Hobbes and Locke Essay

Thomas Hobbes and John Locke are indeed, two of the most brilliant philosophers that ever existed. They may have similarities and differences between them, but it is undeniable that their ideas contributed a lot in shaping the modern world. Both Hobbes and Locke perceive man as a central figure in a society. For Hobbes, it is man’s nature to be mindful of him exclusively, with self-interest going above everything else. On the other hand, Locke perceives man as both self-interested and concerned about other people. The two really have similarities and differences, but in order to know more about them, we need to compare their stand about various aspects of society. One important aspect that we could consider is sovereignty (Williams, 2006). Hobbes made it clear in his Leviathan that a political society’s sole task was to identify a person or a group as the sovereign. This pertains to an election of some sort, which would determine who would be the sovereign. Hobbes regards this sovereign as someone with absolute power, and that every person in the society should give him/them their absolute obedience. For Hobbes, the only time that the people would be sovereign is when they choose who will be the distinguished sovereign of all. Locke on the other hand, would put the public good above all else, thus affecting his notion of sovereignty (â€Å"John Locke,† 2004). In Locke’s Second Treatise of Government, he recognizes the permanence and irrevocability of the social contract, but this limits the legislation only for public good. If and whenever the public trust is violated, say perhaps the people in power overlooked the public good, then they would have to answer to the people. They retained the power to remove or replace the legislative, considered to be sovereign, with a new legislative. Though it is unclear in Locke’s writings, he somehow deposits sovereignty in the people. He recognizes the sovereignty that a legislative may have, but still, it is in the hands of the people to correct any inappropriate actions that violate the public good. Another aspect that we could use to compare Locke and Hobbes is their idea about government. But before that, we need to consider first how these two look at the natural law that all men follow. For Hobbes, man follows a naturally law that eventually leads to a state of war. Their equality leads to conflict between each other, eventually leading to war and chaos. Locke on the other hand, would consider man’s natural law as a movement towards equality and freedom. Both men draw their ideas about the government from their concept of natural law. For Hobbes, government is important because it can be used to control natural law. For Locke on the other hand, government is important in order to preserve natural law. In relation to this, another aspect that we can consider in comparing Hobbes and Locke is their idea about rights. Thomas Hobbes believed that the natural law that man follows result from the rights possessed by each person to do everything in the world. Since they’re allowed to do whatever they want because of the rights they possess, conflict would be unavoidable. In order to avoid this state of war, man follows a social contract in order to create a civil society. This requires them to forfeit or cede some of their natural rights in order to be protected. This somehow controls them from exercising all of their rights, but somehow protecting them from the impending destruction that results from conflicts and wars. As for John Locke, he believes that all of us possess Natural Rights, which is brought about by the state of nature that we follow in the society. These include the right to life, liberty, and property. Both Thomas Hobbes and John Locke believe that all men are equal according to the natural law. For Hobbes however, this equality is seen in a state of war, caused by man’s right to everything. These rights lead them into conflict and boils down to chaos. Still, Hobbes believe that this state of war to be an equal field, wherein the weakest can still kill the strongest. There is no one above others in this state of war. He also believes that all man is sensible by nature, and can agree upon each other to avoid these constant wars. Locke on the other hand, sees man optimistically, wherein they are governed according to reason, thus coexisting equally and peacefully. They are all equal in terms of the rights they possess, thus putting them on the same level as everyone else. Thomas Hobbes and John Locke both agree on the importance of civilizing man. It either control or preserve natural law, either way, it is beneficial. Putting this on the idea of â€Å"the savage†, we can see that they give emphasis on the importance of civilizing man because it makes him better. We can say that for these two, man can’t do away with the social establishments that he created, including the government and their notion of sovereignty, as it preserves and promote order in the society, something that both philosophers can somehow agree upon.

Role of the Insurance Industry in Economic Development

What Role has the Insurance industry In Economic development? The insurance industry has come a long way from ship owners, merchants and underwriters gathering in Edward Lloyd’s coffee house in London to discuss their marine voyages to new colonies of the British Empire. Over the years, Insurance has become essential in our everyday lives. Something we just can’t live without. Our Economics and Societies are growing phenomenal rates and have become more and more interconnected on the rest of the world, the risks exposed to us become more unpredictable and hazardous.The need to protect against unfortunate events has been around as long as human beings existed. Individuals have always recognised their need to alleviate risks that have the potential to ruin the. At the dawn of modern history, widely dispersed groups of tightly knit hunter-gatherers, relied almost exclusively on clan relatedness as their only bulwark against the ever-present risk of death, debilitating inju ry and starvation.For those early ancestors, the concept of risk always existed, exclusively in terms of the physical persons of individuals, mitigated by the guarantee of personal and kin relationships, rather than objects and possessions. (Buckham et al 2011, pp. 1-9). According to Lopez and Raymond 1967, in antiquity, a sea loan was the first sign of transferring risk. A number of German and Italian jurists have regarded it as something close to insurance. It involved a ship owner promising to transport goods belonging to a merchant and at the same time providing a loan, somewhat of a guarantee.If the ship and the goods arrived safely to its intended destination, the merchant returned the loan but if they didn’t arrive safely, the loan was not returned. From its origins in ancient times, the insurance industry has evolved into an essential service in our society and a â€Å"key component for economic development† (Liedtke 2007). Our lives are progressing rapidly, th ere is a significant increase in the general population, technology and science is continuously maturing and the world is becoming smaller.The insurance industry is now faced with challenging obstacles through â€Å"the liberalisation of insurance and capital markets, changing demographics, volatile stock markets, the shifting of climate patterns and the rising numbers of natural and manmade disasters and subsequent losses† (Ayadi and O’Brien 2006). â€Å"The global risk landscape is growing and the size of potential losses is continuously increasing† (Coomber 2006). Society has progressed significantly from ancient times and our need of insurance has drastically transformed accordingly.The increasing sense of ambiguity and uncertainty in our lives regarding our future economic prosperity and the devastating impact of catastrophic events has certainly reinforced the need for insurance to shield us against new and emerging risks. This paper asks the imperative qu estion: What role has the insurance industry in our economy development? The Importance of the insurance industry for an economy can only in part be measured by the sheer size of its business, the number of its employees in a given country, the assets under management, or its contribution to the national GDP.But insurance is not just about employment and the financial compensation of Victims. It actually plays a more fundamental role in the workings of a modern society, it creates huge capital assets. Due to the nature of insurance contracts which usually involve long time periods, money coming from insurance, usually stays in the financial market of a given economy for quite some time. It is not a fickle investment capital that rushes around looking for quick gains, it is oriented toward the medium to long term. It creates a stable environment by allocating assets according to market forces where needed (Liedtke 2007).There are six main areas where the insurance industry fosters ec onomic growth. I will now go into detail on these six areas (CEA 2011). Private insurance improves firm’s financial soundness: Insurance allows firms to expand and take on economic risk without the need to set aside capital. If a firm did not have adequate business insurance cover this could be harmful particularly for small firms. Small firms have limited capital and have difficulty in accessing financial markets which make them particularly vulnerable to adverse events.Without insurance large contingency funds would have to be in place to protect firms against risk. For most small firms this would represent more capital than they presently employ which would not be viable for most small firms and this would lead to a reduction the population of firms. Fostering entrepreneurial attitudes, encouraging investment, innovation, market dynamism, and competition: To be innovative you have to take risks. Since entrepreneurs just like ordinary people are characterised by risk aversi on, the willingness to take risks can be considered a scarce resource (Kugler and Ofoghi 2005).More will be produced if greater risk is taking. Well developed insurance markets contribute to the development of an economy by helping to optimise the allocation of the scarce resource of ‘risk taking’ by moving it from a conservative to an innovative and high profits activities. On the other hand uninsured firms are very conservative and generally do not exploit new business opportunities and invest less in innovation and their degree in the global markets is low. Offering social protection alongside the state, releasing pressure on public sector:In all industrialised countries a major problem is not too far down the line. Due to improvements in healthcare and quality of life population’s structures in industrialised countries are changing where people are living a lot longer and at the same time the birth rate has also decreased. People are also expecting to receive a high level of healthcare, pensions, unemployment allowance and other social benefits. This raises great concern as public expenditure will be put under huge pressure and will lead to significant decreases in economic growth.The role of the insurance industry is vital to provide an additional pillar alongside the protection supplied by the state. Insurance products like payment protection insurance play a vital role in protecting household in times of unemployment in an economic downturn. Many industrialised countries such as the United Kingdom provide free healthcare to its citizens. In the future what we are going to see is the health system in these countries being privatised and individuals buying private health insurance. Currently 47% of the Irish population have health insurance (Nolan 2006).Similar systems will have to be introduced to the pension systems. These measures will help reduce government expenditure on these areas and in the long run help with the development of the economy in the countries. Enhancing financial intermediation, creating liquidity and mobilizing savings: Insurers are massive institutional investors in the economy with over 11% of worldwide assets in 2007 (Munich RE 2007). They therefore see benefit in the development of a modern , competitive financial market that facilities firms access to capital and offers a wide range of investment opportunities.In this respect insurance companies look favourably upon initiatives taken by governments to ensure shareholder rights and to maintain high standards of corporate governance. Promoting sensible risk management by firms and households, contributing to sustainable and responsible development: Insurers risk assessment is reflected through in price and policy conditions. In this way they offer firms and households an indicator of their level of risk. Firms and households in can take action to reduce the risk by engaging in risk management.Risk management is the process of gauging or accessing risk and developing strategies to manage it (Squiddo 2012). Therefore by means of risk pricing insurance encourages sensible risk management. Both the client and the insurer benefits from sensible risk management as the client’s premiums are reduced and the chances of the insurance company having a claim are also reduced. This process influences investment decisions and thus contributes to the development of the economy. Fosters stable consumption throughout life: Consumption is the main driver of economic growth as its accounts for over 80% of GDP.By having insurance it offers lifelong financial protection and allows stable consumption throughout an individual’s life. * Insurance for house and other damages allow individuals to secure assets in case of an adverse event. * Liability insurance covers household for damages that might occur to other people. * Life insurance protects relatives in the event of a death and also provides financial support in retirem ent. * Health and accident insurance provides cover when it is needed most. * Credit insurance eases consumption but does protect against excessive debt through pricing and acceptation policies.Another new phenomenon in the insurance industry is Micro insurance. It aims to alleviate poverty, distribute products in new ways and create sustainable financial growth for individuals, families and small scale businesses in underdeveloped countries. The need to provide insurance products is vital if their economies are to develop. People in underdeveloped countries are most at risk to adverse events and they have a significant negative impact on their lives. When a hurricane, flood or other adverse events occur and their homes are destroyed or their livestock is wiped out, these people have no financial compensation.These communities have to start from scratch. Insurance companies recognise that the poor require a range of insurance products that meet their needs. Zurich was an early mover in micro insurance, when it started its first micro insurance programme in Bolivia in 1999. It hasn’t been an easy move due to a lack of trust and confidence by people in underdeveloped countries but if these problems can be resolved there is huge potential for growth in the market and also for a dramatic improvement in economic development in these countries (Pope 2011).Conclusion: When we think of economic development, most attention is devoted to the relationship between the financial markets and economic development with insurance only receiving a passing mention. However in recent times there have been several interesting lines of research into the role the insurance industry plays in economics development. I have shown in this paper how the insurance sector plays a fundamental role in the development of our economy and without insurance we would live in a world that would be less economically developed and much less stable.Insurance supports research and development, i nnovation and new technologies, it supports economic stability and sustainable growth and also supports the sustainable use of resources and helps modernise social protections systems. The evidence suggests that there is substantial potential for the insurance industry to make a greater contribution to economic growth especially in lower and middle income countries. Currently insurance lags behind financial services in the extent of globalisation, but if we can continue to expand the insurance industry we will see substantial growth opportunities.Bibliography Ayadi, R. and O’Brien, C. (2006) â€Å"The future of insurance regulation and supervision in the EU: New developments, new challenges† Buckham, D. , Wahl, J. and Rose, S. (2011) Executive’s Guide to Solvency II, United States of America: The Wiley and SAS Business Series. Coomber, J. R. (2006) â€Å"Natural and Large Catastrophes– Changing Risk Characteristics and Challenges for the Insurance Indust ry†, The Geneva Papers, 2006, 31, (88-95) Kugler, M. and Ofoghi, R. (2005) Does insurance promote economic growth? Evidence from the U. K. University of Southampton Paper, July 2005. Liedkte, P. M. (2007) â€Å"What’s Insurance to a Modern Economy†, The Geneva Papers, 32, (211-221) Lopez, R. S. and Raymond, I. W. (1967) Medieval Trade in the Mediterranean World: Illustrative documents translated with Introductions and Notes, New York: WW Norton & Company Inc. Nolan, B. (2006) â€Å"The Interaction of the Public and Private Health Insurance: Ireland as a Case Study†, The Geneva Papers, 31 (663-649) CEA (2011) â€Å"Better off in Europe: How the EU’s single market benefits you†, available: http://ec. uropa. eu/publications/booklets/move/56/en. pdf Munich RE(2007)â€Å"The fundamental role of insurance†, available: http://www. genevaassociation. org/Portals/0/COP15_Munich_Re_presentation. pdf [accessed 25 October 2012] Pope, C. (2011) â€Å"Do we really need Private Health Insurance†, The Irish Times, 24 Jan, available: http://www. irishtimes. com/newspaper/pricewatch/2011/0124/1224288161882. html Squiddo (2012) â€Å" Principles of risk management†, available : http://www. squidoo. com/the-principles-of-risk-management [accessed 26 October 2012]

