Thursday, October 31, 2019

College Admission Essay Example | Topics and Well Written Essays - 500 words - 4

College Admission - Essay Example I want to join Purdue University to get a formal education in computer engineering and later on get a job in the industry. In today’s competitive job marketplace people seeking work must have at least a Bachelor’s degree to have a legitimate shot at getting a job. The unemployment rate in the United States is currently above 9%. I want to take advantage of the amazing education Purdue University provides its alumni to help change the world through innovation similarly to the way the late Steve Jobs was able to leave his mark on society. I want to invent or bring something into this world that serves a great and noble purpose. My personal and professional goals can only be attained if I am able to complete a Bachelor’s degree in computer engineering. My first goal upon graduation is to land my first job as IT professional. Educational credentials from University of Purdue will enable me to be considered for a job position with better chances than people that graduate from other universities or community colleges due to the reputation of Purdue University as one of the most prestigious higher educational establishments in the world. A second goal of mine, once I reach the job marketplace, is to save money for a few years in order to accumulate sufficient initial capital to start my own computer business. In future I want to become a successful entrepreneur. Once I join Purdue University I plan on taking advantage of every opportunity I get to expand my networking capabilities. There are thousands of students at Purdue that have similar aspirations. It is possible that my long term goal of starting a computer business can be accelerated if I am able to find suitable business partners for the venture. Having a team that has plenty of human capital can give my computer business a competitive advantage. Besides, Im sure Ill become a valuable addition to students community too in many

Tuesday, October 29, 2019

Hospitality Operations Management Essay Example | Topics and Well Written Essays - 3000 words - 1

Hospitality Operations Management - Essay Example This enhances timeliness and relevance in learning topics. The main purpose for this organization is to roll out a program that aims at boosting the overall performance of students in colleges and to help them nurture their talents. As a mission plan, this is highly valued and the executives work hand in hand to achieve it. They provide an opportunity to all students to interact with the virtual arts for the first time and improve their academic performance. The main goal of Hilton is to transform the image of arts and culture among its members and the entire world. They also seek to transform the educational sector for all students to have an experience of new technologies and how they influence studies. The target market for the products will be the college students. To reach out to them, the organization will be relying on the social networks which are commonly used by students. One the social media will provide signup option for the students that they will use to register with them organization. Such accounts will provide a platform for students to pin ads at a commission; this posses a large number of students to register with the organization for such ideas. The other way to reach out to their target customers is through creation of flyers and leaflets to persuade more people to join the organizations production tastes. For this kind of organization, their target markets are the students in various institutions and colleges. Their demands are always incorporated in the strategic developments. It is perceived that most of the college students are accessible to online sources of information and can easily read them. This organization, therefore, uses this opportunity to nurture their marketing opportunity to ensure that they realize large sales volume on their products. This also assists in identifying various market segments for such products and coming up with a good marketing and promotional

Sunday, October 27, 2019

Analysis of Quality Improvement Initiative

Analysis of Quality Improvement Initiative With reference to the practice development literature, critically discuss the principles informing a quality improvement initiative in your area of practice as a Community Registered General Nurse Introduction The purpose of this assignment is to critically analyse a quality improvement initiative, namely the updating of care plans and other documentation within the student’s area of practice, which is Community Nursing. The chosen initiative has occurred within the framework of practice development. The concept of practice development originates from the 1980s when Nursing Development Units (NDUs) were established with the aim of advancing the profession of nursing in order to benefit both patient care and the profession (Bassett and McSherry 2002). Practice development is becoming a part of every Trust’s strategy, being seen as an essential requirement for modernising health care. A key component of practice development is the integration of research- based evidence into practice. Another key element of practice development is Total Quality Management (TQM), a process that involves quality assessment, quality improvement and quality assurance (Blackie and Appleby 1998).Clinical governance is a system whereby health care providers are accountable for the provision of quality services (McSherry et al 2002). Magnet hospitals provide an example of centres of excellence that actively demonstrate high standards of care (UK healthcare 2007). Practice development also involves increased interprofessional working and the empowerment of patients and clients, thus embracing the concept of consumerism (Chin 2003). Consumerism within healthcare refers to its recipients having more informed expectations about healthcare provision and being able to articulate these (Gough P 2002). In Ireland the Commission on Nursing (1998) recognised that increasingly, people are being cared for in the community as opposed to other settings and accordingly made recommendations for the development of public health nursing with more emphasis to be placed on health promotion and prevention, thus paving the way for practice development within community nursing. Inevitably practice development involves change. Within healthcare there have been several areas of reform, which have been influenced by social, economic and political factors (Brooks and Brown 2002). As a result health care services need to be responsive to the need for change. Theoretical overview This section will further examine the relationships between practice development, quality issues and change theory, with particular emphasis on the implementation of change. Practice development is a continuous process of improvement that works towards the transformation of care. It is a process that requires management, in order to advance its progress, which needs to be done in a systematic and rigorous way (Titchen and Higgs 2001a). In some areas facilitators have been appointed with the specific remit of advancing practice development; elsewhere practice development units have been established (Bournemouth University 2007a). Practice development is said to dovetail with clinical governance standards (Bournemouth University 2007b) and is linked to quality issues in the following ways: by empowering healthcare professionals, patients/ clients and carers; by promoting a client- centred approach towards delivery of care; by promoting interprofessional communication and collaboration; by working towards clinical governance; by facilitating the selection, recruitment and retention of quality staff; by influencing organisation strategy in line with National Policy and by drawing upon the knowledge and skill of identified experts. An essential element for the delivery of quality care is evidence- based practice (Parsley and Corrigan 1999). As highlighted within the introduction, an important element of practice development is ensuring that practice is informed by research. Strategies for introducing research into nursing practice include the creation of nurse researcher posts; encouraging nurses to access continuing development opportunities that will enhance their research skills, promoting research- mindedness as well as research activity; making research findings accessible to practitioners; forging stronger links between educational institutions and clinical practice areas and setting- up journal clubs. Because of the developing nature of the discipline, community nurses are often involved in research activity whether as participants or researchers (Lawton et al 2000). However there is evidence to indicate that not all nurses are actively basing their practice on research findings; some are neither researc h active nor research- minded, so there is developmental work needed in this area (Banning 2005). As previously identified within the introduction, it is inevitable that practice development involves the need for change.(Titchen and Higgs 2001b). The change strategies framework by Bennis (1976) provides a useful model for understanding and challenging the different assumptions we have about what effectively brings about change. The framework includes three strategies for bringing about change which are based on different assumptions about human behaviour, and which involve three distinctly different approaches. The first strategy (rational- empirical), is based on the supposition that ‘knowledge is power’. Within this strategy it is assumed that an individual will change in response to receiving reliable and valid information. For example, if a manager in a healthcare setting wishes to initiate change, this strategy would involve giving information to the healthcare practitioners involved, that includes valid reasons for making changes to their practice. The reality is that people are often resistant to change and may adopt certain strategies in an attempt to avoid change. For example, they might adopt Freudian mental defence mechanisms, which are (in this case) maladaptive coping strategies used to circumvent evidence that change is necessary. These include denial, intellectualisation (which i nvolves citing contradictory evidence), or rationalisation, among others (Lupton 1995). Resorting to these defences can undermine the power of knowledge and evidence, however valid and reliable it is. The second strategy (power- coercive) involves the use of legislation and policy change in order to enforce health- related change. Within this strategy, a manager would use power, authority and/ or disciplinary procedures to bring about changes in practice. Inevitably there are some legislative and policy changes that inform practice, so there will be times when this strategy is used. The first two strategies adopt a ‘top- down’ approach whereas the third strategy (normative- re-educative) is based on the assumption that an individual is more likely to change if they have had involvement in bringing about the change; if they feel empowered. According to Wheeler and Grice (2000), this last approach is critical if the enthusiasm and cooperation of those affected by the change process is to be gained. This is the approach that the student aimed to use when putting her chosen change initiative into practice, which is analysed within the next section. Practice Development initiative The chosen initiative was to update care plans and other documentation. As nurses we are accountable through our documentation; there could be legal consequences to what we write (Richmond and Whiteley 1999). Care plans and other nursing documentation are essential communication tools. The language used therefore, should be clear and unambiguous, and avoid the use of abbreviations. A well- written care plan should provide all the information that a nurse needs to provide comprehensive care to a patient. A care plan should not just be a ‘paper exercise’ but an integral part of nursing activity. The need for this change initiative was identified by staff, patients and management. This was a promising start as the drivers for the change came from everybody who would be affected by it. As the last section proposed, change is more likely to be taken on board if all involved have been included within the decision- making process. It was found that the existing care plans were insufficient for use with a client- group who have increasingly complex needs. Care plans are based on nursing models, which are derived from nursing theory. Nursing theory is a knowledge base that has been developed specifically for nursing. Practice development and research contributes towards the continued development of nursing theory. A nursing model is a conceptual framework; a blueprint for nursing practice. The appropriateness of nursing documentation contributes towards closing the theory- practice gap. We should therefore review our nursing documentation at regular intervals and strive for excellence in relation to these tools. The model of choice for the revised care plans was Orem’s Self- Care Model which is based on the belief that the individual has a need for self- care actions, and that nursing can assist in meeting that need. This model is widely used in all areas of nursing. Orem suggests that a person needs nursing care when the person has a health- related self- care deficit. She has defined three nursing/ care systems based on the premise that the nursing/ care system depends on the self- care needs and abilities of the clients: wholly compensatory the nurse gives total care to meet all needs; partly compensatoryboth the nurse and the client perform care measures; supportive- educative the client can carry out self- care activities but requires assistance (Taylor et al 1997). The emphasis on self- care within this model was the rationale for choosing this model for use within a community setting where frequently the nurse works in partnership with the patient and their informal carers and facilitates the reduction of their dependence on her, as the ability of the patient to be self- caring increases. With most if not all, change processes there are factors that can be harnessed to drive change, and there are factors which impede or restrain, change. A model which can be used to identify driving and restraining factors is forcefield analysis (Martin and Whiteley 2003). This enables us to identify and work with, both the negative and positive forces. In relation to the change initiative i.e. updating care plans and other documentation, the driving forces were identified as: the commitment of most staff; strong leadership and a generally agreed need for an increased customer focus. The restraining forces were identified as: resistance from a small number of staff; lack of time to devote to the project and the need for education and training in the effective and consistent use of care plans. It was essential that the tools to be developed met with recognised quality standards and guidelines; therefore the developmental work was informed by the Irish Health Services Accreditation Board (2007). The Board is concerned with quality and safety issues across the health care system in Ireland. The values which underpin its work; patient- centredness; integrity and accountability; excellence, innovation and partnership provided us with an excellent framework upon which to base the development of the new care plans. The change initiative could also be described as a benchmarking project (Pickering and Thompson 2003). Benchmarking involves: the sharing of best practice; user involvement; a user- focused approach; the use of an evidence- based approach and the use of stepping stones to work towards the benchmark (NHS Modernisation Agency 2001). As far as possible the initiative was designed to meet these criteria. Drawing upon the principles of the forcefield analysis outcomes, the guidance provided by the Irish Health Services Accreditation Board and the benchmarking criteria, the project was designed as follows: A working group was set up to represent the views and input of all who would be affected by the change which included user representation. It was hoped that if those affected by the change were involved in the development of the initiative from the start, then they would be more committed towards it. Staff who showed an initial resistance tended to become more enthusiastic about the project once they became involved in the initiative. Time issues were addressed by delegating aspects of the work to different people, which was coordinated by a project manager. By breaking the task down into manageable parts, these became the ‘stepping stones’ of this benchmark project and helped to promote involvement from different people. Assistance from the Education Institution with which we are associated was mobilised in order to provide the essential theoretical input and to provide some education and training regarding the principles of care planning, which addressed one of the identified restraining forces. Care plans from other areas were also scrutinised (with permission) in the spirit of sharing best practice (derived from the benchmarking criteria), in order to gain new ideas that might help to inform our work. Once the new documentation had been developed, it was piloted to test its effectiveness. A patient survey (Graves 2002) was conducted to gather their views about the newly- developed documentation. The final version of the new care plan and other documentation was produced and introduced to all staff with some training sessions to support this new initiative. The use of the new documentation will be monitored and its effectiveness will be regularly evaluated. Conclusion and Recommendations Practice development is about continually improving our practice, which should be evidence- based. We should increasingly work in partnership with patients/ clients and their informal carers. Practice development has implications for change. With any change there are both driving and restraining forces, and those affected by change may be resistant towards it. Change therefore, needs to be managed. We can draw on change theory to inform the management of change. A learning outcome from the change initiative described above is that people are more likely to be responsive to change if they are involved in all stage of the change process. Other important aspects of the change process were the sharing of knowledge, the integration of theory and practice with input from academics and working in partnership with those ultimately affected by the change initiative i.e. the patients/ clients and their informal carers. References Banning M. Conceptions of evidence, evidence-based medicine, evidence-based practice and their use in nursing: independent nurse prescribers views. Journal of Clinical Nursing. 14(4) 2005. 411-417 Bassett and McSherry Practice Development in the Clinical Setting: A Guide to ImplementationNelson Thornes 2002. p. 11-12. Blackie C and Appleby F. Community Health Care Nursing. Elsevier Health Sciences. 1998 p. Bournemouth University. Institute of health and Community Studies. Practice Development Unit: What is a PDU? http://www.bournemouth.ac.uk/ihcs/pduwhat.html. Accessed: 20th January 2007. Brooks, I. Brown, R. The role of ritualistic ceremonial in removing barriers between subcultures in the National Health Service. Journal of Advanced Nursing, 38 (4) 2002 341 – 352. Chin H. Practice Development: A Framework Toward Modernizing Health Care in the United States and the United Kingdom and a Means Toward Building International Communities of Learning and Practice. Home Health Care Management Practice, 2003 15 (5), 423-428 Commission on Nursing. Report of the Commoission on Nursing: A blueprint fro the future. Stationery Office. 1998. p. 8. Gough P. Churchill Livingstones Guide to Professional Healthcare. Elsevier Health Sciences. 2002. p. 36. Graves P. Quantifying Quality in Primary Care. Radcliffe Publishing. 2002. p. 246 Irish Health Services Accreditation Board. Mission, Vision and Values. http://www.ihsab.ie/mission_statement.html Accessed: 20th January 2007. Lawton S Cantrell J and Harris J. District Nursing.: Providing Care in a Supportive Context. Elsevire Health Sciences. 2000. p. 109. Lupton D. The Imperative of Health: public health and the regulated body. Sage Publications. 1995. p. 111. Martin and Whiteley. Leading Change in Health and Social Care. Routledge. 2003. pp. 160-162 NHS Modernisation Agency. Essence of Care: patient- focused benchmarks for clinical governance. 2001. Department of Health. Parsley K and Corrigan P. Quality Improvement in Health Care: putting evidence into practice Nelson Thornes. 1999. p. 2. Pickering S and Thompson J. Clinical Governance and Best Value: Meeting the Modernisation Agenda. Elsevier Health Sciences. 2003. p. 164. Richmond J and Whiteley R Nursing Documentation: writing what we do. Ausmed publications. 1999. pp. 2,3. Taylor C. Lillis C and LeMone P Fundamentals of Nursing: The Art and Science of Nursing Care Stanley Thornes and Lippincott 1997 Titchen A and Higgs J. Professional Practice in Health, Education and the Creative Arts. Blackwell publishing. 2001. pp. 186-7 UK Healthcare. Magnet Status Fact sheet. http://ukhealthcare.uky.edu/publications/healthfocus/fact_sheets/magnetfst.htm . Accessed: 20th January 2007. Wheeler N and Grice D. Management in Health Care. Nelson Thornes. 2000. p. 136.

