Eng DB 4 Essay Example | Topics and Well Written Essays - 750 words

Eng DB 4 - Essay Example Its’ prose possesses a lyrical quality which we generally come across only in poetry. It is a love story in which the exquisite understatement only serves to highlight the passion. On further perusal, we are immediately struck by the wealth of imagery cleverly used by the author. Undoubtedly, as Anne Beattie says, â€Å"Seconds and symbols are left to sum things up.† We are almost swamped by the tidal wave of imagery and symbolism that carries us through the story. Snow, contrary to its’ usual connotation of cold and desolation, is here used as a symbol of the love that â€Å"somebody† has for â€Å"her lover† – a love that is pure, fresh and warm [warm? snow?]. This kind of contradictory symbolism gives us the first hint of impending tragedy and somehow fixes for us the disconnect that exists right from the start in the attitude of the two lovers towards their relationship. The chipmunk is the girl – cherished in her lovers’ arms and carried to a house in the winter countryside. He is obviously older than she is and is rather bemused that this creature has come to share his world. Their house, in its’ winter isolation, appears to signify that their love needs to be insulated from the rough and tumble of everyday life if it is to survive – again an indication of the fragility of their relationship. The only intruders are transient visitors. The ‘scraping’ during the first week is symbolic of the lovers getting to know each other, discovering the layers of their past lives like â€Å"wallpaper under wallpaper.† The yellow paint signifies the beginning of their new life together, attempting to put their past behind them. Once more, that stubborn vein of cynicism that runs through the story comes into play - the grapes represent the past which refuses to go away and lurks just beneath the surface, waiting to â€Å"tenaciously push through† the fabric of their present. The fireplace is the token of the warmth of their love, which is amazing

Why states obey the laws of war Essay Example | Topics and Well Written Essays - 750 words

Why states obey the laws of war - Essay Example These laws and treaties have actualized an environment of self-regulations, so that the countries obeying it, have maximally minimized aggressive overtures against other countries as well as their own citizens. However, that is not the case all the time, as certain countries without obeying the international laws have acted or are acting aggressively and unilaterally. This gross violation of international laws by countries has raised doubts about the validity and efficacy of these laws. Even amidst these disobeying of laws, countries tend to obey laws due to certain reasons. States obey the laws and the related treaties and conventions due to mix of certain valid reasons, which mainly borders on self-interest and need for self-legitimacy, and also minimally due to coercion. Self interest constitutes various factors and one key factor is the want of the country to create a positive identity for itself. Participation in the transnational legal process and obeying all the laws helps â⠂¬Å"constitute the identity of the state as the one that obeys the law†. (Coleman). Importantly, they does not want to acquire the tag or reputation of a law breaker or a rogue nation, and thereby standing isolated and facing a barrage of debilitating sanctions. That is, if a nation continues to disobey the laws and thereby acts in a detrimental way against particular nations as well as global community on the whole, certain nations and also overseeing body like United Nations will impose economic sanctions, trade, food and other essential commodities embargoes, etc. These punitive actions will negatively impact the nation as well as its people. In order to avoid these scenarios, nations will tend to obey the laws. As another form of self interest, nations will obey laws to make or demand other nations to do the same. States will tend to obey laws whose underpinning political rational is clear and which they agree with, especially the laws relating to territorial integrity and inviolability of borders.(King 2005). Once obeying of law based on self-interest is done, then legitimacy will automatically fall into place. That is, states will always want legitimacy to its words and actions, and to get that they have to obey the laws. If they want other countries to be legitmate, they have to create and obey laws appropriately. This was validated by Professor Frank who states that legitimacy means that quality of law must derive from a perception, to those to whom it is addressed, that law has come into being in accordance with right process. (Rashid 2004). Even coercion and the resultant obeying of the law is also an extension of self-interest. When a state is coerced to obey laws through armed force or other means, they will accept it mainly from self-interest perspective. In certain cases, nations will obey laws as a form of nonconsensual coercion, but would like to exhibit as self-interest. The bottom line is, all states will want to live in peace, prosperi ty and in good coordination with other states and for that they will obey the international laws. When viewed from another perspective, certain States although generally act in accordance to the law, they do not always obey it. This happens mainly in the case of unilateral actions and importantly due to mis-interpretation of the laws according to their self-interests. Also, when certain States feel as they were not part of specific law making process, they are not obligated to follow that law. When states take unilateral actions to fulfil and pursue their self-interests, imperialistic ambitions, etc, they disobey and undermine the international laws. Although, they may be part of the law making process and could have acted in accordance with those laws most of the time, they could disobey. As an