Laboratory Information Management Systems Research Proposal

Laboratory Information Management Systems - Research Proposal Example The use of the Bell and LaPadula Model has been successful in modeling information that is relevant to security, even though this success might be responsible for the vagueness of the model about its primitives. This vagueness can also be examined with respect to the theory that the Bell and LaPadula Model and Noninterference are equivalent. Laboratory automation makes it possible for scientists to explore data rates that otherwise may be too fast or too slow to properly examine. Therefore, an automated laboratory reduces the need for human intervention and creates a more efficient environment in which human beings and technology can interact to produce a great deal more information and accurate data that was not possible prior to automation. Its approach is to define a set of system constraints whose enforcement will prevent any application program executed on the system from compromising system security. The model includes subjects, which represent active entities in a system (such as active processes), and objects, which represent passive entities (such as files and inactive processes). Both subjects and objects have security levels, and the constraints on the system take the form of axioms that control the kinds of access subjects may have to objects.           While the complete formal statement of the Bell-LaPadula model is quite complex, the model can be briefly summarized by these two axioms stated below: The simple security rule, which states that a subject cannot read information for which it is not cleared (i.e. no read up) The property that states that a subject cannot move information from an object with a higher security classification to an object with a lower classification.              These axioms are meant to be implemented by restriction of access rights that users or processes can have to certain objects like devices and files. The concept of trusted subjects is a less frequently described part of the Bell-LaPadula model.

Divisions between the British tabloid and the serious, quality Press Essay

Divisions between the British tabloid and the serious, quality Press - Essay Example In as much as these media publications have different names and are no longer in circulation; they have something in common which lacks in the current media newspapers that we have today. The old publications represented the partisan ‘radical press’ that agitated for the betterment and improvement of the society (Stephens 2006, p. 23). They influenced the beliefs and the attitudes of the working class. This is because it defined the society to be made up systems of exploitations and not as a series of disjointed events. Additionally, the radical press played a significant role in undermining the social order normative support through challenging the validity of the economic and social institutions in which the social order was based (Seymour-Ure 1991, p. 150). The radical press obtained funding from subsidies from social movements and sales it made from the circulations of the publications. This is contrary to the independent press of the recent times which obtains its f unding from advertising revenues and sales of publications. Introduction Several debates revolving around the current state of British newspapers are being conducted. However, recent findings reveal that the traditional news values that dominated the media have become revolutionized and reformed (Negrine 1994, p. 87). In the recent times, the dominance of social and celebrity news, the blurring of the line separating reality shows and news, as well as the advent of civilian journalism, demonstrates that the nature of news and news values are changing; and that the traditional values of news are becoming irrelevant. It is worth noting that the old traditional news values are being replaced by the tabloid news values. These values represent the interpretive work of journalists, and they cut across the broad sectors of public life. For instance, this news revolves around crime, sports, scandals, pop culture, just to mention but a few (Hampton 2008, p. 98). On the other hand, pertinent issues such as public affairs and politics are given minimal attention. The tabloid news stories are normally personified in order to impart high emotions and sensation (Franklin 2008, p. 23). According to media historians, tabloid news values are present in the English newspapers in the recent times because of two factors, namely; media ownership and advertisements. This is because they contribute to the existent of hierarchies in the journalism profession. It is debated that there is no narrowing in the divide that exists between broadsheets and tabloid newspapers (Keeble 2008, p. 45). This is attributed to the fact that there are several changes in their features. Therefore, this paper shall seek to explicate as to whether tabloids are similar to broadsheets, as well as determine if the ‘quality press’ is concentrating primarily on issues that touch on public interests. In order to make my arguments clear, I will use examples to emphasize on my main points. Discussio n Studies reveal that broadsheets newspapers undergone a tabloidization process. Tabloidization refers to the style of papers that does not pay much attention to foreign affairs and government policies. Instead, it as an entertainment-oriented style of journalism that centers on celebrity, lifestyle, crime/ scandal and entertainment (Sparks & Dahlgren 1992, p. 123). Some of the reasons of tabloidization are

Samsung Galaxy XCover Snowfield Advert Essay Example | Topics and Well Written Essays - 1000 words

Samsung Galaxy XCover Snowfield Advert - Essay Example It is, arguably, the leading Smartphone manufacturer in the contemporary society. Cheil, a Chinese advertising company based in Beijing, China prepared the Samsung Galaxy X Cover Snowfield advert and published it in October 2011. The advertisement is a creative play of the idea that the Samsung X Cover device is so high-tech, that it will be the ultimate guide to the user even in destinations that they have never visited. In their words, ‘Just like you have been there.’ The mobile advert generally portrays a relatable mood of adventure and curiosity. The advert is rich in color from the subject matter to the general serene surrounding. On the Samsung Galaxy X Cover: Snowfield advert the setting is on the top cap of a mountain. The background is beautiful, bright and oozes an undeniable sense of natural tranquility. This is the ideal destination for explorers and tourists. For the free-spirited individuals, it is the epitome of a good time. The authors of this mobile adve rt clearly envisioned the young, fun-loving and free-spirited people as their target audience when they set out to create this advert. The subject in this advert is a young male who is set out to have the best skiing ride of his life (Hope 79). The angle focus is perfect for it clearly implies how the skiing will take place. The target audience for this advert relates to the setting since almost everyone has or strives for a dream destination or an adventurous quest. The appeal of pathos in this mobile advert is achieved by connecting.

Endometriosis Case Study Example | Topics and Well Written Essays - 500 words

Endometriosis - Case Study Example However, the growth is less likely to be found in other areas such as the lungs. The misplaced tissues develop into growths that respond to the menstrual periods in a similar way as the uterine lining. Consequently, this allows blood to flow from these endometrial growths but cannot leave the body. Such an aspect subjects the person to internal bleeding, tissue breakdown and inflammations that can even cause infertility and bowel problems (Watson, 2007). Endometriosis differs from endometritis in various ways ranging from its causal effect, and the pathophysiology and its presentation on the affected organs. For instance, endometritis is an infection that occurs in the endometrium lining that may occur during a prolonged labor pains, uterine instrumentation or even a C-Section. It can be also be caused by sexually transmitted diseases such as gonorrhoea, chlamydia or a mix of the vaginal bacteria. These aspects make it differ from endometriosis that occurs as a response to hormones for tissue growth on the peritoneal cavity (Burrage and BSMO, 2013). The causal factor of endometriosis has remained unknown, however, for the endometritis it is caused by infections on the uterus. An individual with endometriosis may feel pain in their intestines, pelvic or even at their lower back. Additionally, they may experience pain during and after sexual play at the inner vaginal walls that may appear swollen. On the other hand, they may experience heavy menstrual cycles, or bleeding or spot between periods. This differs from endometritis in that the individual experiences abnormal vaginal discharges, with discomfort, swelling of their abdomen and pain in the pelvic region (Burrage and BSMO, 2013). While there is cure for endometritis that is subjected to antibiotics, endometriosis has no cure but there different treatments. The treatment for this female victim depends on the age and the intense of the pain associated with the endometriosis. If the patient

Case Study Paper also referred to as the Applied Learning Theory Paper

Paper also referred to as the Applied Learning Theory Paper - Case Study Example In Kounin’s ‘Teacher With-it-ness theory’, the teacher must balance all of these aspects of childhood personality development and social learning methods in order to be able to control and transform the tensions that appear in the classroom and school. In this manner, a combined approach that takes the best of these theories and applies them to education and classroom management as Patricia P. Willems and Alyssa R. Gonzalez-DeHass do in â€Å"Educational Psychology Casebook† can lead to a more efficient learning process for both the teacher and students in public education or private schools. Development - Case 19: Erikson’s Personality Development Statement of Problem: â€Å"To Belong or Not to Belong† Mr. Turner is a 10th grade teacher is a three-year high school with both male and female students. The students have no dress code or uniforms, and come from a wide variety of diverse social backgrounds. Mr. Turner has a â€Å"Goth† stud ent in class who he identifies with in her inter-personal relationship struggles with other cliques in the school. Mr. Turner is not certain how to motivate the full range of his students or why they are not all preparing their assignments or completing the readings. He has a reputation of taking on large problems at the school and in teaching deep themes in English literature. Mr. Turner discusses the problems with the cliques with another teacher who advises him to take a more influential role in the character development of the students and to become more involved in building outreach to the community. Mr. Turner does not see the problem involving a wider solution outside of the classroom. Analysis: In Erik Erikson’s theory of human development, the girls are in the adolescent stage representative of Erikson’s 5th stage of personality development representing ‘Identity’ and ‘Identity Conflicts

Political Science questions Essay Example | Topics and Well Written Essays - 1750 words

Political Science questions - Essay Example These reflected into two that is extreme realism and moderate realism that all provide a different opinion on realism. Extreme realists William of Champeaux related realism as a position in which the universals exist through an independence of the humans and other particular things related in the field. On the contrary, other philosophers viewed this realism as so extreme and considered realism in the eyes of God as the relation through which particular things are created. This moderate theory as proposed by St. Thomas Aquinas and John of Salisbury. In relation to political realism, international relations come to consideration. These relate to general theories of political realities of the world. The aspect of political realism on this international perspective reflects aspects of competiveness within international communities and conflicting aspects that relate to the ultimate security aspects. Idealism and liberalism are part of this realism parameters. Idealism and liberalism deal more with the emphasizing of cooperation’s on an international level. It is therefore fair to conclude the position of the world based on realist as a connection of different states with regard to competition that has raised conflicts through which security has soured.