Friday, October 25, 2019

is there too much reality tv? :: essays research papers

Is there too much reality TV? On the other hand shows like big brother only occur for a certain part of the year, however when big brother is on it is on for a long time therefore it consumes a lot of TV airtime. Even so a lot of the British public enjoy big brother and text in there votes every week. It might also be argued that people only watch reality TV because there is nothing else on TV at these times. On big brother alcohol is the most comely drunk beverage no one drinks water when there’s a bottle of wine to be had this influence young adults with access to alcohol Each year, students spend  £3 billion on alcohol that’s a lot more than they spend on soft-drinks, tea, milk, juice, and coffee. How ever alcohol in reality TV shows some young adults that if they get drunk bad things can happen and people can’t control them selves therefore it may put off some young adults from excessive drinking although youths may want to be like the new celebrities on the TV by drinking and copying there behaviour. Violence is a big issue and not only in reality TV many children see a large quantity of people being murdered on TV, on the contrary murders only occur on reality TV which is fiction e.g. Recreations of past times like the wars. It might also be argued that violence on reality TV is only shown after the watershed which means that parents are responsible for their kids if their children watch these violent shows. Therefore most parents complaining about violence on reality TV are the causes of children watching the violence and possibly copying what they see, and shouldn’t let their children watch the shows after nine o’clock. Television is making England fat. Harvard University researchers discovered that the odds of a child becoming obese have risen from 12 to 20% for each daily hour of television he/she watches. On the other hand reality TV is only a small cause of this on the other hand the snacks people consume while watching reality TV are overwhelmingly high in fat, cholesterol, salt, and sugar, and low in vitamins and minerals. The U.S. Surgeon General has revealed "that 70% of food advertisements are for foods high in fat, cholesterol, sugar, and salt, while only 3% are for fruits and vegetables.

Thursday, October 24, 2019

The Haight Ashbury Free Clinic: Internal Control Case Study

According to published reports, what happened at Height Suburb Free Clinic Is typical of the types of employee fraud that happens day In and day out at many organizations. It was nothing overly sophisticated and demonstrated how Insiders who know the peculiarities of differing requirements use their knowledge for their own enrichment. A former SCOFF of the clan took advantage his knowledge that requires nonprofits receiving federal grants to return any unspent money. This money Is supposed to go directly to a federal office.However at the free clinic, authorities claim the SCOFF created an account at a Sacramento bank under a name salary to the federal office. For over two years he had clan workers return these checks. Which he deposited into this account that he actually owned. He allegedly set up several accounts with names similar to legitimate vendors. The SCOFF had payments intended for these legitimate vendors be sent to his dummy corporations and later cashed the same checks. These schemes began in June 2001 and went on for over two years.After the irregularities were uncovered and investigated, the SCOFF was fired ND the case was turned over to prosecutors, who miraculously prosecuted and got a conviction. We say miraculously because white-collar crime is rarely prosecuted. Even more amazing is the fact that he was convicted. He was sentenced on April 30, 2008 to serve four years in prison, make restitution and pay back taxes and fines. Returning checks to anyone besides the intended payee is a break in best-practice procedures. What happened here demonstrates clearly why returning checks to anyone but the payee is such a bad practice.Clearly the process for setting up new endorsed was lax at the clinic. Possible Solutions 1 . Use appropriate segregation of duties including master vendor file responsibilities. 2. Limit access to the master vendor file and require dual approvals before a new vendor is added to the master vendor file. 3. Do some sort of v erification of new vendors, checking TIN and phone numbers to ensure you are not dealing with a phony vendor. Get W-as from every new vendor before making the first payment. Run W-as against the IRS TIN (Taxpayer Identification Number) Matching Program before making the first payment.Check to e If duplicate vendors have the same TIN. Conclusion While very few organizations will employ all the practices described above, the more a corporation Incorporates Into their policy and procedures, the more difficult It Is for a fraudster (either an employee, former employee or someone else) to steal from the company. The Height Suburb Free Clinic: Internal Control Case Study By Saying-Chou Saying Chou According to published reports, what happened at Height Suburb Free Clinic is typical of the types of employee fraud that happens day in and day out at many organizations.It was nothing overly sophisticated and demonstrated how insiders own enrichment. A former SCOFF of the clinic took advantage his knowledge that money is supposed to go directly to a federal office. However at the free clinic, similar to the federal office. For over two years he had clinic workers return these checks, which he deposited into this account that he actually owned. He allegedly set 1 . Use appropriate segregation of duties including master vendor file responsibilities. See if duplicate vendors have the same TIN. A corporation incorporates into their policy and procedures, the more difficult it is for

