Shops and Shopping in Victorian England :: European Europe History

Shops and Shopping in Victorian England    As the population of London grew during the nineteenth century, the means of production and distribution would need to change to meet the needs of the increasing masses. Prior to this period goods and products for the most part were gotten at markets or fairs. "From a country which had been predominantly agricultural and self-sufficient in essential commodities, England became a great manufacturing centre. The industrial towns of the North and Midlands developed and England was the workshop of the world, the markets for her products being assured by the growing needs of the pioneers of her Empire" (Borer 253). Not only was the growing Empire a vast market for England's goods; but within England, London in particular, we can see perceptions about products and people's shopping practices begin to evolve. It is at this point in history that Raymond Williams in his work, Culture and Society: 1780-1950, marks the shift in the meaning of the word "industry." "Industry, before this period, was a name for a particular human attribute, which could be paraphrased as 'skill, assiduity, perseverance, diligence'. . . . industry came also to mean something else; a collective word for our manufacturing and productive institutions, and for their general activities" (xi). With this shift we can begin to see a stronger emphasis on Industry and production in Victorian England. The end result of a greater concentration on production is a vast increase in goods. This change in thinking, coupled with England's neglect of its agricultural pursuits, would force hundreds of thousands of people off the land and into industry. Fairs and markets could no longer meet the needs of the English public and shops began to crop up as a new way to distribute the goods of this mechanism of mass production. Within this window of opportunity we can begin to see the development a new breed of businessmen, the middleman. Middlemen performed a unique function in an economy that had earlier depended on labor-based products. The middlemen would make their money off the sweat of others and their services consisted of reaping rewards with minimal physical exertion. These new breed of merchants made their livelihood by buying and selling for himself or others on commission; speculating; dealing in money and credit; and insuring goods and ships transporting goods. In the literature of the time we can see the depictions of these parasitic, venture capitalists in not the most flattering terms. Shops and Shopping in Victorian England :: European Europe History Shops and Shopping in Victorian England    As the population of London grew during the nineteenth century, the means of production and distribution would need to change to meet the needs of the increasing masses. Prior to this period goods and products for the most part were gotten at markets or fairs. "From a country which had been predominantly agricultural and self-sufficient in essential commodities, England became a great manufacturing centre. The industrial towns of the North and Midlands developed and England was the workshop of the world, the markets for her products being assured by the growing needs of the pioneers of her Empire" (Borer 253). Not only was the growing Empire a vast market for England's goods; but within England, London in particular, we can see perceptions about products and people's shopping practices begin to evolve. It is at this point in history that Raymond Williams in his work, Culture and Society: 1780-1950, marks the shift in the meaning of the word "industry." "Industry, before this period, was a name for a particular human attribute, which could be paraphrased as 'skill, assiduity, perseverance, diligence'. . . . industry came also to mean something else; a collective word for our manufacturing and productive institutions, and for their general activities" (xi). With this shift we can begin to see a stronger emphasis on Industry and production in Victorian England. The end result of a greater concentration on production is a vast increase in goods. This change in thinking, coupled with England's neglect of its agricultural pursuits, would force hundreds of thousands of people off the land and into industry. Fairs and markets could no longer meet the needs of the English public and shops began to crop up as a new way to distribute the goods of this mechanism of mass production. Within this window of opportunity we can begin to see the development a new breed of businessmen, the middleman. Middlemen performed a unique function in an economy that had earlier depended on labor-based products. The middlemen would make their money off the sweat of others and their services consisted of reaping rewards with minimal physical exertion. These new breed of merchants made their livelihood by buying and selling for himself or others on commission; speculating; dealing in money and credit; and insuring goods and ships transporting goods. In the literature of the time we can see the depictions of these parasitic, venture capitalists in not the most flattering terms.