The Extras Assignment Example | Topics and Well Written Essays - 500 words

The Extras - Assignment Example Still this single case of their alone communication with its final interruption of people pretending to be from police, which have come for the blind neighbor without a warrant, lowers both Salem and Nada from heaven to the earth. Now they again realize the whole desperateness of their state with their hollow tries to free from the cage of inequality. Film’s title â€Å"The Extras† itself probably speaks for director’s intention to underline the subordinate role of ordinary people who have no money so cannot be powerful and make decisions for the benefit of the same citizens. The obvious reason for such a title is in the situation of Syria in the nineties when the representatives of the Arab socialist autocracy held the reins of power. So, with the help of drama and tragicomedy Nabil Maleh establishes several acute for his country themes, such as: a subject of humiliated state of ordinary Arabs and their social vulnerability to the repression of autocratic rulers, being depicted on the example of the blind neighbor musician and through Nada’s reflections about people who are forced to be silent, and the theme of love relations between Muslims (the case of Salem and Nada, Adel and his fiancà ©e). In fact, the film also deals with Syrian identity, which is realized through the striving of main characters for freedom and democracy within their lives and the present of their country. Moreover, the social inequality is a crucial point of the film, which is shown not only through the unjust acts of police and inability of Salem-lawyer to help the oppressed neighbor, but also through various theatre parts of Salem as an extra. This is a particular point of social situation in Syria, which appears to be under critics of the film. Poverty and injustice are another two peculiarities of Syrian socio-political situation of the nineties, which keep pace with each other, and their

Teenager problems Research Paper Example | Topics and Well Written Essays - 1500 words

Teenager problems - Research Paper Example Teenagers all over the world face many problems as they grow up. Many people have suffered teenage problems and, therefore, understand too well the magnitude of the devastation caused by such problems. In fact, there are few parents across the globe who admit that parenting teenagers is rosy and for most of these parents, the experience is not consistent and thus fluctuates between being downright possible and difficult. In the current world, so many parents acknowledge that they have problem teenagers. In so many ways, teenage years may be the greatest experience for many parents. This is because it is the time they witness the results of their efforts of parenting as their children grow up into adult and prepare to take on life’s challenges in the modern world. However, it is acknowledged by many parents that controlling the activities of teenagers is not an easy task as this is the time drug abuse, late night parties, drinking, and peer influence are most prevalent. Boyfrie nds, girlfriends, and some many confusing arenas of sex, love and sexuality begins, and the teenagers often find themselves under intense psychological pressure. This is also the time in a teenager’s lives when they find themselves distressed by the direction their lives are taking. This is, therefore, the point in their lives when they require a lot of advice and guidance to help them shape their lives in the right way. This calls for the government and adults to ensure t hat teenagers are nurtured well. This paper will discuss why the government needs to put money on teenagers’ problems and the need for adults to provide these teenagers with hope. World Youth Report (189) notes that these days teenagers, regardless of the country of residence, social origin or gender, are subject to individual risks and meet new individual opportunities with some beneficial while others are disastrous. It notes that in most cases, youths tend to engage in illegal behaviors as they en gage in drug abuse and addiction, and the infliction of violence against their peers. A survey by World Youth Report shows that apart from the US, rates of juvenile delinquency rose in 1990s (189). The report reveals that, in Western Europe, several arrests of juvenile delinquents and under-age criminals rose by an average of 50 percent between 1980s and 1990s. Juvenile crimes have also increased in Eastern Europe and other commonwealth countries. The report reveals that most of the juvenile delinquents are related to drug abuse and excessive consumption of alcohol (189). The report also suggests that, despite most programs and studies on juvenile delinquency, and focus on teenagers as offenders, the youths themselves fall victim to acts of delinquency. This, therefore, poses many threats in their lives. For instance, the report show that teenagers who are at risk of becoming delinquents in most cases lives in difficult situations (189). World Youth Report (200) argues that violence against youth violates their fundamental human rights. This calls for the government, individuals and institutions to commit their time, expertise, money and resources necessary to address this world problem. It is widely acknowledged that early intervention provides the best approach to juvenile delinquency prevention (Roucek 32). These measures prevent the youths from breaking the law. The government should, therefore, take up an initiative of providing money and setting up professional development programmes to provide legal alternatives to youth income generation. These include providing youths and adolescents with increased economic opportunities, education, professional training, new workplaces and some form of assistance in organizing business (world youth Report 201). This will help prevent the teenagers from getting involved in delinquent acts. The government should also provide money to be used in setting up educational centers focusing on youth educational programmes (He ilbrun, Goldstein, and Redding 124). This will help

Culture And Crime Essay Example for Free

Culture And Crime Essay The crime rate of societies differs with each other. If the crime rates of European countries and American countries were compared, the results would be different. The same is true if countries from the East and West were compared in regards to their crime rates. This can be attributed perhaps to different norms and concepts on crime of different societies, as well as the overall way of life of the people in any given area. If this were analyzed further, it will be noted that culture plays a role in the way that crime is viewed in a given society. This essay deals with the concept of culture, especially in the way that it relates to crime. Culture, Society and Criminality Before juxtaposing crime and culture, however, it would be necessary to define the overly used and abused concept of culture. Generally, culture is the overall pattern of the way of life of a given community of people together with the structures of symbols and meanings that they attach to various aspects of their society. This also includes the morality of the society as well as the collection of acceptable and non-acceptable behaviors (Krober Kluckhohn, 1952). Since the moral system is included here, it impinges upon the conception of what is right, as well as the way that people in a given society view law, together with the commission of crimes. Given that culture affects the overall lifestyle of peoples in a society, it is inevitable that crimes are also affected by culture. For example, in a study conducted by Karstedt (2001), she mentioned that culture has been recognized by criminology as one of the factors influencing crime. The study took note of various social control means in Asian countries with low crime rate such as Japan. Karstedt called for the introduction of methods and ways through which cultures may be effectively compared to study the differences in culture and its impact on crime. By conducting an extensive survey in one of the Southern States in the US, Warner (2003) found out that cultural disorganization affect crimes. Her findings show that a prevailing culture conditioned by disadvantage in the society and the disconnection of social ties have significant impact on the level of social relationships and ties of the community. This in turn impacts informal modes of social control in the society. Without these informal social control, it would the tendency for crimes to be committed becomes stronger. On the other hand, Leonardsen (2002) investigated the apparent anomaly of Japan—an urban country with very low crime rate. In his study, Leonardsen pointed out to apparent loss of too much individualism in Japan while focusing on the overall community. He argued that although the loss of individuality can be seen in Japan, it has much to teach to Western countries, especially regarding identity, obligations and social connections. Conclusion Based on the studies mentioned above, it can be seen that indeed culture has a significant impact on crime. Crime cannot only be prevented through formal means such as law, police force, and the prison system. Rather, there are informal institutions and norms that help prevent or perhaps encourage the occurrence of crime. When social ties are severed and a â€Å"negative† culture of the disadvantaged spawns, social controls are weakened, thus increasing the likelihood of the occurrence of crime. A focus on the community’s norms, however, can result to a more orderly society with low incidence of crime. These studies are congruent with Black’s theory that if the culture and the means of informal social control in a society are weak, then the tendency for that society is to have laws that are more powerful as compared with other societies with stronger social control means (Black, 1976). A combination of effective laws and informal social controls, are however necessary so that order can be kept within the society. Reference Black, D. (1976). The Behavior of Law. San Diego, CA: Academic Press. Karstedt, S. (2001). Comparing Cultures, Comparing Crime: Challenges, Prospects and Problems for a Global Criminology. Crime, Law and Social Change, 36 (3), 285-308. Kroeber, A. L. Kluckhohn, C. (1952). Culture: A Critical Review of Concepts and Definitions. Cambridge, MA: Peabody Museum. Leonardsen, D. (2002). The Impossible Case of Japan. Australian and New Zealand Journal of Criminology, 35 (2), 203-229. Warner, B. D. (2003). The Role of Attenuated Culture in Social Disorganization Theory. Criminology, 41 (1), 73-98.

Defence Mechanisms Essay Example for Free

Defence Mechanisms Essay Defence mechanisms are psychological actions brought in by the unconscious mind to change, deny or become a twisted reality. Defence mechanisms are usually referred to as ego defence mechanisms. A defence mechanism forms when anxiety occurs, this then means that the defence mechanisms will be triggered off. All defence mechanisms share two common properties they appear unconsciously and they tend to disfigure, transform a person’s reality. Defence mechanisms occur in some level in every person. Many play important roles in socialization and allowing the way in which people function in society. Others are seen as problems and they show signs of clients developing a dangerous psychological issue. For example regression, this means you return to a childlike state, this defence mechanism can get very dangerous as it can lead to clinical issues. There are many different defence mechanisms such as: Projection- Suggesting that others share the negative beliefs and thoughts you have, making yourself think that everyone thinks like that so it is okay to think like that as well. This can lead to very irrational thoughts. Such as when someone is depressed they then start to believe thoughts that their mind has made up maybe leading them to become suicidal. Displacement- Turning emotion into physical action (aggression) May tend to lash out to get rid of the emotion that have inside. This could lead to putting themselves and others into very serious danger as they could get progressively aggressive. This often occurs in mental health as they don’t know how to deal with certain emotions and situations. Rationalization- Illogical thoughts and explanations for your behaviour. Making up excuses just to get away with it. Making up things that don’t make sense. This could lead to them believing their own thoughts and starting to think they are real, sending them mentally ill. This could be when a doctor/surgeon makes a mistake during a procedure and they try to cover up their mistakes by using excuse and lies. Isolation- Removal of all emotional reactions so they are in emotional denial. Can’t cope with all of the emotion. In a hospital a nurse/doctor could not like a patient because of different beliefs and maybe ersonalities so provides them with different treatment. If someone is in denial then they will force themselves to not believe what they have been told to be true and not accept it. For example a person is diagnosed with a terminal disease, they will not believe it and just block it out so they don’t have to deal with it as they don’t know how to. They are refusing to accept the situation they are in. Eventually that person will have forced it out of their head so much that they generally think it hasn’t happened and it was all just a lie. Regression this is when you return to a childlike state acting immature, for example in a family when a new sibling arrives the other sibling gets jealous so therefore they may start to wet the bed as they want attention as they feel as if the other sibling is getting all of their parents attentions (feeling left out. ) Some people may go to therapy to identify the defence mechanisms that benefit them and work in a good way and also to identify the defence mechanisms that are really dangerous and that they shouldn’t be using.