Kaiser Permanente Risk Management Executive Summary Essay Example for Free

Kaiser Permanente Risk Management Executive Summary Essay Organization Description Kaiser Permanente (KP) is the nation’s largest integrated health care delivery system. KP serves nine states and over nine million members, with an annual operating revenue in 2013 of 53.1 billion. KP is a leader in quality improvement efforts in the health care industry through participation in studies performed by the National Committee on Quality Assurance (NCQA), The Joint Commission (TJC) accreditations, and the implementation of a state of the art electronic health records system, which focuses on integration and quality of care standardization. The focus of this summary is on KP hospitals in the northern California region and will include topics such as the purpose of risk and quality management, risk identification and management, current risks, quality outcomes, organizational goals, and the relationship between risk and quality management. Risk and Quality Management Purpose General The purpose of risk management in health care is simply the process of protecting the assets and minimizing financial losses to the organization (Singh Habeeb Ghatala, 2012). A comprehensive risk management strategy within a health care organization will include focus on continuous quality improvement (CQI). The purpose of CQI in health care, according to Sollecito and Johnson (2013), is to offer a â€Å"structured organizational process for involving personnel in planning and executing a continuous flow of improvements to provide quality health care that meets or exceeds expectations† (p. 4). Through linking the processes of risk management and quality improvement the success of both processes is more likely to be realized. Kaiser Permanente The key concepts for risk and quality management at KP are commitment to quality, patient safety, privacy protection, and fraud prevention. KP risk management and quality management programs are central to their mission, values, and culture. Methods currently utilized to support these concepts  within KP are consumer surveys, the use of an integrated EHR with evidence based guidelines and clinical decision-making functionality, stringent patient privacy regulations and processes, continuous clinical and administrative staff training programs, and participation in studies focused on standardizing national quality measures (Kaiser Permanente, 2012). Risk Identification and Management Steps While KP is a leader in health care risk and quality management there are specific steps this consultant is recommending on a continual basis that will improve risk identification and management within the organization. 1. Identify and analyze loss and exposure While there are many methods utilized within the health care industry in the identification and analysis of loss and exposure, the recommended methods for KP are as follows: a) Incident-reporting analysis b) Improvement on the current performance management process for employees to bring focus on risk mitigation and quality improvement. c) Quantitative analysis of patient complaints and satisfaction surveys. d) Review of the organizations past professional liability and workers compensation reports. e) Review of surveys completed by TJC and NCQA on other hospitals in order to identify risk areas that KP should focus on. (McCaffrey Hagg-Rickert, 2009) 2. Research and propose alternative risk techniques To mitigate risks that are unavoidable at KP, a combination of alternative risk techniques will help reduce situations that might negatively affect the organization. A financial analysis and risk analysis should be performed in order to ascertain the likelihood of utilizing the exposure avoidance technique. This is not a likely option as the financial impact of eliminating services may out weigh the risks involved with continuing them. A loss reduction approach is more likely to be the technique chosen for this organization. The core prevention activities that must be present in the loss reduction technique are as follows: a.) Ongoing staff education b.) Current policy and procedure review and revision c.) Updates to the organizations current EHR system to ensure the data present in the clinical decision-making and evidence-based clinical guidelines technology is the most current data available. According to Chen, et al (2009), â€Å"a growing body of literature confirms the value of electronic health records (EHRs) in improving patient safety, improving coordination of care, enhancing documentation, and facilitating clinical decision making and adherence to evidence-based clinical guidelines† (p. 323). 3. Risk management technique selection This two-part process of risk management technique selection is accomplished through forecasting and application of an ongoing measurement process, which will allow KP to analyze the risk management technique with regard to outcome and cost effectiveness. Included in the measurement process both risk treatment and risk-financing techniques should be measured (McCaffrey Hagg-Rickert 2009). 4. Implement the selected techniques Implementation of the chosen risk management techniques may include decisions on insurance coverage and policy changes, overall department workflow changes to ensure compliance with state and federally mandated regulations and guidelines, and elimination of processes that impede or hinder patient safety. 