Knowledge Management in the Pharmaceutical Industry Essay

The study of Knowledge Management is a process that has been researched for centuries by western philosophers and traditional theorists, however it is only until recently that knowledge management has been the main focus for many organisations. Many have said that it was the publishing of Karl Wiig’s, â€Å"knowledge management foundations† (1993), that sparked the huge interest in knowledge management and nearly two decades on KM is now considered as an essential tool for companies to improve their performance and adaptability. 1] Not only this but the concept of knowledge has been regarded as a businesses most precious asset and highly critical in keeping a firm competitive. [2] This study will look at the knowledge management of one of the most Knowledge intensive industries in the world, the pharmaceutical industry, looking at, comparing and criticising the different strategies that are used within the industry. The pharmaceutical industry is rapidly growing and rap idly evolving , with organisations constantly investing in their research and development departments for the development of new and valuable explicit information. In 2007 â‚ ¬6,525 million was spent on R+D in the UK for the pharmaceutical market, showing that firms invest large sums of money in this knowledge intensive industry. [3] Pharmacy as an enterprise system The Pharmaceutical Industry is sort of like a â€Å"community of practice† (CoP) where all the organisations share a common interest in medicine, working together to promote the acquisition and sharing of knowledge, with a common goal of providing the â€Å"best practice† for the public. [4] It is clear that the industry is heavily dependent on using IT in storing and accessing information. Since the introduction web 2. 0 there has been a rapid increase in the use of enterprise systems across the industry. An enterprise system allows for data to be identified, captured and embedded in software to be accessed by all organisations within the industry. [5] A clear example of this comes from a professional body called the department of health, this body stores explicit data on the internet in a PDF called the â€Å"green book†, this can be accessed by any member of the public, as well as any organisation. The book provides the latest information on vaccines and vaccination procedures for all vaccine preventable diseases. [6] Not only is the book accessible via the web but also a hard copy of the book has been distributed to immunisation health professionals around the country, making it very easy for any pharmacy to find the information it needs. What makes this store of information so reliable and valuable to organisations is that it updates itself with new editions from information shared between different pharmacists, adding new vaccines etc. This type of knowledge management system is effective for this industry and can be better explained using Dalkir’s knowledge management cycle: [7] As it shows, knowledge is captured by different organisations through the use of research and development, this knowledge is then assessed and shared with organisations and pharmacies all over the country via the use of the â€Å"green book†. Pharmacy’s then use this knowledge to purchase the right medicine and vaccinations to sell to the public. The update part of the life cycle comes in the introduction of new editions brining new information. There is a sense of a â€Å"mini community† within this management system, where the role of culture is valued quite highly as a knowledge sharing environment is created and designed so firms and organisations can share their information. [8] However one of the main drawbacks that comes with this knowledge management system is that it does hinder competitiveness. Larry Prusak (1996) said â€Å"The only thing that gives an organization a competitive edge – the only thing that is sustainable – is what it knows, how it uses what it knows, & how fast it can know something new! † [9] The introduction of the green book meant every pharmacy in Britain has access to the same information, making it difficult for organisations to get ahead in terms of knowledge. However it is important to note that pharmacy’s are not entirely profit orientated, but also aimed at providing the best possible medicine and vaccinations to the public. The General Pharmaceutical Council and its implications Continued professional development is vital in the pharmacy profession as it allows for individuals and organisations to reflect back on their practice and then create plans to upgrade and improve. There is a professional body dedicated entirely to this system called the General Pharmaceutical Council (GDP), [10] this body provides a particular framework for individuals and organisations to set targets based on their previous practices. The CDP offers a cycle for firms to reflect on their previous practices and then plan on ways to improve practices on the future based on experiences and knowledge they have acquired. Another aspect of the CDP is something called Continued Professional Development (CPD) [11] This is a set of standards that are universal to all companies in the industry and which they must all comply with. What makes this so effective is the CPD is applied to all pharmacists and failure to meet the standards would result in the pharmacy losing their registration. The CPD expects each pharmacist to make a minimum of 9 entries a year, based on the knowledge acquired to update their own practices. This is a huge incentive for all firms to get involved as failure to do so would result in losing their registration. Although this is a good strategy in attempting to engage organisations in learning, there is a key fundamental drawback. Although the system allows for storage of explicit data from each organisation, it does not allow for pharmacies to access information from other pharmacies therefore stopping any sharing of information or data. However it is clear there are other professional bodies available for this. The effect of IT The internet for many may have made the storage of knowledge much easier, however there is a negative associated with heavy reliance on IT. The effect may be that members from departments and organisations no longer need to confer with each other as the information can be taken from a directory from any enterprise system. This will reduce â€Å"face to face† conversations between specialists which spark new ideas resulting in a lack of new information coming in. The availability and easy access of knowledge will act as a disincentive for individuals to search for new information. Conclusion Knowledge management is now considered essential, with many agreeing the knowledge a business has is one of it’s most precious assets. Overall it is quite evident that the pharmaceutical industry is heavily reliant on the use of IT to process, store and share knowledge. The professional bodies mentioned above are only a few of the number of enterprise systems dedicated to allowing organisations to update their knowledge of the profession and maintain a high level of customer satisfaction. The use of a universal framework to engage pharmacists in assessing their own practices is an essential tool in making firms acknowledge their own level of knowledge as well as keeping them up to date with the most recent information. The fact that there is still competition and huge sums of money invested into R+D shows that all across the industry people are still challenging new ideas, however one thing is for certain, each organisation relies on each other for new information and knowledge in this ever changing industry.

