Business in context

What responses do you have to the reading or video e. G. Fresh understandings, opinions, Insights or questions? What connections does the related additional reading or video have with the required reading or video? How does It reinforce or critique the ideas In the required reading/evolved? This reading presents us the approach of utilitarianism, real life cases that related to utilitarianism, three common mistakes that people usually make when they applying Utilitarianism and the difficulties of measuring utility.Case 1 When Ford motor company was having dilemma of modifying pinto's gas tank or keep the original design, they chose to use utilitarian approach to calculate the utility of tooth options and the result Is cost over benefit, so they chose to risk their customers' lives rather than correcting their poorly designed cars. Case 2 Lawrence summers The director of the white house wrote a memo that proposed shipping wastes form rich countries to poor countries is a beneficial ac tion to world's welfare and he make 4 arguments and I think the first 3 are supported by utilitarianism. Understandings: utilitarianism support that the right action is one that produces the most utility and minimizing the negatives, and the utility that reduced by the action Is not only for the person performing the action but also for all person involved in the action. Question: In the end of the reading it clearly states that health and life is beyond measuring, but Ford company and Lawrence they are putting a price on each person. Is not it would considering as an UN-ethical action? If it is not then I think we are nothing but slaves In this world.In my opinion the additional video is not quit related to the required reading. Peter singer's ethics says that every Individual has their own interests and It Is perfectly normal that we want to spend our money on expensive reduces under our own desires, but it will be considering as ethical action if a person spend money on contribut ing the would instead of buying luxuries. And he also states that the purpose of life is making the world a better place by one's actions and presence. Lecture 2 Required Reading Reference: Shaw, W. Barry, B. & Sandburs, G. (2009). Moral issues In business (1st Asia-Pacific De. ). Melbourne, Australia: Coinage (Kantian ethics). Up 71-78 Lecture 2 Dilation Reading Reference: California Newsreel. (2008, December 2). Health for Sale . Retrieved from: http:// www. Youth. Com/watch? V=Jukeboxes Record a brief description of what the required reading was about. What responses do you have to the reading or video e. G. Fresh understandings, opinions, insights or questions?What connections does the related additional reading or video have with the required reading or video? How does It reinforce or critique the Ideas In the required reading/evolved? Kantian ethics consequences are, and the performer must motive by good wills. An action might looks like an ethical action but if it was motive by self-interests or there concerns then this action will be considering as lack of moral worth (recording to the shop assistant case) Formulate an universal law that applies on all our actions is what Kant wanted.And this categorical imperative rule is the measurement of ethic or UN-ethic. Understanding: After reading this article I realized that everything we do has a propose, if the foundation of the propose is good will then it is ethical, but if the propose is not based on good will then it is not ethical. Question: What if an action is following one's good will but in the same time it might break the universal law? This video is about UN-ethical behaviors of the world pharmaceutical market. 5% of drags were used on 11% of the people who need them and can afford them, But only 15% of drags were used on 89% of people who need them but do not have the money to buy them. And some drags are no longer producing because the people who need them could not afford them, the poor people are not the target of pharmaceutical market. This kind of behaviors is UN-ethical because drags were meant to help people not only focus on making profit, companies ignored the poor is not an action of good will recording to Kantian theory.