5. Monitor and improve upon the implemented risk management program In order to continue improving upon the newly implemented risk management program a comprehensive monitoring strategy should be employed. In fact, McCaffrey and Hagg-Rickert, (2009) stated, â€Å"a multidisciplinary approach to evaluating the risk management program ensures that the impact of additional opportunities to improve the risk management function are fully explored† (p. 21). a.) Prepare an annual risk management report b.) Compare the new annual report against prior years risk management data (McCaffrey Hagg-Rickert 2009) Current Risks Three risks that KP should take special care to avoid are rejection of newly implemented risk management and CQI procedures by employees, statute and regulatory changes, and health care associated infections (HAIs). 1. Rejection Change implementation is never an easy task and without special care taken the rate of rejection to change by clinical and administrative employees is high. In order to achieve successful CQI changes the following guidelines and recommendations are presented. a.) Minimize employee rejection through easily implemented and followed CQI procedures. b.) Engage employees in planning to increase acceptance. c.) Ensure lateral linkages within the organization across specialty departments to improve communication (Sollecito and Johnson, 2013). 2. Statute and regulatory changes With the ever-changing landscape in state and federal statutes and regulations surrounding the health care industry, special attention to this risk area must be taken. In fact, Cohen (2009) stated that â€Å"health care is one of the most heavily regulated of all sectors of commerce† (p. 328). Failure to comply with state and federal statutes and regulations can bring about negative financial affects at KP, including but not limited to; fines, loss of accreditation and credentialing, and an increase in malpractice lawsuits, not to mention a decrease in quality of care. a.) Risk management and quality improvement officers stay current and involved in statute and regulation changes. b.) Mandate educational goals for risk management and quality management officers with regard to state and federal regulations. c.) Implement a monthly employee newsletter within which the risk management officer and quality improvement officer outline regulation changes. Include processes that emplo yees should expect to see implemented to maintain compliance. Include a signature page with those editions that include changes to policy and ensure all employees sign and return to the human resources department. d.) Ongoing training for clinical and administrative employees with regards to statute and regulation. The risk management and quality improvement officers will be responsible to work with the organizations education department to implement new workshops as needed. e.) Include these responsibilities in the performance monitoring strategy for the risk management and quality improvement officers. 3. HAIs Health care associated infections are a serious risk in hospitals, as noted by Sydnor and Perl (2011), in their statement â€Å"HAIs are the most common complication seen in hospitalized patients† (para. 20). Improper prevention can lead to increased costs, lengthier hospital stays, and even patient death. Additionally, a Condition of Participation (CoP) (42 CFR 482.42) by CMS mandates hospital infection control programs to adhere to specific requirements. Recommendations are as follows. a.) Implement a house-keeping checklist to ensure proper sanitization of patient rooms. b.) Implement a sanitization checklist for clinical staff that will enforce hand washing before and after patient contact. c.) Develop a committee to review and revise the KP infection prevention and control program. Revisions should focus on compliance with TJC and the Center for Disease Control (CDC) regulations. Quality Outcomes Internal and external Three internal and external factors that influence quality outcomes are organization management of interpersonal relationships between physicians and patients, patient compliance, and continuity of care. Without proper management of interpersonal relationships between physicians and patients, the organization will face degradation in trust and openness. Patients should be involved in all treatment decisions, through proper education on their diagnosis and treatment options. This will bring about patient engagement in this decision making process. While KP cannot force their patients to comply with treatment guidelines, the external influence of patient compliance is crucial to quality outcomes. Programs focused on thorough training and education of patients and family members will improve the rate of compliance, thus improving the probability of positive quality outcomes for patients. Lack of patient compliance will hinder the treatment process and lower the level of quality outcomes standards at KP. Continuity of care is another internal influence that can affect quality outcomes. Regular follow up with patients will also increase patient compliance. Without improving continuity of care, the KP organization will see a reduction in positive quality outcomes and an increased in undesired outcomes (DeHarnais, 2013, chp 5). Goals Short-Term 1. Design new regulatory and statute training programs for all clinical and administrative employees. 2. Review and revise the KP infection prevention and control program 3. Revise the performance management system to include CQI measurements and risk management procedures as performance metrics. Long-Term 1. Increase adherence to state and federal regulations and statutes throughout the KP organization. 2. Reduce HAIs by 10% throughout KP hospitals in the northern California region. 