Creative learning environments in education Essay

Education is one of the important aspects of one’s life. †learning creativity, creativity leads to thinking, thinking giving knowledge, knowledge to make you great† (Abdul Kalam, 2015). This clearly shows that education creates creative and inventive person because if one thinks then a new idea is born, †Education is not a factual learning, but a thought-thinking education† (Albert Einstein, 2015) .so everybody needs to support and encourage the younger generation to pursue their studies to university level. Furthermore, in a free market, higher education would become the preserve of wealthy families who can afford to send their children to university. Therefore there is a strong case for the government providing higher education free at the point of use. In my opinion, the government has to give free education to attract students to further their studies. Education has positive benefits for the rest of society. There also have some country provides fre e university education for the student for example, in, Nordic nations Denmark, Finland, Iceland, Norway, and Sweden all offer opportunities to study free or at low-cost: In Norway, university study is available free of charge to all students, regardless of study level or nationality. My first point is equality. There is also a strong argument that university education should be free to ensure equal opportunities. If a student has to pay university education, this can prevent them. Theoretically, students can borrow or work part-time, but this may be enough to prevent students from learning and otherwise can enter the early job market. (Pettinger, 2017) Equality plays an important role in university-level education. †Education is the strongest weapon you can use to transform the world† (Mandela, 2017). University education is very important for an individual to improve his / her standard of living and to advance the nation. If everyone gets a full university education then negligence can be avoided and they know what needs to be done for their bright future. For example, if medical education is given free then many doctors in the country are born and can help the community by providing free medical services with this reduced rate of death and illness. Governments have to stress more profoundly to give birth to many graduates. Besides,the enhancement of the specialization of work. There are many specializations of which are specialization by professional, specialization by a process, specialization by region and international specialization. The global economy has forced countries, such as the UK to specialize in higher value-added products and higher-end products and services. The largest export industries in the UK include pharmaceuticals, organic chemicals, optical and surgical instruments, and nuclear technology (Pettinger, 2017). Therefore, there is a greater opportunity for skilled graduates who can contribute to this high-tech industry. The world is now pointing towards technology, so all countries should produce IT graduates in large quantities. IT plays a big role in this capital world as an example human beings can stay on planet Mars, there is water on the planet Pluto, and so can be detected through NASA technology. Furthermore, Education is a virtue. One of the virtues is that people can underestimate the benefits of learning and undervalue of higher education. †Success is not final, failure is not fatal: it is the courage to continue that counts †(Churchill, 2017). This clearly shows that education is not merely a thought but a birth to a human being Experienced in education. Education creates good and high potential for self-development, society, and nation. If one is fully educated in the university then one has a lot of job opportunities in the state as well as international level. University education is not just for work but it can be used in everyday life. For example, a retail store trader has experience on product brands, prices, shortages and advantages of a product that can promote to the community can help improve the level of communication.

