Death, Dying and Other Ethical Dilemmas

Death, dying and other ethical dilemmas are issues that all Intensive Care Units (ICUs) throughout the world have to face and address. In the Current Opinion in Critical Care, Vol 16, No 6, December 2010, p. 640, Dixon-Woods and Bosk, writing on the topic of â€Å"Death, dying and other ethical dilemmas† under the journal’s section of ‘Ethical, legal and organizational issues in the ICU’, have stated that â€Å"Recent ethnographic work suggests that ethical dilemmas associated with end-of-life care in ICU clearly persist, even if clinicians are now more open about patients’ chances of surviving.An Australian study identified how decisions and actions made outside the ICU—such as proceeding with surgical procedures with very poor prognosis or admitting moribund patients who had sustained severe respiratory or cardiac arrest—led to a higher than expected rate of non-booked admissions. Staff believed these to be the result of futile inter ventions by staff outside the ICU that then resulted in ICU staff having to manage the patient and family through the dying process.ICU staff believed that this practice was detrimental to families by offering false hope of recovery, and that they were left to ‘clear up the unfinished work of medical staff’. Other studies have also documented the problems faced by staff confronted by patients whose potential for recovery is, at best, marginal, or when patients’ ‘significant others’ seek to influence ICU priorities and distribution of resources. Tensions exist between the critical care clinician’s view of the ICU as a place for caring for patients who can be salvaged, and an external view of the ICU as a place appropriate to send desperately ill, dying patients.Patients admitted to ICU despite ICU staff’s belief that they are not candidates for intensive care lead to role conflicts and other dilemmas for staff. The conflict is embedded i n whom ICUs serve, the relative ease with which non-ICU clinicians can ‘turf’ their most critical patients to ICUs, the tensions ICU clinicians experience when delivering what they believe to be futile care, and the despair that family and clinicians share when having to abandon hope. †This administrative ethics paper takes a look at the issues contained in the article of the aforementioned journal, Current Opinion in Critical Care, Vol 16, No 6, December 2010, and applies these issues to the situations faced by ICUs today and in particular, the ICU healthcare personnel at the 6-bedded ICU at the San-Fernando General Hospital (SFGH), a general multi-disciplinary 680-bedded hospital situated in the south of the island of Trinidad and which serves a catchment area of 600,000 people. Trinidad and Tobago is a twin-island republic in the West Indies, south of the archipelago with a population of 1. million people. The SFGH also has a 4-bedded HDU (high-dependency unit) . Brainstem death The future plan for brain-dead patients whose hearts have been resuscitated by doctors in the Emergency Department (ED) of the SFGH following a cardiac and or respiratory arrest at home, poses an ethical dilemma for the healthcare personnel at the SFGH. Should these patients be admitted to the ICU which has only six beds to serve a population of 600,000? Shouldn’t these ICU beds be kept for patients with potentially reversible and salvageable pathology?Emergency physicians at the SFGH defend their decision to resuscitate such patients on the grounds that they cannot predict with any certainty which patients have reversible brain function and which do not. The present practice at the SFGH to provide ventilator support for these patients in the ED instead of the ICU while tests of brainstem function are being carried out, is frequently met with severe criticisms from relatives and loved ones who claim that the best is not being, and cannot be, done for such pa tients in the ED as opposed to the ICU.And to a certain extent, this is true bearing in mind the chronic shortage of doctors and nurses in the ED. Frequently therefore, here in Trinidad, the ICU personnel have no choice but to transfer such patients to the ICU for monitoring and cardio-respiratory support. Passive Euthanasia â€Å"While active euthanasia is illegal, passive euthanasia, or allowing a patient to die naturally, is legal everywhere. Passive euthanasia includes withdrawing basic needs such as hydration and nutritional feeding† (Fremgen, 2009, p. 304).The Ministry of Health, an arm of the Government of Trinidad and Tobago, has issued a written protocol/policy for the discontinuation of life-support from patients on whom the diagnosis of brainstem death is confirmed but, for such discontinuation, written consent is required from the relatives. â€Å"The person should be pronounced dead, and there is no need for the permission of the surrogates to cease treatment, a lthough there are still questions about consent for donation† (Garett, Baillie, McGeehan and Garett, 2010, p. 253).But intensivists here in Trinidad face an ethical dilemma because forty-five percent of the population consists of people of East Indian descent who, because of their religious and cultural background, do not readily agree to the discontinuation of ventilator support from their loved ones who have been pronounced brain-dead. For similar reasons, they do not readily agree to the donation of organs while the heart is still beating, a situation that has stymied the development of transplant programs here in Trinidad and Tobago. The Surrogate’s Obligation Patient-physician relationship is at the heart of patient management. The trend over the recent years has been towards promoting patients’ autonomy. This model falls apart, however, when the patient loses decision-making capacity. Surrogacy is one means of preserving patient autonomy. Several European c ountries have recently developed laws defining the physician’s role, as well as patients’ and surrogates’ rights† (Lautrette, Peigne, Watts, Souweine and Azoulay, 2008, p. 714). â€Å"Each of the principles (the best interests principle and the rational choice principle) entails problems.The best interests principle asks the surrogate to do what is nearly impossible—to judge what is best for another. Furthermore, it does not address the fact that the interests of the patient and the interests of the surrogate may be in conflict. The rational choice principle assumes that we know what the patient would have chosen when competent and after having considered every relevant factor. This is a very broad assumption. We doubt that anyone can know what a person would have done in all circumstances† (Garett, Baillie, McGeehan and Garett, 2010, p. 2). When surrogates refuse to give permission for their brain-dead loved ones to be disconnected from the ventilator, intensivists at the SFGH in Trinidad, well aware of the limitations and constraints of the situation that exists at the SFGH, choose the ethical route and not only discontinue all drug and intravenous fluid therapy but also reduce the settings on, and oxygen therapy going to, the ventilator to as low as is possible, so as to satisfy the family that the patient has not been disconnected from the ventilator.A do-not-resuscitate order (DNR) is not only written, but is also verbally communicated to the nurses by the doctors in the event of a cardiac arrest. The Cost Factor â€Å"Critical care medicine is expensive and its high cost has been a concern for many years. † (Halpern, 2009, p. 591). Canada’s health care system, including its delivery of hospital-based critical care services, is changing due to fiscal pressures. â€Å"Critical care services should be delivered to those who can benefit from them.Limiting therapy in patients with a poor prognosis may he lp redirect resources† (Leasa and Sibald, 1997, p. 320). Trinidad and Tobago, like the rest of the world, is currently facing an economic recession and so the Government of the day has to be very prudent in its fiscal spending. The Ministry of Health which is responsible for providing the financial resources for running the health system in the twin-island republic simply does not have the money required for the provision of quality healthcare at this time.ICUs are expensive and as such all attempts must be made by all stakeholders involved in the ICU to ensure that monies spent in this area of the hospital are spent wisely, ethically, effectively and efficiently. Conclusion This administrative ethics paper took a look at various challenges faced by healthcare personnel in ICUs today as they deal with death, dying and other ethical dilemmas. Particular reference was made to the ICU at the San Fernando General Hospital, Trinidad, West Indies.