Swot And Marketing Analysis Of Philip Morris International Marketing Essay

Swot And Marketing Analysis Of Philip Morris International Marketing Essay SWOT analysis helps one to fine out the strengths, weaknesses, opportunities and threats of an organization or a company. Strength and weakness are internal to organization whereas opportunities and threats are external. Strength and weakness both related to internal environment of organizations but opportunities and threats are the outsiders and can be evaluated using PESTLE analysis. The followings are the Strengths, weaknesses, opportunities and threats of Philip Morris International. Strengths: Strong finance: The Company has a base of strong financial situation. According to its corporate website, its operating income in 2008 was $10,284 million, and its net earnings were 6,890. There was an increase as the same for the year 2007 was $8,894 and 6,038 respectively. Well established Brands: The Company produces famous brands like Marlboro, LM, Chesterfield, Philip Morris, Parliament and Virginia Slims. When the product establishes itself as a brand there is a less need of spending money on its promotion. Strong manpower and employees: The Company boasts of more than 75,000 employees throughout the globe from different culture and ethnicity. With the variety in their workforce there is a variety of ideas and concepts, which can be beneficial for the survival in the global environment. Strong Management team: the company under the chairmanship of Mr. Louis C. Camillieri has a strong and efficient management team. David Bernick , a senior Vice president and General counsel is university of Chicago, law graduate, Andrà © Calantzopoulos , chief operating officer ,Kevin Click, chief information officer and Doug Dean, research and development make the strong management team of the company. Leading Markets: The Company boasts of leading 11 markets out of the top 30 international markets. That is equivalent to occupying 33% of total top market shares. This is one of the strength of the company. These are the basic strengths of the company, a strong financial condition with plummeting profits, well established brand names of the product, skilled, well trained and diverse work force, a strong leading management team and the huge share in top international markets. Weaknesses: As far as a weakness of the company is concerned the litigations seem to be the only weakness. Government policy on the promotion and sale of tobacco related product stops the company from aggressive marketing and promotion of its products. It is the weakness of the company. Opportunity: Increasing tobacco market: Although anti tobacco activists are raising their voices against the production and distribution of tobacco, the tobacco market is still lucrative. It raises billions of pounds as revenue to the government as well as the producers. Advantage of globalization: Globalization offers the company an opportunity to take an advantage of cheap labour cost and cheap production cost offered by third world countries. Factories established in China, Nepal offers the company cheap production of its products hence huge profits. Mergers and collaborations: The Company tied its knot with Altria and it recently announced its partnership with fortune Tobacco Corporation. These kinds of mergers and collaboration offer the company an opportunity to expand its market share. Threats: Anti Tobacco activists: The Company has remained a most controversial company because anti tobacco activists have always criticized the tobacco company for being responsible to the death resulting from smoking. For example, activists in Philippines raised their voices against the merger of fortune Tobacco Corporation with Philip Morris. They have feared this merger can draw more smokers in Philippines. (http://www.abs-cbnnews.com/business/02/25/10/anti-tobacco-group-expects-intensified-marketing-philip-morris-deal 25/03/2010) Government legislations: The governments rule of banning the sales of tobacco related products to people below certain age limits and other rules related to smoking ban on public places can reduce the sales of tobacco. For example research in UK shows that number of smokers has reduced after smoking ban in public places and after the age limit for the sale of tobacco has been set. Public Awareness: People are more aware about the consequences of tobacco consumption because of the advertisement of anti tobacco activists. This has resulted in the reduction of sales in many markets. Strength and weaknesses are considered as internal factors whereas opportunities and threats are considered as External factors. Basically strengths and weaknesses of an organization are related to people, resources, innovation and ideas, marketing, operation and finance, whereas opportunities and threat are associated to the factors that organizations find hard to control sometimes. They are political, economic, social, technological, legal and environmental environment in which the organization exists. Now lets examine the external factors of Philip Morris International. Political environment: (http://www.executivehm.com/media/media-news/infographics/091117-EHM-Smoking.png, on 25th April 2010) The details above show that by the year 2009 there are 44 countries with active smoking ban. The data also shows that more than 1 billion people are protected by smoke free laws. These laws mean reduction of sales for the company. The company can either promote its products in these markets or have their sales restricted by severe laws. For example, they do not allow people below 18 to buy cigarettes in England and Wales. They have increased the age limit from 16 1st of October 2007. Politicians are always trying to seek public favour and by introducing laws like smoking ban and binge drinking ban or increasing tax for products like these they are trying to catch public sentiment. These kind of political activities are although favourable to general public, they are not at all favourable for a company like Philip Morris, whose revenues are based on the sales of its tobacco related products. Economical: There is not much difference to Philip Morris International due to the recession. Its profits did not plummet heavily even though the world was hit by economic downturn. Following table show its financial data. (in millions of dollars except per share data)   Ã‚  Ã‚  Ã‚  Ã‚   2009   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   2008 %  Change   Net revenues   $62,080   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  $63,640   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  (2.5)% Cost of sales   Ã‚  Ã‚  Ã‚  Ã‚  9,022   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   9,328   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  (3.3)  Ã‚   Excise taxes on products     Ã‚   37,045   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  37,935   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   (2.3) Gross profit   Ã‚   16,013   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   16,377   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   (2.2)   Operating income     Ã‚   10,040   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   10,248   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  (  2.0) Net earnings     Ã‚  Ã‚     6,342   Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   6,890   Ã‚  Ã‚  Ã‚  Ã‚   (8.0) Basic earnings per share   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  3.25   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚      3.32   Ã‚  Ã‚  Ã‚  Ã‚   (2.1) Diluted earnings per share Source: Philip Morris Webpage Sociological: Being criticized as a main contributor of smoking related deaths in the World, Philip Morris International has to do a lot to cope up with the sociological issues. Therefore their social responsibility activities are directed to these five areas of society, extreme poverty and hunger, environmental sustainability and living conditions in rural communities, domestic violence, and disaster relief. The company has spent billions of pounds for charity purpose to restore its tarnished image. Legal: Philip Morris had to suffer heavy loss due to several legal proceeding that it had to go through as people blamed of killing people. It has a history of being sued by people, distributors or companies. For example, 16 wholesalers filed legal action in a federal court in Tennessee claiming that Philip Morriss wholesale leaders program 2003 constitutes price discrimination and attempts to monopolize. (Financial Times of London, 8th July 2003.) To cope up with these kinds of legal issues, the company has its own legal department that deals with all the legal issues associated with the company. Environmental: Environment is a hot topic in present day world. The problem of thinning of ozone layer or the global warming draws the attention of each and every organization. Most of the organizations have designed their social responsibility programme associating themselves with the environmental issues. Philip Morris international too has done the same. They have set up performance goals for their energy use, water use, and waste water discharge, waste to be sent to landfills and waste to be recycled. The following table show their goals. Source: Philip Morris website can be accessed at http://www.pmusa.com/en/cms/Responsibility/Reducing/Reducing_Our_Environmental_Impact/default.aspx, on 26th March 2010. Competitive analysis using Porters 5 Forces model. Michael E. Porter of Harvard Business School developed a framework for the industry analysis and business strategy development. According to him an attractive industry has all the forces he has developed works for the overall profitability of the industry. The five forces of Porter are, Competitive rivalry Threat of substitute products Threat of new entrants Bargaining power of customers Bargaining power of suppliers In case of Philip Morris, he too has competitive rivalry. He occupies 15.6 percent of the total market share. The rest is occupied by his competitors. It is for the same reason, Philip Morris is focussed on promoting new products. To beat its competitors, it has developed a strong social responsibility plan along with modification of its products. The launch of smoke free cigarettes can be considered as a product of competitive rivalry. Threat of substitute products: Philip Morris is quite free from the threat of substitute products. It has always maintained the standard of its products and priced them reasonably. This has lessened the chances of acceptance for the substitute products that are available in the market. Threat of new entrants: Philip Morris is famous for its cigarettes. No one in the world is unaware about Marlboro. It is a reputed brand name in the field of tobacco industry. But a reputed brand gives Philip Morris an advantage. It is almost free from the threat of new entrants. The reason for this is, cigarette smokers have a strong loyalty to their brands. So, although there is a constant arrival of new products, they do not affect the market share of Philip Morris as it has endorsed its product with heavy promotions and established all of its products as a Brand. Bargaining power of the customer: Bargaining power of the customer does not seem to affect the company. The reason behind it is, the perceived value of Philip Morris products is quite high because they are heavily promoted through media. They have a brand image and are free from the bargaining power of the customer. Moreover most of the customers of tobacco trade are loyal to the products they are used to, and are ready to pay whatever amount of money they are asked to pay. So Bargaining power of the customers doesnt seem to affect the company. Bargaining Power of Suppliers: Bargaining power of supplier affects every company. Philip Morris too is affected by it as it follows strict rules concerned with Fair trade. Moreover it has launched special benefit package to its suppliers. It helps the children of its tobacco supplier with education facilities and other general benefits. It is doing this just to reduce the effects of bargaining power of its supplier. Conclusions: Whatever progress the company made is not just a coincidence. The company did not lose much of its profits even in the economic downturn. The reason behind this can be summarised as the proper knowledge of the strength and weaknesses of the company and summoning all pertaining questions related to its external environment. Its commitment to follow all legal requirements of the government, introducing chewable tobacco instead of smoking ones, commitment to environmental conservations and billions of pounds spent on charitable purposes are activities to keep the external environment favourable for the company. Task 2 Phillip Morris and global political change: Any multinational company that has operations throughout the world has to acclimatize themselves with the political scenario of the concerned country. Politics is stable only in few countries that too limited to the few developed countries. Moreover, as Philip Morris is concerned with producing tobacco related products, it is affected by any kind of political change that occurs in the country. By global political change we understand the political changes that occurred in the world. For example, the First World War, when ended in 1919 brought a lot of changes in the world. Similarly the end of Second World War too brought a lot of changes. One of the biggest changes was the start of cold war between the USA and the Soviet Union. The cold war divided the world into two halves, the capitalists and the socialists. Socialists denied the products of capitalist world to enter their countries, whereas the same thing applied to the capitalists world. Philip Morris thus could not expand his business to Russia and other socialist countries until the cold war was about to end. Philip Morris was able to penetrate the Russian market in 1977 when the socialist country was about to accept some change. Similarly, global terrorism has also affected the policy and decision making of the company as tobacco can be smuggled to developed countries where they have higher prices from the least developed or developing countries. It is said that terrorist have sometimes made tobacco as one of the source of funding to backup their activities. Philip Morris thus has set strict restrictions so as it products are not smuggled. Moreover its factories located in different part of the world restrict its products from being smuggled as they have their own identification number on them. Recession that recently occurred in the world can be the after-effects of the political upheavals in the world. Or economic activities and political change have interdependence. So recession in a way can be seen as an effect of wrong political decisions in terms of economic activities. Philip Morris dealt with it quite perfectly. According to statistics, ongoing earnings of Philip Morris rose by 11% as it coaxed solid grains in its food business and continued to find new market for its cigarette. (http://www.thestreet.com/storycomments/10007704/1/philip-morris-ignores-recession.html, on 27th March 2010) Question that present days political leaders are raising is the phenomenon of climate change. Global warming is a big problem and politicians throughout the world are trying to solve it out through joint efforts. All the countries are imposing their own kind of rules and regulations to reduce carbon emission and help in the reduction of global warming. Philip Morris can help in the reduction of carbon emission by investing in third world developing countries for example in the generation of electricity, or other sources of energy which can reduce deforestation and emission of carbon dioxide in the air.