Nursing and nutrition

IntroductionIn different healthcare institutions the question of feeding patients, particularly those who are seriously sick and expected to die soon, raises questions of moral and ethical nature thus making a decision making process very difficult for the caring staff. Such questions may include:–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How can decisions of giving or withholding feeding and hydration be made?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   What values and assumptions underlie these decisions?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Which courses of action are in the patient's ‘best interest', and how is this ‘interest' determined?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How and when, if ever, should a decision not to feed or hydrate be made?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Can so basic a provision as food and water ever be considered as optional care?In most of the healthcare institutions whether they are hospitals or senior homes, the decision making lies within the practice of the nurses who are usually faced with dilemmas. While doctors are more advanced in professional knowledge they rarely find themselves in the difficult situation of making the decision of withholding nutrition or giving it. However, there is sometimes a differentiation between nutrition as part of the care given to the patient and nutrition as a biological life sustaining process:â€Å"In modern practice there is often an underlying tension between two different understandings of ‘nourishing' the patient. First, nourishing as an intrinsic part of giving care, which falls within the realm of nursing. Second, nourishing as a biological and technical process, a life-sustaining treatment under the control of the medical or nutrition team (from which the nurse may be excluded).† (Hunt, 1994)Yet the daily practice and the roles of nurses and doctors indicate that the nurses find themselves in the dilemma of making the decision more than other medical staff. In many cases where the withholding of nutrition is legally right and in the interest of the patient, the nurse still finds herself in the ethical and professional dilemma. She is not given the opportunity to discuss her opinion or given any information. As a result whatever decision she makes may be taken as wrong regardless of the fact that she was partially ignorant.The dilemma is even more difficult when considering nutrition as a basic need or a medical treatment. For a seriously sick person one may accept withholding medication or a technological device that prolongs life unnecessarily, but it is not easy to withhold nutrition which is the basic need for healthy and unhealthy persons.  Ã¢â‚¬Å"Dresser asks, ‘Ought we to regard tube and intravenous feeding as forms of medical treatment, or should we classify them with more basic sorts of care?'† (Dresser, 1985)The decision of withholding nutrition or hydration is a difficult ethical questi on that poses emotional stress on the nurses. Withholding medication or technological devices is justifiable and there is enough professional and legal guidance for healthcare staff to follow. Indeed, â€Å"Food and water are so central to an array of human emotions that it is almost impossible to consider them with the same emotional detachment that one might feel toward a respirator or a dialysis machine† (Lynn & Childress, 1983)In this research I am going to study this issue in order to confirm or rule out the possibility of establishing a professional guidance that assists the nurses in decision making. This is expected to relief them from a lot of stress and confusion that are imposed as a result of dealing with the issue on personal terms rather dealing with it objectively according to professional guidance and standards.The proposal for this research will be studied under the following headings:1.    Description of a case study2.    Literature review3.      Pro posal4.      Summary and ConclusionsDescription of a Case StudyA case study either from literature or from the records of healthcare institution is expected to illustrate the extent of the problem and its importance. In addition this will emphasise the roles of nurses, relatives and patients in the decision making process. It would also highlight the difficulties facing nurses at different stages of care giving for seriously sick persons.  At this stage of building the skeleton of this research paper very little can be said about the case study until one has been adopted.Literature ReviewThe literature generally confirms the importance of the problem and has been addressing the issues related to the problem of nutrition for sometime now. While it is suggested in the literature that in some cases of chronically ill persons the provision of nutrition is burdensome rather than beneficial, it is agreed that the interpersonal and inter-professional tensions of nurses are ignored. ( Hunt, 1994) It is also pointed out that the stressful environment in which nurses provide their professional care sometimes result in burnouts.The burnout case â€Å"evolves by a process involving three stages: (a) an imbalance between resources and demands, (b) the immediate short-term emotional response to the imbalance, and (c) changes in attitude and behavior such as negativism and emotional detachment† (Riordan & Saltzer, 1992). However, it is also indicated that there are personal differences here: while one may react to stressors by becoming a burnout another with personal hardiness may find the stressors only minor irritants. Riordan and Saltzer (1992) assert:  Ã¢â‚¬Å"Current literature points unanimously to a proactive approach in preventing burnout. This preserves organizational integrity by maintaining human resources and supplying cost-effective care while maintaining quality† (Riordan & Saltzer, 1992).There are a number of suggestions for reducing stress and assisting nurses to cope with the environmental difficulties, though no specific guidelines or procedures are given for dealing with the problem of nutrition and hydration.  