Ilm Developing Yourself and Others

Know how to identify development needs 1. 1 Identify own learning style(s) and the learning style(s) of another team member To identify the learning and development style of myself and a team member we both completed a Multiple Intelligence (MI) test developed by Howard Gardner. After completion of the test on myself I have discovered that I have a learning style of Logical – Mathematical, with a majority score of 37, closely followed by Interpersonal with a score of 32, (see Appendix 1). People who are strong in logical-mathematical intelligence are good at reasoning, recognising patterns and logically analyse problems.These individuals tend to think conceptually about numbers, relationships and patterns. Characteristics of Logical-Mathematical Intelligence are: * Excellent problem-solving skills * Enjoys thinking about abstract ideas * Likes conducting scientific experiments * Good at solving complex computations The conclusion of the test does not come as a revelation to me . As I am the Finance & HR Manager with an accounting qualification this examination confirms my knowledge and learning style as being logical thinking with ability to evaluate and solve problems.During the course of my career and training aspects I believe that I learn and develop in a methodical and analytical way. I execute mathematical calculations, detecting irregularities and patterns, creating resolutions to issues that have been identified, plus producing a strategy to achieve successful working systems within my role. After completing the MI test myself I then requested a member of my team (Jane Doe) to complete the same learning styles questionnaire to see what type of style they were. On completing the questionnaire she scored equally n 3 areas; Linguistic, Logical-Mathematical and Intrapersonal, (see Appendix 2) People who are strong in linguistic intelligence are able to use words well, both when writing and speaking. These individuals are typically very good at wri ting stories, ability to learn languages, memorizing information and reading.They tend to learn best by reading, taking notes, listening to lectures, and by discussing and debating about what they have learned. The characteristics of Linguistic Intelligence are as follows: * Good at remembering written and spoken information * Enjoys reading and writing Good at debating or giving persuasive speeches * Able to explain things well * Often uses humour when telling stories Individuals who are strong in intrapersonal intelligence are good at being aware of their own emotional states, feelings and motivations. They tend to enjoy self-reflection and analysis, including day-dreaming, exploring relationships with others and assessing their personal strengths. The characteristics of Intrapersonal Intelligence are: * Good at analysing their strengths and weaknesses * Enjoys analysing theories and ideas * Excellent self-awareness Clearly understands the basis for their own motivations and feeli ngs 1. 2 Use a simple technique to identify own development needs and the development needs of another member of the team To identify any development needs that would enhance my current skills and abilities I decided to complete a development needs analyses in the form of a SWOT analysis (Strengths; Weaknesses; Opportunities; Threats). Strengths: * Very organised and meticulous with excellent prioritisation skills * Always willing to help others, friendly and approachable * Ensures protocol is followed by me and others at all times * Quick learner *Conscientious * Finance / Accounts * Excellent communication skills with all levels of people| Weaknesses: * Expect others to be very tidy and meticulous like myself * Sometimes try to take on too much work, as I don’t like to say no * Forget people have different learning speeds * Perfectionist * Health & Safety management * Management training| Opportunities: * Work closely with the Director of Support Services * ILM Course * Job Opportunities * Network meetings with other business managers * External / Internal training| Threats: * Funding for courses due to funding cuts * Unexpected things in personal life * Out of comfort zone * Policy Changes| I then requested for a member of my team (Jane Doe) to carry out a development needs evaluation by completing a SWOT analyses. Strengths: * A willingness to learn * Always happy to help others * Quick learner * Can work at a quick pace * Good IT skills (Excel / Word)| Weaknesses: * Not always very confident with others * Need to have confidence in my answers, so I don’t need to check I am doing things correctly * Stress easily under pressure * Works too quickly at times and make trivial mistakes|Opportunities: * Take work from others to learn new roles * Study AAT * In-house training with colleagues. Shadow colleagues to learn new roles * Read policies / bulletins / news to keep up to date with rules and regulations * Customer Service courses| Threats: * Not enough time to learn new tasks due to busy office environment * Not enough funding to pay for training * Training too expensive to pay from personal income * Confidence| After completing the SWOT for me and Jane the following development needs were identified: * Myself – Leadership & Management Training; HR development training; Health & Safety development * Jane – Customer Service Training; AAT Qualification; In-house training to improve skills. 1. 3 Identify potential barriers to learning. After considering the DELTA model and barriers to learning I have found that there are potentially a various number of barriers that Jane and I face. I have listed the potential barriers below: My Self Time /Workload – Work is extremely busy and the amount of work is exceptionally high, therefore to take time out of work to attend training would mean work could suffer, get backlogged and deadlines missed. * Personal Commitments – This is due to home life being very busy and possibly not having time to complete studying on an evening or weekend. * Resources / Funding – due to funding cuts with the LA, the school has had to reduce budgets therefore depending on the costs of courses there may be no funds available to pay for training. Jane Faulkner * Time / Workload – Work is extremely busy and the amount of work is exceptionally high, therefore to take time out of work to attend training would mean work could suffer, get backlogged and deadlines missed.Costs for AAT training is expensive and she is unable to afford the full costs from her personal income * Confidence / Fear / Self-esteem – Jane is very quiet and shy, and she feels very uncomfortable in unfamiliar surroundings and may shy aware from learning. * Personal Commitments – This is due to home life being very busy and possibly not having time to complete studying on an evening or weekend. * Mobility / Transport – Jane doesn’t drive t herefore if a course is some distance she may have difficulties getting there. * Resources / Funding – due to funding cuts with the LA, the school has had to reduce budgets therefore depending on the costs of courses there may be no funds available to pay for training. 1. 4 Explain how barriers to learning can be overcome.There are a number of solutions for Jane and I to be able to overcome the barriers to learning that was mentioned above: 1) Time / Workload – Some courses/training aspects are important and workload should not be a reason for not attending any coursers. Jane and I need to ensure workload is organised and prioritised, and possibly get other staffs assistance to ensure work load does not get behind. 2) Expensive Training Costs – Contribution or full costs of any training development should be paid for by the school or at least a contribution towards the costs if the training will benefit the school and improve Jane and the service she provides th e school. 3) Confidence / Self Esteem – Put Jane at ease and give her ownership of and pride in what she can do.Also have regular progress reviews in order for her to measure her personal achievements and progress. 4) Personal Commitments – Undertake training through the school day or provide time off in lieu if the training is beneficial to the service we provide. 5) Funding – Free training may be available, if very beneficial to the school funding should be located. 6) Transport – Training can be provided in local colleges or at school, therefore there would be very little travel required. Jane would be able to get local public transport and costs would be reimbursed by the school. Section 2: Know how to develop self and others to achieve organisational objectives 2. Briefly analyse learning/development options to meet need(s) of self and another member of the team. After studying and analysing the SWOT analyse and appraisals completed earlier in the ye ar, I have identified various learning opportunities for Jane and I. After undertaking my appraisal in December 2011 it was identified that I required further training on leadership and management of others. I felt that this was a significant area to develop as I had never received any training on managing staff, yet I have line managed several numbers of staff over the years. I am now currently undertaking the ILM Effective Management course. Another area that I found to have a weakness in is Health and Safety Management.I currently line manage a member of staff who has the responsibility for the Health and Safety of the school, pupils and staff. I currently have limited knowledge in this area and believe that this is an important area to improve to ensure I can manage the member of staff and her role efficiently. The member of staff is currently attending a diploma course in Health and Safety, which was organised by me through school. I have also arranged for myself to attend a 2 day workshop on Health and Safety within the workplace. A further area for development for me is HR & Recruitment policies and procedures. As a HR manager I feel that I have not received adequate training relating to HR Law, rules and regulations and Recruitment policies.I also feel this is the same for my team that manages the day to day processing of personnel matters, including contracts, sickness, maternity leave and much more. I have therefore arranged a one day seminar with a HR Adviser from OMBC to talk to myself and the team on HR & Recruitment policies and procedures to develop my team and I. Through Jane’s appraisal completed earlier this year and the SWOT analyses I feel that a vital area for development is her confidence with people, including staff and pupils. With her lack of confidence this sometimes affects her customer service, therefore I have arranged for a customer service course to be done at the school so Jane and 14 other staff receive training in this remit.Also to improve her confidence within the work place I ensure I give her tasks that encourages her to leave the sanctuary of the office and work with other colleagues in the school. Another development for Jane, which she is keen on is to commence her AAT (Association of Accounting Technicians) qualification. This is an expensive course and I have arranged for the school to contribute funds towards the costs of this course. Jane will also be attending a one day seminar that I have arranged in relation to HR and Recruitment policies and procedures. She currently works in the Finance & HR office and all staff come into the office asking questions in relation to contracts, pay, special leave, recruitment and I feel this is an area for her to develop.I have also arranged for some training to be provided to Jane, by me, on the payroll system so she can learn how to process timesheets, unpaid leave, and sickness pay. Again this is another vital area for Jane to develop i n to enable her to progress in the future in her career. The development of my needs and the needs of my team are always connected to the service provided to the school and to improve their professional development. 2. 2 Identify support mechanism for the development of self and another member of the team. For me, Jane and all other members within my team there are a number of significant support mechanisms in place. These are: * Annual appraisals where discussion on past progress and future development takes place. Termly (3 times a year) 1:1 meets take place to discuss any issues, training requirements, any difficulties they may be facing. * Monthly team meetings providing updates, and any questions, queries or ideas the staff may have to improve service or themselves. * Termly www. ebi (what works well & even better if) feedback from staff in relation to the office or themselves. * Regular in-house training provided by me to improve necessary skills for their development of t hemselves and the team. *Flexible working arrangements if necessary. * Engraining a whole school Continuous Professional Development (CPD) attitude and constantly reminding staff that school funding is available for self-development. 2. Prepare a development plan to achieve a learning objective either for self or another team member. The below table has been extracted from the staff appraisal which is completed every year and referred to throughout the year to review and monitor the development of the staff members development. Development Need| Development Action. | Approx. Cost| Measure of Success (Training Outcomes)| Evaluation Outcomes (Individual Outcomes)| Who to take action /By| Customer Service training to improve confidence and service| Arrange training course to come to school and provide training for 15 staff (including Jane)| ? 800 for 15 staff| Jane to attend and complete course. Improvement to Jane’s customer service| Line ManagerCourse booked for March 2013 ins et day| AAT Qualification training for work and self-development| Oldham College contacted and course information, dates and costs sent out to me and Jane. Jane to commit to 2 evenings per week at college| ? 1200 approx. for 1st year. This is a 3 year course. | Jane to attend course over the year and enrol for year 2. | To improve knowledge of basic accounts, improve self-confidence with attending college. | Line Manager & Jane Doe. Information obtained by December 2012. Funding secured by February 2013. Enrol during August 2013. | HR & Recruitment Training| HR Adviser from OMBC contacted by Helen Sharples.They are to provide training in the school conference room for HR team| Free| Jane & other HR staff member to attend one day seminar| To improve knowledge of HR/ Recruitment policies and procedures for whole of the team| Line ManagerNovember Inset training day. | 2. 4 Describe a method that could be used to monitor the development of self and another member of the team . One method that can be used to monitor the development of people, myself and team members is an appraisal system. This is what is currently used in my place of work. The main objective of an appraisal system is to review performance, potential and identify training and career planning needs. Performance reviews give managers and employees opportunities to discuss how employees are progressing and to see what sort of improvements can be made or help given to build on their strengths and enable them to perform more effectively.They are also used to look back on what has been achieved during the specific period and agree objectives for the next year. By using the appraisals system this can help to improve a team member’s job performance by identifying strengths and weaknesses and determining how their strengths can be best utilised within the organisation and weaknesses overcome. They can help to reveal problems which may be restricting employees’ progress and causing i nefficient work practices. As a manager I appraise my team on an annual basis setting target and development needs. In their initial or annual appraisal the staff member and I talk about how they wish to develop and progress within their role and the team.The areas of development are then discussed to ensure training is provided, either in-house or an external provider, to meet the development needs. Target dates are then set to ensure the training has commenced or completed before the next appraisal. Throughout the year I monitor the progress of the team member on a regular basis to ensure they are developing as discussed and no issues have come up. When monitoring I review their targets through 1:1 meetings which are done every half term. At the end of the 12 month period the training and development of the person is reviewed and assessed to ensure the training has had a beneficial impact on the person and the service the team provide. They cycle then commences again with a new se t of targets for the next 12 months are agreed.