3. Improve CQI measurement and risk management policy adherence throughout the northern California region by 20% among clinical employees. Risk and Quality Management Recommendations Risk management policies 1. Quarterly peer review The Health Care Quality Improvement Act (HCQIA) of 1986 â€Å"encourages hospitals, state licensing boards, and professional societies to identify and discipline physicians, dentists, and other health care providers who, after adequate, nondiscriminatory peer review, were found to have engaged in negligent or unprofessional conduct† (Cohen, 2013 p. 333). Through ongoing screening of new and current clinicians, KP will take responsibility for offering their patients that highest quality of care and reducing the risk of employing negligent clinical employees. 2. Zero tolerance adherence policy for all employees with regard to infection control procedures Part of the CMS CoP (42 CFR 482.42) regulation is the â€Å"designation of an infection control officer and development of relevant policies that address the identification and control of infections and communicable diseases. Without full compliance with all CoPs, KP could face the loss of their Medicare provider agreement. 3. Vulnerability analysis chart and emergency plan policy. According to Rawson and Hammond (2009) â€Å"by evaluating vulnerabilities and taking appropriate preventive action, loss can be minimized in an emergency†Ã‚  (p. 506). Health care facilities should include prevention measures in their emergency plans that include the risk of terrorist attacks. While terrorist attack risk cannot be completely mitigated, it is the responsibility of the health care facility to be prepared for such an emergency. Obtain additional information on including risk of terrorist attacks from the National Institute for Occupational Safety and Health (NIOSH). Quality management policies 1. Adherence to evidence-based clinical guidelines While it has been shown that â€Å"clinicians have customarily enjoyed a great deal of autonomy in their practices† (Argawal, 2010, para 3), it is imperative that clinicians follow evidence-based clinical guidelines. If exceptions should be made the details of, the patient diagnosis and variations should be presented for peer review prior to altering treatment plans. 2. Minimum score of 88% on customer satisfaction surveys Clinicians must maintain an average score of no less than 88% on customer satisfaction surveys quarterly. In today’s health care market, measurements of quality include consumer satisfaction. In fact, Bernard and Savitz (2009) state that in todays â€Å"competitive health care environment, consumers want and expect better health care services and hospital systems are concerned about maintaining their overall image† (p. 185). Relationship between risk and quality management In the past, risk management officers and quality improvement managers worked autonomously from one another, in fact they most often reported to different superiors. However, today healthcare organizations are realizing that in order to reach quality of care goals and maintain effective risk management programs these disciplines must work together closely. An example of how risk management efforts and quality improvement efforts complement one another is seen in the reduction of medical errors. The risk management plan must consider ways to reduce medical errors, while the quality improvement plan will offer solid steps toward minimizing medical errors (Sollecito and Johnson, 2013). Conclusion This summary focused on topics such as the purpose of risk and quality management, risk identification and management, current risks, quality outcomes, organizational goals, and the relationship between risk and quality management. While KP is the nation’s largest integrated health care delivery systems and leader in CQI standardization, there is always room for improvements. This consultant understands the importance of improvement at KP, thus humbly presents this summary and recommendations to the board of directors. References Agarwal, R. (2010, May). A Guideline for Quality Accreditation in Hospitals. Quality Digest, (), 1-4. Retrieved from http://www.qualitydigest.com/inside/twitter-ed/guideline-quality-accreditation-hospitals.html Chen, C., Garrido, T., Chock, D., Okawa, G., Liang, L. (2009). The Kaiser Permanente electronic health record: Transforming and streamlining modalities of care. Health Affairs, 28(2), 323-33. Retrieved from http://search.proquest.com/docview/204522974?accountid=458 Cohen, M. (2009). Statutes, Standards, and Regulations (chp 10) in McCaffrey, J. J., Hagg-Rickert, S. (2009) Risk Management Handbook (5th ed.). San Francisco, CA: Jossey-Bass. DesHarnais, S. I. (2013). The outcome model of quality (chp 5) in Sollecito, W. A. and Johnson, J. K. (2013). McLaughlin and Kaluznys Continuous Quality Improvement In Health Care (4th ed.). Jones and Bartlett Publishers. Emily R. M. Sydnor, Trish M. Perl (2011, January). Clin Microbiol, 24(1): 141–173. Retrieved from http://www.ncbi .nlm.nih.gov/pmc/articles/PMC3021207/ Kaiser Permanente. (2014). Kaiser Permanente, Retrieved from http://share.kaiserpermanente.org/article/history-of-kaiser-permanente/ McCaffrey, J. J., Hagg-Rickert, S. (2009, Chp 1) Developing of a Risk Management Program in Risk Management Handbook (5th ed.). San Francisco, CA: Jossey-Bass. Rawson, M. L. and Hammond, H. Y,. (2009) Emergency Management in McCaffrey, J. J., Hagg-Rickert, S. (2009, Chp 7) Developing of a Risk Management Program in Risk Management Handbook (5th ed.). San Francisco, CA: Jossey-Bass. Singh, B., Habeeb Ghatala, M. (2012, August). Risk Management in Hospitals. International Journal of Innovation, Management and Technology, 3(4). Sollecito, W. A. and Johnson, J. K. (2013). McLaughlin and Kaluznys Continuous Quality Improvement In Health Care (4th ed.). Jones and Bartlett Publishers.