It is also indicated in the literature that nutrition and hydration in some terminal cases may only prolong the biological life which is thought to be burdensome for some patients and their families. As Hunt (1994) asserts: â€Å"Feeding may in some circumstances prolong the process of dying and may cause avoidable suffering to the dying patient.†While generally the decision of using nutrition support for the terminally ill people is discussed as a problem facing nurses, some scholars relate the decision to dietitians.  Ã¢â‚¬Å"Clinical guidelines for nutrition support indicate that dietitians should be members of institutional ethics committees and should have an integral role in institutional policy development concerning nutrition support at the end of lifeâ€Å" (Langdon et al, 2002)To put it in a nutshell the literature review confirms the dilemma facing healthcare professionals, particularly nurses, and families in dealing with the decision of providing nutrition and hydration or withholding it for chronically ill people whose illness is diagnosed as terminal. It is also confirmed that the decision making involves personal feelings, ethics, and sometimes legal consideration. Yet there are no clear professional guidelines that streamline the decision making in this issue in the professional practice. Rather there are observations of some acceptable practices.Sometimes the distinction between ordinary and extraordinary is used as a means of reaching decision.  Ã¢â‚¬Å"However, there appears to be an increasing opinion that artificial feeding can be viewed as a'heroic' method of treatment and is morally optional (Meyers and Grodin 1991, Hoefler and Kamoie 1994, Singer 1995, Gillick 2000).This optional treatment is referred to as ‘extraordinary' and is more likely t o be invasive, artificial or complex. Nevertheless, the Hastings Centre guidelines, cited in Meyers and Grodin (1991), stated that decisions over whether to provide artificial nutrition and hydration cannot be made solely on the distinction between ordinary and extraordinary methods of treatment. Despite this, Solomon et al (1993) demonstrated that 74 per cent of health professionals continued to use this distinction in termination of treatment decisions. It would also seem that the decision was significantly influenced by whether it was a decision to withdraw treatment or simply not initiate it in the first place. The Hastings Centre guidelines stipulate that this distinction should not be a consideration (Meyers and Grodin 1991)† (Young et al, 2002).The problem of decision making in providing or withholding nutrition and hydration in the case terminally ill people is a dilemma for nurses until some professional steps are identified to make the decision an objective one made on the basis of professional judgement   rather than being a personal one affected by personal feelings, ethics, beliefs etc.ProposalSince the aim of the study is to justify a professional basis for decision making, in this study we will attempt to investigate the possibility of establishing professional guidelines that may relief the burden on nurses. This will involve identifying criteria that make withholding nutrition more beneficial to the patient than prolonging his biological life. It should also be essential to identify professional means that enable healthcare staff to decide that a patient is not making any sense of life and advise families accordingly to participate in decision making. This should be important especially when the patient is suffering pain or given morphine regularly.In order to be able to design a professional tool or procedure that assists nurses in decision making through this study or alternatively recommend further research on this issue, the study will be a non-experimental one designed to elicit the RN’s attitudes towards nutrition of chronically ill patients using survey instrumentation.The sample will be full time RNs employed by a healthcare region in hospitals and nursing homes of the region. It is advisable to include also a sample of dietitians working in the same healthcare institutions. The RNs involved need to be well informed about the study and its aims and should be positively motivated to participate in the study.It is also important for the study to be approved by a professional body that confirms the study question and methods are ethical.  The instruments of the study should be designed in a way that they measure the attitude of the study sample towards giving or withholding nutrition and hydration for a variety of terminally ill patients. It is also important to determine the internal consistency reliability for the questionnaires and structured interviews.Summary and ConclusionsThese will follow na turally from the analysis of data and discussions and will eventually constitute a recommendation: either a draft of a guideline for assisting nurses in decision making or alternatively suggestions for further research in order to identify a suitable professional tool for relieving the burden on nurses.ReferencesI am not going to list the references now since this is just a skeleton to discuss with your supervisor; unless you deem it necessary.  