Wednesday, October 23, 2019

Mukherjee vs Rodriguez

Mukherjee vs. Rodriguez As of today, The United States accepts more legal immigrants as permanent residents than any other country in the world. The number of immigrants totaled 37. 5 million as of 2006. All of this has to do with Richard Rodriguez and Bharati Mukherjee’s stories based on immigration in the United States. Entitled â€Å"Los Otros, Mis Hermanos† and †Two Ways to Belong in America†. Where as Rodriguez’s story is about a young Mexican immigrant finding it hard to live in a society where he struggles to understand it’s main language. He believes as a child that he doesn’t belong in a country where it’s main language is not of his. He only feels at peace when he is with his family speaking his own language. As well as where Mukherjee’s story is of two sisters named Mira and Bharati, both immigrants and very successful in their careers. Explaining how Mira all of a sudden has rage towards the country she has lived in for thirty years, due to the lack of effort shown by the U. S. Congress to enact a legislation that would not allow any government benefits towards resident aliens. As for Bharati, she has mixed feelings on the subject at hand. Rodriguez and Mukherjee’s stories share a common theme and purpose, but are diverse in their conflict and focus. Los Otros, Mis Hermanos† and â€Å"Two Ways to Belong in America† share a common theme in where they both are legal immigrants living in America. Rodriguez’s story is based on his childhood where he is living as a Mexican immigrant. Since Spanish is the only language he is able to interpret, he reference â€Å"The language of thei r Mexican past sounded in counterpoint to the English of public society† (Rodriguez pg. 309). For â€Å"Two Ways to Belong in America† the two sisters are living in the United States while Bharati is an American citizen, Mira is not. However both have Indian roots within them. For both of them their cultural backgrounds are very strong within them. As of course, them being an immigrant in a new country that they are not familiar with, they both have very strong bounds with their cultural heritage. Where as for example in Mukherjee’s story she shows how traditional her family is with their Indian marriages by saying how they are properly done in her home country. Mukherjee states †We would endure out two years in America, secure our degrees, then return to India to marry the grooms of our father’s choosing† (Mukherjee pg. 316). However, they both did not follow those guidelines by marrying grooms of their own choosing. In Rodriguez’s story he shows how speaking Spanish made him feel at home, by whenever he spoke to his family members or friends in Spanish he felt as if he was recognized as someone special. While there are similar qualities between the two stories there are contrarieties too. One being their formalities of education, reading where Mukherjee’s story was coming, from the sisters were well educated and successful in their careers. They both received degrees in their prestige subjects. As for Rodriguez’s story when he was younger it seemed as if it was very difficult for his upbringing into education. For example, his parents learning of the English language, as he states â€Å"In public, my father and mother spoke a hesitant, accented, not always grammatical English† (Rodriguez pg. 309). It seemed as if the schooling where he was coming from was not as much of a impact as compared to mukherjee’s learning’s. In â€Å"Los Otros, Mis Hermanos† as a young boy Rodriguez was very secluded from the rest of civilization by reason of his inability of learning the English language. In â€Å"Two Ways to Belong in America† the sisters were very much in content with the rest of the world. They would travel all throughout the world willing to try anything new. Where as Rodriguez, he was concealed from his very own neighborhood, he didn’t know the names of his neighbors, as he states, â€Å"But no one in the family knew the names of the old couple who lived next door; until I was seven years old, I did not know the names of the kids who lived across the street† (Rodriguez pg. 309). The stories by Rodriguez and Mukherjee’s stories had a similar case and dedication, however were disparate in their upbringings and socialization. Being in a country where your not accustomed to is difficult enough, living their must be an even bigger challenge. In Rodriguez’s case he couldn’t speak Spanish outside of his home so he felt at lost. In Mukherjee’s situation even after living for 30 years in this country they were still at subject to be dismissed from it. This shows you being the outsider in a world isn’t as easy to sustain, even when they had thought they had finally made it.

Tuesday, October 22, 2019

HIV AND AIDS essays

HIV AND AIDS essays Good afternoon everyone. Today I would like to inform you all about HIV, human immunodeficiency virus, and AIDS, aquired immune deficiency syndrome. Statistics show that about 35% of AIDS cases have been in the age group of 20-29. Now many of you may already know that AIDS has a long period between infection with the virus and the appearance of symptoms. Meaning that some of those people between the ages 20 and 29 probably contracted the virus when they were teenagers. Being that most of us in this room fall near or in that age range, my goal today is to inform you of how the virus is contracted, symptoms of this disease, and most importantly, the best way to go about taking more precaution into preventing this fatal disease. AIDS is preceded by HIV infection. HIV can only be transmitted three different ways (refer to visual aid). (1) The first is through sexual contact. This is the most common way HIV is contracted. It can be passed when an infected person has vaginal or anal intercourse with another. (2) The second way this deadly virus is transmitted is through the exchange of blood. This method of transmission is now almost entirely limited to people who inject drugs and share needles. This type of contact between an infected person and someone else is the second most common way this virus is passed. HIV can also be contracted through blood transfusions. Now blood transfusions are far safer now than they were in the early years of the AIDS problem. (3) The third way is from mother to child. Sadly, most children with HIV contracted it from their infected mothers during pregnancy or childbirth. If the woman is infected, her child has a 50/50 chance of being born with the virus. Once, or if, this virus is contracted through these ways, the symptoms of the HIV infection may not appear for a long time after the person gets ...

Monday, October 21, 2019

Free Essays on Socio-biographical Sketch Of A Fam Member

Socio-biographical sketch of Alice Culture changes across time and place, thus redefining its values, norms, laws, and dress, among other things, and giving new meaning to society. One’s life chances and choices, however, are shaped not just by the cultural practices of but by his/her position within the society in which he/she lives. For this paper, I analyzed the influence of my grandmother’s class, race, gender, and institutions made available to her in creating her location within society, and therefore her life decisions. The religious institution introduced to my grandmother, Alice, since her birth in 1927 had a tremendous influence on her. She attended a Baptist Church with her mother that had been started by missionaries from Sweden. It was attended mainly by immigrants and first generation Americans of Swedish descent, my grandmother being a first generation Swedish-American. This social fact of her life, as well as the others I will point, reflect C. Wright Mills’ perspective of the â€Å"sociological imagination†, which he defined as the ability to see the societal patterns that influence an individual as well as a group of individuals. To do so, he said, one must have knowledge of the social and historical context in which people lived (Andersen and Taylor, 5). Alice attended this church because her mother believed the teachings of it and wanted her child to be introduced to them as well. Her mother attended this particular church because she had immigrated to Sweden to the U.S. and wanted to worship amongst those who shared this with her. Thus, my grandmother’s ethnicity and religion were large influences on her moral values which she still carries with her. These values, Alice explained, were typical of the Swedish and also were expected of her church’s followers. As I have noticed in my Grandma, as well as her pointing this out in the interview, honesty to and respect for everyone were things that were and ... Free Essays on Socio-biographical Sketch Of A Fam Member Free Essays on Socio-biographical Sketch Of A Fam Member Socio-biographical sketch of Alice Culture changes across time and place, thus redefining its values, norms, laws, and dress, among other things, and giving new meaning to society. One’s life chances and choices, however, are shaped not just by the cultural practices of but by his/her position within the society in which he/she lives. For this paper, I analyzed the influence of my grandmother’s class, race, gender, and institutions made available to her in creating her location within society, and therefore her life decisions. The religious institution introduced to my grandmother, Alice, since her birth in 1927 had a tremendous influence on her. She attended a Baptist Church with her mother that had been started by missionaries from Sweden. It was attended mainly by immigrants and first generation Americans of Swedish descent, my grandmother being a first generation Swedish-American. This social fact of her life, as well as the others I will point, reflect C. Wright Mills’ perspective of the â€Å"sociological imagination†, which he defined as the ability to see the societal patterns that influence an individual as well as a group of individuals. To do so, he said, one must have knowledge of the social and historical context in which people lived (Andersen and Taylor, 5). Alice attended this church because her mother believed the teachings of it and wanted her child to be introduced to them as well. Her mother attended this particular church because she had immigrated to Sweden to the U.S. and wanted to worship amongst those who shared this with her. Thus, my grandmother’s ethnicity and religion were large influences on her moral values which she still carries with her. These values, Alice explained, were typical of the Swedish and also were expected of her church’s followers. As I have noticed in my Grandma, as well as her pointing this out in the interview, honesty to and respect for everyone were things that were and ...