Ignorance Of Physical Health In Mental Illness

Ignorance Of Physical Health In Mental Illness According to World health organization, Health is a state of complete physical, mental and social well-being not merely the absence of disease and infirmity. From this definition it can be inferred that health includes three major aspects and consideration of all aspects of health while providing care to the patients is very important. This definition applies on both psychiatric and medicine field because without holistic care it is impossible to achieve a complete state of wellbeing. The health care professionals taking care of physically ill patients also consider their mental health (Sturgeon, 2007). On the other hand physical health of patients with serious mental illness is neglected which leads to high premature mortality rates in this population group (brown, 2012).Writing on this topic will help in understanding about importance of holistic care in mental health care setting. According to (Thornicroft, 2011) 20-year mortality gap for men, and 15 years for women, is still experienced by people with mental illness in high-income countries. The combination of lifestyle risk factors for chronic diseases, higher rates of unnatural deaths and Poorer physical healthcare contributes to this scandal of premature mortality. It shows that high mortality rate in mentally ill patients is due to the ignorance of physical health so it is important to consider the physical health of such patients to maintain good quality of life. Likewise, I have witnessed the ignorance of physical health during clinical in Karwan-e-Hayat.18 years old female was admitted in Karwan-e-Hayat with diagnose of schizophrenia. On clinical day I saw that she was sitting in her bed shivering and constantly going to wash room. I informed staff about her condition but they ignored and say she will be all right. Next day she was in same situation, looking very tired and anxious again I informed staff but they did not do anything. Next week when we went there I asked staff about her condition they told that she was suffering from severe diarrhea and was admitted in Zia-u-din hospital. Reflecting on this scenario its very upsetting that staff are ignoring physical health of patients which leads to more distortion of their health, economic burden, and many other unexpected out comes such as death and serious illnesses. Mentally ill patients are more prone to physical illness then the general population because of many reasons such as lack of exercise, high rates of smoking and poorer diet contributes to higher rates of hypertension, high plasma cholesterol and triglycerides, diabetes, obesity, cardiovascular disease, cancer, and respiratory illness etc. (Chacà ³n, 2011). Moreover some researches also show that there is strong genetic relationship between some psychological and physiological illness such as diabetes and schizophrenia that people with diabetes have the tendency to get schizophrenia. Patients with severe mental illness are unable to maintain a healthy behavior which leads to many serious physical illnesses. So it is the duty of health care professionals to provide holistic care to these patients. Further somatic pain is also a reason for example, when such patient complains about pain staff perceives it as somatic delusion and they did not do any assessment which leads to further con sequences. Thornicroft (2011) states there are many barriers which contribute to physical illness. He gives the concept of diagnostic overshadowing that people with mental illness receive worse treatment for physical disorders. For example people with co-morbid mental illness and diabetes that presented to an emergency department, were less likely to be admitted to hospital for diabetic complications than those with no mental illness. It may be also due to the negative stereotyping and stigma related to the illness. Furthermore workload and shortage of staff is a factor because of workload the staff is unable to give time to individual patient. On the other hand lack of trained staff, lack and ignorance of daily assessment by trained staff leads to various physical health problems in mentally ill patients. For example in the above mentioned scenario the patient was shivering and was frequently going to washroom but the staff did not take notice of it and later it was found that the patient was having severe diarrhea. Brown(2012) added that health disparities experienced by these people is due to poverty, social isolation, problems accessing health assessment or lack of resources from management like tools and equipments to assess the physical symptoms of patients e.g. there is no BP cough to assess the BP of patients. Moreover mentally ill patients are unable to identify problem in their own body because of altered thought process and side effects of psychotic medication such as seizures, hypotension extra pyramidal symptoms these all factors contribute to serious physical illnesses. According to Maslows Hierarchy of Needs physical needs and health are most important to be fulfilled. He says that physiological needs are deficiency needs, meaning that these needs are important in order to avoid unpleasant consequences. These physiological needs include the most basic needs that are important to survival, such as the need for water, air, food, sleep, and health. So from this model we can infer that physical health and needs are very important in order to maintain a healthy life. Mentally ill people are appearing to give less priority to their physical health needs. Health promotion for such people