Gathering Research Data-Police Officers and Job Hazards Essay

What is the goal or purpose behind your proposed research? The purpose of this study is to identify the degree to which quality of performance by police officers is affected by actual hazards in the execution of their jobs. What type of interview structure would you use? Why? The interview will be structured to answer the two main questions; what hazards police officers are faced with? How does it determine the way an order is executed? Obviously, the interviewing questionnaire would consist of three parts. The first section will ask basic biographical questions pertaining to gender, length of time in the service among other items relevant to the study. Sections two and three would embody responses pertaining to the research hypothesis. It would be so designed to offer scope for comparative an analysis between the variables quality of performance on the jobs and hazards affecting execution of duties. It is important for it to be structured in this way to excluded biases in the study. As such the research would create a balance. This is expected to expose transparency and validity. What would be some questions you would ask? Why? Biographical data— Age, sex, marital status, length of service, educational back ground and rank. Questions pertaining to work performance— The likert scale could be used here to solicit responses. From a scale 1-5 five being the highest, rate the extent to which you love your job; what tasks you like performing best? (A list of duties will be offered to be circled); what are do you feel you perform best? A list of tasks will be offered as a selection) Questions pertaining to hazards—A likert scale could be adopted for the first responses. Rate using the scale 1-5 five being the highest; how likely are you to proceed with the order of arresting a harmed criminal? How would you react if instructed to conduct a investigation in a know drug infested community (a list of options will be designed for selection). What is your perception of hazards in the execution of you duties? This would be an opened ended question without a structured response. These are the questions which would most likely offer the basis for a comparative analysis of the research. What are some distinct advantages of a qualitative data-gathering strategy, such as participant observation, over more quantitative approaches? It is a mater of subjectivity as against objectivity. Respondents during a quantitative research believe that they are expected to behave in a particular way so they act it. This violates internal validity. In a qualitative analysis the sampled populations do not know that they are being researched. Therefore there is no compromised behavior. Hence the criteria of validity can be precisely evaluated. The only subjectivity to the research are those influenced by the researchers’ paradigms. When conducting survey research, how important is informed consent and confidentiality? From the perspective of both the police as a public offer and the police as a researcher the question of informed consent and confidentiality borders on professional ethics; be it a professional researcher or police officer. It is therefore pertinent that legal rights to privacy be maintained at every level of institutionalized practice. The real importance lies in the fact that the legislated right to privacy must be adhered to. It spreads across vey discipline. Information derived from studies such as these are used to redesign public policy. As such the participants must give written or verbal consent for the information to be used for what it was intended. It must also be confirmed that information would not be shared to jeopardize their future.

Lead and manage people Essay

I used to work at a fine dinning restaurant, the restaurant manager there was very good. He has very strong knowledge about how to manage people. He never being aggressive or uses any inappropriate language. He never asks someone to do the job that he doesn’t know how to do. He shows people how to get the job done efficiently. No matter what kind of issues or problems that staff have, he always is willing to help. He gains respect from people not only about his position but also his knowledge, skill as well as his personality. Also he has a strong knowledge about all the wines and the food that we were serving. He made the perfect matching wine list for the menu that impresses everyone who worked or ate there. People enjoy working with him, as he give his knowledge to everyone, as a model to teach people a better way to do things and improve the way we usually do. His encouragements made our target easier to achieve. We worked like a family, people took care of each others. I used to work at a Thai restaurant, the mission statement was to bring the authentic Thai cuisine to life and let people enjoy. In order to achieve this mission statement, we need to cook as authentic Thai food as possible as well as let the guests to enjoy the cuisine that we bring overseas. I think the statement is effective for the company. Cuisine changes as it moves overseas. People travel overseas and know how the authentic local cuisine is. They cannot find it in Melbourne because cuisine shifts then the flavour changes. Imagine if there is only one restaurant can keep the real authentic taste that would be the selling point. That’s what this business wanted and they succussed. They do actually follow the statement. They hire the chefs from Thai to train and monitor other chefs, follow all the steps to make dishes in Thai way, import all the necessary ingredients only from Thai, keep in touch with the authentic Thai cuisine, and always ask well known Thai chefs to tast e the food. I will discuss this change in both formal and informal communication ways, such as via email, staff notice board, through meeting, and face to face to talk about this change. The email and the notice board are just the tools that I want staff to know there is a change to be happening in 6 weeks. Let them to discuss themselves first, get themselves well prepare for the change, and also to establish some issues to discuss in the incoming meeting, like new color against the religion, discrimination, etc. The meeting process is to formally hand out the change and receive the feedback from staffs. It may require a bit editing or more work on to suit everyone. Last for the individual problem, I will have to discuss the problem in person and try to get a best outcome. I want to delegate the job of making sauce A to Jahn, as he is the new apprentice of the job. As well as sauce A is the dairy big job for this section. In 2 weeks time, Jahn should be able to make the sauce A without any supervision and within a very short period of time. But meanwhile, I need to guide through him all the information that he needs to make sauce A. Demonstration is necessary. When he is making sauce A, I will have to supervisor the whole process, just to make sure he follows correct procedures ensure he is able to make it by himself. Sauce A is a very complex job for anyone, therefore 2 weeks training is required. After 2weeks time, people should be able to make it without supervision. We can delegate the task but not the responsibility, therefore I still need to check the correct seasoning for sauce A from Jahn’s work, also the actual time he spends on making it. If I am not at work, then other chefs will supervisor his work as well, just to make sure he keeps his work consistence. Coaching is more than just pure training and it involves more of personal relationship over time and in many ways it is like mentoring. It makes better environment for the organisation from management to the workers together to build a better workplace in order to achieve a better result. As a chef de cuisine, I would evaluate each individual’s skill and put them in the right place, such as put someone on web design or programming if he/she is good at doing computer. Then consider the current situation to establish a plan for coaching. Well explain to members about the plan, make sure they  understand and make changes for any better leads. I will also demonstrate the task to members. I need to show members that I can complete the task better not just I can’t do it therefore I have to hand out for you guys. When there is a specific skill require for the cut, I will show them how to do it, and I am willing to help to teach them and develop their individual skill level. Teach them what is the best way to do things right here. To help them to multi-tasking from my past experience.I think I will be using ‘democratic’ and ‘Laissez-Faire’ style to coach people, they are more guider and helper kind of coaching style instead of being boss to ask around. As a learner, people is willing to learn from others especially from the one who is easy to talk to, image if your teacher is very grumpy, would you ask him/her any questions? I will ask open questions rather than close questions. It is also a good way to get the feedback from people according to their answers. The recognition and promotion are my motivation at the moment. As I just started a new chef job at a different restaurant, everything starts from fresh, humbly gaining knowledge from co-workers. I need to fit in the new working environment is the priority. Within a month period, the recognition from headchef or other chef is my motivation, learning new knowledge everyday at the same time improve myself. I can see myself is improving a better understanding of the food that I make, developing the better skill that as a chef should have, etc. Those factors create satisfaction for myself in order to achieve better position to the job as well as lead co-workers feel is good to have me on board. According to Herzberg’s motivation-Hygiene theory, they are leading to satisfaction. My motivation has changed over the past few years. When I first came to this country, I just needed a job to feed myself, therefore my motivation at that time was just money, and I didn’t care about t he quality of work environment or the skill that I could improve. Then I moved to another restaurant, also I had a fair amount of money to start with, so at that time a better working environment, better pay, better standard was my motivation. It is more like Maslow’s Hierarchy of Needs, different stage has vary needs, as well as the motivations. Maslow’s Hierarchy of Needs can also explain why younger people have different motivational goals than older people. At different age group,  people are tend to have very needs, those needs result different motivational goals. For example, at age 3 you may do what it takes to satisfy your parents in order to get a lollypop. But you wouldn’t do the same when you are 20. Because the lollypop wouldn’t be your motivational goal at all after you already had hundred of them.Assignment activity 7 Trust-Trust employees, headchef give new staff the opportunity to run the section him/herself. Fully delegate responsibilities to new staff without micromanaging the outcome. They feel being trusted, they will work well in a soften environment. If you always doubt the ability of employee, then they are not happy, how could they work for you. Support- Do not hide the information, give employees the information they need to get the job done. Management should make itself open for the talk regards to the employee manner or dairy issues. As well as welling to help employees to solve the problems that they are facing. Employees feel loved, then they can provide a better outcome to work for you. Facilitation- Provide a happy environment for employees to work with in order to maximize the outcome. No, I don’t think so. One of the previous restaurant that I worked, it doesn’t have a well communication system. When we say communication, it means two ways, the message from the sender to the receiver, then the feedback from the receiver back to the sender. At that place we have staff notice board and staff communication board. But they are only use to post from the top management only. No staff feedback is needed. It doesn’t work as it is only a one way communication tool, it is really hard for management to know if staff understand or award of the new ideas and so on. Within hospitality industry, two ways communication is important, well understand the message and the feedback is essential as they can improve the quality of work or service. Therefore, they should provide the feedback form for staff to fill up, management should really go down and understand what staffs really want. Email out the ideas then get the reply direct from staff may be a good way to start with. The manager at the last place that I used to work, I reckon he uses both paternalistic and democratic management styles. He understands each one of workers within the company and he talks to each one of them like family, therefore everyone calls him ‘brother’. As a ‘brother’, he takes care of each of us and releases the pressure from both workers’ family and work. He listens to people, and talks to people very gently, never use any offensive language. When there are some decisions need to be made, he always listens to all the workers’ need and try to minimize the issues would cause. Those styles were effective for him. He is happy to delegate tasks to colleagues, gaining more power by earning people’s respect. I personal believe he is a good manager as after he took over the place, the revenue was increase and less staff turnover, everyone works together like in a family.