Adapting Community Interventions for Different Cultures and Communities Essay

The Mexican Americans had their own unique identity. They had their own style in each decade starting from the 1940s– including the Zoot Suit Riots, to the Chicano Movement, then to the 2000s –which is known as the LA punk looks. During the 1940’s, young Mexican Americans wanted to fight for their justice against the United States servicemen. They started a group and began to wear clothing that was out of the ordinary. They wore baggy dress pants and big drape jackets, including a hat. Because of their clothing, people called them the Zoot Suits but they referred themselves as Pachucos and Pachuca. According to the article â€Å"6 Decades of Mexican and Mexican- American Style Evolution† (Agrawal), there are 6 different decades of the Mexican- American style that include: the 1940s– the Pachuco look, the 1950s– the start of the Civil Rights Movement, where Rock music combined with fashion and included curled hair and polka-dot dresses for the women, the 1960s, the Chicano Movement and the Chicano Activists movement, the 1980s– which was shaped due to hip- hip and was known to be the Chola look, then the 1900s– which starred Selena, the Queen of Tejano music who became known due to her iconic style and became a well known music idol, and lastly, the 2000s. The 2000s allowed women to express their strength and solidarity through the LA punk style by keeping a simple makeup look. Although Mexican- Americans used their art through music, Chinese Americans believed in respecting their art through appropriation . Another significant time in US history was the Chinese Exclusion Act that included Chinese Immigrants. According to the article, â€Å"The Chinese Exclusion Acts: A Racist Chapter in U.S. Civil Rights History† (Chin), The Act that started in the year of 1882 prohibited: immigration on Chinese laborers, denying naturalization, and enforced Chinese laborers who are already legal in the United States and later want to re-enter and receive a certificate to return. The Chinese Immigrants worked as servants, fishermen, farmers, etc. They also worked on railroads and miners. Due to the Chinese Exclusion Act, it has turned the table around and changed history for Chinese immigrants and they were treated differently. They were treated differently because they were â€Å"different† from others by their looks and the way they dressed. Non- Chinese people would sometime be jealous of what Chinese Americans accomplished. Sticking to their cultures and backgrounds, the Chinese men wo uld usually have their hair long and in a ponytail, their clothing would consist of cultural robes, which is known as a Cheongsam. Cheongsam is worn as Chinese cultural appropriation for respect. Usually Chinese friends and family have to give the approval if you are allowed to wear a Cheongsam. Until today’s world, many people still stereotype not only Chinese people but Asian Americans in general due to what they wore back then because of their culture. Despite the appropriation, the Chinese Americans believed in, African Americans took a stand and did for what they believed in to achieve justice as well as the Mexican Americans. Going back into the 1900s, African Americans then segregated into urban housing. As they began to take over a community in New York City and begin with the Harlem Renaissance, which was located in northern Manhattan. During the Harlem Renaissance, several groups and organizations appealed to improvements economically and educationally. According to the article â€Å"The Harlem Renaissance a Cultural Rebirth† (Hall), after black soldiers engaged in World War I, they wished for a better America for themselves. This time period included African Americans making a great remark within their culture. Due to their remark, they also created a climatic change within their fashion statement. This fashion statement included: the Flappers, a masculine look for women, and day and night dresses. Flappers is another word for dancers because of the dresses they wore that made it easier for them to dance in. During this era, women decided to stand out and portray the masculine look. Women woul d want to wear men’s clothing and began to smoke, drink and drive, etc. Because of this movement, they created several movies until today’s world portraying â€Å"the Harlem Renaissance†. Some movies include Harlem Nights, Brother to Brother, Murder in Harlem, and the recent popular one that features similar actions of the Harlem Renaissance would be The Great Gatsby that features Leonardo DiCaprio. Although during the Harlem Renaissance was more of a fashion statement by making a remark, the Native Americans were quite different in terms of making their own fashion. During the time of the Wounded Knee Massacre, there were about 300 Native American deaths. There was a battle between the Native Americans and the United States soldiers in the Wounded Knee Creek in South Dakota. During this time Native Americans took belief in their Ghost Dance. The Ghost Dance was a religious dance to bring back their original world and to protect themselves. During this time Native Americans would have to hunt for animals to use their skin to make clothing and to stay warm. Hunting and gathering was a way for them to survive. In today’s society, American Indian culture has changed. As of now we usually see depictions of the American Indian culture in social media. Such as music videos, movies, or television shows that portray the American Indian culture. It has changed compared to back then. Their culture contains making art, clothing, jewelry, dance, and fashion. To the Native American culture, they typically don’t have a certain clothing they wear for appropriation. According to the article â€Å"Native by Design† (Montgomery), they believe that appropriation does not matter and what matters is representing where they came from and showing off their beliefs as much as possible. Urban Outfitters –the popular clothing company– brings off the Navajo vibe in every store. This includes the designs in the store, several pieces of their clothing, and the setting of the store. This represents that even though Native Americans had one culture back then, it doesn’t mean it has changed drastically. Throughout time, culture, beliefs, and traditions, we soon come to realize the true beauty behind it all. We realize the true beauty of different ethnic groups, especially of our own culture and beliefs. Yes, it will all change over a certain span, but it all depends on what we want to believe in and what we want to keep believing in. Till today’s society, the beliefs we used to believe in will become more and more modern as time goes by and it will evolve quickly before we know it. Stereotypes will change, beliefs will change, etc. It is best to understand the true beauty of one’s culture. Despite all the stereotypes and the modern technology, we should take in consideration of our own culture and admire what we have. Fashion will change each and every year but we just have to make the most of it and express ourselves through art. Like these four different Ethnic groups: Mexican Americans, Chinese Immigrants, African Americans, and Native Americans; they all believed i n different cultures and beliefs but each group used their own unique way to express what is theirs.