The word count may not be exactly 3500, but I think what has been written here is enough for your purposes. As soon as you give feedback on this I will start work on the proposal. Nursing and nutrition IntroductionIn different healthcare institutions the question of feeding patients, particularly those who are seriously sick and expected to die soon, raises questions of moral and ethical nature thus making a decision making process very difficult for the caring staff. Such questions may include:How can decisions of giving or withholding feeding and hydration be made?What values and assumptions underlie these decisions?Which courses of action are in the patient's ‘best interest', and how is this ‘interest' determined?How and when, if ever, should a decision not to feed or hydrate be made?Can so basic a provision as food and water ever be considered as optional care?In most of the healthcare institutions whether they are hospitals or senior homes, the decision making lies within the practice of the nurses who are usually faced with dilemmas. While doctors are more advanced in professional knowledge they rarely find themselves in the difficult situation of making the decis ion of withholding nutrition or giving it. However, there is sometimes a differentiation between nutrition as part of the care given to the patient and nutrition as a biological life sustaining process:â€Å"In modern practice there is often an underlying tension between two different understandings of ‘nourishing' the patient. First, nourishing as an intrinsic part of giving care, which falls within the realm of nursing. Second, nourishing as a biological and technical process, a life-sustaining treatment under the control of the medical or nutrition team (from which the nurse may be excluded).† (Hunt, 1994)Yet the daily practice and the roles of nurses and doctors indicate that the nurses find themselves in the dilemma of making the decision more than other medical staff. In many cases where the withholding of nutrition is legally right and in the interest of the patient, the nurse still finds herself in the ethical and professional dilemma. She is not given the oppor tunity to discuss her opinion or given any information. As a result whatever decision she makes may be taken as wrong regardless of the fact that she was partially ignorant.The dilemma is even more difficult when considering nutrition as a basic need or a medical treatment. For a seriously sick person one may accept withholding medication or a technological device that prolongs life unnecessarily, but it is not easy to withhold nutrition which is the basic need for healthy and unhealthy persons.â€Å"Dresser asks, ‘Ought we to regard tube and intravenous feeding as forms of medical treatment, or should we classify them with more basic sorts of care?'† (Dresser, 1985)The decision of withholding nutrition or hydration is a difficult ethical question that poses emotional stress on the nurses. Withholding medication or technological devices is justifiable and there is enough professional and legal guidance for healthcare staff to follow. Indeed, â€Å"Food and water are so central to an array of human emotions that it is almost impossible to consider them with the same emotional detachment that one might feel toward a respirator or a dialysis machine† (Lynn & Childress, 1983)In this research I am going to study this issue in order to confirm or rule out the possibility of establishing a professional guidance that assists the nurses in decision making. This is expected to relief them from a lot of stress and confusion that are imposed as a result of dealing with the issue on personal terms rather dealing with it objectively according to professional guidance and standards.The proposal for this research will be studied under the following headings:1. Description of a case study2.   Literature review3.   Proposal4.   Summary and ConclusionsDescription of a Case StudyA case study either from literature or from the records of healthcare institution is expected to illustrate the extent of the problem and its importance. In addition this will em phasise the roles of nurses, relatives and patients in the decision making process. It would also highlight the difficulties facing nurses at different stages of care giving for seriously sick persons.At this stage of building the skeleton of this research paper very little can be said about the case study until one has been adopted.Literature ReviewThe literature generally confirms the importance of the problem and has been addressing the issues related to the problem of nutrition for sometime now. While it is suggested in the literature that in some cases of chronically ill persons the provision of nutrition is burdensome rather than beneficial, it is agreed that the interpersonal and inter-professional tensions of nurses are ignored. (Hunt, 1994)It is also pointed out that the stressful environment in which nurses provide their professional care sometimes result in burnouts. The burnout case â€Å"evolves by a process involving three stages: (a) an imbalance between resources an d demands, (b) the immediate short-term emotional response to the imbalance, and (c) changes in attitude and behavior such as negativism and emotional detachment† (Riordan & Saltzer, 1992). However, it is also indicated that there are personal differences here: while one may react to stressors by becoming a burnout another with personal hardiness may find the stressors only minor irritants. Riordan and Saltzer (1992) assert:â€Å"Current literature points unanimously to a proactive approach in preventing burnout. This preserves organizational integrity by maintaining human resources and supplying cost-effective care while maintaining quality† (Riordan & Saltzer, 1992).There are a number of suggestions for reducing stress and assisting nurses to cope with the environmental difficulties, though no specific guidelines or procedures are given for dealing with the problem of nutrition and hydration.It is also indicated in the literature that nutrition and hydration in some t erminal cases may only prolong the biological life which is thought to be burdensome for some patients and their families. As Hunt (1994) asserts: â€Å"Feeding may in some circumstances prolong the process of dying and may cause avoidable suffering to the dying patient.†While generally the decision of using nutrition support for the terminally ill people is discussed as a problem facing nurses, some scholars relate the decision to dietitians.