A Streetcar Named Desire – A Tragic Hero

There are nine types of heroes in this world, each of them with their own unique stories, plots, cliches etc. Among those is the classic tragic hero, one who is destined to fail no matter what. In a Streetcar Named Desire, the tragic hero is Blanche Dubois, an aging Southern Belle living in a state of perpetual panic about her fading beauty. In this essay it will be discussed what makes Blanche a tragic hero and how she compares to a typical tragic hero.A typical tragic hero is first and foremost, born of noble stature. This gives the hero something to fall from, so they can â€Å"fall from grace† (Avril Lavigne, Nobody's Home). Blanche Dubois born in Laurel, Mississippi, to a wealthy family. She is a former schoolteacher who had been evicted from Belle Reve (a family home) after being declared a woman of loose morals. This was because years earlier, Blanche's husband committed suicide after she expressed her distaste on his sexuality. She later had many affairs trying to numb her grief on the death of her husband.The second condition for a tragic hero is what is called Hamartia, a tragic flaw that causes the downfall of the hero. Blanche's tragic flaw is that she is dependant on men, so much so that she makes choices and does things that are morally questionable. She manipulates and lies to potential suitors to make herself seem more attractive and younger-which in her mind is the only way a man will love her. She does this with Harold â€Å"Mitch† Mitchell and it seems to be working until Mitch is informed of all the lies he's been fed, at which point Mitch breaks up with Blanche and leaves her vulnerable for Stanley to rape.The reversal of fortune, peripeteia, is when the fortunate hero is down on his luck. In Blanche's case, she loses Belle Reve, her husband is a homosexual and dead, she is evicted from her own town and is losing her beauty. She used to be a wealthy and beautiful Southern belle with a loving family and kind husband but her luc k changed directions and she lost everything she held dear.One of the most obvious conditions of a tragic hero is nemesis, the fate that  cannot be reversed. In other words, no matter what the hero tries or does their fate is sealed. Blanche's fate is inevitable, all people can do is watch as she falls deeper and deeper into her delusions and misconceptions of reality.In the end of the tragedy, the audience should be left feeling pity or fear after witnessing the downfall of the tragic hero, catharsis. This is because the punishment dealt to the hero is not wholly deserved, the punishment far exceeds the crime. Blanche was a sad and confused woman who was looking for comfort and someone to take care of her.She lied and manipulated people to try and get the happy life she wanted but that did not mean she deserved to be raped, abandoned by her own sister and publicly humiliated. Blanche herself said â€Å"It [deliberate cruelty] is the one unforgivable thing in my opinion and it is the one thing I have never, never been guilty of.† (Williams, Scene 10 Pg 126)Anagnoririsis is the recognition or discovery made by the tragic hero, the point in time when the hero realizes what went wrong and why. Most other tragedies like Hamlet and Mcbeth feature this but this does not happen to Blanche.In the end Blanche was sent to a mental institution, she never gained any knowledge of what truly happened and why. In this way, it could be said that Blanche is not your typical tragic hero because she does not meet this point but that is not a bad thing. Blanche is a unique tragic hero who will never know what went wrong as she has submerged herself in her own little world.A typical, yet unique, tragic hero, Blanche did her best to be happy, her only goal. Unfortunately for her, she did not go about the right way of doing it. The wrong people were angered and others tried to force Blanche to face reality.Blanche was unable to let go of the walls that protected her from th e harsh truth, and so she fell from grace. The final scene in which Blanche utters her most famous line â€Å"†¦I have always depended on the kindness of strangers.†, is the sad culmination of Blanche's vanity and total dependence on men for happiness.A typical tragic hero is first and foremost, born of noble stature. This gives the hero something to fall from, so they can â€Å"fall from grace† (Avril Lavigne, Nobody's Home). Blanche Dubois born in Laurel, Mississippi, to a wealthy family.She is a former schoolteacher who had been evicted from Belle Reve (a family home) after being declared a woman of loose morals. This was because years earlier, Blanche's husband committed suicide after she expressed her distaste on his sexuality. She later had many affairs trying to numb her grief on the death of her husband.The second condition for a tragic hero is what is called Hamartia, a tragic flaw that causes the downfall of the hero. Blanche's tragic flaw is that she is dependant on men, so much so that she makes choices and does things that are morally questionable.She manipulates and lies to potential suitors to make herself seem more attractive and younger-which in her mind is the only way a man will love her. She does this with Harold â€Å"Mitch† Mitchell and it seems to be working until Mitch is informed of all the lies he's been fed, at which point Mitch breaks up with Blanche and leaves her vulnerable for Stanley to rape.The reversal of fortune, peripeteia, is when the fortunate hero is down on his luck. In Blanche's case, she loses Belle Reve, her husband is a homosexual and dead, she is evicted from her own town and is losing her beauty. She used to be a wealthy and beautiful Southern belle with a loving family and kind husband but her luck changed directions and she lost everything she held dear.One of the most obvious conditions of a tragic hero is nemesis, the fate that cannot be reversed. In other words, no matter what the her o tries or does their fate is sealed. Blanche's fate is inevitable, all people can do is watch as she falls deeper and deeper into her delusions and misconceptions of reality.In the end of the tragedy, the audience should be left feeling pity or fear after witnessing the downfall of the tragic hero, catharsis. This is because the punishment dealt to the hero is not wholly deserved, the punishment far  exceeds the crime. Blanche was a sad and confused woman who was looking for comfort and someone to take care of her.She lied and manipulated people to try and get the happy life she wanted but that did not mean she deserved to be raped, abandoned by her own sister and publicly humiliated. Blanche herself said â€Å"It [deliberate cruelty] is the one unforgivable thing in my opinion and it is the one thing I have never, never been guilty of.† (Williams, Scene 10 Pg 126)Anagnorsis is the recognition or discovery made by the tragic hero, the point in time when the hero realizes w hat went wrong and why. Most other tragedies like Hamlet and Mcbeth feature this but this does not happen to Blanche.In the end Blanche was sent to a mental institution, she never gained any knowledge of what truly happened and why. In this way, it could be said that Blanche is not your typical tragic hero because she does not meet this point but that is not a bad thing. Blanche is a unique tragic hero who will never know what went wrong as she has submerged herself in her own little world.A typical, yet unique, tragic hero, Blanche did her best to be happy, her only goal. Unfortunately for her, she did not go about the right way of doing it. The wrong people were angered and others tried to force Blanche to face reality.Blanche was unable to let go of the walls that protected her from the harsh truth, and so she fell from grace. The final scene in which Blanche utters her most famous line â€Å"†¦I have always depended on the kindness of strangers.†, is the sad culminat ion of Blanche's vanity and total dependence on men for happiness.

How Does Knowledge of the Foundations and History of Nursing Provide a Context in Which to Understand Current Practice? Essay

Without an understanding of basic nursing there is no room for improvement. â€Å"By understanding the history and foundation of nursing nurses can develop a sense of professional identity and build a better future for the profession and the people they serve† (lc.gcumedia.com, 2013). We also have a better appreciation for the nursing profession and what it has evolved into today. Three trends that were demonstrated by the interactive timeline were: 1.Nursing was for the undesirables. â€Å"Ill individuals were taken care of by â€Å"sinners, saints, or mothers† â€Å"(lc.gcumedia.com, 2013). Florence Nightingale was born in a wealthy English family and had educational opportunities; however she would still often find herself wanting to help the poor. Soon after completion of nursing school she travelled to the Crimea War. There she suggested there were â€Å"five essential components to an optimal healing environment; pure air, pure water, efficient drainage, cleanl iness and light† (Kelly, 2012, p. 2397). With those changes alone the mortality rate decreased and the meaning of nursing was forever changed into what we know today. 2.Nursing was predominately for males. Like every profession in the past, men would work while women stayed at home. During war men would act like nurses by treating injured soldiers and attempting to save others lives. Florence Nightingale once again changed nursing from the past to what we know today by walking on the battle fields rendering aid to those who were wounded. 3.The birth of the American Nurses Association. The American Nurse Association (ANA) was founded in 1896. The ANA has enabled nurses to achieve higher education and given them more opportunities by providing routes to become credentialed in certain specialties and â€Å"published a vast collection of material on nursing practice and the profession† (lc.gcumedia.com, 2013). These trends have influenced me by making me thankful to all who have made nursing what it has become. Today’s nurse has evolved from a profession of the â€Å"undesirable† to the â€Å"honorable†, changed from a profession that was predominately male to n ow include females and lastly grown from only an individual’s perspective to having a huge voice within a major organization (ANA). The nursing profession has come a long way and there is always room for improvement but without the knowledge of foundations and history it wouldn’t be where it is today. References http://lc.gcumedia.com/zwebassets/couseMaterialPages/nrs430v_timeline.php. Kelly, J. (2012). Editorial: What has Florence Nightingale ever done for clinical nurses?. Journal Of Clinical Nursing, 21(17/18), 2397-2398. doi:10.1111/j.1365-2702.2010.03455.x

Copyright, intellectual property and innovation Essay

Copyright, intellectual property and innovation - Essay Example It can be difficult for a developer to prove a new piece of software is theirs, especially when an unscrupulous competitor starts claiming they made it, and claiming huge amounts of money from the developer. Property rights are a complete nightmare for the small company or ordinary person who simply wants to develop software for its own sake and wishing to make a small profit while doing so. Copyright is one area of protection that should be straightforward, but it is not. Patenting software seems a good idea, but this can be difficult, time consuming and expensive. Intellectual property rights means’ software has to be proven to be unique, which is not always possible at the start of a project where such thinking may not even occur. For as the project begins, from the moment the first code is written and an idea aired, there is the danger of theft. For the public who want to use the software, there are problems not of their making in all the property rights, such as serious t ime delays in getting something up to date and useful for them. Intellectual Property Rights (IPR) have only been in existence since 1967, and software has only been recognised as needing protection since the late 1970’s, before that it was not considered very important and was usually supplied by the company who built the hardware as a complete entity. Once it was realised that software could be a separate product with its own market value, and then it started to become important to protect it. Later the type of thing that could be protected was argued over by software companies unclear as to what was in the common domain and what was completely theirs. A few years ago there was a massive argument between Apple computers and Microsoft over the use of the Trash Can in their respective operating systems. Apple claiming their right to it as their invention and Microsoft saying it was something in the public domain, needed by any operating system. The argument went

Masters Level Education for Nurses Essay Example | Topics and Well Written Essays - 1250 words