Childhood Glaucoma and the Nurse's Role Research Paper

Childhood Glaucoma and the Nurse's Role - Research Paper Example Glaucomas are majorly classified into two classes depending on the angle that the iris of the eye forms with the cornea at the anterior chamber of the eye. The two classifications are open-angle and closed-angle glaucoma. They may also be divided into primary types or secondary types. Childhood glaucoma is a very dangerous disorder due to the fact that the child may develop blindness and other eye complications if at all the condition are not corrected early. To suffer blindness at such an early age would make life difficult for the child. It may also make the life of the parents difficult as they attend to the child. Such a child requires massive care from the nurses of health institutions. The nurses also have a role of teaching the care principles to the parents or siblings of the affected child. My discussion will illustrate the disease process of glaucoma. I will then analyze the management measures directed by the nurses to aid in the recovery of the child, or to assist the chi ld lead a normal lifestyle. The disease process The optic nerve is responsible for transmission of visual images from the eye towards the brain. These contribute to perception of images by the brain. In glaucoma, components (axons) of this nerve are destroyed. They result in the death of the cells of the ganglions of the optic nerve. This in turn causes atrophy of the nerve. The result is that images are not transmitted to the brain for perception. This explains the vision loss in patches. There are many conditions causing the destruction of these neurons, however, the commonest cause is an increase in the contents of the eye. This is termed to as an increase in the intraocular pressures (IOP) of the eyes. Increased IOP may be due to obstruction of secretions of the eye or inhibition of flow. The major secretions of the eye are the aqueous humor and the vitreous humor. Physical injuries and congenital causes play a role in the obstruction of flow. The commonest congenital form of gl aucoma in children is referred to as Primary Infantile Glaucoma also referred to as congenital glaucoma. In this condition, there is hindrance to the passage of a secretion the eye referred to as aqueous humor of the infant or child. This raises the IOP with a possible damage of the optic nerve. This causes patchy blindness in the child or infant. Statistics reveal that the incidence of affecting one eye is 40% while in both of the eyes it is 60% (Merck Manual of Diagnosis, 2010). Primary infantile glaucoma may occur in infants following traumatic events or after surgery involving the ocular structures. Signs and symptoms The primary symptom in a child with infantile glaucoma is the swelling of the eye beyond its normal size. This is because of thee the IOP cause stretching of collagen fibers of the sclera of the eye. The infant or child affected experiences intolerance to bright light (photophobia) and tearing. The cornea of the eye becomes thin. It is normally about 12mm. The corn ea of the eye may also be cloudy. If the condition is not given urgent medical care, the cloudiness may progress, the optic nerve will be destroyed and patchy blindness occurs. Surgical intervention is the cardinal correction measure. Diagnosis: role of the nurse Early diagnosis of the condition is very important in children because some children have the condition without the parents

Nursing research Essay Example | Topics and Well Written Essays - 250 words - 46

Nursing research - Essay Example These questions determine the stage of innovation by nurses during the process of research utilization and adoption. In a clinical setting, a thermometer is one of the fundamental tools used by healthcare practitioners. In line with this, it is important for a thermometer to be reliable and valid in order to provide the correct measure of patients’ temperature and give the appropriate diagnosis and medication. Effectively, a thermometer’s validity can be determined by ensuring that the thermometer was bought from organizations that manufacture quality healthcare products since they understand the qualities required in a thermometer. Conversely, a tape measure should be another tool that requires being reliable and valid. A tape measure provides the length in a measure and it is crucial for this tool to be valid since providing the wrong measure affects the diagnosis especially when providing the BMI of an individual. In effect, the validity of this tool is determined by comparing the scale used with another tool that is standardized. In addition, the tool should be sourced from a ven dor who dealt with standardized

Family-based Care or Nursing Home Care in the Face of Dementia Essay

Family-based Care or Nursing Home Care in the Face of Dementia - Essay Example Dementia is a collective term used to refer to a range of diseases that involve the deterioration of cognitive function over time. For those suffering dementia, their quality of life can substantially decrease, and they quickly become dependent on others to help them with even their most basic needs. The prevalence of dementia increases dramatically with age, as a consequence the number of people suffering from dementia at a given time is likely to rise as our population in general ages. As a consequence of this, the government is increasingly interested in determining what method of care is of lower cost. In general, it is often assumed that it is cheaper to care for an individual through family-based care as opposed to caring through nursing facilities. However, this does not take into account costs that are incurred by family members in terms of finances or time. This is an important factor, as dementia patients frequently require full-time care, thus when dementia patients are being cared for through family-based care it is likely that at least one member of the family has reduced hours at work compared to under normal circumstances. When labor and costs are taken into account, studies have shown that for patients with severe levels of dependence it was more economically viable for them to be cared for through nursing home care than through family-based care. Thus, despite the financial costs of nursing home care, it is still equal in cost, or cheaper than family-based care. The financial cost is not the only consideration in regards to deciding the best type of care for those suffering dementia. Dementia is progressive and destroys mental function. When it is a family member or loved one that this is occurring to, the process can be very painful to watch and can cause feelings of helplessness and mental trauma. There are many reports of caregivers of dementia  patients suffering from severe depression as a consequence of watching the progression of the disease (Eisdorfer et al. 2003). As a consequence caring for an individual with dementia exerts significant mental pressure on those responsible.