Sunday, October 20, 2019

A Case Study At The HSBC

A Case Study At The HSBC Chapter 1 Literature Review 1.1 Overview of Corporate Social Responsibility The notion that business has duties to society is firmly well-established, despite the fact that in the past there has been a revolution in the way people view the relationship between business and society. Numerous researchers suggest that companies which indulge in corporate social responsibility obtain consumers’ positive product and brand evaluations, brand choice, brand recommendations, good attitude to firm, good image of the firm, purchase intention and even enjoy a premium price. Spurred at least in part by such evidences, more companies than ever before are backing CSR initiatives such as corporate philanthropy, cause-related marketing, minority support programs, and socially responsible employment and manufacturing practices with real financial muscle. Not surprisingly, this trend is also reflected in the pervasive belief among business leaders that CSR is an economic imperative in todayâ₠¬â„¢s national as well as global marketplace. However despite the increasing importance of CSR, there is little research available about CSR’s impact on consumers. According to Yoon (2003), it is not clear when and how CSR activities influence consumer evaluations. Recent researchers have suggested that a CSR activity might backfire on the company if the consumers have become suspicious and infer that the company’s true motive for the CSR activity is only to improve its image to sell more products without trying to act for the sake of consumers 1.1.1 Defining Corporate Social Responsibility According to Kotler (1991), Corporate social responsibility is about doing business in a way that maintains or improves both the customer’s and society’s well being; Fombrun and Gordberg (2000)’s point of view is that, corporate social Responsibility is something that no sane chairman should be without. On the other hand, Petkus and Woodruff (1992) believe CSR i ncludes both avoiding harm and doing good. Corporate social responsibility is viewed as a company’s commitment to minimize or eliminate any harmful effects and maximizing its long run beneficial impact on society. Corporate social responsibility activities include numerous factors; namely meeting customer expectations, demonstrating commitment to environmental responsibility, improved environmental performance, staying ahead of the legislation, and increased employee motivation. Mohr, Webb, and Harris (2001, 47) define CSR as â€Å"a company’s commitment to minimizing or eliminating any harmful effects and maximizing its long-run beneficial impact on society.† Though, Angelidis and Ibrahim (1993) define corporate social responsibility as corporate social actions whose purpose is to satisfy social needs, Lerner and Fryxell (1988) suggest that CSR describes the extent to which organizational outcomes are consistent with societal values and expectations. While some view CSR as an obligation, others, namely: Enderle & Tavis (1998) define corporate social responsibility as â€Å"the policy and practice of a corporation’s social involvement over and beyond its legal obligations for the benefit of the society at large†. 1.1.2 Dimensions of Social Responsibility The dimension of social responsibility was propounded by Carroll (1979). It was proposed that organisations have to have 4 pillars that must be fulfilled to be good corporate citizens. They are: Economic Dimension. Economic responsibility is to be profitable for principals, by delivering a good quality product, at a fair price, is due to customers.

Friday, October 18, 2019

Warehousing Essay Example | Topics and Well Written Essays - 2500 words

Warehousing - Essay Example The need for operations managers to reduce manufacturing costs, optimize productivity and improve product quality in order to stay in the market has become imperative. Many organizations now recognize the importance of automation, optimization of scheduling and a proper inventory management system, and are incorporating total quality management and total quality in their operations. Every organization invests a considerable amount of capital on materials. In many cases, the cost of materials exceeds 50 percent of the total cost of goods produced ((ICMR), 2003). Such a large investment requires considerable planning and control so as to minimize wastage. Even before we talk about planning and control it is inevitable that the material is stored in a safe place and such place of storing materials is termed as a warehouse. Hence, Warehousing can be defined as the process of storing goods or merchandise safely (Answers.com, 2004). Inventory refers to a stock of goods, commodities, or other economic resources that are held by firms at a particular time for their future production requirements and for meeting future demands. Inventories can be direct or indirect. Direct inventories include goods that play an important role in manufacturing of a product and become a part of the finished product. Direct inventories include raw materials, work-in-progress goods, etc. Indirect inventories include goods that are necessary to run the production process but do not become part of the end product. For example, lubricants, grease, oils, stationery etc, are indirect inventories. 2. Brief History of Warehousing As defined above, a warehouse is a commercial building used for storage of goods. Warehouses are used by people like manufacturers, importers, exporters, people in the logistics industry etc. They are usually large plain buildings in industrial areas of cities and towns. They come equipped with loading docks to load and unload trucks; or sometimes are loaded directly from railways, airports, or seaports. They also often have cranes and forklifts for moving goods, which are usually placed on ISO standard pallets loaded into pallet racks (Answers.com, 2004). With advent of globalization and information technology, now-a-days, warehouses are being fully automated. In such automated warehouses, there are hardly any workers found working inside. The pallets and product are moved with a system of automated conveyors and automated storage and retrieval machines coordinated by programmable logic controllers and computers running logistics automation software (Answers.com, 2004). With the introduction of new and recent technologies like Just-in-time (JIT) and ABC classification systems,

Nursing Profession in Australia Essay Example | Topics and Well Written Essays - 1500 words

Nursing Profession in Australia - Essay Example In 1856, she pressed the need for better hygiene conditions in all military hospitals of U.K. On her insistence, Royal Commission on the Health of the Army was established. It was in 1860 when the Nightingale Training School was established on two basic principles; first, that nurses should get training in hospitals and second was that nurses should live in a home devoted to discipline and moral life. Through this school, Nightingale transformed nursing from its disreputable past to a respectable career for all. (Florence Nightingale)Nursing Profession in AustraliaIt was in 1902, that the Australian Army Nursing Service was formed and since then more than 6,700 nurses have served not only in two world wars but in the wars of Korean, Vietnam, and the Gulf wars. (South Australians†¦)Before World War II, the training and education of nurses in Australia was modelled on apprenticeship.   Students got selected on the basis of their moral and educational standards. Students were not charged for lodging, boarding or for vocational training. After completion of the training they were supposed to provide the services to the hospital. Students used to gain valuable experience under the supervision of the 'Ward Sister' in different areas. Ward Sisters were trained and qualified nurses and capable to train student nurses. The system was known as 'Nightingale System’ and got established so firmly that it remained unchanged for several decades. (National Review†¦)... (South Australians†¦) Before World War II, the training and education of nurses in Australia was modelled on apprenticeship. Students got selected on the basis of their moral and educational standards. Students were not charged for lodging, boarding or for vocational training. After completion of the training they were supposed to provide the services to the hospital. Students used to gain valuable experience under the supervision of the 'Ward Sister' in different areas. Ward Sisters were trained and qualified nurses and capable to train student nurses. The system was known as 'Nightingale System’ and got established so firmly that it remained unchanged for several decades. (National Review†¦) Another era of nursing is said to have started from 1943 that remained until 1984.That started with the pressure on old system of training. Recurring shortages of nurses was due to resignation of many practicing nurses and also due to high dropout ratio among nurses under train ing. The reasons were mainly status of nursing, their wages, and work conditions. In 1943, the Kelly committee suggested various measures to improve the status of nurses and the complete overhauling of the training of nurses. The committee further suggested to appoint sister tutors and sister instructors to all training schools at the postgraduate level and to establish a College of Nursing. (National Review†¦) Subsequently, almost 25 years later in 1967, the Institute of Hospital Matrons of New South Wales along with Australian Capital Territory came forward to appoint a Committee to look into the various aspects of nursing. The report emphasised to prepare for training on nursing

The International Marketing Mix Case Study Example | Topics and Well Written Essays - 3000 words - 4

The International Marketing Mix - Case Study Example In terms of product, PepsiCo utilizes a wide variety of different positioning strategies for each product brand. However, as each food and beverage product is being distributed to different multinational consumers and a high volume of competition exists in this market, PepsiCo must use its marketing focus to create a connection with consumers through various branding activities. For example, if the typical Aquafina (bottled water) drinker is the athletic and motivated consumer fitting the psychographic profile of social and recreational enthusiast, PepsiCo must position Aquafina as a brand which befits lifestyle and utilizes various marketing communications (as an integrated bundle of marketing messages) to appeal to this demographic. In some developing countries, Aquafina might be more of a staple drink in an environment where clean, city water systems are not common in foreign neighborhoods. This would provide PepsiCo with the opportunity to position Aquafina as a reliant brand suc h as emphasizing its quality or mineral content. For instance, PepsiCo, in an attempt to appeal to the international consumer with a dedication for environmental advocacy, created a partnered marketing strategy with Sam’s Club (a Wal-Mart company) entitled Return the Warmth to promote recycling and other environmental initiatives (Annual Report, 2007). This indicates how the company utilizes various social trends and a desire to make brands appeal to different demographic segments as a means to give PepsiCo brands competitive advantage and boost international profitability. Â   Â   Â   Â  The company also utilizes creative marketing practices, such as new logo design and product packaging visuals, to appeal to the diverse multinational consumer. With the recent decline in global demand for PepsiCo products, the company is attempting to reinvigorate the Pepsi brand by changing cans. In an attempt to appeal to the foreign, contemporary U.S. consumer, the Pepsi brand designed the cans to reflect various emotions which are used in countries where text messaging is popular (Birchall, 2008).

