disputes and does not require the dissolution of a partnership unnecessarily. Liability of Michael as Agent Finally, there is the issue of Michael who did not become a partner who was sufficiently involved at the outset that his name has been placed on stationery. The firm purchased equipment from a personal friend of Michael, based on this personal relationship, with the belief that Michael was a partner in the firm. The question here therefore is whether it is reasonable for the company to be taking action against Michael personally, or whether he was acting as an agent for the firm. Typically, where an individual is acting as an agent between the firm and the supplier and this is known by supplier, it is the firm that would remain entirely liable for any agreement entered into. However, in this case, it would seem that Michael was acting as for an undisclosed principal and the supplier was not aware that they were in fact contracting with the firm, which was a partnership which did not include Michael. The supplier seemingly believed that he was contracting directly with Michael as a partner within the firm. When this is the case the third party i.e. the supplier, has a choice as to whether they enforce the contract against the principal, i.e. the firm or the agent, i.e. Michael. The actual discussion or arrangement with Michael is not clear; however, it is known that Michael had his name on the stationery used to communicate with the supplier. Therefore, it would seem reasonable to suggest that the supplier would have felt they were dealing with Michael personally or at least as part of the firm. On this basis, and with the fact that the supplier is now concerned about the financial validity of the firm, it would seem likely that the firm is going to look towards Michael personally to be liable for the contract. Conclusions and Summary The position within this partnership remains volatile, with three separate partners all of whom have agreed to the partnership agreement, all having disputes of some nature with each other. Fundamentally, however, in accordance with the Partnership Act 1890, it is necessary for each partner to be acting in good faith and to the overall benefit of the partnership and not on their own account. This standard will need to be borne in mind when looking at Andrea’s proposition of bringing on board both of her daughters. There is seemingly little argument in favour of the partnership bringing on board Tina; however, this is slightly less obvious with Helen, as she brings necessary skills to the partnership. The majority of the partnership cannot vote to expel an individual, in this case Julia, unless such conditions are contained within the agreement. According to the extract of the agreement provided, an expulsion is possible where the partner was not acting in good faith. A crimina l conviction does not necessarily indicate bad faith and this would be a matter of fact to be determined by the two partners looking to expel Julia. Finally, there is a strong argument that Michael, by virtue of the firm stationery and potentially any discussions with the supplier, will be held personally liable, having acted as an agent for an undisclosed principal. Bibliography Atwood v Maule (1868) 3 Ch App 369 Blisset v Daniel (1853) 10 Hare 493 Partnership Act 1890 section 24 r.7 Partnership Act 1890 section 25 Maillie v Swanney (2000) SLT 464 Morse, G (2010) Partnership Law, Oxford University Press. p.153 Sealy, L Hooley, R Commercial Law: Text, Cases and Materials, OUP. P.122 Watteau v Fenwick, [1893] 1 QB 346

A Study Of Thailands Sex Tourism

A Study Of Thailand's Sex Tourism 4Sex Tourism in ThailandAs we enter a new millenium the post-colonial nations in the world are still searching for ways to compete in an increasingly globalized, consumption driven economic environment. Many developing countries have speculated that Tourism is an effective catalyst for development as well as increased international understanding. Thailand, who has embraced tourism as the key to its modernization strategy, has been hailed by many as a paradigm for success. Over the past twenty years Thailand has enjoyed one of the fastest economic growth rates of any developing country. This rapid progress has allowed Thailand to emerge as an economic leader in the Third world. The $4 billion a year in tourism revenue is the core support of the Thai economy (Bishop, p. VI). Thai officials have attributed the success of the tourism industry to the many attractions located in various parts of the country as well as the uniqueness of the Thai people their friendliness and hospitality (B ishop, p. 67). However the Thai government has failed to recognize the contributions of sex tourism which is estimated to generate about $1.5 billion every year, according to Professor Krikiat Phiapatserithan of Thammasat University (World congress, regional profiles, p. 3). Thailands failure to recognize the sex tourism is reflective of the discourse used by the worldwide tourism industry to analyze the industry s success. From the standpoint of the tourism industry the success of tourism is directly related only to economic factors, anything else is seen as unnecessary. It is in the best interest of tourism corporations and the countries that are dependent on tourism to discourage the circulation of information regarding any of the potential negative effects related to tourism. The censorship of information by these entities has caused much of the general public to be ignorant of the adverse consequences of the mass tourist industry in Thailand. The purpose of this paper is to give an overview of the sex tourism, using Thailand as the basis of my investigation. I will begin by shedding light on the complex social and economic factors that has formed the modern sex industry of Thailand. Then I will link the damaging effects to the Thailand s cultural va lues and quality of life to the emergence of child sex tourism, which in recent years has immerged as a significant contributor of tourist revenue. Subsequently I will give examples of how deliberate manipulations of information by the Thai government and the tourism industry is responsible for the spread of inaccurate images relating to sex tourism. Then I will attempt to link the manipulation of information to tourist s behaviors and attitudes as well as Thai government policy. In conclusion I will give the future outlook for sex tourism in Thailand.Historical, Social