Philosophy of Nursing Essay Example | Topics and Well Written Essays - 750 words - 1

Philosophy of Nursing - Essay Example The life philosophy may vary based on individual differences, cultural differences and the religious differences. Philosophy is a kind of beliefs, values and goals a person sets in his life. Philosophy in short is the personal belief about how to live or how to deal with a situation. On academic terms, philosophy is the origin of every sort of knowledge. In olden times, when science was not developed much, the philosophers were the persons who interpreted the problems and they were able to provide answers to the doubts of the common people. Philosophy was the first sort of knowledge originated in human history. All the other subjects like, science, mathematics, literature etc gradually separated from philosophy when the knowledge became gradually increased. Since the origin of every sort of knowledge is attributed to philosophy, the highest degree awarded in all the subjects is labelled as Doctor of Philosophy or PhD in academics. Two persons working in an organization, in the same department and same position may approach their work differently because of their difference in attitudes and philosophy about work. For example, consider two accountants working in the same company. One may finish his works daily and may not keep anything for the next day. The other may not finish his works in time and he may keep something for the next day. This is because of their difference in attitude or philosophy in approaching the profession. Nursing profession is considered as a noble profession because of their contributions in saving the life of sick people. For me nurses are not getting the respect they deserve from the society considering the nature of their services. I have selected nursing as my profession because of its relevance and value in the society. For me human life is the most important thing in the world and I am happy, if I am

Social AND Environmental Accounting Assignment Example | Topics and Well Written Essays - 3500 words

Social AND Environmental Accounting - Assignment Example Each group has its own interests; these interests are directly or indirectly affected by the activities of the companies. These stakeholders are; local communities, environmental groups such as Friends of Earth and Greenpeace, media, political and other pressure groups. Additionally, the impacts of companies’ activities have considerably increased. In the recent history, the mismanagement of oil spill in the Gulf of Mexico by British Petroleum (BP) has unmasked the dirty and unethical corporate practices exist; and their existence can seriously undermine the life of stakeholders. For example, BP is heavily fined over its mismanagement of oil spill. Is that fine going to bring back the same kind of environment that existed before the oil spill in the Gulf of Mexico? Is the damage to the environment ever being repaired to its pre-oil spill level? Can we fully understand the total impacts of the oil spill over the sea life? In this single environmental disaster at the hands of BP , the entire sea life may face a threat of extinction since it is not possible at this point of time to fully comprehend the short term and long term impacts left by this environmental disaster. ... While ensuring the corporate objectives, many companies do not give much consideration to the current and potential negative effects of their activities. Due to the recent pressures from the governments, local communities and from the environmental groups, many companies produce the reports on corporate social responsibility and sustainability reporting. In which, companies mention their positive and negative impacts of their activities on social and environmental stakeholders: They try to be transparent and accountable for their activities. In their sustainability and environmental reporting, the companies also describe their current policies towards social and environmental issues. In order to show off that they care for the social and environmental stakeholders, they mention in their sustainability reporting about their current and future investments with an aim of reducing their negative impacts over society and environment. However, many critics such as Friedman (1970), find no reason to believe on their genuine and realistic resolve towards mitigating their impacts as the companies are only established to serve the objectives of their shareholders which is to increase profits for them. Their only social responsibility is to increase the wealth of their shareholders Friedman (1970); at the end of the day, they are accountable to them not to society. In the subsequent parts of this essay, first environmental accounting, and its different types are included and critical analysis is included subsequently. Environmental accounting Environmental accounting has considerably evolved and received significant attention in the field of accounting after the work of the Gray in the year of 1990(Elkington,1993). Many

Lean Thinking Research Paper Example | Topics and Well Written Essays - 750 words