Thursday, October 17, 2019

Planning and monitoring work Assignment Example | Topics and Well Written Essays - 1250 words

Planning and monitoring work - Assignment Example This research will begin with the statement that different policies of the organization have a strong effect on planning and allocation different resources. Organization develops different strategic planning process in its policies. It develops policies according to its goals and objectives. The company makes plans according to those policies. These strategic plans help the company to guide and implement its policies successfully for meeting its mission and vision. Based on the strategies organization develop different plans for its betterment and employee growth. Organizational policies contribute a lot in forming various plans for improving management strategies. These plans help to implement trainings and programs within the company. The plan also influences the work process of the organization. Allocation of work depends a lot on company’s policies. According to the policies the company allocates resources to its different group of employees. It helps to make different spe cific teams within the company to maintain smooth work process. The HR policies of the company help to identify the appropriate employees which are required for doing different types of work. The organizational policies help to make different financial plans for implementing its various policies. The example of an objective that a team is working on to achieve is to increase the productivity of that particular team. For increasing the productivity the team will undergo specific trainings which will improve the strengths of its different team members.

Folkloreterm paper on capoeira Term Example | Topics and Well Written Essays - 2500 words

Folkloreterm on capoeira - Term Paper Example This style is known today as Capoeira and reflects much of the Brazilian culture. This paper explores the rituals of Capoeira, revisits the history of the martial art and the country it originated from, takes a look the cultural aspect of the art, and explains the relevance of Capoeira to the style that is practiced today in the United States. The Ritual One of the interesting parts of this style of training is that the students usually learn to sing and play an instrument as a part of their training and development in Capoeira. Songs are sang in Brazilian Portuguese, which is why students are encourage to learn at least a basic understanding of the language. According to Lucia Viti (2003), the songs are used to set the pace of the fight. Chanting and clapping are also used to create rhythm and add excitement to the class. Some fights are aggressive and exciting, while others are low and intertwined. Capoeira contains a wide range of musical instruments used to mediate the mood or fe el of the class and widen the skills of the practitioner, particularly the advanced students. Some of the instruments allowed and commonly used in Capoeira are the drums, agogos, tambourines, berimbaus, the ago-ago, known in the United States as a cowbell. ... The Breakdown of the Classes, Fights, and Events The class is often broken down into two sections. In the first section of the class, the students are working on their technique, warming up, and learning concepts about the game. In the second section, the students get together as a group and form a ring. Two students are chosen to step inside the ring and perform. These students engage in a non-violent fight where they display their skill to the group. The other members of the group, still forming a ring, chant and sing while the two in the middle fight. The participants can be male or female and sometimes they are pitted against each other. To begin, the opponents squat down low to the ground to shake hands with each other. The ginga, or the swing, is the most basic move in and more or less the fighter’s stance. This would be equivalent to the sparring stance in Taekwondo or another sparring sport. This is acceptable, since this is not a contact sport. During the fight, the e valuation examines the fight itself and how it feels rather than focusing on the fighters. The fighters are considered successful when they follow the feel or rhythm of the music and atmosphere. According to Delmont (2006), â€Å"Festivals include baptism and graduation ceremonies, when masters from other cities come in to judge, give demonstrations, and teach classes† (____) Acrobatics are an important element that sets Capoeira apart from many other martial arts. Capoeira involves cartwheels and inversions often as a part of the intent of the fighters. The acrobatics display physical ability and serve a diversion to the opponent. Many fighters implement acrobatics into their fighting styles. Even instructors in their 50s

Wednesday, October 16, 2019

Legal Environment and Business Decisions Essay Example | Topics and Well Written Essays - 3000 words

Legal Environment and Business Decisions - Essay Example The Law of tort is used to punish people mishandling their rights carelessly or deliberately. The 14th century French word â€Å"Tortum† translating to ‘twisted’ is the base of the legal word â€Å"tort† (Smellie, 2002). Negligence is an unintentional irresponsible act considered as a breach of legal duty which any rational person would not do under normal circumstance. Any breach of duty which harmed the victim due to defendant’s fault can fetch the victim proper compensation for the injury or damage caused, under the negligence of tort law (Winfield, 2006). According to the Law of Tort, the prima facie case requirements for the victim to file a case are as follows 1. As strong evidence for breach in duty of care 2. Proof that the plaintiff’s damage is caused in connection to the defendant’s negligence 3. Proof that the foreseeable nature of the harm or damage was ignored by the defendant due to their negligence (Cooke, 2005). Analysis There are five important elements of consideration in this case. (1) Did the defendant Michael owe Anna duty of care? (2) If so, how did Michael breach his duty of care? (3) What damages have Anna suffered due to his Negligence? (4) Room for contributory negligence and voluntary assumption of risk in the case (5) Sort of compensation Anna is seeking and the chances for reduction Anna will be compensated only if the first three elements are proved to the satisfaction of the court. Tort law will provide the required remedy as compensation to the plaintiff based on the next two elements. The compensation may be of any form ranging from injunction to monetary rewards (Harowood, 2003, p.5). Duty of Care A person shall be subjected to trial if they fail to fulfill their â€Å"Duty of care†. Donoghue v Stevenson case, states Michael was supposed to help Anna according to the â€Å"Neighbor principle† in a vulnerable situation. Michael did so, but was not able to fulfill his â€Å"Duty of Care† completely as he did not foresee an accident. Breach in Duty of Care Michael was drunk and had difficulty in driving when Anna approached him for lift. He offered to help Anna considering her risky situation. But did not take enough care to drive safely. The defendant did and did not offer reasonable care in this case. â€Å"Reasonable care when dealing with others† is the most emphasized point in duty of care. Each case has a different level of reasonable care in accordance with the people and the situation dealt. The tort law determines what is reasonable care based on the explicit situation defined in each case (Atiyah, 1972). Anna’s Damages Anna suffered severe physical injuries along with Michael when the vehicle slipped off. She suffered monetary losses due to absence from work. The physical pain and monetary loss caused her great mental agony leaving her in a state of depression. Can Michael be held responsible for Anna’s loses? According to Anna, Michael was committing a legally wrong act by driving drunk. His decision to take Anna along with him when he himself had difficulty driving safely was a breach in duty of care. Contributory Negligence Anna noticed Michael smelled strongly of alcohol before parching on his vehicle. Since it was raining, late night and the plaintiff did not see any other means of transport

Folkloreterm paper on capoeira Term Example | Topics and Well Written Essays - 2500 words

Folkloreterm on capoeira - Term Paper Example This style is known today as Capoeira and reflects much of the Brazilian culture. This paper explores the rituals of Capoeira, revisits the history of the martial art and the country it originated from, takes a look the cultural aspect of the art, and explains the relevance of Capoeira to the style that is practiced today in the United States. The Ritual One of the interesting parts of this style of training is that the students usually learn to sing and play an instrument as a part of their training and development in Capoeira. Songs are sang in Brazilian Portuguese, which is why students are encourage to learn at least a basic understanding of the language. According to Lucia Viti (2003), the songs are used to set the pace of the fight. Chanting and clapping are also used to create rhythm and add excitement to the class. Some fights are aggressive and exciting, while others are low and intertwined. Capoeira contains a wide range of musical instruments used to mediate the mood or fe el of the class and widen the skills of the practitioner, particularly the advanced students. Some of the instruments allowed and commonly used in Capoeira are the drums, agogos, tambourines, berimbaus, the ago-ago, known in the United States as a cowbell. ... The Breakdown of the Classes, Fights, and Events The class is often broken down into two sections. In the first section of the class, the students are working on their technique, warming up, and learning concepts about the game. In the second section, the students get together as a group and form a ring. Two students are chosen to step inside the ring and perform. These students engage in a non-violent fight where they display their skill to the group. The other members of the group, still forming a ring, chant and sing while the two in the middle fight. The participants can be male or female and sometimes they are pitted against each other. To begin, the opponents squat down low to the ground to shake hands with each other. The ginga, or the swing, is the most basic move in and more or less the fighter’s stance. This would be equivalent to the sparring stance in Taekwondo or another sparring sport. This is acceptable, since this is not a contact sport. During the fight, the e valuation examines the fight itself and how it feels rather than focusing on the fighters. The fighters are considered successful when they follow the feel or rhythm of the music and atmosphere. According to Delmont (2006), â€Å"Festivals include baptism and graduation ceremonies, when masters from other cities come in to judge, give demonstrations, and teach classes† (____) Acrobatics are an important element that sets Capoeira apart from many other martial arts. Capoeira involves cartwheels and inversions often as a part of the intent of the fighters. The acrobatics display physical ability and serve a diversion to the opponent. Many fighters implement acrobatics into their fighting styles. Even instructors in their 50s