â€Å"Clinical guidelines for nutrition support indicate that dietitians should be members of institutional ethics committees and should have an integral role in institutional policy development concerning nutrition support at the end of lifeâ€Å" (Langdon et al, 2002)To put it in a nutshell the literature review confirms the dilemma facing healthcare professionals, particularly nurses, and families in dealing with the decision of providing nutrition and hydration or withholding it for chronically ill people whose illness is diagnosed as terminal. It is also confirmed that the decision making involves personal feelings, ethics, and sometimes legal consideration. Yet there are no clear professional guidelines that streamline the decision making in this issue in the professional practice. Rather there are observations of some acceptable practices.Sometimes the distinction between ordinary and extraordinary is used as a means of reaching decision.â€Å"However, there appears to be an increasing opinion that artificial feeding can be viewed as a'heroic' method of treatment and is morally optional (Meyers and Grodin 1991, Hoefler and Kamoie 1994, Singer 1995, Gillick 2000). This optional treatment is referred to as ‘extraordinary' and is more likely to be invasive, artificial or complex. Nevertheless, the Hastings Centre guidelines, cited in Meyers and Grodin (1991), stated that decisions over whether to provide artificial nutrition and hydration cannot be made solely on the distinction between ordinary and ex traordinary methods of treatment. Despite this, Solomon et al (1993) demonstrated that 74 per cent of health professionals continued to use this distinction in termination of treatment decisions. It would also seem that the decision was significantly influenced by whether it was a decision to withdraw treatment or simply not initiate it in the first place. The Hastings Centre guidelines stipulate that this distinction should not be a consideration (Meyers and Grodin 1991)† (Young et al, 2002).The problem of decision making in providing or withholding nutrition and hydration in the case terminally ill people is a dilemma for nurses until some professional steps are identified to make the decision an objective one made on the basis of professional judgement   rather than being a personal one affected by personal feelings, ethics, beliefs etc.ProposalSince the aim of the study is to justify a professional basis for decision making, in this study we will attempt to investigate t he possibility of establishing professional guidelines that may relief the burden on nurses. This will involve identifying criteria that make withholding nutrition more beneficial to the patient than prolonging his biological life. It should also be essential to identify professional means that enable healthcare staff to decide that a patient is not making any sense of life and advise families accordingly to participate in decision making. This should be important especially when the patient is suffering pain or given morphine regularly.In order to be able to design a professional tool or procedure that assists nurses in decision making through this study or alternatively recommend further research on this issue, the study will be a non-experimental one designed to elicit the RN’s attitudes towards nutrition of chronically ill patients using survey instrumentation.The sample will be full time RNs employed by a healthcare region in hospitals and nursing homes of the region. It is advisable to include also a sample of dietitians working in the same healthcare institutions. The RNs involved need to be well informed about the study and its aims and should be positively motivated to participate in the study.It is also important for the study to be approved by a professional body that confirms the study question and methods are ethical.The instruments of the study should be designed in a way that they measure the attitude of the study sample towards giving or withholding nutrition and hydration for a variety of terminally ill patients. It is also important to determine the internal consistency reliability for the questionnaires and structured interviews.Summary and ConclusionsThese will follow naturally from the analysis of data and discussions and will eventually constitute a recommendation: either a draft of a guideline for assisting nurses in decision making or alternatively suggestions for further research in order to identify a suitable professional tool for relieving the burden on nurses.ReferencesI am not going to list the references now since this is just a skeleton to discuss with your supervisor; unless you deem it necessary.The word count may not be exactly 3500, but I think what has been written here is enough for your purposes. As soon as you give feedback on this I will start work on the proposal.

Eusebius - History of the First Church Term Paper

Eusebius - History of the First Church - Term Paper Example Nothing is known of the parents of Eusebius, though, it is clear from his works that he must have received an extensive education in philosophy, biblical and theological sciences. He was greatly admired and cherished as a man and regarded as one who was very influential over his colleagues. At one time he was Presbyter of the Church, though it is difficult to narrow down an exact date for this. Eusebius was born C. 260 and lived through May of 339. He was baptized and ordained at Caesarea where Pamphilus gave him the name ‘Eusebius Pamphili’, meaning â€Å"son or servant of Pamphilus† (Eusebius Of Caesarea). It is possible that Eusebius was imprisoned for some time by Roman authorities as he was taunted years later for having escaped through some acts of submission though this is verified. He began to write the Ecclesiastical History during the Roman prosecutions and it was revised several times between 312 and 324. He described this work as a full and complete documented history of the Christian Church in which he used many paraphrasing and quotes from outside sources. This allowed earlier portions of work to be preserved which adds significant historical value. Eusebius’ role in the doctrinal debates and disputes within the Catholic Church during the fourth century included issues regarding the nature of Jesus Christ, enquiring as to the possibility that he had always existed in some form prior to human. Eusebius knew nothing of the Western Church and his strength was not in being a historian. Eusebius became the Bishop of Caesarea in 313 and in 318 became involved in controversy stemming from the views of a Priest from Alexander who taught subordination of the son to the father, and Eusebius, accordingly, soon became a leading supporter of Arius. Eusebius’ style was one that â€Å"weaved short entries into a broader scheme† (Ferguson), though some considered