Lean Thinking - Research Paper Example Its adoption of this strategy seems to be the reason why this business organization has survived in a competitive business environment. Supply chain management is a strategy that is used to streamline all business operations to ensure that they occur at the least cost possible and in the most efficient manner. In a competitive market environment, the cost of a product dictates the attractiveness of a business and consequently the inflow of customers (Taylor and Brunt, 2001). The development of products right from the time when raw materials are acquired to the time the final product reaches the customer has a cumulative impact on the cost of the products delivered in market. Harrison and Hoek (2011) point out that understanding consumer behaviour is important for a business that intends to survive in a competitive market. This is the reason why the Starbucks Corporation has decided to develop its lean thinking strategy to model an effective supply chain. One lean strategy of the Star bucks was to reduce the employee motion by bringing products closer to the customers. The company has a team of lean thinking implementers who have engaged in developing strategies that will define an effective supply chain. Ms Jordan, a developer in the lean team noted â€Å"†¦. how much my partners were moving for things that were never at the same place †¦Ã¢â‚¬  and notes the much that was wasted while preparing a single cup of coffee (Jordan, 2009). In response, she advised the employees to place goods on top so that they can avoid the time wasted while bending. Also, she suggested that some essential ingredients be placed closer to the customer to ensure that every customer has access to the product without having the need for employees to supply them every time. Saving time was part of developing an effective supply chain that reduces wastage of time, an important resource in an organization. The strategy employed by Starbuck Corporation can be regarded as minimiza tion of waste of unnecessary motions. Harrison and Hoek (2011, P. 195) point out that if employees have to move, bend or stretch unnecessarily, this is a waste of time that would have been utilized in the productivity. The activities of the company benefited this organization in two dimensions. First, the organization was able to increase the amount of sales which directly contributes to the financial performance of the organization. Secondly, customers attach value to organizations that provide timely services without due wastage of time. In fast food companies where time is a factor, responding to customer orders in time assures an organization of loyalty from the customers. This is the idea that Scott Heydon when he engaged a strategy to minimize motion wastage in the organization. Jargon (Para. 15) points out that there was an increase in customer loyalty in Starbucks after the motion in this organization was minimized. In 2008, the customer loyalty changed from 56% to 76% betwe en April and June and the number of transactions increased by 9% during this time. Harrison and Hoek (2011, p. 60) provides that satisfying the customer value is a key business aspect that garners loyal customers and pulls new buyers. This kind of business trends is important for an

Compare the importance of team work and personal attributes Essay Example for Free

Compare the importance of team work and personal attributes Essay There are three ways Asda and Betta Value can use communication skills this is done through written, verbal and listening skills. Asda and Betta Value have different structure and size so the businesses needs a different balance of team working skills personal attributes in their staff. Listening, verbal and written skills At Asda Written is internally most dependants for the reason that they are a big business if you are relying on verbal communication the employees need good listening skills and good at following instructions. More instructions will be written into rules and processes to follow, their will be more check lists to make sure tasks are done and dusted. Betta Values uses verbal skills because of the size and level of the business this is because that Betta Values is a flat structure so the staff uses a lot of verbal communication Both businesses need to listen because they are both dealing with customers, if staff dont then they will loose clients but Asda is more likely to formally train employees in communication skills. For Asda personal presentation will be more consistent because staff will get issued with full uniform and it says on terms and conditions you must wear full uniform as for Betta values dress code and badges is what they have to wear because Betta Values has fewer budgets to spend. There will be more details in terms and conditions in employment regarding the job at Asda than Betta Value. Punctuality and time planning Punctuality and time planning are what both businesses want so the staff must be punctual so that they get full value for the wage they are paying. Time planning at Asda is critical because you have to link job and role in matrix structure which have to link with mesh and also time and planning is critical at Asda. Betta Values can afford a slightly relaxed aptitude to time planning but each manager controls the whole function so this means the managers have to many issues, time effectively because no one to pass on work. Betta Value would need good time management and planning because they have 19 people to control and make sure all employees are working effectively. Head office Head office at Asda supports the store project teams this means you have to time scale running in the business 1) To coordinate the functions at head office 2) For the store to meet their sales targets and objectives 3) The role of the project team at Asda is to synchronise the time for head office with through for the store Time scales at Asda is important to the achievement of the company. Betta Value can afford a little calmer attitude to time planning but every boss controls an entire function; this means with the purpose of the managers have to handle their own employment load independently for the reason that they have no one to pass on their work. Courtesy, honesty and confidentiality These are qualities that every retailer expects in their employees at Asda and Betta Values. Courtesy is when dealing with a customer the employee should be polite at all times because if they do not they will loose their customers. Honesty is an essential quality because retailers have stock and cash on premises dishonesty of staff means costs go up and profit goes down because of wasting and theft. Betta Value would its finance manager to be honest, as the manager will be dealing with a big amount of business money and if this money is taken Betta Value would be left bankrupt Confidentiality is most workforce at Asda wont have access to confidential information but Betta Values is a small value of staff and are more likely to overhear or find out sanative information therefore they may want to check how good staff are at and keeping affairs private an example through references. Interdependence of team members Group responsibilities share as individual targets In store at Asda staffs work in teams and have similar skills supervisors will have more experience and knowledge but they will have the same skills Reliance on specialist skills of other members and reliance on other teams The specialists teams at both business relay on other specialists from outside the team at Betta Values these are Human Resources and Finance etc at Asda specialists are located at head office and deliver through the matrix structure. Both businesses will have team targets but its because the operations (store managers team) at Betta Values has various specialists in the team targets and responsibilities will be very general but individual targets will be more specific. An example at Asda you will have specialists team groups and responsibilities are shared and individual targets will focus on developing staff. But at head office the people specialists with in a function their and their staff and their specific role in the team.