Tuesday, October 15, 2019

Electronic Health Records Essay Example for Free

Electronic Health Records Essay Implementing a new electronic health records (EHR) system to replace manual records is an extremely complicated task. EHRs use complex algorithms to exchange patient data among different physicians and departments such as a pharmacy and laboratory. EHRs are becoming popular because employees and patients can access records anytime and anywhere. Patient drug alerts are also part of the system to warn emergency room and intensive care nurses about potential drug reactions. A needs assessment is a systematic procedure to determine what components are required for EHR implementation to prevent failure of the highly costly investment. Although EHR systems have been shown to dramatically reduce human error, proper assessment before undergoing the implementation process is critical or errors and costs could actually increase. An EHR assessment must be completed before the software packages can be selected to ensure it is conformed perfectly to the specialized needs of the hospital. According to the California Medical Association the assessment has two steps: 1.) Readiness Assessment; and 2.) Work Flow Analysis (Ginsberg et al., n.d.). The assessment should be done by a seasoned group of engineers, physicians, lab workers, billing staff, pharmacists, and nurses to collaborate so that each department increases patient safety and efficient care. The assessment should include a web-based demonstration that allows all stakeholders to identify gaps that would hinder their job responsibilities. Once the needs assessment has been done and vendors chosen as potential suppliers, the readiness assessment should begin. One of the most important data to collect is financial resources. Are more physicians going to be  hired that will increase training costs? Can the organization truly afford the upstart investment and ongoing computer support? Space considerations are also critical to evaluate because most closets are too small for the new EHR platforms that have huge servers. High-speed internet capabilities are a must for EHR data exchange between stakeholders. Moreover, are existing medical records planned to be thinned to put the data into the new system? If so, data needs to be destroyed according to HIPP protocol to protect patient confidentiality. The work flow analysis portion of the needs assessment looks at step-by-step procedures. Examples are scheduling, diagnostic tests, and reviewing tests, prescribing medication, clinical notes, and billing data (Ginsberg et al., n.d.). Other data to be analyzed for the EHR system should be medical history forms, lists of current medications vital signs, insurance, and referrals. The flow of steps in this planning process involves network upgrades, expanding server room space, a Medicare fraud plan, selection of three EHR vendors, visiting other hospitals using the systems, negotiating, and finally select the model that is best suited to all stakeholders. A 10-year study done by the Canada Health Info way about who should be consulted during adoption of an EHR system looked at 29 key stakeholders involved in establishing policy (Rozenblum et al., 2001). They found that stakeholders should be consulted from a bottom-up, clinical needs approach first because they will be the heaviest users of the system. This means physicians, nurses, certified nursing assistants, billers, lab workers, and pharmacy employees need to have significant input into selecting what aspects are most important. The number one reason for implementation failure is inadequate involvement of line-worker clinicians (Rozenblum et al., 2001). Therefore, the informatics team must work very closely with these stakeholders. Other critical stakeholders to consult are the finance department to ensure how much funding is available. Patients are also important stakeholders because no one wants their health information linked to a huge system that is insecure and prone to hacking confidential medical records. Policy makers at the executive organizational and governmental level also have powerful sway over which EHR is chosen. Lack of  collaboration among these diverse groups can delay implementation of the system for decades. Appropriate needs assessment provides relevant feedback to upper management. This helps these higher-ups make wise decisions based on financial resources, training needs for staff, vendor choice, and whether or not EHR is even necessary (Hartzler et al, 2013). Upper management is also provided with the ability to analyze which employees should have access to the system (or what parts of the system) to complete their designated tasks. Gaps between â€Å"wants† and â€Å"needs† can also be identified so that valuable resources are analyzed in cost-benefit analysis. Training needs or additional hiring of employees can also be anticipated to prevent glitches in the system due to human error. EHR systems can increase profit margins and protect patients from human error if assessed closely prior to purchase and implementation. References Ginsberg, D. (n.d.). Successful preparation and implementation of an electronic health records system. Best Practices: A guide for improving the efficiency and quality of your practice. Retrieved December 26, 2014 at https://www.cmanet.org/files/pdf/ehr/best-practices-7.pdf. Hartzler, A. et al. (2013). Stakeholder engagement: A key component of integrating genomic information into electronic health records. Genetics in Medicine, 15, 792-801. Rozenblum, R. (2001). A qualitative study of Canada’s experience with the implementation of electronic health information technology. CMAJ, 183(5), E281-E288.