Masters Level Education for Nurses - Essay Example Studies show that errors may very well not have anything to do with the competence of staff but with the complexity of the systems that have evolved. This paper will discuss this healthcare system and how the Masters prepared nurse fits into it as well as that of the Masters prepared nurse with a specialty in Education. Strong partnerships are needed to advance the profession of nursing and to address the myriad of challenges that will be faced in the near future. These partnerships have the promise of making the kinds of changes that could be lasting and advance the nursing profession in such a way as to put nursing at the forefront of addressing the present dysfunctions in the system. After all who better to address those dysfunctions than nursing who is the caring advocate of the patient and system.(Lukosium, DiCenso, Brown 2004). There is not single definition but this writer would expect to be a part of extending the traditional scope of nursing in a highly autonomous practice, which maximizes the use of nursing knowledge and contributes to the development of the profession. Those things ca occur through the professional activities that include evaluating nursing interventions, enhancing the nursing role in the new models of care delivery, research education, and facilitating change in healthcare policies and practices. There is an expectation to be able to use innovation in this advancement which cannot occur without the education that a Masters degree provides. The Masters further provides this writer with the ability to achieve an integration of that knowledge in such a way as to include clinical practice, education, research, professional development, and organizational leadership. Masters Nurses are definitely leaders in their profession. "Today's assignment: Find more nurse educators." (Tressman, 2009). The battle cry for staff nurses has only quieted for a short time, quieted by the economy at this time. Soon it will begin again. It is far from over. How do we fill those nursing position when we do not have educators. The average age of a doctorally prepared full professor is 59 years old, 56 for associate professors and 52 for assistant professors (Tressman, 2009). Most nurse faculty retire at 63 therefore the pool of professors will be very much decreased very shortly. More than 50,000 qualified ap0plicants were turned away from baccalaureate and graduate nursing programs in 2008 in a large part because of insufficient numbers of nurse faculty. Most of the major Colleges of Nursing have faculty positions that they are searching at this time. There are many other drawbacks including pay and benefits. However, nursing program deans firmly believe that the benefits of being a nurse educator far outweigh the drawbacks. Two of the reasons that most faculty give for the importance of their job are that they are involved in influencing the next generation of nurses and the they have the ability to create new knowledge through research that benefits nurses and patients. These are the very reasons why this writer would want a specialty in Education. If one has a passion for nursing, one has a passion

Case Study Essay Example | Topics and Well Written Essays - 500 words - 32

Case Study - Essay Example Under normal circumstances, the Federal Emergency Management Agency (FEMA) was expected to take a leading role in providing relief to the affected people but in this case, it is seen working against its mandated task. The then director, Brown, turned down offers of assistance from the police, army as well as the other relief agencies and this was only compounded by a directive that prohibited all the emergency services departments not to respond to any call to assist the victims of the hurricane without being lawfully requested. A year passed after the devastating Katrina but a greater part of New Orleans remained in ruins with little reconstruction taking place. In my own opinion, I think the responsible authorities neglected the areas that were hardest hit by the hurricane. Instead of responding positively through offering assistance to the affected people, they are seen blocking emergency relief as if the disaster was premeditated. Natural disasters are not controlled by man and they cause untold suffering to the affected people, hence the need to put measures in place that are meant to avert the impacts of these disasters. The government is the main body representing all the citizens and it has the responsibility of ensuring that the welfare of its citizens is up to standard. In case of unprecedented natural disasters, all the levels of government in collaboration with other relief providers should take a leading role in ensuring that all the affected people get the needed assistance. Measures to ensure disaster preparedness should always be in place and the government should offer quick responses whenever there is a serious disaster unl ike the case of New Orleans where the responsible authorities are seen blocking aid. It is recommended that public policies which do not discriminate against race or creed must be enacted and fully implemented in all states. It is highly probable that the victims of Hurricane Katrina in New Orleans were neglected on the

Store locations Essay Example | Topics and Well Written Essays - 1500 words

Store locations - Essay Example To further deal with the marketability of the location, with regards to the aforementioned pharmacy, obtaining location and marketability data from two of its branches is a perfect barometer in determining how the location of the said establishment is essential in determining the feasibility of it. This study focuses on two selected branches of Walgreens in Miami and how will those branches show profitability and compliance with several criteria on why these locations were selected among others. Furthermore, this study aims to establish that location is indeed one of the most important factors to consider in putting-up a business enterprise in dealing with the marketability and profitability of the company. By analyzing two selected branches of Walgreens with regards to location, it would be possible to track the strong and weak points of the establishment with regards to its location and how this element affects the over-all standing of a certain business. This branch is situated almost in the center of Miami, Florida. ... A certain commercial online real estate described this location between Footlocker and Burdines Department store; this store will draw from both the local resident and daytime population, and the foreign tourists and more than 25 million cruise line passengers visiting Miami annually2. The description alone of the website would give the idea that the place is indeed visited by different people of different classification in which the store has a huge opportunity of being seen and visited by people because of its accessibility to the customers. However, analyzing the goods and services that Walgreens offer, it is very important to know, how many of these people would avail the goods and services it gives In other words, how many customers the store would be able to obtain from those people who manage to pass the location where the branch is located In these cases, it is also important to know the classification of the location in order to know if the place is indeed marketable for this enterprise to click and prosper. If we are to analyze, there are several hospitals and allied services in Florida that are located in the aforementioned street and would be an important factor for the said branch to obtain customers. It is established that these institutions needs the services of the said branch and therefore, the marketability of the branch is now clearer and established. The likes of Miami Children's Hospital, Mercy Hospital, Miami Heart Institute and Medical Center and other hospitals boost the chances of the said branch to penetrate the market with regards to the goods and services it offers. Also, the location is an ideal one as the aforementioned premises are

Barack Hussein Obama Research Paper Example | Topics and Well Written Essays - 1000 words

Barack Hussein Obama - Research Paper Example President Obama has plenty of detractors and many blame him for things that he really has no control over. But despite this, Barack Obama represents America in ways that few other Presidents have in the past. He is a unique president that has been elected because he has experiences and attributes that appeal to the rapidly changing demographics of the United States of America. An important distinction that President Obama has that makes him unique among Presidents of the United States is his ethnicity. President Obama’s mother, Ann Dunham, was a student in Honolulu, Hawaii when she met Barack Obama Sr. They were both studying in the same program at the university. Ann was from a working class family that had lived throughout the Midwest before relocating to Hawaii. She was a smart, able student with a passion for learning about cultures from all around the world. Barack Obama Sr. was from the Luo tribe in Kenya. As a child, he herded goats in his native Kenya. He was attending college on a scholarship. Ann and Barack Obama Sr. married in 1961 and Barack Obama Jr. was born a few months later. The fact that Ann was a white woman from the Midwest and Barack Obama Sr. was a black man from Africa is significant. President Obama became self-conscious about his race when he was a young teenager (Barack Obama Biography, 2011). He wondered why being black was looked down on by some white people. This is significant because President Obama is leading America during an age when ethnic minorities are the new majorities in several major metropolitan regions. America is a more ethnically diverse place and it is important that there are people in leadership that have experienced discrimination first hand. Some minorities think the Barack Obama should do more for them than he has while he has been in office. There may be few legislative victories he can point to, but it is good to have an ethnically mixed President so the issue of race can be discussed in a more constru ctive way than in the past in America. Barack is an important President for our day and age because he is a minority and that helps all Americans know that minorities are capable of sound judgment and capable leadership. Barack Obama’s parents divorced when he was two years old. He then moved to Indonesia and lived with his step-father, mother and step-sister for several years. This is a second reason that President Obama is uniquely qualified to be our President. He is the only President in the history of the United States to have lived in a Muslim country for any period of time. America’s relations with the Muslim world are at an all time low in many respects. We still have close allies such as Saudi Arabia, Qatar, Bahrain and Yemen. But many Muslim countries hate America and Americans. Having experienced Muslim culture first hand, President Obama is in a strong position to understand the Muslim world. He knows from first hand experience that not all people in the Mu slim world are bad. He understands that the vast majority of Muslims are peaceful people that want peace with America. President Obama gave a famous speech in Cairo soon after he was elected. In this speech he called for greater unity and understanding between the western, democratic nations and the Arab, Muslim nations (Holzman, 2009). It is interesting to note that many of those people that heard this speech would begin peaceful protests two years later,

Youth Violence In Schools Essay Example | Topics and Well Written Essays - 750 words

Youth Violence In Schools - Essay Example en all the basic necessities in their lives including good foundation for their social and emotional needs (Haapasalo & Pokela, 1999; Goldhagen & Lansdown, 2008). It is also important to consider that without this proper care, there is a great absence of providing other needs that children can use when they grow as young adults. The young adults face different situations in their lives including different problems. One of these is youth violence in school. Youth violence is a prevalent issue in the world. However, this issue is highly integrated not just within school premises, but inside home. Thus, youth violence in school is a problem in the society that starts from home. Youth violence in school is a problem in the society that starts from home because it is a place that has become an integral part of one’s life where values, characters and personalities are formed (Harden & Whittaker, 2011). In there, there are parents who always have the chance to influence their children. It is their obligations to show to their children the good values, characters and personalities to live by. Failure of these parents to show these will usually result to undesirable expectations. In most of the time, children are always blamed about their being foolish or hard headed when in fact; the bottom line of it all is the failure of parents to show good influence at home. In the same way, young adults usually find themselves blamed about their own actions when in fact, the very foundation of the problem starts from the kind of influence they receive at home from their parents. Youth violence is a problem that starts from home because it depends on the level of communication parents invest in their children’s lives. Aside from setting a good influence of parents for their children, it is tested and proven that a good communication between them would also work out. Children who receive constant communication with their parents have many things to learn (Tates & Meeuwesen, 2000).

Group Process Essay Example | Topics and Well Written Essays - 500 words

Group Process - Essay Example The concept of self censorship has been around since long. Firstly this term mainly got related with writers and journalists but now we literally see everyone doing it around us along with me. Many individual and social ingredients convince a person to censor himself to others. Duncan (1994) writes that, "People in different societies are more collectivistic than Americans, who tend to be individualistic." (p.79) Although, I agree strongly that we are products of our societies but Americans are little bit more loath to openly express their ideas and opinions. Most of times, I know my colleagues are wrong but I don't let them find out due to many reasons. At times, I lack confidence and I end up blocking my self to others. Other times, I fear that people will oppose me and question me. I feel challenged. It takes a lot from me to convince people and satisfy them with my answers. Eventually I feel embarrassed and rejected by my group. I also censor my views to avoid arguments. From time to time, I do it to avoid conflict of ideas and interests. I have also felt that when I get along with my group very well and feel close to them then I am afraid to raise a question due to peer pressure.