Gregor Mendels Fruit Flies Essay -- Biology Gregor Mendel Essays

Gregor Mendel's Fruit Flies Introduction   Ã‚  Ã‚  Ã‚  Ã‚  From simple heredity experiments with garden peas, to cloning sheep, the field of genetics has come a long way. Now we are closer to mapping out the human genetic map due to advances in technology, and years and years of research. Perhaps the most influential and groundbreaking scientist, Gregor Mendel, he was responsible to provide a path to where genetics is now today with his experiments of garden peas.   Ã‚  Ã‚  Ã‚  Ã‚  In lab, fruit flies were crossed to observe inheritance patterns in their offspring. The motivation for this was to further understand how genes and characteristics are inherited. To use fruit flies would be much more effective and easier because of a couple of reasons. The genetic makeups of the flies only consist of 4 pairs of chromosomes. This makes it easier to spot characteristics, and is easily distinguishable. Another plus to using flies is that fruit flies can produce a whole new generation of offspring in two weeks, which is very convenient for researchers. This is why files are used instead of humans, but not only time, ethics have also been a major, if not the most important factor.   Ã‚  Ã‚  Ã‚  Ã‚  The traits observed here in this experiment were the wing types, whether vestigial or normal, and the eye color, whether brown or white. The genotype of the vestigial wing was a homozygous recessive vv. The normal wings were either Vv, or VV. The eye color was denoted by the genotype BB, and Bb for brown, and bb for...

Organizational Structures Essay -- Organizational Development, McShane

Introduction McShane and Von Glinow state that â€Å"the best organizational structure depends on the organization’s external environment, size, technology, and strategy† (409). To identify the best organizational structure for Protegà © Engineering, I will first determine what ‘Organizational Structure’ means. In a second step I will analyze its elements and carve out the important components for the considered organization. Finally I will provide a conclusion and recommendation. Organizational Structures In general, organizational structure is related to the way that an organization organizes employees and jobs, so that its work can be performed and its goals can be met. McShane and Von Glinow define ‘Organizational Structure’ in more detail; they state that organizational structure â€Å"refers to the division of labor as well as the patterns of coordination, communication, workflow, and formal power that direct organizational activities† (386). To understand what this means we will have a look at each component. The division of labor is related to the â€Å"subdivision of work into separate jobs assigned to different people† (McShane and Von Glinow 386). The patterns of coordination refer to the coordinating of work activities between the employees where they divide work among themselves. This process requires coordinating mechanism to ensure the workflow, which means that everyone works in concert (McShane and Von Glinow 386). The primary means of coordination are informal communication which involves â€Å"sharing information on mutual tasks and forming common mental models to synchronize work activities†, Formal hierarchy which refers to the â€Å"assigning legitimate power to individuals, who then use this power to direct work pro... ...ble when the merging organizations operate in different industries or countries because cultures differ between industries and countries (McShane and Von Glinow 428). Conclusion and recommendation The integration process of merging companies is a combination of the existing cultures into a new culture that maintains the best features of the previous cultures, and it is most likely to succeed when existing cultures already need improvement so that employees are motivated to accept change. This strategy is particularly challenging when the members of the organization are satisfied with their previous culture because they will be resistant to change. Another very important factor for the success of mergers is the level of commitments made by the employees. Therefore, employees should be brought into the process as early as possible (Badrtalei and Bates 314).

Tess Of The D’Urbervilles by Thomas Hardy - Is Tess a Pure Woman? Essay

Thomas Hardy’s Tess Of The D’Urbervilles (A Pure Women) - Do You Agree with Hardy’s Subtitle, A Pure Women? ‘Tess Of The D’Urberville’ was written by Thomas Hardy in 1891. Tess is the main character who gets exploited by the character, Alec. The question is whether Tess is pure or not. The subject of purity caused a lot of controversy in the Victorian times. The dictionary definition of the word purity is that if someone is pure they are innocent, fresh, virtues, chaste and very trustworthy. Thomas Hardy English poet and novelist, famous for his dispictions of the imaginary county â€Å"Wessex†. Hardy’s work reflected his stoical pessimism and sense of tragedy in human life. In the Victorian times you were able to buy names depending on whether you were rich or not this will show if you have social status or not. Victorians believed that any man or women having a sexual relationship or sexual contact before marriage was seen as a sinner. If you pregnant and was not married society will not accept you they were very strict and very religious. In the Victorian times there were three classes. The Masses, the Nouveax Riches, and the Landed Gentry. The Masses were the poor working class, the Nouveax Riches were the people who worked in factory’s In the city they get the new money and that is were the name came from, they were hated by the Landed Gentry because they were almost the same standard as them, the Landed Gentry were the rich people who didn’t work but got their money from their ancestors (old money). Tess a young cottage girl ‘she was a fine and handsome girl†¦ and large innocent eyes added eloquence to colour and shape†¦Ã¢â‚¬â„¢ Tess and her family were the poor working class and were happy the way they... ...Angel and tells him what she has done and says that if anything happens to her he has to promise to look after her younger sister Liza- lu this shows us that she is very loving towards her sister and is willing to do anything for her happiness. Tess is then captured and is hanged in the last chapter. Conclusion: To conclude I think Tess is a pure woman. I have shown how fate has taken a major part in her life. Thomas Hardy is a person who wrote most of his novels in a pessimistic way. His view on life and in women was completely different to the rest of the society; he reckons that men and women should have an equal right. The reason why he wrote ‘A Pure Woman’ as his subtitle is because he wanted to put it out to the rest of the society and because this is a question everyone wants an answer to. This subject caused a lot of controversy at the time.