and Economic Roots:Vietnam is believed by many to be the beginning of the creation of a large-scale sex industry in Thailand. During the Vietnam War Thailand was a popular destination for rest and relaxation for American servicemen. To meet the demands of American soldiers, who were eager to pay for a temporary sexual partner, new brothels and go-go bars sprang up almost overnight. Following the war the Thai government took an active stance in promoting the growth of the tourist industry in the hope that it would contribute to the modernization process. The half-a-million prostitutes left over from the war were seen as a commodity that could be actively exploited in exchange for the influx of much needed foreign currency. Sex tours from Japan brought many free spending Japanese that significantly aided to the rapid growth of tourism. Tourist arrivals jumped from one million in 1973 to five million in 1990. During this time the Thai government made no attempts to curb the growth of prostitution. In fact they adopted measures that encouraged its growth. Deputy Prime Minister Boonchoo Rojanasathian urged the national conference of provincial governors to encourage certain entertainment , which might be viewed as disgusting and embarrassing because they are related to sexual pleasures (Jubilee, p. 3). The result of this speech was the relaxation of regulations regarding the operation of bars . Eventually the growth of Thailand s tourist industry succeeded in creating rapid economic growth, and modernization. However, Thailand has become so dependent on the tourist industry that a significant reduction of the number of tourist, for any reason, would likely result in the collapse of the entire Thai economy, which would result in widespread poverty. This is one reason why Thai officials have been reluctant to crack down on the sex industry, which is estimated to contribute a quarter of all of the revenues brought in by tourism. The rapid growth and modernization created by tourism has rapidly changed the economic and social structures of Thailand. These shifts have caused the Thai economy and Thai women to be enslaved to the sex trade.Thailand s total gross national income has nearly tripled in the past 50 years (World Congress, background, p. 2). However, despite this rapid growth the disparity of income between the rich and the poor has only widened (Jubilee, p. 4). This disparity has been caused by a drastic shift from an economy based on agriculture to the spread of a market economy. Lower crop prices and crop failures due to drought and floods resulted in widespread poverty among the rural people of Thailand. This has forced the mass migration of the rural population to the cities (Jubilee, p.2). The dire economic reality of these people has caused a disintegration of traditional Thai families. Until recently Thailand was a patriarchal society. One study showed that 73% of the families said they would like to have daughters, while only 27% expressed the desire to have sons (Jubilee, p. 3). Widespread poverty has lead families to consider children, especially females, as economic burdens. Children and women have dropped to the lowest strata of the socioeconomic scale, and have thus suffered the most (Jubilee, p. 4). The closing of options for many families have compelled parents to force their children to fend for themselves and in some circumstances it has led people to sell their children, especially daughters (World Congress, backgrounder, p. 1). The influx of western ideals is another factor that has contributed to the victimization of many women and children by the sex industry. The spread of consumerism by the mass media and through face to face interactions with western tourists has caused Thais to increasingly value money and consumer items. Materialism has led many to value possessions more then their sense of self worth. This materialistic greed has lead many poor families to sell their children in order to obtain material possessions. The market value of a ch ild is between 7,000 and 30,000 baht, depending on the physical attractiveness of the child (Jubilee, p.2). To families living in constant poverty and who only earn 5,000 baht a year 30,000 baht is very enticing. The emergence of the Child Sex Market:The market for children prostitutes has been created by a number of factors. During the 1970 s pedophiles from Western countries were attracted to Thailand because of its lenient laws against prostitution and the high currency exchange rate (Jubilee, p. 3). The supply of customers caused pimps to acquire children through sale and through kidnapping to meet their demand. Widespread rural poverty and the low socioeconomic status of children caused the influx of a large supply of rural children that could be acquired relatively cheep. To prevent the interference of the government Thai officials were bribed or in some cases offered a portion of the profits of the trade. When the AIDS epidemic severely hit the sex industry during the 1980 s many sex tourist began to engage in child sex tourism because children were seen as a safe alternative to adults. Child prostitutes were seen as being less risky due to their young age. Contrary to this notion sex with child prostitutes actually increases the likelihood of the transmission of AIDS due to the immature bodies of children (Jubilee, p. 4). In the past decade the media, most specifically the travel industry, has developed a taste for women with girly qualities. The result of this trend is a st eadily increasing demand for underage prostitutes as well as the continual decline in the desired age for child prostitutes. Due to these unfortunate circumstances the child sex trade has steadily grown and it is estimated that every year one million children are enter the sex trade (World Congress, overview, p. 2). The Manipulation of the Spread of Information by the Government:Despite the immeasurable damage that the sex trade has caused the people of Thailand the government has refused to take an active role in controlling it. In the name of prosperity the Thai government has reduced its focus on matters relating to tourism to exclude everything that is not strictly an economic function (Bishop, p. 66). In essence the Thai government feels justified in sacrificing an entire generation of women and children for economic development. THAI International, a government funded agency, addressed the problems associated with