(industry FIVE FORCES analysis chapter) in my dissertation Essay

(industry FIVE FORCES analysis chapter) in my dissertation - Essay Example Bargaining Power of Suppliers Major suppliers of chemical manufacturers include: oil and gas companies (Data Monitor, 2011, p. 13, 16). Even though oil and gas products are homogenous or undifferentiated by nature, we should keep in mind these materials are non-renewable items. As a common knowledge, there is no other product substitute for oil and gas products. Considering the fact that there are only a few numbers of large-scale companies that could supply oil and gas to chemical manufacturers, the bargaining power of suppliers is considered high. Therefore, chemical manufacturers do not have the power to control the market prices of oil and gas products. Due to the fact the number of oil and gas suppliers is relatively few as compared to the number of chemical manufacturers around the world; the cost of switching from one supplier to another and suppliers’ dispensability is moderate (Data Monitor, 2011, p. 16). Bargaining Power of Buyers Large multinational companies that u sually purchase chemicals on a daily basis include manufacturing companies that manufacture the following items: plastic, perfume, pharmaceutical products, soap and detergents, shampoo, and people who are involved in agricultural businesses among others (Data Monitor, 2011, p. 13, 15). ... By nature, chemicals are undifferentiated products. For this reason, the buyers’ cost of switching from one chemical manufacturer to another and product dispensability is low (Data Monitor, 2011, p. 15). Even though establishing a strong business relationship with chemical manufacturers increase customer loyalty, the fact that the cost of switching is low makes the buyers’ tendency to switch from one chemical manufacturer to another moderate. In most cases, potential buyers are sensitive to price. Therefore, the only way for chemical manufacturers to persuade potential buyers to purchase their products is for them to be able to manufacture their products at a lower price. Rivalry among Existing Firms Competitors within the chemical manufacturing industry includes chemical manufacturers of basic chemicals (i.e. petrochemicals and plastic resins), specialty or fine chemicals (i.e. additives, paints, coating, fragrances, soaps, and detergents), pharmaceutical products (i.e . medicinal active ingredients and formulations), fertilizer and agrochemicals (i.e. chemical fertilizers and herbicides, insecticides) (Data Monitor, 2011, p. 7). Because of the continuously increasing number of chemical manufacturers in the global markets, the market competition within the chemical manufacturing industry is intensely competitive. In fact, there are quite a lot of local and international companies that are continuously competing for the same group of customers. Upon analyzing the chemical manufacturing industry, it is clear that the rivalry among the manufacturers of chemicals is very intense due to the fact that these companies are

Search Engine Advertising Essay Example | Topics and Well Written Essays - 1000 words

Search Engine Advertising - Essay Example Written language is a powerful tool for expressing ideas and feelings when used correctly and to the right audience. The ambiguity of spoken word is one of the reasons behind the development of text theory. The main aim of text theory is to engrave systems of unambiguous rules which put across the association between connotation and text in various languages. Text theory, therefore, seeks to ensure that written word is free of ambiguity and well understood by the audience. Online advertising relies majorly on the written word. It is therefore important to ensure that these advertisements are rational especially to the persons who will be privileged to read them. Companies should, therefore, take the keen interest in the text that conveys advertisement message on the internet (Hollis 2005). Question two Affiliate programs refer to planning between an online merchant website and associated web sites that enable the later to accept traffic from the merchant web sites for a fee. Links are normally posted by the associated websites and payments are made depending on agreed terms and conditions. In most cases, the contract is based on factors such as the number of persons the associate web site transfers to the merchant site. Other agreements may involve payments depending on the number of persons that pay a visit to the web page that has the merchant website advertisement poster. This is fundamental especially for upcoming companies that want to grow the business at a faster rate.... This is fundamental especially for upcoming companies that want to grow business at a faster rate. Written language is a powerful tool for expressing ideas and feelings when used correctly and to the right audience. Ambiguity of spoken word is one of the reasons behind the development of text theory. The main aim of text theory is to engrave systems of unambiguous rules which put across the association between connotation and text in various languages. Text theory therefore seeks to ensure that written word is free of ambiguity and well understood by the audience. Online advertising relies majorly on the written word. It is therefore important to ensure that these advertisements are rational especially to the persons who will be privileged to read them. Companies should therefore take keen interest on the text that conveys advertisement message on the internet (Hollis 2005). Question two Affiliate programs refers to planning between an online merchant website and associate web sites that enables the later to accept traffic from the merchant web sites for a fee. Links are normally posted by the associate websites and payments are made depending on agreed terms and conditions. In most cases the contract is based on factors such as the number of persons the associate web site transfers to the merchant site. Other agreements may involve payments depending on the number of persons that pay a visit to the web page that has the merchant website advertisement poster. Ideally, when a hyperlink on an associate website earns the merchant site finance or popularity, it is the duty of the merchant site to make payments to the associate site as pertains to the contract (Evans 2009). Three parties are in most cases involved in an

Studying abroad Essay Example | Topics and Well Written Essays - 500 words - 1

Studying abroad - Essay Example Problems encountered by international students should be given attention and solutions to help foreigners cope with their new environment and perform well in their studies. This paper will discuss some of these problems such as homesickness and the multi-cultural experiences of international students. Perhaps the most common complaint among foreign students is homesickness. Studies show that â€Å"students in America experience homesickness due to culture shock† (Harrison and Brower). The culture in America is definitely different from most foreign students especially those coming from eastern countries. It is not just the language that is different but the divergences in food, clothing, customs and practices are also quite astonishing to foreign students. This makes them long for familiar environments and people they have been used to. From the studies of Harrison and Brower, this separation anxiety has a strong correlation to psychological hardiness- â€Å"a personality variable that seemingly impact students’ adjustment to their often challenging and bewildering host cultures† (Harrison and Bower). The research of the shows that those who are able to adjust and actively involve themselves in whatever challenges individuals are faced with, experience less h omesickness. In addition, those who are able to act strong and able in their new environment are less stressed and therefore are able to cope with the demands of their host culture. Those who are resilient to changes are also found to be stronger in times of emotional and psychological troubles among foreign students. In contrast to the negative effect of foreign studies, there is also a great advantage especially with those who have strong psychological hardiness and are open to challenging experiences. According to Christine Lee, David Therriault and Tracy Linderholm, â€Å"multicultural experiences such as studying abroad are quantitatively and qualitatively

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

Diabetes type 2 - Essay Example inactivity, fat distribution (excess fat in the abdomen), age (above 45 years), race (African Americans, Asian Americans and Latinos among other natives), pregnancy and prediabetes (higher than normal blood sugar level). This paper will discuss two treatment methods of diabetes type 2 and the professionals involved in these treatments. With over 2.9 million of UK population being diagnosed with diabetes, and there being no cure for diabetes, an effective treatment plan is necessary and which should be followed. The two common methods of treatment of this disease are monitoring the blood sugar level and using medication. The first treatment method is the use of medication. This treatment method is mainly for those who cannot maintain a reduced blood sugar level or their condition has advanced. Some of the diabetes medications prescribed includes metformin (which is aimed at lowering production of glucose in the liver), glipizide (aimed at stimulating the pancreas to release more insulin) or acarbose (that prevents enzymes from breaking down carbohydrates in the intestines). Other than these medications, there is also insulin therapy which is administered through injection and its advantages is that it works rapidly and lasts longer (Spencer and Hughes, 2005). Monitoring of the blood sugar level requires a change in the lifestyle (as some of the risk factors are associated with lifestyle). This will require the diabetes patient to constantly exercise to burn off excessive weight around the abdomen area and in order to also reduce weight generally for those considered obese when a BMI (body mass index) is conducted. Healthy eating is also required which means eating foods high in fibre like whole grains, plenty of fruits and vegetables. A reduction in the intake of carbohydrates, sweets and animal products in general is also one of the treatment plans. It is also important to lay off stress or factors causing or perpetuating stress as well as reducing alcohol

The 14 Points Plan by Woodrow Wilson Essay Example | Topics and Well Written Essays - 2000 words

The 14 Points Plan by Woodrow Wilson - Essay Example However Treaty of Versailles had little connection with these fourteen points and was not ratified by the US senate. On October 16, 1918, an interview was conducted by President Woodrow Wilson and William Wiseman. This interview was the basis of acceptance of these fourteen points by German Government. A negotiation report was also made on these fourteen points. These fourteen points were also accepted by Italy and France. After the session Britain signed acceptance to all the points except freedom of sea due to the condition of allies. These fourteen points are based on the research of inquiry. This speech included many principles of progressivism which promoted domestic reforms in US and translated then into foreign policy (Mulder, 71). This fourteen point speech is the only statement which aims to focus on wars as compared to any other nation fighting in World War I. Some nations tried to give indicators in relation to their aims, but majority of nations tried to keep their war go als private. This speech also reacted to Vladimir Lenin’s Decree on Peace in October 1917; in it Russia made an immediate proposal of withdrawal of war and promotes peace and freedom, which was further compromised by territorial annexations. 1.2 Fourteen points.The first five points of fourteen points focuses on international concerns, while the others refer to territorial questions.†¢Open diplomacy.There should be open peace in the nations, which means there should not be any private international understanding among nations. Open diplomacy should be promoted in order to be frank with the citizens and to understand public views. Freedom of the seas There should be absolute freedom to navigate on seas and territorial waters. It should be available in both the cases i.e. wars and peace. However, while enforcing international covenants it can be closed wholly or partly. But this can be done only in case of international actions and practices. Removal of economic barriers A ll economic barriers should be removed and a sense of equality should be created among all nations. There should be peace among all nations. Reduction of armaments National ornaments should be greatly reduced in order to ensure domestic safety in the nations. A guarantee should be given for the reduction of armaments. Adjustment of colonial claims There should be enhancement of open minded and free adjustment of colonial claims. It should strictly follow the principle of identifying sovereignty in relation to the interest of citizens. People should be given equal weight age with the colonial claims of government. Conquered territories in Russia There should be a migration in Russian territory. All issues affecting Russia must be resolved, so that they can work on the basis of cooperation with other nations of the world. This will create an unrestricted and blatant opportunity for the nation in order to be independent. It should be able to identify its own national policies and polit ical developments. Russia should be invited to enter as a free nation, making its own choices and beliefs. In spite of invitation, all kind of assistance should be given to this nation in order to fulfill its desires and needs. This help if given to Russia, will lead to test the nations goodwill and understanding their needs. It will differ from the