Leadership Principles for Healthcare

America needs good leadership in every comer. Too often mediocrity is present in business, government, schools, and churches. In a rapidly changing world, it is crucial to have strong leaders. Although no set formula exists for defining leadership, studies show a few basic commonalities among people generally considered effective leaders. This paper discusses the principles of effective leadership in healthcare. Credibility As a leader in healthcare, one is required to perform all assigned duties, regardless of their size or perceived importance, up to standard, on time, and to the best of one’s ability. Others are interested in one’s past only insofar as it may indicate future capability. They want to know how well one performs one’s duty today, so that they may estimate what one will do tomorrow. The reputation that counts most is the one earns today. Any evidence of slipshod work, halfway measures or â€Å"after-the-fact† excuses will not be viewed favorably (Bryson & Crosby, 1992). For missions to succeed, especially in times of uncertainty, ambiguity, and adversity, leaders in healthcare must live and conduct all their activities so that others may look them squarely in the eye knowing that they are associating with and placing their trust in an honorable individual. Leaders exert themselves to promote the well-being of others. They do something or stand ready to do something for others. They develop self-reliance in others so that they can become effective members of an interdependent team. Self-reliance means that a staff member does not need the presence of the boss to carry out the tactical and operational elements of his or her own job. As a leader, one should state the job to be done but leave it to one’s subordinate to recommend the methods that will accomplish the desired results, at the time required, with due regard for costs (Conger, 1989). If one wants to lead people in healthcare, one has to communicate information directly and honestly. One cannot hem and haw or water down the truth. One has to keep one’s people and the people to whom one reports, grounded in the reality of one’s situation. Although most people believe that they are honest, few are direct. Many women, especially, respect the social value of an indirect approach to problems, and this places them at a disadvantage in leadership situations. If one has trouble with the direct approach, one should put one’s points in writing, structuring them so that when one goes into a meeting, one can use one’s notes as an aid until one feels comfortable in delivering verbal reports without them. Dishonesty of any sort is quickly perceived as very disturbing and unlikable. It also carries a â€Å"permanent† connotation that isn't easily erased. Honesty is a deeply held value and can run all the way from one’s surface sincerity and â€Å"realness† to one’s basic ethics and morality. Conversation or behavior that is not very honest waves a red flag that causes other people to back off and not trust one. Trust is necessary for good communication and good communication is the main tool of successful supervision (Conger, 1989). The defensiveness typically caused by even minor dishonesty shuts down communication. There are many verbal and non-verbal indicators of dishonesty to-watch for, including elusive eye contact, contradictory body language, tone and flow of voice, behavioral inconsistencies and aggressive posture. The effective leader in healthcare models the way he or she desires his or her followers to act. (Kouzes, James & Posner 1987) This characteristic of the effective leader has also been described as the â€Å"management of trust.† (Bennis 1989) The group learns very quickly that it can rely on the leader, who is exactly what he or she appears to be. The actions of a transformation leader represent the beliefs and commitments that are spoken. Building Strong Relationships Interpersonal relationships play a critical role in the management process. As noted by Gabarro (1987,p. 172), â€Å"relationships are the principal means through which organizations are controlled.† Friendships and related social networks in organizations have been investigated in relation to such factors as organizational choice (Kilduff, 1990), turnover and organizational commitment (Krackhardt & Porter, 1985), culture (Krackhardt & Kilduff, 1990), and organizational conflict (Nelson, 1989). Much of the research that has investigated the nature of the leader-follower relationship has taken place within the context of leader-member exchange theory (LMX). Leader-member exchange theory suggests that leaders differentiate among followers in terms of leader behavior rather than enacting â€Å"one best† average leadership style with all followers (Liden & Graen, 1980). The LMX model recognizes the importance and nature of specific leader-follower relationships and emphasizes the differences in the manner in which a leader behaves toward each follower (Vecchio & Gobdel, 1984). A role is informally negotiated between each member of the work group and the leader, and an active exchange of inputs and outcomes occurs between the leader and each follower (Bass, 1990; Dansereau, Graen, & Haga, 1975). Some leader-follower dyads within groups develop roles that are personally satisfying and mutually compatible, while others do not (Graen & Scandura, 1987). Earlier writings referred to followers in the former type of dyad as part of the â€Å"in-group† and the latter as â€Å"out-group† members. Over the years, LMX research has not only verified the existence of differentiated leader-member dyads within groups, but it has also investigated the characteristics of the leader-follower relationship, as well as the process by which leaders develop effective leadership relationships. According to Graen and Uhl-Bien (1995), the development of a leader-member exchange relationship â€Å"is based on the characteristics of the working relationship as opposed to a personal or friendship relationship† (p. 237). LMX is conceptualized as a multidimensional construct, consisting of respect, trust, and mutual obligation, and it refers specifically to these dimensions as they relate to â€Å"individuals' assessments of each other in terms of their professional capabilities and behaviors† (Graen & Uhl-Bien, 1995, p. 238). Vision To lead a group in healthcare, one must have a vision that people support from both a personal and a philosophical perspective. Consider Martin Luther King. What was the vision? His most famous statement, â€Å"I have a dream,† was delivered to more than half a million people who had descended on Washington, D.C., in support of civil rights. What was his dream? Racial equality. Could people relate to that personally and philosophically? Absolutely. Few people argued against the philosophy of racial equality. Furthermore, many supporters believed that he would have a tremendous impact on them personally. King gained overwhelming support because of his vision (Collins & Porgas, 1991). Once leaders develop a vision, they must communicate their ideas. Leaders are often great communicators. Consider Martin Luther King. He had the ability to stir and motivate people, and he excelled when he got in front of a group of people. Former President Abraham Lincoln also had superb speechmaking abilities. One of his speeches, the Gettysburg Address, is so famous that most schoolchildren memorize it at some point in their studies. Communication skills were the strong point of another well-known leader, former President Ronald Reagan. While some people have questioned Reagan's leadership abilities, few questioned his communication skills. Many remember his first State of the Union Address, which was delivered the year after he was wounded by a gunshot from John Hinckley. As with any presidential candidate, there were those who had not voted for him and were not particularly strong supporters. Reagan's address, however, was so stirring and so patriotic that afterward even people who were lukewarm about him wanted to jump to their feet, salute, and flip on their Lee Greenwood tape of â€Å"I'm Proud to Be an American.† The words he chose, and the manner in which he presented them, really touched people (Collins & Porgas, 1991). Passion Passion engenders enthusiasm and creativity. It also drives excellence. Without passion a business is ordinary — for its employees, suppliers and, most importantly, for its customers. It is easier to recognize the absence than the existence of passion. Passion is not a commodity or even an art form that can be taught or bought. It is also quietly frowned on in some circles. Passionate and respected leaders motivate and inspire those around them to share their passion for a product, a concept or an opportunity. By doing so, they encourage others to excel. These leaders recognize the need to foster and embrace a range of complementary talents and experiences. To attract people with these skills and, more importantly, right attitudes, they create the processes and culture to support them. If passion is engendered, encouraged and focused then, all other things being equal, the organization with passion will outperform those without (Bryson & Crosby, 1992). Commitment to Serve Others The effective leader in healthcare empowers others to act. (Kouzes & Posner 1987) He recognizes the potential of the entire organization and freely grants or sanctions individuals the power to act in concert with the group. What appears to be an abdication of power by the leader results in a stronger unison effort? The transformational leader encourages the heart. (Kouzes & Posner 1987) Followers work more effectively if they are frequently praised, and it is the transformational leader who understands the necessity of recognizing their accomplishments. This leadership characteristic suggests that frequent encouragement and praise for even minor accomplishments is appropriate. Positive affirmation does not instill complacency, but instead it results in motivating an individual to perform even better. Mentoring does not have to be one-on-one. With this new twist on an old model, a mentor guides a group of protà ©gà ©s through the complex process of developing their organizational practical understanding and their careers. In the new mentoring model, learning leaders are partners, rather than â€Å"patriarchs.† As experienced organizational veterans with information and knowledge to offer, they act as leaders of group learning and facilitators of group growth. With group mentoring, the setting and emphasis shifts from one-on-one relationships to group relationships. The learning leader helps protà ©gà ©s understand the organization, guides them in analyzing their experiences, and helps them clarify career directions. The process gives the protà ©gà ©s access to the experience and knowledge of a successful, high-level manager. In addition, that help comes from a different paradigm–that of a leader as collaborates. The task of the learning leader is to create an environment for the professional growth of a small group of protà ©gà ©s who can benefit from the experience, knowledge, and support of an organization veteran and of other group members. References Bennis, Warren. (1989). Why Leaders Can't Lead–The Unconscious Conspiracy Continues (San Francisco: Jossey-Bass). Bryson, J. and Crosby, B. (1992). Leadership for the Common Good: Tackling Public Problems in a Shared-Power World. San Francisco: Jossey-Bass Publishers. Collins, J. and Porgas, J. (1991). Organizational Vision and Visionary Organizations. California Management Review (Fall): 36. Conger, J. (1989). The Charismatic Leader: Behind the Mystique of Exceptional Leadership. San Francisco: Jossey-Bass Publishers. Gabarro, J. J. (1987). The development of working relationships. In J. W. Lorsch (Ed.), Handbook of organizational behavior (pp. 172-189). Englewood Cliffs, NJ: Prentice-Hall. Graen, G. B., & Scandura, T A. (1987). Toward a psychology of dyadic organizing. In L. L Cummings & B. M. Shaw (Eds.), Research in organizational behavior (pp. 175-208). Greenwich, CT: JAI Press. Graen, G. B., & Uhl-Bien, M. (1995). Relationship-based approach to leadership: Development of leader-member exchange (LMX) theory of leadership over 25 years: Applying a multi-level multi-domain perspective. Leadership Quarterly, 6(2), 219-247. Kilduff, M. (1990). The interpersonal structure of decision making: A social comparison approach to organizational choice. Organizational Behavior and Human Decision Processes, 47(2), 270288. Kouzes, James M.   and Posner, Barry Z. (1987). The Leadership Challenge (San Francisco: Jossey-Bass). Krackhardt, D., & Kilduff, M. (1990). Friendship patterns and culture: The control of organizational diversity. American Anthropologist, 92(1), 142-154. Krackhardt, D., & Porter, L. W. (1985). When friends leave: A structural analysis of the relationship between turnover and stayers' attitudes. Administrative Science Quarterly, 30, 242-261. Liden, R. C., & Graen, G. (1980). Generalizability of the vertical dyad linkage model of leadership. Academy of Management Journal, 23, 451-465. Nelson, R. E. (1989). The strength of strong ties: Social networks and intergroup conflict in organizations. Academy of Management Journal, 32(2), 377-401. Vecchio, R. P., & Gobdel, B. C. (1984). The vertical dyad linkage model of leadership: Problems and prospects. Organizational Behavior and Human Performance, 34, 5-20.   