the AIDS epidemic and the sex trade, not as a threat to the nation or its people, but as a threat to the tourism industry (Bishop, p. 68). It seems that greed for money, and power has led to widespread government corruption that has led to a sickening disintegration of morals. The Thai government has swept sex tourism under the carpet with a public relations campaign designed at salvaging tourism s identity (bishop, p. 70). Thai social critic Siriporn Skrobanek claims that The ruling class values the bodies of poor women as a means to attract tourists to earn foreign exchange. This strategy made Thailand a country where all people who go there, like it and long to return. It is beautiful and there is something for everybody (Bishop, p. 75). In the past decade the Tourism Authority of Thailand (TAT) and THAI International has led an effort at attracting affluent white male tourists. One add, issued by a company called incentive Asia Destination Services, promises to turn fantasy into reality and reality into fantasy for deserving high achievers . A brochure titled Thai Values: Travel to the Land of Smiles, says Thai values make Thailand the ultimate incentive; So much for so little; Beauty and the beach; Antiques, Thai arts and crafts all at bargain prices; Living values; The most affordable luxury in Asia; and All the pageantry of Thailand at your command. This advertisement is promoting a form of neo colonialism. Goods in the form of pleasure are exploited by rich ex-imperialistic powers at the expense of a poor undeveloped country (Bishop, p. 70). The Thai government refuses to blatantly acknowledge sex tourism. For if they did it would not be acceptable to openly promote the industry. Instead they promote Thailand as a place with sensuous, beautiful, young women who are eager to serve you to the fullest. The Manipulation of the Spread of Information by the Tourism Industry:There are actual sex tours that you can procure for a modest some of money. The promotional advertising can be found in glossy brochures, and through tour information on the Internet. I was able to find two Asian sex tour agencies on the Internet. It is shocking to see how these ads have contributed to creating and supporting stereotypes about the tourist indust ry of Thailand. The first ad that I analyzed is from an agency called Thailand Teenage Girls Bangkok. It reads Have you ever wished you could go on a n exotic vacation and be surrounded by little teenage girls who just want you for sex!! Well if you go a sex vacation you can have sex with lovely little teenage girls like these all day and night a different one each time if you like! Why not take a week vacation to an exotic destination and fuck your brains out. Everything is arranged for you including a guide who can arrange girls for you! See details inside!!! Who knows you may even want to bring one home with you and this can also be arranged! On the front page it shows ten young, dark, nude Thai women. The women on the cover are consciously designed so that the reader believes that all of Thai women are friendly, beautiful, and primitive. The add promotes the hedonistic idea that the women in Thailand who are prostitutes just want you for sex. It fails to mention that many of the women are victim s of poverty, and in some cases kidnapping. The most shocking aspect of this add is the deliberate promotion of prostitution with teenage girls. It is not difficult for one to twist the message of the add so that it says come have sex with little girls and boys. It is illegal for companies to sell sex with a minor. However, despite these regulations it still occurs. Danny Smith, an undercover news reporter for a British television channel, secretly recorded with a hidden camera what a tour operator told him I can confirm that we can get you kids about ten or eleven. No problem at all? If you want the kids younger, just give me an age. Give me a number. Although child sex tourism is not seen in the general public it certainly exists. There have been cases of children as young as four who have been sold into prostitution (Smith, p. 1). The second add is from Ultimate Asia Sex Tour Travel in Video, which is based out of Honolulu, Hawaii. The first paragraph says: If you ever dreamed of going to Thailand and screwing every night with the most beautiful young sexy girls with thousands of the most luscious sexy girls just waiting to satisfy your wildest sexual fantasies now is the time to go with the Thailand Baht at an all time low!!! It promotes the myth that Thai women are all erotic and beautiful and only wish to please you. Also this add promotes the economic inequalities that allows westerners to exploit Thailand. In the first paragraph of the tour update it says: Have you ever fantasized about secretly escaping to a exotic location surrounded by hundreds of young beautiful sexy half-naked girls without a care if anybody see you or talk about you? This paragraph advocates a ritual inversion of behavior. That is, because you are in a different land surround by people you don t know it is all right to act in ways that you might consider unacceptable behavior in your home society. Also the ad promotes neocolonialism because it supports the idea that the women of this land are primitive and inferior which justifies exploiting them for sex. Conclusion and the Future of Sex Tourism in Thailand:In conclusion, sex tourism, although important to the Thai economy, has many serious consequences that have to a large extent been painted over by the media. Due to Thailand s dependence on the tourism industry it would be impossible to completely abolish the trade at once. A more equitable distribution of resources among the people of Thailand is necessary for Thailand to be able to end the sex trade. It is important for the world, as well as the people of Thailand, to be informed about the true consequences of sex tourism. This would dispel many of the myths and stereo types that have perpetuated ethnocentric ritual inversions of behavior by western tourist seeking a hedonistic experience. The people of Thailand must be informed of the drastic cost associated with sex tourism. This could potentially cause enough public uproar to prompt changes in the government s stance on sex tourism. Sex Tourism s place in the future in Thailand and the rest of the world is still very uncertain. It will be interesting to see how the nature of the industry changes in the future.