Business Law Essay Example for Free

Business Law Essay An agreement must contain four essential ingredients to be regarded as a contract. These four elements are offer, acceptance, Intention of legal consequences, and consideration. If any one of them is missing, the agreement will not be legally binding. An offer is defined as the manifestation of the â€Å"willingness to enter into a bargain so made as to justify another person in understanding that his assent to the bargain is invited and will conclude it. † There must be a definite, clearly stated offer to do something. An offer does not include ball park estimates, requests for proposals, expressions of interest, or letters of intent. An offer will lapse when the time for acceptance expires, if the offer is withdrawn before it is accepted, or after a reasonable time in the circumstances (generally the greater the value of the contract, the longer the life of the offer). Only what is offered can be accepted. This means that the offer must be accepted exactly as offered without conditions. If any new terms are suggested this is regarded as a counter offer which can be accepted or rejected. There can be many offers and counter offers before there is an agreement. It is not important who makes the final offer, it is the acceptance of that offer that brings the negotiations to an end by establishing the terms and conditions of the contract. Acceptance can be given verbally, in writing, or inferred by action which clearly indicates acceptance (performance of the contract). In any case, the acceptance must conform to the method prescribed by the offerer for it to be effective. A contract requires that the parties intend to enter into a legally binding agreement. That is, the parties entering into the contract must intend to create legal relations and must understand that the agreement can be enforced by law. The intention to create legal relations is presumed, so the contract doesnt have to expressly state that you understand and intend legal consequences to follow. If the parties to a contract decide not to be legally bound, this must be clearly stated in the contract for it not to be legally enforceable. In order for a contract to be binding it must be supported by valuable consideration. Consideration consists of either a benefit to the promisor or a detriment to the promisee. That is to say, one party promises to do something in return for a promise from the other party to provide a benefit of value (the consideration). Consideration is what each party gives to the other as the agreed price for the others promises. Usually the consideration is the payment of money but it need not be; it can be anything of value including the promise not to do something, or to refrain from exercising some right. The payment doesnt need to be a fair payment. The courts will not intervene where one party has made a hard bargain unless fraud, duress or unconscionable conduct is involved. When there is a breach of contract, an unexcused failure to perform, the other party is usually given damages, rather than specific performance. The rules of damages vary, but are usually intended to make the injured party whole. A party who was supposed to be paid something for that partys performance gets the amount of the payment due, if the performance has been rendered. A party who was supposed to get something of value sometimes gets the difference between the price agreed and the market price. Or, if the party has already paid the paying party sometimes gets the money back.