Campare Sonnet Essay Example for Free

Campare Sonnet Essay Shall I compare you to a summers day? Thou art more lovely and more temperate:| You are more lovely and more constant:| Rough winds do shake the darling buds of May,| Rough winds shake the beloved buds of May| And summers lease hath all too short a date: | And summer is far too short:| Sometime too hot the eye of heaven shines,| At times the sun is too hot,| And often is his gold complexion dimmd; | Or often goes behind the clouds;| And every fair from fair sometime declines,| And everything beautiful sometime will lose its beauty, By chance or natures changing course untrimmd;| By misfortune or by natures planned out course. But thy eternal summer shall not fade | But your youth shall not fade,| Nor lose possession of that fair thou owest;| Nor will you lose the beauty that you possess;| Nor shall Death brag thou wanderst in his shade,| Nor will death claim you for his own,| When in eternal lines to time thou growest:| Because in my eternal verse you will live forever. | So long as men can breathe or eyes can see,| So long as there are people on this earth,| So long lives this and this gives life to thee. So long will this poem live on, making you immortal| My mistress eyes are nothing like the sun;| My mistresss eyes are nothing like the sun;| Coral is far more red than her lips red;| Coral is far more red than her lips;| If snow be white, why then her breasts are dun; | If snow is white, then her breasts are a brownish gray;| If hairs be wires, black wires grow on her head. | If hairs are like wires, hers are black and not golden. I have seen roses damaskd, red and white,| I have seen damask roses, re d and white [streaked],| But no such roses see I in her cheeks; | But I do not see such colors in her cheeks;| And in some perfumes is there more delight | And some perfumes give more delight| Than in the breath that from my mistress reeks. | Than the horrid breath of my mistress. | I love to hear her speak, yet well I know | I love to hear her speak, but I know| That music hath a far more pleasing sound;| That music has a more pleasing sound. I grant I never saw a goddess go;| Ive never seen a goddess walk;| My mistress, when she walks, treads on the ground:| But I know that my mistress walks only on the ground. | And yet, by heaven, I think my love as rare | And yet I think my love as rare| As any she belied with false compare. | As any woman who has been misrepresented by | The sonnet 18 is a Shakespeare’s early love poem which is about affection of a young man to his beloved. It starts with the genuine question, â€Å"shall I compare thee to a summer’s day? † The speaker is thinking about his lover’s beauty rather than putting her poem in a conventional love poem formula. Then, he points out her lover’s beauty was more beautiful and constant than a summer day; her beauty was eternal and would be preserved in the lines of this poem. However, Sonnet 130 is a more convincing love poem because it is more descriptive and realistic in depicting his lover which shows that his love is more sincere and everlasting. Sonnet 18 is about the feeling of perfection of his lover’s beauty while sonnet 130 is about the real appearances of her mistress. In sonnet 18 the speaker says, â€Å"Shall I compare thee to a summers day? Thou art more lovely and more temperate:† Although summer is pleasant season, the speaker never talks about how his lover is like a summer day nor how she was more lovely. He did not give life to his lover because we can use this poem to mostly every woman in the world; he does not specifically describe his lover. In sonnet 130, the speaker explicit states what his mistress looks like. The speaker says, â€Å"My mistress eyes are nothing like the sun;/Coral is far more red than her lips red;/If snow be white, why then her breasts are dun; /If hairs be wires, black wires grow on her head. It explicitly describes his lover in an honest way. Although love poems often use sun, snow and beautiful objects to praise the beauty of their subject, realistic love is not about an idealized sense of beauty. A person cannot love another one simply because they are physically beautiful. We think that the women with red lips, white skin and gold hair are beautiful, but does it mean the women that having â€Å"not so† red lips, brownish skin, and black hair are not beautiful? Beauty is subjective. When people love someone, they would define beauty by his/her st andard. By describing in detail of his lover’s appearance, the speaker of sonnet 130 really know his lover. Love is not only about the feeling of a warm sunny summer day, but know a person as a distinguish individual. Sonnet 130 make his lover feel special and superior because the speaker pay quite attention to her actual appearance, and honestly writes it down in a poem. It also gives her the sense of security because she knows he loves her for who she is and she does not need to pretend to be a perfect figure nor be an everlasting summer day. Sonnet 130 ses reality to prove the speakers love while sonnet 18 uses exaggeration. Sonnet 18 illustrates only the speaker’s love for his beloved’s beauty while in sonnet 130 illustrates more sincere love for her mistress even though she is not perfect. In sonnet 18, the speaker claim his lover was eternal by saying, â€Å"By chance or natures changing course untrimmd;/But thy eternal summer shall not fade /Nor lose possession o f that fair thou owest;/ Nor shall Death brag thou wanderst in his shade,† The speaker praise that her beauty stronger than the nature. Although the speaker values her beauty greatly and even believed her is beauty has the power to overturn the nature, it is only his wish and imagination that her beauty would not change. It will not be convincing to a woman since they consciously know that appearance will change. His lover will feel that the speaker only focuses on her beauty, but not anything else. In sonnet 130, the speaker states, â€Å"I love to hear her speak†. The speaker loves her thinking, her opinions and her intellects. The speaker values her thought which is not very common even in current society. Relationship is about equality and respect. Many men treat women as an object that has nothing inside. Even in sonnet 18, the speaker compares his lover as an eternal summer which also an object. Then, the speaker says, â€Å"I grant I never saw a goddess go;/My mistress, when she walks, treads on the ground:† . The speaker wants to compare his mistress with a goddess as many sonnets do, but he admits that he never saw one. It mocks that other poets are dishonest which compare their lover to a figure they never see. He emphasized the word â€Å"my mistress† which shows that he takes pride that this woman is his mistress as while as the ways his mistress is like. He shows that this poem is about her mistress but not anybody else, not even goddess can compare with his mistress. He cares only his mistress which makes her even superior to a goddess. He shows that although her mistress is not an immortal figure, but her mistress is special for him. Then, speaker of sonnet 130 transits his understanding of her mistress to his confession of love while in sonnet 18, the speaker transits his lover’s beauty to mortality. The speaker of sonnet 18 uses poetry to eternalize his lover while in sonnet 130, the speaker shows that his love for her is eternal. In the end of sonnet 18, the speaker says, â€Å"So long as men can breathe or eyes can see, /So long lives this and this gives life to thee†. The life of the subject will be an endless summer, but only because the speaker has immortalized her in this poem, and only if people continue to read these verses. It makes the readers feel that the poem itself is greater than the subject. The poem builds up this subject with eternal beauty and the subject only lives in the poem. However, this poem is for a living woman, and she is not living by her beauty or by the poem. Every woman knows this poem cannot real give immorality to them because the readers do not even know who the subject is. Not only the woman reading this poem cannot relate herself to this poem, buy she also will feel the speaker’s love is unrealistic and superficial and will not last long. In contract, in sonnet 130, the speaker claims that â€Å"And yet, by heaven, I think my love as rare†. His claim is convincing because in previous lines, he honestly depict his mistress and we expect he is honest when he says that he loves her. Furthermore, if his love for her is not because she is idealized beautiful since she is not, then he must love her because of her which we define as true love. His love would not fate with changing of appearance or time. His mistress would feel that she has the speaker’s heart forever. Sonnet 130 well proved the speaker’s love for her mistress; his love is about understanding and respect; his love is strong and everlasting. In contrast, sonnet 18 is more about the speaker’s passion to his lover’s beauty than his love for her as a whole individual. Many people say romantic love would last long. It is because that when people know each other well, their flaws would appear, and they are intolerance to these flaws. They would try everything to change each other to the way they want, but they most likely fail. Everyone is difference and not perfect, so when people love someone, they should acceptance their flaws.

Symbolism in Hills Like White Elephants Essay Example for Free

Symbolism in Hills Like White Elephants Essay Difficulty and dealing with difficulty are part of the balance that makes up the human experience. Forced to deal on one side with the selfishness of other people and on the other side by a terrible fear of what they do not know, there are two characters in Ernest Hemmingway’s 1927 story, Hills Like White Elephants. Here, the story shows us a man and woman who are overcome by the personal things they are dealing with. In order to deal with them, though, these characters are behaving in a very detached way that seems somewhat defensive against these things. In the female character, named Jig, Hemmingway shows a woman who is ripe for experiences with symbolic meaning. Implied throughout the story is the unspoken idea of a pregnancy. The man aggressively tries to manipulate Jig into having an abortion without ever saying it out loud. This is the issue that beings to become more clear to the reader as the couple talks. They speak with anger and bitterness, and the reader can feel that there is a sense of something bad coming in the future. This is the feeling which is shown through Jig, who makes a statement with importance at the start of the story. She looks at the two white hills showing in the distance with a barren brown piece of land in front of the them. She says that â€Å"they look like white elephants. † (1) The angry conversation that comes afterwards between the two characters shows how they both respond differently to the simile. The woman seems to view the hills with some kind of wonder and even with the consideration that they are of a fantastic nature. This is especially true by the way they were so different looking from the brown earth around them. For the man, the hills and the simile that his partner states make the man a little hostile. He is defensive in a way that says he is afraid or resentful. To him, the objects in the distances look like a challenge. This shows how he views the unknown. Another symbolic way to look at the hills is to see them as symbolic of motherhood or of pregnancy. This pair of hills can be seen as the swollen breasts of a pregnant woman. And with the brown land in front of them, they look fertile in a place that mostly cannot support life. This is a metaphor for the life of the woman in the company of this selfish man. The dry and unforgiving way that the man talks to Jig helps to show why her life has this negative quality. In a very difficult discussion where the couple speaks with sarcasm and dislike, the are detached and argumentative. This shows the unhappiness of the human condition and how they try to hide from themselves and each other. The conversation they have seems like it’s supposed to help them be distracted from their pain the consequences of their lives. Specifically, when the woman says that â€Å"Thats all we do, isnt it look at things and try new drinks,† she shows how directionless she feels her life has become. (1) Even in the middle of a horrible decision like that of having an abortion, the woman tries to dismiss the importance of her own existence. The symbolic relationship between the hills, the matter of the woman’s pregnancy and the overall unhappiness felt over it make a short story that doesn’t state much deeply meaningful anyway. If on the surface the characters battle with each other in a way to hide from their own feelings, they still share the fear of the unknown that is now in their careless lives. Shadowing all of this exchange is the image of the hills and the negative promise which they seem to promise is waiting on the horizon for the tired and unhappy couple.