should aim to raise awareness of variable high-risk lifestyle factors and their control (Buhagiar, 2011). For example it is the responsibility of health care providers and family members to provide awareness to the clients about reducing risk factors that cause physical illness such as sedentary life style, smoking, drug abuse, and consumption of unhealthy diet. Additionally (Buhagiar, 2011)added that locus of control in mentally ill patients is external as compared to physically ill patients, so here comes the main role of health care providers and family members to change their behavior and performing daily assessment of such patients. The timely assessment will help care givers to act pro-actively and take prophylactic measures to control behaviors and diseases in mentally ill patients. Furthermore (Tsay, 2007) explain that we need multidimensional strategy to reduce disparities in physical health of mentally ill patients. For example integration of mental and physical health services will be of some benefit like in above discussed scenario the patient was only receiving care for mental illness, so to provide holistic care the management of such organizations should focus on both mental and physical aspects of health and make sure the availability of physicians and equipments needed for the assessment, treatment and health promotion of such patients. In addition (brown, 2012) mental health nurses and clinicians should play an active role in health promotion, primary prevention and the early detection and management of physical health problems. This would only be achieved when the health care providers are trained and competent in their skills such as therapeutic communication, proper physical assessment, and other psychomotor skills. So the management of any health care organization should arrange different training sessions for providing latest and reliable information that will help staff to provide holistic care, to refresh their knowledge with new researches and make sure the ongoing evaluation and analysis of training sessions. Thus the improvement in all these aspects will help care givers to provide holistic care to mentally ill patients and contribute to complete state of wellbeing. In conclusion, the physical health of mentally ill patients should be part of the field of action of psychiatric practitioners. Health consists of physical, mental, and social aspects, consideration of all three aspects is very essential; change in one aspect will lead to distortion of health. There for it is the duty of health organizations and health care providers to prevent illness promote and restore health and to do screening, diagnosis, and treat physical illness of mentally ill patients. Here my suggestion is that as health care professional we have to consider all three aspects of health and it is our duty to provide holistic care to the patients to achieve a complete state of health.

How Brian Clark avoids Senintimentality in Whose life is it Anyway Essa

‘Whose life is it anyway?’ follows the story of ‘Ken Harrison’, a man who tries to exercise a choice over his own life or death after being completely paralysed from the head down. Harrison received these horrific injuries after being involved in a car accident 4 months before the story starts. He is now in constant care within the hospitals walls being treated and cared for by the medical profession. The play centres on Harrison’s determination to exercise a choice over his own life or death with the medical bureaucracy fiercely opposing. The play leads as he takes the medical staff to court to try and exercise this right officially. This play is seemingly unsentimental in which Harrison responds to his plight with wit and clarity and argues his case with power and persuasion. As this play focuses on ones mans wish to die and the issue of euthanasia we as the audience would expect the play to be very emotional. With the storyline, Clark could have easily made this play the opposite of what it actually is, powerful and fast moving. As Harrison had been though such a terrible ordeal we would expect him to be full of self pity and self indulgence and therefore make the play emotional and miserable. Ken is first seen in Act 1, the first impression he makes on the reader is one of a happy and untroubled man. ‘I used to dream of situations like this†¦ lying on a bed being massaged by two beautiful women.’ This is the first of many comical references Ken makes throughout the play, this is a very strong tool that Clarke uses to avoid sentimentality in his play. It shows that Ken isn’t self indulgent but rather making the best out of his current situation. He is expressing how he feels in the form of humour. This is less emotional than s... ...as purposely avoided. To asses how successful Clarke has been in bringing this serious issue to life we first need to consider our own right to personal choice. Clark has made it very obvious that our own personal choice can sometimes be defied by something as small as the medical bureaucracy. However he has also showed us that with determination, wit and clarity we can argue our right to make our own personal choice. Euthanasia is untimely a very sad issue which is normally dealt with sympathy and self indulgence, Clarke has brought this issue to life and has handled it exceptionally well, he has shown both the comical and sad sides to the debate without showing bias to any side. He has successfully avoided sentimentality in his play by using many different narrative tools such as comedy and rationality and has in the end stopped the play becoming over emotional.