Monday, October 14, 2019

Theory And Practice Of Strategic Planning For Tourism

Theory And Practice Of Strategic Planning For Tourism It is widely acknowledge that planning is crucial to successful tourism development and management; and planning has been a widely adopted principle in tourism development at both regional and natural levels. Tourism in Europe has been the subject of considerable academic debate and commentary since the political even of 1988-89. The debate has often focused on Central Europe, whose future free market depends on planning especially including tourism. In particular, strategic planning in the region will be critical to the future success of tourism as attempts are made to utilise tourism in the process of planned economic change. The lack of coordination and cohesion within the highly fragmented tourism industry is a well-known problem to destination planners and mangers. Gunn (1988) stated that continuous tourism planning must be integrated with all other planning for social and economic development, and could be modelled as an interactive system. He pointed out that the go-it-alone policies of many tourism sectors of the past are given way to stronger cooperation and collaboration. No one business or government establishment can operate in isolation (Gunn 1988; 272). On the other hand, Inskeep (1991) has pointed out the importance of an effective organisational structure for tourism management and the need for continuous, integrated planning. Achieving coordination among the government agencies, between the public and the private sector, and among private enterprises is a challenging task, however, and requires the development of new mechanisms and processes for incorporating the diverse elements of the tourism system. Countries need to have an idea about where they want their tourism sector to be in the future and the route it is going to follow to get there. If nations do not have a strategic plan for their tourism, then the old clichà © can apply. If you dont know where you are going, how will you know when you have arrived? (Tim Hannagan 1998, p. 120). In this write up, the meaning of both strategic planning and tourism will be analysing, and also analytical argument on strategic planning for tourism will be explored. Furthermore, few example of tourism planning activities will be evaluated to support the subject matter. Thus, what is Strategic planning / Tourism Strategic planning is concern with deciding what business an organisation should be in, where it wants to be and how it is going to get there (Smith 1994). Strategy is the direction and scope of an organisation over the long term, which achieves advantage in a changing environment through its configuration of resources and competences with the aim of fulfilling stakeholder expectations (Johnson and Scholes 2005). Harrison et al (1995). Explain that strategic is about clarifying your mission, setting clear long term objectives and formulating a comprehensive and integrated set of steps to achieve it. Strategic planning then is concern with defining and achieving organisational purpose (Porter 1994). planning is the purposive process in which goals are set and policies elaborated to implement them and is concerned with understanding and explaining the substance of policy content and policy decisions and the way in which policy decision are made. (Barett and Fudge, 1981). On the other hand, According to World Tourism Organisation (WTO) the organisation defines tourism as: the short term movement of people to destinations away from the communities in which they live and work, and their activities during their trip, including travel, day visits and excursions (WTO cited in T. Outhart. et al 2001, p.4) so tourism includes short term travel for all purpose, weather for leisure or business. Furthermore tourism is about the temporary, short term movement of people to destinations outside the place where they normally live and work and about their activities during their stay at these destinations. (Outhart O. Taylor L. 2001, p.6). Tourism development is the planning and ongoing development of destinations, facilities and services to meet the need of current and future tourist. When tourism is effectively planned and managed, tourism development can result in huge improvement and benefits both for visit and tourist and for the local population, therefore the need of strategic planning for tourism in order to meet the desire of people living in the demanding world has to be encouraged so as to promote and attract tourist as well as building their confidence with tourism activities. Tourism planning has also been seen as a way of extending the life cycle of a destination with a view of exploring new opportunities, adaptation to the current market demand and marketing harmonisation and as well forecast for the future. As stated by Clegg (1994), tourism activities comprise the worlds largest industry with over trillion of dollars in revenue produced and the challenges in benefiting from such economic impact is the result of efficient planning that will take into account the preservation and protection of the environment, the enhancement of a community quality of life and development and that will attract not only first-time visitors but also repeaters as a result of building a reputation and be a successful destination. (Inskeep 1991, WTO 1994) in their own contribution to tourism planning and development, they stated that planning is crucial to successful tourism development and management; and planning has been a widely adopted principle in tourism development at both regional and national levels. On the other hand, (Cooper et al. 1993; Shepherd, 1998) argued that poor tourism planning will cause social problems, degradation of the environment, short-term benefit and failure or constraints due to lack of analytical details or miscalculations regarding the control of land usage (Cooper et al. 1993; Shepherd, 1998). Furthermore, (Tosun and Jenkins, 1996) elongated the above comment by saying that the failure of central planning caused by lack of community involvement as well as mismatch between central planning and local possibilities is detrimental for the tourism market. Thus emphasising on a new concept of sustainable development to empower the planning system for long term success of tourism as it can help to promote and support conservation, regeneration and economic development as well as enhance the quality of life of visitors and host communities (Holden, 2008; Wall and Mathieson, 2006). Furthermore, Gunn and Varr (2002) stated that if tourism is to reach towards better economic impact it must be planned as well towards goals of enhanced visitor satisfaction, community integration, and above all, greater resource protection. Strategic and Its Resources Implication Fig 1 Stage of strategy process Questions Description STRATEGY FORMULATION Mission statement Statement of aims Statement of Values What is our purpose? What kind of organisation do we want to take? A clarification of the purpose of the business Environmental Analysis Where are we now? This involves the gathering and analysis of intelligence on the business environment. E.g. staffing, resources, competitors, stakeholder expectation Objectives Where do we want to be? This involves detailed articulation of aims i.e. setting a target for the organisation to achieve Strategic choice of strategies How are we going to get these? Strategies describe how the objectives are to be achieved Options analysis Are these alternative routes Here you identify options required to be screened in order to choose the best STRATEGY IMPLEMENTATION Action How do we turn plans into reality? A specification of the operational activities task required. Monitoring and Control How will we know if we are getting these? Taking corrective action as necessary and reviewing strategy Source: (Johnson Scholes 1997 p. 13) (Catterick 1995 p. 14) Many organisations produce separate mission statements and statements of aims, objectives and strategies. The strategic plan will contain all of these, which is also applicable to all countries embarking on tourism activities. Looking at the meaning of tourism and its activities, the theory and practice of strategic planning for tourism sector in every nation cannot be measured. This is evident on the ground that, it is clear that effective strategic planning and management is a prerequisite for the successful utilization of tourism as an agent of change in every nation. Tourism is seen as transcending the traditional economic sectors and is viewed as an industry which can actively regenerate the small business/entrepreneurial sector with all its flexible and responsiveness to dynamic changes. However, the transformation of a centralised economy, characterised by flexible practices and a low priority for tourism, does involve a change of hearts and minds as much as it is needs outside strategic planning from expertise. No wonder that, Hungary has recognised the advantages that tourism can bring as witnessed by Prime Ministerial statement in 1990 lauding tourism as a potential power-house for the economy. However, Halls (1991a) most persuasive point is that, tourism is seen as an integral part of economic restructuring by exposing the system to both national and international forces and, in so doing, introducing potential foreign investors, encouraging privatisation and reducing the level of bureaucracy and centralisation. All this are made possible via strategic planning approach adopted by a given nation. In the case of tourism, Page Thorn (1997) suggested that a national policy or strategy was required in addition to the RMA, if sustainable tourism goals in New Zealand were to be achieved, since then a national strategy has been produced, reviewed and subsequently updated, emphasising the sustainable development concepts and the desirability of integrating environmental, economic, social and cultural considerations in the long-term management of tourism resources. Tourism Planning Approaches (Countries overview) The changing evolution of tourism, its different political and socioeconomic development environments, and the diverse scientific and technical contributions in the fields related disciplines (urban, regional, environmental planning, etc.) shape different approaches to planning. Such approaches have been the object of interesting systematizations, especially the critical perspectives of Getz (1987), and Tosun and Jenkins (1998) for Third World Countries, which are neither mutually exclusive nor a reflection of a chronological evolution: boosterism, economic, physical-spatial, and community-oriented approaches. To these four could be added two more that are omnipresent in todays literature: a strategic approach and planning for sustainable tourism. Boosterism has been the dominant tradition ever since the emergence of mass tourism. It is based on a favourable, uncritical assessment of tourism that identifies it as intrinsically positive and ignores its potential negative effects on economic, socio cultural, and environmental levels. Halls (2000) expresses his doubts about its consideration as a way of focusing on Getzs contributions, four approaches can be distinguished, and planning since it is precisely characterized by being a tourism implementation and development method that reveals lack of planning. The economic approach conceives tourisms as an instrument that can help achieve certain economic aims. It reinforces tourisms character as an export industry and its potential contribution to growth, regional development, and economic restructuring. Public intervention, in its regulating and promoting role, gives priority to economic purposes over environmental and social ones, although it also attends to all the factors that can jeopardize its economic efficiency: development opportunity costs, selection of the most profitable market segments, control over demand satisfaction, estimate of its economic impacts, etc. However, this approach does not usually analyze how the benefits derived from tourism are distributed socially (Burns 1999). The physical-spatial approach incorporates the territorial dimension with the aim of adequately distributing economic activities, and specifically tourism activities, in space, while also ensuring a rational land use. It is an approach in which both town and country planning and tourism planning coverage as a result of the recognition that its development has an environmental basis. This approach mainly focuses on the preservation of the natural resources that make the industry possible and on the management of the environmental impacts it causes. Among the examples of the physical-spatial approach, Hall (2000) mentions the work by Gunn in the late 70s (Gunn 1994) or Insteps integrated approach (Inskeep 1991). The community oriented approach originated in the late 70s with the numerous works that criticized tourisms negative sociocultural effects (de Kadt 1979; Smith 1977). It is not exclusively confined to the aim of solving and preventing those effects. In fact, it promotes a local tourism development control scheme so that residents are the ones who benefit the most from that development, thus avoiding conflict situations that could put the industrys future viability in danger. Murphys work (1985) undoubted constitutes a basic reference point of an approach revitalized by the need to achieve greater social involvement in planning processes. This circumstance has provided the momentum to undertake, from public instances, bottom-top planning schemes, among them the European initiative leader for rural development. Strategic planning moved from the business context to regional and urban planning in the 80s, and it has a strong influence on economic restructuring schemes for declining places and sectors (Borja and Castells 1997; Vazquez Barquero 1993). This approach has been progressively incorporated into tourism planning and essentially focuses on the search for competitiveness of firms and destinations in a changing, complex environment. In short, it contributes to or reinforces the following distinguishing elements of tourism planning: analysis of the competitive environment as a fundamental element in the definition of the firms or destinations strategy; definition of a wide time scope for planning on the basis of foresight and prospective techniques; stress on social participation and the creation of coordination and cooperation channels among stakeholders; and the rise in value of planning as a process that is permanent, flexible and integrated into management (Ansoff 1988; Borja and Cast ells 1997; Hall 2000; Ivars 2001; Porter 1982). Planning for sustainable tourism is related to the great deal of interest aroused by the development paradigm ever since the celebration of the Rio Summit in 1992. The application of its principles to tourism is especially relevant due to its ambivalence, for it can help to preserve and improve the environment. THE STRATEGIC PLAN AND IMPLIMENTATIONS OF COUNTRIES For example, the strategic plan and implementation program for the county of Szolnok in Hungary highlight many of the problems facing the future development and reorientation of tourism in Central European States. During the construction of the strategic plan, the largest obstacle was identifying tourism facilities that would meet the development needs of the county while minimising the risk of social or environmental damage. The county strategic planner came up with the following planning strategy; Phase 1; Immediate Action Improve Quality of Existing Facilities Improve utilization of existing facilities Improve Economic Benefits from Tourism Improve Performance of existing Entrepreneurs Create environment for future tourism planning Phase 2; Immediate to Medium Term Action Develop Szolnok town as tourist centre Increase Accommodation stock Create new restaurants/cafes in tourist areas Develop new tourism activities Build on existing cultural/heritage attractions Encourage the development of closer linkages between sectors Phase 3; Medium to Long Term Action Wider tourist base-conference business Develop new up-marker tourist facilities Widen the marketing activities Establish strong links with national/international organisations Adopt a fully international computerised reservation system Continue to develop monitoring/regulation and research into tourism activities in the county Develop new 5 year tourism development plans. The result of the strategy plan and its implementation is a county that is now poised to break through into wider tourism markets, armed with promotional materials of high quality, tourism information and maps together with a broad spectrum of products, a network of commercial and organisational links that will enable it to capitalise on the potential market for visitors from within and to Hungary. On the other hand the strategic planners for tourism in Spain came up with what is refer to as FUTURES (Master Competitiveness Plan for Spanish Tourism) (Ministerio de Comercio y Turismo 1994). This plan opened a new state of tourism policy in which the state redefined its role within an institutional discourse that intended to consolidate a system of coordination and cooperation between the different administrations. The FUTURES plan became the catalyst of this change encouraging the design of specific plans for the 1992-1995 period, favoring cooperation through actions financed jointly by the different administrations and fostering the participation of public and private agents. The plan was a reflection of the third generation of tourism policies, according to Fayos classification (1996) where competitiveness turned out to be a key element for tourism management. The FUTURES plan formed a part of the structural adjustment theory (Bote and Marchena 1996) which focused on the adaptation of Spains supply to the structural changes caused by the market that jeopardized the competitiveness of the countrys tourism industry. Finally, this period witnessed the start of the planning model derived from Spains entry into the European Union with the preparation of the 1989-1993 Plan de Desarrollo Regional (Regional Development Plan) for Objective -1 regions and the 1989 1993 Plan Regional de Reconversion Regional y Social (Regional Plan for Regional and Social Restructuring) for Objective 2 regions. These plans made possible the application of Europe Structural Funds to tourism in Spain and implied the definition of a regional development strategy where special attention was paid to tourism, both in those autonomous communities in which it has a strategic role and in others where it was perceived as an emergent industry (Ivars 2001). Essential objectives included taking advantage of tourism growth expectations, the valuation of non-exploited resources, the contribution made by new products to territorial rebalance and finally, the incorporation of tourism into local development strategies both in rural and urban milieus. In the case of Barnette County, Wisconsin, a strategic planning was formulated to improve its tourism industry as for decades tourism has been the main economic revenue for the area. Based on existing data collected from a 1993 assessment, an action plan was implemented and the main issues encountered were lack of organisation, marketing performance, finding and government perceptions form which actions were created to eradicate the problem but it didnt escape failure since estimated budget to find a visitor centre wasnt reach due to lack of fund, marketing guides on the county printed but not distributed, eco-tourism was to be developed using a joint marketing grant but was refused by the state of Wisconsin. Overall, it showed the issues of lack of interest and participation from stakeholders (tourism businesses and government) for further tourism development of Barnett County. Looking at New Zealand as a case study, a county that want to increase the level of its tourism activity and sustainable tourism has become the key of the country to do so, which according to Bramwell Lane 2000; Hall Page, 2006), the success of sustainable tourism planning depends on existing planning and management functions that guide appropriate developments and the ability to respond to pressure on infrastructure and environments that increasing tourism demand creates. The concerns for New Zealand are that the tourism product relies a lot on the natural resources and the image of a clean and green country (Tourism New Zealands marketing campaign) and its has been quite a problematic issue in some areas with regards to conservation and preservation of the environment. Page and Thorn (1997) suggested that a national policy or strategy was required in addition to the RMA (Resource Management Act), if sustainable tourism goals in New Zealand were to be achieved. Based on the previous research undertaken by Page and Thorn in 2001 and 2002, the following issues were encountered such as lack of considering the number of international tourist arrival at national level, lack of planning at national level which Page and Thorn argued that if a national plan was needed in order to achieve a more balance equitable and beneficial patterns of tourism activity and development for destinations and host communities, however a PCE (Parliamentary Commissioner for the Environment) report on education for Sustainable development, suggested that the like and dislike and the caring of something lies with the people. What was found from the previous study was the lack of communication and integration between the RMA and the local authorities and resources available from the government was inadequate. However the recent study also reflect the incapacity of the RMA to work together with the national government, since tourism related project were not released but effort has been done to integrate the process of a sustainable development and increase the continuity of collaboration between the public and private sector, but there is still that major gap between strategy and the implementation of the policy formulated in the evolution towards a more sustainable New Zealand. Based on which Page and Thorn (2002) stated that a national plan is required if tourism is to be developed with the target of enhancing the quality of life of its local people and increase environmental protection from the tourism activity. Furthermore, within the tourism planning the goal and objectives set should be achieved to challenge pro-development policy in order for New Zealand to keep up in the term of competitive advantage as a clean, green and sustainable tourism destination. As argued by Edgel, Allen, Smith and Swanson (2008), those destinations, localities and nations that prepare good policies and implement detailed strategic plans will reap the benefits for sustaining their tourism products in the future, which is the indispensable and fundamental basis of New Zealand tourism strategy. Hence leads to betterment of tourism activities in New Zealand. Furthermore, before any implementation, analysis study will be performed through survey of existing data and collection of primary data. The data requirements will include information such as existing tourism profiles, travel patterns, tourist attractions, accommodation and other tourist facilities, land availability, economic and government structure, education and training needs and provisions, environmental indicators, socio-cultural characteristics, investment sources and available capital, relevant legislation and regulation and private sector organisation. (Cooper et al. Tourism Principle and Practices). Ones data has been collected, the issues associated with it will be analysis in terms of assets (infrastructures), market assessment of demand and supply and feasibility study, source of funding and impact of economic, environment and social factors in terms of tourism needs and opportunities and overcome detrimental impact. The result derived from these analysis will help in the formulation of plan and policies such as marketing strategies, human resources management, environmental conservation, economic and tourism development by which implementing and monitoring to ensure the development path and avoid deviation from the actual plan of the nation on tourism sector. The diagram below represents the key stages in the planning process. Fig 2 Key stages in the planning process Source: Tourism principle and practices by Cooper et al. RECOMMENDATION Tourism has been identified as one of the primary industries with the potential to assist local communities in developing economic diversity (Allen et al 1993, Davis Morais, 2004) However, tourism is not a panacea for economic decline. Tourism has the potential to create both positive and negative impacts. Gunn (1994) indicated that, there is no other form of development that has so many far-reaching tentacles as tourism (p.16). For tourism development to be successful, it must be planned and managed responsibly (De Oliveira, 2003; Inskeep, 1991; Martin, 1995). Inskeep, (1991) furthered the concept of responsible management, warning that ill-conceived and poorly planned tourism development can erode the very qualities of the natural and human environment that attract visitors in the first place (p. 460). Thus communities that use or plan to use tourism as an economic development tool to diversify their economy must develop strategic planning policies for the sustainable development of the community. It should be noted that one key to strategic planning for sustainable development of tourism in a community is the inclusion of stakeholders. Without stakeholders support in the community, it is nearly impossible to develop tourism in a sustainable manner. Therefore, a clear understanding of the attitudes and interests of stakeholders is a necessary precursor to the strategic planning and management of sustainable tourism. Strategic planning also emphasise the integration of economic, socio-cultural and environmental, therefore stakeholders should collaborate and take into consideration the preservation of culture and environment while maximising economic growth and returns to community. Jamal and Getz (1995) define these collaborative efforts as a process of joint-decision making among autonomous key stakeholders of an inter-organisational, community tourism domain to resolve planning problems of the domain and/or to manage issues related to the planning and development of the domain. CONCLUSION Tourism exists as a powerful economic force in the development of both community-based and global markets. Today, its activities comprise the worlds largest industry with over three trillion dollars in revenues produced. (Clegg 1994). Accordingly, the success of sustainable strategic planning depends on existing planning and management functions that guides appropriate developments and the ability to respond to pressure on infrastructure and environments that increasing tourism demand creates. As Iskeep, (1991) argues, the special relationship between tourism and the environment, based on a unique dependency on natural and cultural resources, requires a balanced approach to tourism planning and development to maximise the associated benefits and minimise the negative impacts. Therefore, if ill-planned or excessive development is permitted, tourism can damage the special qualities that are essential for sustainable development. Finally, the importance of strategic planning for tourism within a sustainable development context is now acknowledged globally as it was addressed as a specific topic in a review of Agenda 21 in 1997. In 2002, the world summit on sustainable development included a submission on sustainable tourism (chapter IV, paragraph 43) in the Johannesburg plan of implementation, which identified that while tourism has positive effects, uncontrolled (lack of strategic planning) tourism growth can undermine the basis of tourism. However, the extent to which sustainable development ideology is translated into policy and practice requires a strategic planning investigation to uncover the tourism activities that need urgent attention to meet the demand of visitors. This can be in a form of language to be used, create an image to be used, practically assistance and guidance, promotional material and its design, and strategic for the provision of tourism information. Tourism planning has also been seen as a way of extending the life cycle of a destination with a view of exploring new opportunities, adaptation to the current market demand and marketing harmonisation and as well forecast for the future. Therefore, it is on this premise that the researcher believes that the role of strategic planning in tourism development of any nature can not be quantified. Words Count 4365