confounding factor or lurking variable

confounding factor or lurking variable Confounding variable, also known as confounding factor or lurking variable can be defined as an undesirable variable that has an influence on the relationship between the variables of an experiment. Although they are not the variable of actual interest (i.e. the independent variable), they can influence the outcome of an experiment and they are considered to be undesirable as they could add error to an experiment. A proper designed experiment should aim to decrease or control the influence of such confounding variables in order to avoid type 1 error; an error that raises a false positive conclusion that the independent variables have a casual relationship with the dependent variable. The relationship between the two observed variables is called a spurious relationship, hence a confounding variable is a threat to the validity of inferences made about cause and effect, i.e. the internal validity because the observed effect should be attributed to the independent variable rather than to the confounding variable. An example can be illustrated by the relationship between ice cream sales and drowning deaths. When these variables are entered into a statistical analysis, they may show a positive and potentially statistically significant correlation. However, it is a mistake to infer a causal relationship (i.e., ice cream causes drowning) because an important confounding variable which causes both ice cream sales and an increase in drowning deaths has not been accounted for: i.e. summertime. Although there is a body of literature of criteria for causality, Pearl claimed that confounding variables cannot be defined in terms of statistical notions alone; some causal assumptions are sometimes necessary. For example, when causal assumptions are being defined in the form of causal graphs, a simple criterion called backdoor will identify sets of confounding variables. Types of confounding variables Confounding variables may also be categorized according to their source: the choice of measurement instrument, situational characteristics, or inter-individual differences. Solution There are several ways to combat confounding variables in an experimental design by excluding or controlling it. Here is the following: Case control studies: by assigning the same confounding variables to both the experimental and control group can control for such confounder, for example, if the cause of multiple infarct dementia is being studied, age and sex could be the confounding variables, therefore these factors should be matched paired between the two participant groups. In addition, randomization is also another solution as having all confounding variables (whether known or unknown) will be equally distributed across all groups. Cohort studies: this is done by admitting a specific group of participants into the sampling population, for example a specific age range that may affect multiple infarct dementia, therefore only a certain group is chosen for the study design such as male aged 45-50 years old. This would limit the degree of matching between the groups and also cohorts can be comparable in regard to the possible confounding variable. Stratification: in the example of multiple infarct dementia study, physical activity is hypothesized to be a variable that can prevent this dementia from happening. With age as a possible confounder. The sampling data will then be stratified by age group so that the association between physical activity and dementia can be analyzed per age group. If different age group yields different risk ratios (this can be analyzed by statistical tools called Mantel-Haenszel methods), then age is seen as a confounding variable. Despite solutions for the controlling and limiting confounding variables, these strategies have limitations too. For example if a participant in the case-control study is a 47year old African-American from Alaska, avid tennis player, vegetarian, working as an engineer and suffer from multiple infarct dementia. Proper matching would require a person of the same characteristics but with the sole difference of being healthy. This is extremely difficult to achieve and there is a risk of over- or undermatching of the study population. Additionally, in a cohort study, too many people may be excluded with this criteria, and in stratification, single strata can get too narrow and contain only a small, non-significant number of samples. Randomization One of the most common reasons for the existence of confounding variable is when the experimental design does not randomly assign participants to groups or some types of individual difference such as ability, extroversion, height and weight. For example, studies involving a comparison between men and women are inherently plagued with confounding variables since the social environment for males and females is very different to start with. However, this does not mean that there is no value in gender comparison studies or other studies that does not employ random assignment but it implies that results interpretation should be done cautiously. In sum, random assignment is a useful and powerful tool in experimental design. Although it does not minimize the overall amount of extraneous variable in an experiment, it aims to equalize the error that may occur as a result of extraneous variable, therefore it can greatly decrease systematic error: error that varies within the independent variab le. Multivariate analyses Another method for controlling confounding variable is by the use of covariates in multivariate analyses. However, this only gives little information about the strength of the confounding variable compared to stratification methods. Furthermore, confounding variables are not always known or measurable which means residual confounding (term for incompletely controlled confounding) may appear. In an experimental design, covariate adjustment can help to reduce the noise in an outcome variation whilst enabling the manipulation effect to be performed. In sum, successful randomization can minimize confounding variables by bother measured and unmeasured factors, whereas statistical control addresses only confounding variables that have been measured and can introduce more confounding variables and other biases through inappropriate control. Mismeasurement and mis-specification Although it is important to spot confounding variables in a study there is often a risk of having a statistically controlled but imperfectly measured factor that may confound an association of the variables. This is termed residual confounding which describes the mismeasurement and an example is given to illustrate this. In a study example, it was found that people with higher rate of vacation is correlated with lower risk of mortality. Several explanations can account for this as vacation mitigates stress, diminishes anger and encourage more exercise. On the other hand, healthier people might be more likely to travel so vacation may not be a genuine causal factor but only a marker of initial health status that naturally predicts longevity. Consequently, vacation may remain to be a significant predictor even after adjusting for baseline health status as the covariate. It is therefore easy to construct a series of potential confounders but many would lack plausibility. For example, pe ople with more friends may have more vacations and friend was indeed the predictor variable instead, low-stress working environment and wide range of food (I.e. completeness of diet) may all attribute to prolong life too. However, because plausibility is a highly subjective factor for considering whether enough potential founders are included. To identify confounders Priori knowledge of the likely causal pathways are required. The major drawback of this is that observational studies imply that the strength of any causal inference will depend on the biologic plausibility of the putative factor, and the implausibility of uncontrolled potential confounders. In addition, observations contain some judgmental component which varies from experimenters. For example, vacation may prolong longevity because sick people tend to travel less, to deal with this. Measurements of participants initial health may be used as an adjustment but this however cannot be assessed without error. Moreover, hea lth can be measured in so many different ways and not all can be included and controlled for. This raises more and more questions such as: can the use of initial stress test be used to capture aspects of health confounded by vacation? Is body mass index relevant? Consequently, even if the optimal measure of confounder is used it is measured with error and adjustment for it may not eliminate the effects of vacations. From the statistical analysis perspective, poorly measured confounding variables causes more problems as its effect may not be linear, by assuming linearity on the outcome as specified by the model by entering confounding variables as a covariate in standard regression models may not fully adjust for the confounder effects are not linear on that scale. Mediators and confounders There is a common conflict that different causal explanations can be possible when adjustment is used to reduce or eliminate the predictive power of the independent variable. For example, a confounding variable may sometimes be a marker of some causal factors but it is not directly involved in the causal chain from one variable to another and there is a problem of over-adjustment. Considering an example on the hypothesis that high blood pressure (BP) reaction to stress causes Hypertension. To test this hypothesis, a longitudinal study should be conducted where BP reactivity and resting BP levels of a large group of participants should be measured. Result findings should report that excessive reactivity to be the risk factor for later hypertension but the problem is reactivity may just be a marker for elevated BP resting level and it is not important per se. consistent with this problem, those participants with higher resting BP may correlate with high BP reactivity scores. To control for the current confounding variable, the initial resting BP levels should be adjusted by regression analysis which llustrates whether BP reactivity is attributed to any predictive information beside just the initial resting BP level. This may show that reactivity is no longer a very predictive factor and most of the variation in the follow-up BP levels may be accounted for by the initial resting levels. However, this does not mean that reactivity is not causally related to future BP status, i.e. if increased reactivity preceded initial increase in resting BP level, it could also be responsible in part for the initial increase in resting BP level. This is a situation whereby a single variable may have both confounding and mediating roles simultaneously. The example of vacation and mortality is used to illustrate this: assuming that people who go on more vacations are less likely to die over a 5-year longitudinal study, including a factor: initial health status in the regression mod el could eliminate this association. Alternatively, if people in poor health take fewer vacations then this elimination may reflect the removal of a confounding variable by health status. However, if the participants tendencies to go on vacation are constant over the 5 year period then health status will reflect the cumulative health impact of a lifetimes vacation habits. This shows that health status will contribute partly as a mediator of vacationing effects. This confusion between a mediator and a confounder will be less apparent if the risk factor is not stable over time. For example if the participant has only just started having vacations, then these will not be reflected in the initial health status and may have higher opportunity to predict subsequent health with initial health status as a covariate in the analysis. However, if these changes become out of control, it can create a quasi-experimental design. For example, if people take vacations due to change in their company policy rather than the reason of making friends or have spare time, and other group have less vacation for the same reason. Then in this case, it is possible to assess the effect of vacation independently of initial health status. In sum, indiscriminate adjustment of covariates may result in erroneous conclusions and many socialdemographic variables can be mediated by other factors such as low income, unfulfilling jobs, no friends etc. moreover, there may also be other intermediate variables like self-determinations and release of stress hormones that may affect the results. Considering the wide range of variables listed, any inaccurate measures of them may lead to a reduction or elimination of predictive power. Moreover, by controlling a mediator may produce further confounding variables, which will then increase or decrease the associations of the independent and dependent measures. Furthermore, it may even create a new spurious association when in fact no effect is present. In sum, despite the number of limitations discussed in this critical review, they have an important role in behavioural research as randomized trials are sometimes found to be impractical and unethical. In spite of the hazardous statistical control of confounding variables will gain insight into special cautions in drawing conclusions and writing research in the future.