Analgesic and Facilitator Pain Assessment

Individual search name Critique Presentation Resource The analyze work that you selelelectro toyvulsive therapyro liftvulsive therapyed in Week ii Develop a 10- to 15-minute origination in which you address the fol sufferinging points (7 pts) Strengths and weaknesses of the get a line theoretical and modeological limitations Evidence of searcher pre buncoceived opinion Ethical and legal considerations related to the security department of human subjects family race amidst theory, implement, and research Nurses role in implementing and disseminating research How the ask provides induction for evidence-based hold Identify the next for the research break down selected (choose 1 or 2 non BOTH) 8 pts. 1. Quantitative Research hold Critique (Follow the example pp. 433442 of the text) a. frame 1 Comprehension b. Phase 2 similarity c. Phase 3 abridgment d. Phase 4 Evaluation 2. Qualitative Research Article Critique (Follow the example pp. 455461 of the text) a . 1. hassle (problem statement purpose research questions belles-lettres come off frame of computer address research tradition) b. 2. Methodology (sampling & strain information accrual protection of human subjects c. 3. Data ( direction compendium . 4. Results (fin blaringgs discussion logic evaluation compend Format the presentation as oneness of the following (5 pts) Poster presentation in class Microsoft PowerPoint presentation inclu ring detailed speakers notes Video of yourself giving the presentation uploaded to an Internet video sharing set such as www. youtube. com Submit the link up to your facilitator, include a written reference page in APA format other format ratified by your facilitator spite mind in Persons with Dementia Relations pelvic girdle amid Self-Report and behavioural Observation Ann L.Horgas, RN, PhD,A Amanda F. Elliott, ARNP, PhD,w and Michael Marsiske, PhDz OBJECTIVES To check over the descent betwixt self-report and behavioral in dicators of twinge in cognitively afflicted and inbuilt old(a) adults. DESIGN Quasi-experimental, cor similarityal topic of senior(a) adults. SETTING Data were amass from residents of breast feeding propertys, help invigoration, and privacy apartments in northcentral Florida. PARTICIPANTS 1 hundred twenty-six adults, signify age 83 64 cognitively inherent, 62 cognitively afflicted.MEASUREMENTS ache c tout ensemble into questions ( offend presence, eagerness, locations, sequence), wound behavior barroom, Mini-Mental call forth Examination, analgesic practice of medicines, and demographic characteristics. Participants over(p)d an utilizebased protocol to induce incommode. RESULTS 86 percent self-report regular infliction. cabbagetrolling for analgesics, cognitively subverted participants account slight(prenominal) ache than cognitively inviolate participants afterward fecal matter b arly not at rest. Behavioral put out indicators did not differ between cognitively sacrosanct and stricken participants. add up image of inconvenience oneself behaviors was signi? antly related to self-reported vexation in the neck mass (b 5 0. 40, P 5. 000) in cognitively inbuilt sr. mickle. finishing cognitively afflicted remote tribe selfreport little imposition than cognitively inbuilt senile deal, independent of analgesics, neverthe little notwith accepting when assessed after movement. Behavioral trouble indicators do not differ between the groups. The kin between self-report and wound behaviors swans the severity of behavioral sagaciousnesss in this population. These ? ndings support the use of 2-dimensional disorder judgment in persons with madness.J Am Geriatr Soc 57126132, 2009. Key words paroxysm frenzy barroomment From the ADepartment of Adult and immemorial cargon for, University of Florida, College of c are for, Gainesville, Florida wDepartment of Ophthalmology, School of Medicine, University of atomic design 13 at Birmingham, Birmingham, Alabama and zDepartment of Clinical and wellness Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida. Address correspondence to Ann Horgas, College of nurse, University of Florida, PO Box 100197-HSC, 101 S.Newell Drive, Room 2201, Gainesville, FL 32610. electronic mail emailprotected?. edu DOI 10. 1111/j. 1532-5415. 2008. 02071. x ain, a heady occasional problem for m whatsoever hoary adults, is associated with corporal and social disability, depression, and poor tone of voice of life. 1 Between 50% and 86% of erstwhile(a) adults possess annoying 32% to 53% of those with monomania experience it quotidian. 2 The high prevalence is associated with proliferation of put out-related health conditions in late life, such as osteoarthritis, hip fractures, peripheral vascular disease, and freightercer. Dementia complicates throe assessment, because it impairs memory, judgment, and verbal communication. Dementia is associated with central loath several(prenominal)(prenominal) system changes that alter fuss tolerance4 only if not some(prenominal)er thresholds (e. g. , minimum take at which a incommodeful stimulant drug is acknowledged as distressingness). 5 No empirical evidence indicates that persons with dementia physiologic eithery experience less fuss rather, they turn out less satisfactory to recognize and verbally communicate the presence of offend. Findings that cognitively impaired old adults underreport distress relative to nonimpaired antique battalion7 and are less potential to be treated for throe than their cognitively total peers8,9 re? ect dif? culty assessing put out in this population. Self-report is considered the banner standard of injure assessment. disdain recent studies supporting the dependability and validity of self-report in persons with dementia,7,10 healthcare providers and hassle adroits recognize t hat selfreport totally is insuf? cient for this population and that thoughtfulnessal offend sensationfulness assessment strategies are necessitate.In 2002, the American geriatrics union essayed extensive guidelines for assessing behavioral indicators of wo(e). 1 More recently, the American Society for distressingness reignment Nursing line of work Force on upset Assessment in the Nonverbal Patient (including persons with dementia) recommended a house-to-house, hierarchical nestle that integrates selfreport and observations of vexation behaviors. 11 Recently, tools to measure paroxysm in persons with dementia cast proliferated. In 2006, a comprehensive stateof-the-science inspection of 14 observational perturb measures was correct.The authors concluded that existing tools are withal in the early stages of development and interrogatory and that more(prenominal) psychometric work is leaded before tools are recommended for broad acceptation in clinical pract ice. 12 former(a)s, including an interdisciplinary expert consensus P JAGS 57126132, 2009 r 2008, Copyright the Authors Journal compilation r 2008, The American Geriatrics Society 0002-8614/09/$15. 00 JAGS JANUARY 2009VOL. 57, zero(prenominal) 1 PAIN assessment IN PERSONS WITH DEMENTIA 127 panel on torment assessment in one-time(a) persons,13 have corroborated these conclusions. 4 In particular, these authors spotlight the need for more evaluation of observational throe measures, including validation against the criterion standard of self-report in sacrosanct and impaired populations. Al slightly all research on touchstone wound in persons with dementia has pointed wholly on persons with confine to fearsome disease. in that respect has been whole one published workplace that compared put out behaviors and self-reported imposition in persons with and without cognitive impairment, save it focused on postoperative patients undergoing rehabilitation and acute bothe ration associated with physical therapy. 5 Thus, the purpose of this study was to investigate the alliance between self-report and behavioral indicators of incommode in the ass in cognitively intact and impaired older adults with grim smart. Speci? cally, this study evaluated whether cognitive office (intact or impaired) differentially in? uenced verbal and sign(a) expression of twinge. It was hypothesized that self-reported pain would be sire in cognitively impaired venerable people than in those who were cognitively intact just that pain behaviors, because they are more re? exive and less reliant on verbal communication, would be equivalent in both groups.The affinity between pain behaviors and self-reported pain was as well as evaluated in cognitively intact aged people to validate whether behaviors measured are indicators of pain. The following research questions were asked. Does cognitive consideration in? uence self-reported pain? Does cognitive positioning in ? uence spy pain behaviors? ar self-reported pain and discover pain behaviors related, and is the relationship different in cognitively intact and impaired elder people? unmatched hundred forty participants were enrolled and holy the baseline wonder 126 (90%) accurate the protocol. Attrition analyses revealed no signi? ant contrarietys between completers and noncompleters on demographic, residential positioning, health, or pain variables. The ? nal specimen was preponderantly female (81%), Caucasian (97%), and widowed (60%), with a esteem age of 83 (range 5 6598). Thirty-nine percent resided in nursing homes, 39% resided in aid living, and 22% lived independently in loneliness apartments. Participants average Mini-Mental State Examination (MMSE) stark score was 24 (range 5 730, normal 5 27, mode 5 29). Based on 10th centile pedagogy-adjusted MMSE norms as the cutoff,16,17 64 (50. 8%) were cognitively intact, and 62 (49. %) were impaired. See postpone 1 for a des cription of the aggregate sample and of cognitively intact and impaired subsamples. Groups differed barely in residential view (cognitively put over 1. try Characteristics, Overall (N 5 126) and jibe to Cognitive locating innate Sample Cognitive StatusA Intact afflicted (n 5 64) (n 5 62) PValue Characteristic METHODS The University of Florida institutional review board approved this study. Informed accept was obtained from cognitively intact participants and from impaired elderly peoples legally permit representatives, with assent from persons with dementia.Design A quasi-experimental, correlational purpose was used to investigate pain in older adults with mild to subside dementia, because dementia status cannot be experimentally manipulated. cognitively intact elderly people functioned as a analogy group to go done behavioral indicators and self-reported pain in the deuce groups. If self-report and behaviors were related in cognitively intact persons, there would be a ny(prenominal) radical to infer that the same behaviors indicated pain in cognitively impaired elderly people. Participants One hundred ? ty-eight older adults were screened for enrollment from 17 assisted living facilities, nursing homes, and retirement communities in north central Florida. inclusion criteria were aged 65 and older, English-speaking, able to stand up from a chair and fling in place, diagnosed osteoarthritis in the lower body, and adequate vision and hearing to complete the interview. Sex, n (%) Male 24 (19. 0) 12 (18. 8) 12 (19. 4) Female 102 (81. 0) 52 (81. 3) 50 (80. 6) Race, n (%) White 123 (97. 6) 63 (98. 4) 60 (96. 8) Black 1 (0. 8) 0 (0) 1 (1. 6) Other 2 (1. 6) 1 (1. 6) 1 (1. 6) Marital status, n (%) Married 37 (29. ) 21 (32. 8) 16 (25. 8) Unmarriedw 89 (70. 6) 43 (67. 2) 46 (74. 2) Education, n (%) ohigh educate 11 (8. 7) 5 (7. 8) 6 (9. 7) grad utmost school graduate 38 (30. 2) 17 (26. 6) 21 (33. 9) Some college or 31 (24. 6) 18 (28. 1) 13 (21. 0) equ ivalent College graduate or 34 (27. 0) 18 (28. 1) 16 (25. 8) more Residence Assisted living 49 (38. 9) 28 (43. 8) 21 (33. 9) Nursing home 47 (37. 3) 14 (21. 9) 33 (53. 2) Retirement apartment 30 (23. 8) 22 (34. 4) 8 (12. 9) Analgesics interpreted 579 ? 1,320 313 ? 699 853 ? 1,708 (in acetaminophen equivalents), mean ? SD Age, mean ? SD 82. 2 ? 7. 3 81. 9 ? 7. 83. 1 ? 7. 6 Number of health check 6. 7 ? 3. 1 6. 6 ? 2. 9 6. 9 ? 3. 4 diagnoses, mean ? SD .93 .59 .39 .84 .001z .02 .55 . 63 A Cognitive status was computed utilize the following education-adjusted Mini-Mental State Examination win as cutoffs o8th grade education, 20 9 to 11 grades, 24 high school graduate or equivalent, 25 some(prenominal) college, 27 and college degree or higher(prenominal) 5 27. 16,17 w Unmarried 5 never married, widowed, separated, or divorced. z Chi-square 5 15. 2, degrees of freedom 5 2, P 5. 001. t (124) 5 2. 22. SD 5 standard deviation. 128 HORGAS ET AL. JANUARY 2009VOL. 57, nary(prenominal) 1 JAGS mpaired elderly people were signi? shiftly more likely to reside in assisted living or nursing home facilities). to use in elderly adults than the conventional visual analogue scale. 21 Procedures Participants completed a brief screening interview to con? rm study eligibility and to ascertain cognitive status. Those eligible were interviewed about their pain and completed an activeness-based protocol designed to evoke pain behaviors in persons with persistent pain ( observe in more detail below). Activity communications protocol Participants were asked to sit, stand, lie on a bed, walk in place, and transfer between activities.Based on precedent work, the occupation protocol had several strengths for use with this population. First, it simulates performance of basic activities of daily living, thereby enhancing ecological validity of the tasks. Second, it was tested in other studies, and activities were shown to induce pain in persons with osteoarthritis and degenerativ e low back pain, thus providing a naturalistic pain induction method. Third, use of these realworld tasks avoids inordinate health or safety risks for elderly adults and eliminates potential bias associated with arti? cially induced (e. g. , laboratory-based) pain induction techniques. 8,19 The protocol was simpli? ed by using only 1-minute legal action intervals (to tailor complexity of directions and physical demands for frail or cognitively impaired participants) and substituted walking in place for walking across the way and back (to accommodate physical lacuna limitations in residential care facilities where info were collected). Activities were conducted in random order to calumniate order effects, and the entire 10-minute protocol was videotaped. Measures Self-Reported torture The principal investigator (ALH) or a trained research assistant interviewed distributively participant in a buck private session about their pain experience. distressingness presence, speciali ty, locations, and duration were assessed. chafe Presence. Questions from the Structured painful sensation hearing (SPI)20 were used to assess presence of self-reported pain. During the pain screening interview, participants were asked Do you have some pain all(prenominal) day or to the highest degree every day (daily pain)? suffer was besides assessed directly before the array of the natural process protocol (Are you having any pain right now? (pre-activity)) and immediately after it (Did you experience any pain during these activities? (postactivity)).Response choices to all three questions were yes (1) or no (0). pain military capability If participants responded yes to experiencing pain (daily, pre-activity, or postactivity), they were asked to rate the strength using a numerical rating scale (NRS). The NRS was presented as a horizontal line with 0 5 no pain and 10 5 worst pain as anchors and equally spaced dashes representing pain color rating of frames 1 throug h 9. The scale was printed in large, bold fountain on an 8. 5 A 11 paper to facilitate use with older adults who may have vision dif? culties. The NRS is considered valid, original and easier distressingness Duration Participants were asked to indicate how long (in months and years) they had experient daily or almost daily pain. Responses were enterd as less than 1 year, 1 to 5 years, 6 to 10 years, 11 to 15 years, or more than 15 years. trouble oneself Locations The pain map from the McGill imposition Questionnaire22 was used to assess pain locations. Participants indicated areas on the body drawing in which they were presently experiencing pain. Total fig of painful locations was summed. This astray used measure has been validated in several epidemiological studies and has high interrater reliability (average kappa 5 0. 