Psychosis in Children

Psychosis in Children Psychotic disorders in children are not common, however it is generally agreed that its prevalence increases during adolescence. The prevalence of psychosis in 13 to 19-year-olds was reported to be 0.54%, increasing from 0.9 per 10 000 at age 13 years to 17.6 per 10 000 at 18 years.8 Among adults with schizophrenia, 5% of them report onset of psychosis before the age of 15 years old and 20% of them have their onset before the age of 20 years old.9,10 Nevertheless, psychotic disorders in adolescence often mark the beginning of a lifetime contact with mental health services. Psychotic disorders in adolescence can pose not only diagnostic and treatment challenges, but also difficulties to the adolescent as well as their families. As can be seen in MLS’s case, there were challenges since the initial onset of symptoms including diagnostic uncertainties, difficulties faced by MLS and his parents due to the uncertainty in diagnosis which then led to worsening of symptoms and a rehospitalisation. In addition, the onset of symptoms at the age of 17 would be of significance for MLS as this is the age where several important life events would take place such as the major school examinations Sijil Pelajaran Malaysia, which may determine his academic and occupational future, in addition to other important life transitions such as having a relationship with the opposite sex, completing school and making a decision regarding the next step in his life such as whether or not to pursue further education. As such, accurate and early diagnosis, with appropriate tre atment is of utmost importance to ensure achievement of remission and to minimize any disabilities. Though schizophrenia in prepubertal children is rare, the prevalence of schizophrenia in adolescents is approximately 1 to 2 per 1,000, with an estimated ratio of 1.67 boys to 1 girl. The rate of onset is reported to increase during adolescence, and while the onset of illness is usually insidious, it may occur suddenly in a previously well child, such as in MLS’s case. Multiple aetiological factors contribute to the development of schizophrenia, including genetic, neurodevelopmental, as well as environmental risk factors.11 There is a family history of psychiatric illness among 2 of MLS’s paternal relatives and although their diagnoses could not be ascertained, it is likely that his paternal uncle had suffered from a psychotic illness in the past from the description given. This contributes to genetic loading which poses as a risk factor for the development of MLS’s illness. Another significant finding is that child and adolescent-onset schizophrenia is associated with premorbid developmental and social impairments. Some children and adolescents with schizophrenia are premorbidly more likely to have lower intelligence quotient, social withdrawal, isolation, poor peer relationships, excessive anxiety and academic trouble as compared to adult-onset schizophrenia, while some others may have histories of delayed motor or language milestones similar to some symptoms of autistic disorder. 12,13 A study on child and adolescent-onset psychoses found significant difficulties in social development affecting ability to make and keep friends in a third of cases with schizophrenia.14 MLS had poor eye contact as a child and although he did not have any other features of autism, he appears to be more socially reserved, having only few friends. This puts him at risk of developing schizophrenia, however whether premorbid impairments pose as a risk or precursor of psychos is remains a question. These premorbid impairments may be a causative factor for psychosis, or on the other hand, could be markers of an underlying neuropathological process which may be the cause of both the premorbid social impairment and psychosis. In addition, MLS had reported seeing shadows on a few occasions during childhood, at age 10 and 12 years old. An association between self-reported psychotic symptoms during childhood and later schizophrenia has been found.4 A 15-year longitudinal cohort study demonstrated a very high risk of schizophreniform disorder at age 26 among individuals who reported psychotic symptoms at the age of 11 with an odds ratio of 16. 42% of the schizophreniform cases at age 26 reported one or more psychotic symptoms at age 11 years, including hallucinatory experiences and delusional beliefs. The individuals who reported the psychotic symptoms at age 11 did not have mania or depression at age 26, suggesting specificity of prediction to schizophreniform disorder.15 Though this study found an association between psychotic symptoms in childhood and later schizophreniform disorder but not schizophrenia, it appeared that attenuated psychotic symptoms contribute a significant high-risk premorbid phenotype. 4 Growing up, MLS’s parents executed different parenting styles towards him. While his father gave him freedom and did not seem very involved in his daily living, his mother was overinvolved and controlling of his activities. The different types of parenting were described by Diana Baumrind in 1966 who introduced three models of parental control, namely authoritarian, authoritative and permissive. In permissive parenting, the parent is non-punitive and acceptant towards the child’s actions and desires, makes few demands for responsibility, allows the child to regulate his own activities and avoids the exercise of control.16 The parent imposes few maturity demands and either indulges or neglects the child’s needs.17 On the other hand, authoritarian parenting is characterized by high expectations of conformity to parental rules. The parent is obedience-oriented and the child is expected to obey orders without explanation. According to Baumrind, both permissive and au thoritarian type of parenting may prevent the child from being able to engage in interaction with people. Children and adolescents of authoritarian parents are tend to have less self-confidence and become socially withdraw, while permissive parents tend to suffer from problems with emotional regulation and self-control, and thus they were reported to be more likely involved in problematic behaviours and aggression.18 In MLS’s case, as MLS’s mother plays a more dominant role in the family compared to his father, her authoritarian parenting had resulted in MLS becoming more socially withdrawn, mostly staying at home with few friends. More importantly, this had resulted in a lack of bonding between MLS’s mother and himself. MLS had started to develop symptoms of unusual behaviour 3 days after being discharged from Klang Hospital for dengue fever, in addition to being socially withdrawn and deterioration in functioning. Though MLS seemed preoccupied when admitted to University Malaya Medical Centre the first time, he was unable to describe any