NonUS Health Care System Analysis Essay Example | Topics and Well Written Essays - 1250 words

NonUS Health Care System Analysis - Essay Example The year 1900 saw a symbolic opening of the new century's scientific internationalism with the awarding of the first Nobel prizes. From that point on the nations of the world have become enmeshed in a great variety of regional and global organizations established for every conceivable purpose. International health activities have grown steadily in breadth and complexity, as more and more actors are involved in a process that continues to accelerate. Official agreements between sovereign states in the field of health exist in many forms. Some are developed through membership in multilateral agencies. Others derive from bilateral cooperative contracts between pairs of countries, often developed and developing. Here we will describe the evolution and structure of some of these organizations from about 1900 to the present. Over the three decades from 1874 to 1903 biomedical science advanced far more than it had in the previous three millennia. The acceptance of Darwin's concept of evolution, the application of quantitative reasoning, and developments in chemistry and microscopy led to an unprecedented accumulation of new knowledge. This knowledge, combined with field-based research all over the world, revealed for the first time the means of transmission and causative agent of almost every infectious disease important to human and veterinary medicine. International bickering and the chaos of the worldwide economic depression, with resultant wavering support and a chronic shortage of funds, marked operations of the National Health Service (NHS) in the 1940s. Communication was carried out by (sea) mail, telegrams, and, where possible, by telephone or two-way radio. Obtaining timely information about disease outbreaks in remote areas was a continuing problem. The principles governing the work of the National Health Service were to inform national health authorities on matters of fact, to document them on methods of solving their technical problems and to afford them such direct assistance as they may require. The work of the NHS is divided into two major categories: central technical services and services to governments. The central services include epidemiological intelligence; work toward international agreements concerned with health aspects to travel and commerce; international standardization of vaccines and pharmaceuticals and the dissemination of knowledge through meetings and reports of expert committees, seminars, study groups, and publication of technical and similar literature on national health problems. Headquarters also coordinates the work of several hundred NHS collaborating centers, laboratories, and institutes throughout the country that provide expert consultation and services in many fields. An important contribution to national understanding is made by the NHS fellowship program, under which thousands of persons have gone for brief study tours abroad in fields such as public health administration; environmental health; nursing, maternal and child health; other health services;

Financial essay Example | Topics and Well Written Essays - 1500 words

Financial - Essay Example (Experian Plc. 2010) This company, in its history, has acquired numerous other corporations allowing it to expand its products and services. By 2009, Experian, Plc. declared in its annual report that its business now covers the provision of information, analytical tools and marketing services to organizations on a global scale which helps their clients manage risks, find and retain customers as well as automate decision-making. Experian, Plc. has a long history of mergers and acquisition. The main player in Experian’s development, however, was TRW. In 1996, TRW sold its Information System & Services Division to an investor group which in turn sold it to the British General Universal Store PLC (GUS PLC), which later merged the division with CCN. (Jentzsch 2007, p. 73) This conglomerate became what is now known as Experian and has an accumulated 240 million consumers in its file with a strategy guided by an aggressive acquisition around the world. (p. 73) Experian’s Information Solutions alone works with over 50,000 clients across industries including financial services, telecommunications, healthcare insurance, retail, catalog, automotive, manufacturing, leisure, utilities, property, e-commerce and government. (Plunkett 2006) As previously mentioned, Experian, Plc. follows an aggressive acquisition strategy around the world, successfully penetrating many European countries and as far as South Korea and South Africa. The latest of its overseas foray involved the acquisition of the full license to operate a credit bureau in India. This emphasis on merger activity is driven by the aim to gain competitive advantage by acquiring a wide range of services. According to Jenzsch, Experian has two other big rivals and that the competition is fierce with the high volume of credit reports needed by industries and consumers. (p. 74) All in all Experian’s range of merger activities reflect a vision which involved: The