Sunday, October 13, 2019

The Writing Style and Beliefs of Kate Chopin Essay -- Biography Biogra

The Writing Style and Beliefs of Kate Chopin  Ã‚     Ã‚  Ã‚   Kate Chopin was an extraordinary writer of the nineteenth century. Despite failure to receive positive critical response, she became one of the most powerful and controversial writers of her time. She dared to write her thoughts on topics considered radical: the institution of marriage and women's desire for social, economic, and political equality. With a focus on the reality of relationships between men and women, she draws stunning and intelligent characters in a rich and bold writing style that was not accepted because it was so far ahead of its time. She risked her reputation by creating female heroines as independent women who wish to receive sexual and emotional fulfillment, an idea unheard of in the 1800s. In the late nineteenth century, the central belief of the vast majority was that the woman's job was to support and nurture her husband and children. Women were given no individual identity and were seen only in relation to a family. Women of this time could not vote and therefore had no say in any political matter. Women who wished to comment politically did so with some form of art, including music, painting, and writing (Magill, American 387). According to Frank Magill, when a woman considers herself only as a part of a relationship with someone, then that relationship becomes the central issue of her life (American 386). As a woman whose husband died young, leaving her six children to raise alone, Chopin understands that kind of dependency upon relationships (Magill, American 384). Almost as working out of her own role, she explores in her writing the complexity between men and women. Readers realize that Chopin's writing in the 1890s was far ahead of ... ...'The Storm'." The Markham Review 2.2 (1970): 1-4. Baker, Christopher. "Chopin's 'The Storm.'" Explicator 52.4 (1994): 225-226. Chopin, Kate. "The Storm." Literature Across Cultures. 2nd ed. Sheena Gillespie, Terezinha Fonseca, Carol A. Sanger. Boston, Allyn: 1998. 345-348. ---. "A Respectable Woman." Gillepsie, Fonseca, and Sanger. 342-344. ---. "At the 'Cadian Ball." The Awakening and selected stories by Kate Chopin. Ed. Sandra M. Gilbert. New York: Viking Penguin Inc., 1983.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  179-188. ---. "Athà ©naà ¯se." Gilbert. 229-261. Dyer, Joyce. "Gouvernail, Kate Chopin's Sensitive Bachelor." The Southern Literary Journal 14.1 (1981): 46-55. Magill, Frank N., ed. Critical Survey of Short Fiction. New Jersey: Salem Press, 1981. 1132-1136. ---. Magill's Survey of American Literature New York: Marshall Cavendish Corporation, 1991. 386-391.

Saturday, October 12, 2019

My Life on Togetherness Essays -- family, parents, religion, freedom

I belong to a family that is characterized by being quite Post-modern. Talking about my parents, they do both participate in the public sphere. They both work in two separate domains, having consequently more freedom in the public sphere they encounter as a daily basis. For example, my mother works as a teacher, so she comes across mostly teachers and professors, and my father works as an architect, so he encounters mostly architects, without corrupting one another by endless phone calls or whatever. So Togetherness, which is the opposite of autonomy, is not really seen. What I described before is how things go between my parents, but I did not yet talk about the situation between my parents and us, their children. Our freedom grows proportionally with our age. When we were young, we weren't restricted to communicate only to the family members. In school, we were free to meet and talk to whoever we want. Of course they do warn us of the bad persons we might encounter, but we were feeling comfortable. As we grew up, the relationship between us start to be friendlier. Trust is there, which I believe is one of the most important criteria that should exist within a relationship, happiness is there, everything is fine. However, a criterion of togetherness was missing, which is the freedom of choice. Choices available to me were those that my parents provided me with. For example, one of my goals in my Life was, and still is, to become a Formula 1 racing driver, but unfortunately I wasn't able to achieve that, because my parents simply weren't able to assimilate the idea that I drive a "dangerous", fast car. I know it's too late now, but my dream is still to drive a Formula 1 car, at least before I pass away. Anyway, my family is the ... ...rnal or external. when everything's ticking along just fine, I don't think most people give much thought to it; evidence of that can be found in the confusion with which most people will respond to questions like, "what makes someone a man/woman?", or, "how do you know that you're a woman/man?", without referring to biology. But as soon as something's not quite right, whether that's an internal feeling of incongruence or an external challenge to one's gender, suddenly it becomes very important indeed. Finally it does work for me, and I am not emphasizing any counter ideas toward girls. I don't have any problem with them; each of us is different at several levels. I can have positive criteria by being a boy and my sister, for example, can also have positive criteria that I do not have by being a girl. I was born a male; I will grow as a male, and will die as a male.