Essay on Manipulation through Language in The Memorandum

Manipulation through Language in The Memorandum  Ã‚  Ã‚  Ã‚   How one utilizes language to perpetuate certain images or perspectives can greatly influence the way people think. One can use language to manipulate the minds of others and bring them under some form of subjugation. In Vaclav Havel's The Memorandum certain characters use this tactic of manipulation through different means that involve language, and in the process, they gain the authority or recognition they are seeking. Ballas promotes the new creation of the synthetic language, Ptydepe, which reduces humans by mechanizing them for the purpose of a more scientific and efficient system of communication. The language is created so that people will show no emotions or flaws when speaking. This system is analogous to the bureaucracy, which also implements its linguistic power to establish and maintain order in every aspect of The Memorandum's society. Havel illustrates how language is intrinsically omnipotent by exemplifying the drastic effects it can have on people's rationality. The c haracters in the play who use language to their advantage gain power, and those who allow language to control them become victims of the cyclic struggle to systematize humanity.            Ballas is one person who uses language to manipulate and abate people, thereby exercising his power. Although subordinate to Gross by title in the beginning of the play, Ballas manages to finesse Gross into signing the supplementary order for the official introduction of Ptydepe, even though Gross is in opposition to the idea of an artificial language. He uses public opinion over the rubber stamp affair to manipulate Gross into submitting to his demands. Ballas strategically attempts to tell Gross what he be... ... also lapse into self-alienation, unable to identify with who they are as humans. The characters in the play have become so involved in a systematic way of living that they keep a knife and fork in their office drawers that they take with them everyday to lunch "in a solemn, funeral-like procession" (2.12). As long as people allow this oppression of humanity, the circle of power will never cease. In the play, although Ptydepe was eventually condemned as a failure, instead of ridding the organization of the system, Ballas implemented a new method of communication, Chorukor. Just as the play ends as it begins, the system that controls people's actions and thoughts will remain intact until a greater power can control the system. WORKS CITED Havel, Vaclav. The Memorandum in The Garden Party and Other Plays. Trans. Vera Blackwell. New York: Grove Press, 1993.

Business coursework; Fish and Chip shop (Burnham high street) Essay

Introduction I am doing an investigation on a small local business to identify ways that it could be improved and what the business is doing wrong at the moment that is preventing it from making the progress that it could make. The local shop that I chose was the fish and chip in Burnham high street, SeaWorld. I chose this shop because I am a fan of seafood and when I go into a seafood place I expect to find many items that are actually seafood but normally they have different varieties of food but rarely any seafood. They normally have kebabs, chips, burgers, but chips are a necessity with fish. Preparation We started off making our individual surveys for both customers and workers and chose the best survey to be printed out. We also were planning on tasting the food in SeaWorld as well to see how good the product was. We thought of the types of shop that would be competitors. What we did For our research we had about an hour to go to the fish and chip shop in Burnham high street, but unfortunately SeaWorld was closed so we decided that some of us would take out the surveys on the public while the other group would see how the point of sale looked and find anything wrong with it. There were quite a few surveys done, and we managed to figure out some problems with the point of sale. Luckily there was a worker inside SeaWorld who did not mind us asking questions about his workplace. I think that we had taken a few surveys of people who go there regularly, but would have liked to see how the business was when it was open. Things like how many people go there, what there menu was, how well priced the food was, what majority of the regular customers thought of the seafood shop. We also looked out for competitors and how accessible their shops are, how their shops looked and how close they are to SeaWorld. Place SeaWorld is in Burnham high street and because it is quite a small high street even a small number of competitors would be a problem. There aren’t any seafood restaurants or seafood take-away as such in Burnham high street but there are cafes and fast food shops and there is a seafood shop in Burnham. These are also competitors because if people go into these shops it can pose a threat to the business of SeaWorld by reducing its market share. The other issue with the place is how easy it is for the customers to access the shop in terms of parking, distance and is there a contact number so they can order over the phone? The restaurant has a telephone number next to the restaurant’s name which is convenient for the customers and the business because it won’t be crowded so they will have enough seats but they will still be getting the sales and revenue. The first take- away or restaurant that you see when you enter the high street from hog fair lane is SeaWorld which means that for ease of access and to save time people will go here. Therefore I think that the place that the seafood shop is not bad, but