Forced ranking and motivation Case Study Example | Topics and Well Written Essays - 1000 words

Forced ranking and motivation - Case Study Example It is usually done by use of periodical interviews conducted by managers or filling out questionnaires by supervisors and/or fellow subordinates. The results are afterwards analyzed and assessed (Spector, 2008). It is paramount to understand what forced ranking is with regard to performance appraisal before an individual gives an own opinion on whether it succeeds in motivation employees or not. Forced ranking is a contentious management tool that is used as an intervention of performance of organization’s employees. It is uses what statisticians refer to as a normal distribution curve to rank the employees from the highest performing to the poor performers in a given period of time. This is done after a series of periodical assessments of results using person-to-person comparisons. The premise behind this management tool is that in order for an organization to achieve its goals, they must categorize their best and worst performers. At this point, the management is left with e mployees at both extremes (Scullen, Bergey & Aiman-Smith, 2005). The next phase entails nurturing the best and rehabilitating or discarding the poor performers. In my opinion, forced ranking does not serve to improve results for any organization and does not motivate employees. To start with, whenever forced ranking results are completed, the majority of the employees fall at the mediocre level of the curve. Therefore, they feel comfortable that their jobs are still secure. This would lead to constant workers input that only saves them from being ranked as the poorest in an organization. In addition, the forced ranking does not portray the real picture of quality in any employee’s effort. When we consider motivation, forced ranking may sabotage the performance of highly rated employees. This is because, in any given appraisal activity, the method produces a normal curve irrespective of the performances staged by the employees (Pinder, 2008). In this case, an employee may have performed to the expected levels and capacity. These employees would expect to be recognized as having worked within their capacity thus providing exceptionally good results. However, they would still be ranked as a poor performer simply because some other employees have slightly better performances. According to the expectancy theory, the anticipation of the employee would affect his or her motivation towards work if the forced ranking places this kind of an employee at the poor performers’ level. The result would be a discouraged employee whose expectations of a reward do not come to be (Schultz & Nembhard, 2006). The obvious reaction after such an appraisal would lead to the employees comparing their respective performances. The poorly ranked employees would feel that the appraisal results were unfair whenever the perception of equal performances is imminent. According to the equity theory, the negative perception to unfairness would affect the employee’s complianc e to perform to their capacity. Furthermore, some employees who are ranked higher would compare their rewards to others of similar positions (Spector, 2008). If such employees think that they have been under-rewarded, they may end up underperforming in the subsequent years. Therefore, this method of appraisal does not motivate employees. As mentioned above, the premise of the equity theory is based on the perception of

Customer behavior Case Study Example | Topics and Well Written Essays - 250 words

Customer behavior - Case Study Example By cooling down, one is prepared to answer back courageously and explain exhaustively if the statement is untrue. It must be understood that some customers make negative comments in order to trick hotel management into offering them discounts, free visits to the hotel, and money back guarantee. Make professional responses (Cheng et al, 5). Customers are ken on any statement made in favor or against the allegation. Therefore, hotel managers should show empathy and concern to show customers’ feelings are respected. Offer a long lasting solution when necessary and be willing to learn from what customers comment. However, in cases where defaming statements are made, it is good to request review sites administrators to evaluate its credibility and remove such comments if they are not worth. In most cases, customers buy commodities depending on what others have commended about them. I can only buy items through an online platform if am guaranteed quality. Therefore, I will check what previous buyers have said about it. The same applies to hotel bookings. When visiting new places for a tour, it is always difficult to tell where to spend the night. However, through the help of travel directories and customer reviews in regards of hotels in that location, it is easy to make an informed decision on where to stay depending on cost, customer service, and comfort. Consumer behavior is shaped by what people hear, see, and read about products they intent to purchase. Therefore, marketers must be keen in making sure customers get the very best out of the products. However, it is almost impossible to avoid negative online reviews. Therefore, companies must be ready to learn from the reviews in cases where they make sense and explain to customers where there is misunderstanding. Cheng, Vincent TP, and Mei Kun Loi. "Handling negative online customer reviews: the effects of elaboration likelihood model and distributive justice." Journal of