2). 23 spy Pain Behaviors Pain Behaviors A modi? ed magnetic declination of the Pain Behavior Measure18 was used to measure behavioral indicators of pa in. Based on like behavioral de? nitions, occurrence of the following speci? c pain behaviors was evaluated rigidity, guarding, bracing, stopping the activity, rubbing, shifting, grimacing, sighing or nonverbal vocalization, and verbal complaint. Standardized de? nitions were adapted from preceding(prenominal) work,18,19 modi? ed for use in this older, moreimpaired population, and pilot tested in a sample of nursing home residents with dementia. 4 This measure has adequate reliability and validity. 13 Pain Behavior Coding Independent raters, all registered nurses blind to participants cognitive status, scored the videotaped activity protocols. Coders completed extensive training in steganography procedures until intrarater and interrater agreement (with the master coder (PI) and some other rater) r apieceed a kappa coef? cient of 0. 80 or greater, indicating in effect(p) to very good reliability. 25 after coding reliability was attained, reliability checks were conducted on 10 % of all videotapes to minimize rater drift.Noldus reviewer software was used to analyze digitized videotapes and code pain behaviors (Noldus Information Technology, Wageningen, the Netherlands). The following thick variables were created and used in the analyses total issuing of pain behaviors observed, number of times apiece behavior (rigidity, guarding, bracing, stopping, rubbing, shifting, grimacing, sighing or nonverbal vocalization, and verbal complaint) was observed, and total numbers of pain behaviors observed during each activity state (e. g. , number of behaviors while walking, reclining, sitting, standing, and transferring).Cognitive Status Cognitive status was assessed using the MMSE,26 an 11-item screening instrument widely used to assess general cognitive status in elderly adults. The following MMSE scores served as the cutoffs to classify participants as intact or impaired less than 8th grade education, 20 9 to 11 years, 24 high school graduate or equivalent, 25 some college, 27 and college degree or higher, 27. 16,17 JAGS JANUARY 2009VOL. 57, no. 1 PAIN ASSESSMENT IN PERSONS WITH DEMENTIA 129 Analgesic Medications Drug entropy for each participant were coded according to the American Hospital Formulary Service system.All pain medications were identi? ed and converted to acetaminophen equivalents. 8,27 This like drugs and dosages to a common metric and facilitated comparison of analgesic dosing. To ensure that only analgesics very taken would be temperled for, equianalgesic dosages were considered in these analyses only if they were taken within the standard remedy dosing window for each drug (e. g. , acetaminophen, every 46 hours) before the activity protocol. Data Analysis SPSS, version 15. 0 (SPSS Corp. , Chicago, IL) was used for data digest.Descriptive statistics, Pearson chi-square (w2) tests, and t-tests were used to describe sample characteristics and assay group engagements. Analysis of covariance (ANCOVA) was used to tes t relationships between cognitive status, pain intensity, and pain behaviors. Logistic reasoning backward toward the mean was used to predict pain presence. sixfold regression was used to predict pain intensity and number of pain behaviors, with a centered cognitive statusbypain intensity interaction end point to identify group differences standardized regression coef? cients (b) are reported in the results.RESULTS Self-Reported Pain The majority of participants (86. 5%) reported experiencing pain every day or almost every day. More than 65% reported experiencing pain for more than 1 year ( $ 40% indicated duration of 45 years). On average, participants reported pain in quaternity body locations (range 5 125) normal pain intensity was 4. 3 (moderate) on a scale from 0 to 10. directly before the activity protocol, 45 (35. 7%) participants reported experiencing pain. have in mind pain intensity was rated as 1. 7 (range 5 09). After the protocol, 79 (62. 7%) reported experienci ng pain during the activities mean pain intensity was 3. (range 5 09). Relationship Between Cognitive Status and Self-Reported Pain Chi-square analyses were conducted to examine the relationship between cognitive status (impaired vs intact) and presence of self-rated daily pain and pain duration at baseline. The baseline pain interview was not always conducted on the same day as the activity protocol, and analgesic use before the interview was not assessed. Thus, initial analyses are descriptive only and do not control for analgesic use. At baseline, 77. 4% of impaired and 95. 3% of intact participants reported experiencing pain every day (w2(1) 5 8. 6, P 5. 003).Cognitively impaired elderly people also recalled shorter pain duration (w2(3) 5 16. 0, P 5. 001) than intact participants, but no signi? camber differences were reported in the number of pain locations. Logistic regression, arrogant for acetaminophen equivalents, indicated that cognitive status was not signi? cantly pro phetic of pre-activity pain presence. Regression analyses, with pre-activity pain intensity as the dependent variable and cognitive status and analgesics as predictors, revealed no signi? cant difference between the two groups (Figure 1). Intact Impaired 16 14 12 lowly values 10 8 6 4 2 0 In te a * t ns y SR a re- cti v in Pa ng cing ing rbal aint sity pi b l n e ra uar ig Sh op rima Rub onv mp Inte B G R St G N al co ain P rb Ve activ tos SR b Pain indicators cin g n di g i id ty in ift g a tt Si g g g g g in din kin yin rrin l e n L sf a Wa St an Tr c Activity states Figure 1. Relationship between self-report and observed pain behaviors in cognitively intact and cognitively impaired elderly people (N 5 126). aMean self-reported (SR) pain intensity, controlling for acetaminophen equivalents taken. bMean number of behaviors observed for each pain indicator, controlling for acetaminophen equivalents taken. Mean number of behaviors observed during each activity state, controlling f or acetaminophen equivalents taken. 130 HORGAS ET AL. JANUARY 2009VOL. 57, none 1 JAGS At the end of the activity protocol, cognitive status was signi? cantly associated with the reported presence of pain, controlling for analgesics (b 5 1. 2, P 5. 002) cognitively impaired elderly people were less likely to report pain. Impaired participants also reported signi? cantly lessintense pain than intact participants after the activity protocol (3. 8 vs 2. 6 F (1) 5 A 5. 0, P 5. 03).Paired t-tests indicated that pain intensity increased signi? cantly from start to end of the protocol for both groups (Figure 1). Table 2. Relationship Between Self-Reported Pain Intensity and Observed Pain Behaviors (N 5 126) Total Number of Behaviors Observed Model bA P-Value 1 Pre-activity pain intensity Analgesics taken Pain intensity A cognitive status R2 F 2 Postactivity pain intensity Analgesics taken Pain intensity A cognitive status R2 F Standardized regression coef? cient. R2 5 coef? cient of deter mination. A Relationship Between Cognitive Status and Observed Pain Behaviors On average, 21. pain behaviors per person (range 5 350, median 5 21, mode 5 16) were observed during the activity protocol. ANCOVA models, controlling for analgesics, revealed no signi? cant differences in mean number of pain behaviors observed between cognitively intact and impaired participants (covariate-adjusted means 5 21. 8 and 21. 3, respectively F (1) 5 0. 08, P 5. 77). The number of occurrences of each of the eight behavioral indicators observed was summed. ANCOVA models, controlling for analgesics and using Bonferroni subject for multiple comparisons (P 5. 005), revealed no signi? ant differences between cognitively intact and impaired elderly people for any behavioral pain indicators investigated (Figure 1). Of the activity states observed during the protocol, transferring elicited the most frequent pain behaviors (mean 5 13. 4 range 5 243). No signi? cant differences were noted between cogniti vely intact and impaired participants in number of behaviors observed during any of the ? ve observed activity states. Relationship Between Self-Reported Pain and Observed Pain Behaviors Regression analyses were conducted to examine the relationship between elf-reported pain intensity and total number of pain behaviors observed, controlling for analgesics. forrader the activity protocol, pain intensity was signi? cantly predictive of the pain behaviors sum score (b 5 0. 27, P 5. 002), but the relationship did not differ between cognitively intact and impaired participants. After the activity protocol, self-reported pain intensity was signi? cantly (and more strongly) related to number of pain behaviors observed (b 5 0. 40, P 5. 000), and the painby-cognitive status interaction was signi? cant (b 5 0. 22, P 5. 008). Thus, postactivity pain intensity and summed behavioral indicators were signi? antly related in intact but not impaired participants (Table 2). DISCUSSION It was lay ou t that cognitive impairment diminishes selfreported pain assessed at rest but only when analgesics are not controlled. At baseline, cognitively impaired elderly people were signi? cantly less likely than cognitively intact elderly people to report pain, agreeable with reports in the literature,7 but when analgesics were controlled for, these differences disappeared. This ? nding highlights the need to control for analgesics taken when making group comparisons, which to the best of the authors knowledge, has not been antecedently done.The few studies reporting medication use include drugs prescribed or number of doses taken 0. 27 0. 01 0. 09 0. 08 2. 9 0. 40 A 0. 03 . 22 . 18 6. 70 .003 . 99 . 30 . 02 . 00 . 75 . 01 . 000 (regardless of medication class), whereas the genuine study identi? ed analgesics in the subjects body during the pain assessment protocol. After the activity-based protocol was completed, selfreported pain intensity increased for both groups, but cognitively impa ired elderly people reported less-intense pain than their intact peers. This ? ding supports the usefulness of the protocol to exacerbate pain in those with painful conditions and highlights the importance of mobility-based pain assessments. 12,14 This ? nding held even when the amount of analgesics taken by participants was controlled for in the statistical analysis. Behavioral indicators of pain observed during activities were equivalent across both groups. This ? nding contradicts previous work15 and may re? ect that medication use was controlled for and that the focus of the current study was on persistent pain, as opposed to more-acute, postoperative pain. This research con? ms that reliance on selfreport alone is insuf? cient to assess pain in older adults with dementia, because the pain experience may be underestimated,11 and supports growing recognition that behavioral observation is a necessary and useful pain measure, particularly in subjects with cognitive impairment. Cog nitively impaired elderly people took signi? cantly more pain medication than their intact peers. The difference was approximately 500 acetaminophen equivalents, approximately the dose of one extra-strength acetaminophen tablet. This ? nding, which contradicts previous work,8,9 warrants further investigation.Post hoc analyses indicated that this difference was not attributable to residential status, number of medical conditions, or demographic characteristics. Thus, it may re? ect recent changes in prescriptive practice as a result of heightened focus on pain in older adults with dementia. Another important ? nding is the signi? cant relationship between self-reported pain intensity and observed pain behaviors in cognitively intact persons. This ? nding provided support for the validity of behavioral pain JAGS JANUARY 2009VOL. 57, NO. 1 PAIN ASSESSMENT IN PERSONS WITH DEMENTIA 31 indicators against the criterion standard of self-report, as least in cognitively intact elderly people, and is consistent with other researchers ? ndings. 28 Because there is no evidence that cognitively impaired elderly people experience less pain, it is likely to infer that pain behaviors are a valid indicator of pain in persons with dementia, although this assumption cannot be directly tested unless biological tests are developed. 12,24 Pain is subjective, and pain behaviors can be dif? cult to interpret, be subject to bias, and lack speci? city. 14,29 It has been uggested that some behaviors may indicate anxiety or generalize distress, not pain, in those with advanced dementia. 29,30 Thus, pain behavior measurements should be used in conjunction with selfreport, not as a replacement, and in the context of a comprehensive pain assessment. 14,30 Study strengths are that cognitively intact and impaired elderly people participated, thereby facilitating comparison of assessment strategies in persons of differing cognitive abilities, that a careful analysis of analgesics used during the pain assessment was conducted, and that persistent pain was focused on.Most related former research has included only persons with advanced dementia and postoperative pain. The sample was limited, however, by being primarily Caucasian and by being restricted to individuals with mild to moderate dementia. This was likely because of inclusion criteria requiring that participants be able to rise, stand, and walk. Individuals with severe dementia are typically more immobilized and unable to follow directions, factors that would impair ability to complete the activity-based protocol in this study. Thus, generalizations are limited, and further study is needed.This study contributes several important ? ndings to the discourse on pain assessment in persons with dementia. First, it was con? rmed that self-reported pain, although still attainable, may be less reliable in those with mild to moderate dementia than in cognitively intact elderly people, depending on when it is assessed. Se cond, assessment of pain during movement is supported. Cognitively intact and impaired elderly people both showed greater self-reported pain intensity after movement, indicating that soundless assessment may underestimate pain.Third, results support the validity of behavioral pain assessment against the criterion standard of self-report and provide evidence of an association between summed pain behaviors and self-reported pain intensity. More work is needed to establish scale properties of pain behaviors in relation to pain severity before this approach can be translated to clinical practice. Fourth, ? ndings highlight the importance of carefully evaluating analgesics taken when measuring pain, since results indicate that cognitively intact and impaired elderly people with persistent pain are often medicated differently.This ? nding may re? ect a change in prescriptive practice that warrants further investigation. (Dr. Horgas) and a John A. Hartford Foundation mental synthesis Aca demic Geriatric Nursing talent Pre-doctoral Scholarship (Dr. Elliott). Authors Contributions Dr. Horgas was prudent for scienti? c oversight of all aspects of the study reported in this manuscript, including study design, data collection, data management, data analyses, and manuscript preparation. Dr. Elliott provided lively review of the manuscript and contributed to the design and study methods, data collection, and data coding.Dr. Marsiske provided critical review of the manuscript and contributed to the design and study methods, data management, and statistical analyses. All authors have approved the ? nal version of this manuscript that was submitted for publication. Sponsors Role The National Institute of Nursing Research sponsored this study but had no role in the design, methods, subject recruitment, data collections, data analyses, or manuscript preparation. REFERENCES 1. American Geriatrics Society. 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