the look of the point of sale from the inside and outside needs to change. It needs to be re-painted and the inside needs to be looking more spacious to attract more customers. Product I did not have the opportunity to get a good look at their menu because at the time they were not open, but from what I saw there was a range of fried and battered fish food, chips and drinks which is what their customers would expect and this makes them look good. There was a problem though which was that on the outside of the shop there was a label that said ‘kebabs’ that is something that you wouldn’t expect in a fish and chip shop and I don’t know if they do sell kebabs but if they didn’t then that would be misleading the customers which would be irritating for them and they could potentially lose customers. If they did have kebabs then it would be inappropriate. Price I was not able to ask or look at the prices that they had for their food but the price needs to be below five pounds for each product and above a pound. If the products are priced too highly customers would not buy from that shop and if it was too low then they will be at a loss and will not be able to run efficiently. Theoretically the lower the price the more demand there is for that product, but you also need to balance between charging high enough to cover costs but low enough to keep the customers buying. Sometimes even if the prices are high the demand still remains the same, this is because things like customer service is good and the product also should be better than others. For the seafood shop it means that they need to be friendly to customers, deliver orders on time and put the customer’s needs and requests first. Promotion Walking along Burnham high street I did not see any form of promotion for the seafood shop. This is one of the crucial factors of getting a small business to succeed. If people do not know where you are or even if you exist then how will you get more customers? The seafood shop does not even have a website which means that it makes it harder for people find out about such a shop. The locals around Burnham high street might know about the shop but not many other people will. Therefore they need to find a form of promotion that will allow them to be known but not too expensive either. Picking the promotion The ways of promotion best for SeaWorld is through leaflets through letter boxes, this is a form of promotion suited to this business because it will be spread throughout the local area, because people from other areas are not going to travel a long way just to get to SeaWorld and it is not that expensive. The down side to leaflets is that it is often seen as junk and discarded, so it has a low success rate and you would need to find someone to hand them out or put them in letterboxes this means they need to pay that person as well. Another way that is cheap and affordable is advertising in the local newspaper, this would reach a wide local audience and there is only the cost of publishing it in the newspaper. The size of the advert can be adjusted so that it fits the budget of the seafood shop, but to get a large sized advert that is well designed it may be expensive. Another promotion that is totally free, very reliable and trustworthy is customer word-of-mouth recommendation; this is when customers recommend the shop to family and friends. When it is recommended by family and friend’s people trust that it is a good shop and go there, but it is the customer’s choice to do it and you cannot control it. You can aid this by providing excellent customer service, good value for money and good standard of food. A good thing to advertise is offers like buy one get one half price or tokens on newspaper or leaflets that have good offers which they can claim. Offers for a meal are actually cheaper than buying them all individually so it encourages customers to buy more and they would chose a place that has offers on food to one that does not. Loyalty cards are also a good incentive to get new customers and keep existing customers to come back for more and this would increase sales because a certain number of purchases would get them a reward, which is normally more food. Frequent customers would feel angry that they do not get discounts or complimentary food. Survey of worker We did a questionnaire on the worker about the Seafood shop, and working conditions and he seems to be very positive about working there, but from how he spoke we realised that he was being bias so we cannot really trust everything that he said. He said that it was a good environment to work in and that the working conditions were good. The environment would be good because it would be busy. The workers seem happy and motivated therefore I would expect the customer service to be good as well and the food to be of a good standard. I asked what kinds of fringe benefits or monetary benefits they get but it seemed that he did not get any. The staff cannot be kept well motivated for long without any benefits. The owners can make the staff more motivated by giving monetary benefits at first and then fringe benefits. At first they would find that money is what they need and will be motivated when money is at the other end and it will be cheaper to give small monetary benefits than fringe benefits. When the business grows it can afford fringe benefits and the workers need benefits other than money to motivate them. The easiest fringe benefit could be a discount on the food in the fish and chip shop, or free lunch for the workers. To keep them well motivated there needs to be a better fringe benefit that they will get for working well or achieving a target number of sales.