positive symptoms of psychosis until the second admission when he had developed auditory hallucinations, persecutory delusion and thought echo. It has been reported that children and adolescents with psychosis can typically present with a prodromal period characterized by deterioration in personal functioning and negative symptoms such as concentration and memory problems, unusual behaviour, bizarre perceptual experiences, social withdrawal, apathy and reduced interest in daily activities, some of which are observed in MLS’s case. These symptoms may follow an acute period of stress or a physical illness, which was dengue fever in MLS’s case.19 Frank p sychosis develops within 12 months of symptom onset in 40% of patients20, and this prolonged duration of prodromal period may affect school performance as well as delay the diagnosis of psychosis or schizophrenia, but for MLS the psychotic symptoms developed much earlier. The acute episode which follows the prodromal period is usually characterize by positive symptoms of hallucinations and delusions, which may lead to a sense of fear of puzzlement during the period of delusional mood. As perceptual disturbances may be new experiences for children or adolescent, they may be distressed or confused, as can be observed in MLS who appeared confused and preoccupied, and may subsequently develop secondary delusional belief such as being replaced with doubles when they experience themselves or family members as being unfamiliar. As for MLS, the lumbar puncture performed on him in the neuromedical ward may have strengthened the persecutory delusion where he started to believe that someone intentionally removed a bone from his spine and further persecutory delusion such as the belief that people wanted to poison his food in the ward. A detailed assessment including thorough history and physical examination as well as diagnostic workups need to be performed as psychosis in childhood and adolescence may result from an organic cause such as infection as well as neurological, autoimmune, endocrine or metabolic conditions. Neuropsychiatric conditions such as encephalitis, temporal lobe epilepsy, cerebral lupus, drug intoxication as well as neurodegenerative illnesses such as Wilson’s disease need to be ruled out particularly when there are neurological signs or fluctuating levels of consciousness, in which blood tests, computed tomography (CT) scan, MRI or electroencephalography (EEG) may be helpful.19 As for MLS, organic workup was performed during both the admissions to UMMC due to the acute onset of abnormal behaviour and presentation after dengue fever during the first admission, as well as an episode of recorded fever and confusion during the second admission. MLS was investigated for post-dengue encephalitis during the first admission to UMMC. Dengue viral infection can present with varying clinical manifestations ranging from asymptomatic infection to life threatening haemorrhagic fever and dengue shock syndrome. Apart from the cmp renal and hepatic dysfunction, dengue fever can present with neurological complications including dengue encephalopathy, encephalitis, neuromuscular complications as well as neuro-ophthalmic involvement in 4-5% of confirmed dengue cases.21 While the more common symptoms of encephalitis include headache, disorientation and seizures, neuropsychiatric symptoms such as psychosis, mania and dementia have been reported as post-infectious sequelae.22 A case report in 2013 described a 12-year old boy who presented with behavioural change characterized by emotional lability, dependence, alteration in rhythm of language and tone voice, anxiety and change in tastes in addition to fever, severe headache, seizures and vomi ting. Though magnetic resonance and computed tomography showed no brain changes, serology for dengue was positive for both IgM and IgG and cerebrospinal fluid revealed high protein levels and increased lymphocytes. The boy had improved with risperidone, but behavioural symptoms were still reported to be present 60 days later. 23 Another author reported a 21-year old man who developed an episode of classical manic symptoms including overactivity, excessive talking, argumentativeness, irritability, grandiosity, abusiveness and decreased need for sleep on the 6th day of dengue illness with thrombocytopenia, and was successfully treated with carbamazepine and haloperidol.24 The diagnosis of dengue encephalitis may be made either by detection of virus or antibodies in the cerebrospinal fluid, but the absence of antibodies will not rule out encephalitis. MRI, the modality of choice of brain imaging, may show findings consistent with viral encephalitis such as cerebral oedema, white matter changes, brain atrophy and necrosis.25 In MLS’s case, there was no evidence suggestive of infection in his blood or cerebrospinal fluid tests, while blood imaging and electroencephalography did not reveal any significant findings. This points against the diagnosis of post-dengue encephalitis, although the investigations done by the neuromedical team during both admissions were justified and thorough. The management of adolescent psychotic disorder encompasses many aspects and should take into consideration a risk assessment to self and others, mental state, insight into illness, likely adherence to treatment as well as level of support available, in addition to any predisposing, precipitating, maintaining and protective factors. As children and adolescents with psychosis or schizophrenia and their families may experience significant distress, it is important to engage both the young person and their parents or carers in the management of their illness, which is the foundation of subsequent pharmacological and psychosocial interventions. The Early Pyschosis Declaration emphasizes the reduction of long delays that families face by services working better together and earlier to meet needs of young people and their parents. Among the issues that need to be considered in the management of children and adolescents with psychotic disorder include the normal developmental tasks of adole scents, effectiveness and safety of particular treatments as well as offering service and information to parents about costs and benefits of any recommended treatment. Psychoeducation for the young person and their families is important, such as in MLS’s case as his parents have limited awareness of mental illness and had missed MLS’s initial psychiatric appointment as they thought that he was well when he was still preoccupied and had started to develop positive psychotic symptoms. Explanation about the illness, guidance as well as involving family members in treatment decisions are important in ensuring compliance and continuity of care particularly as the young person such as MLS transits from adolescence to early adulthood.19 Though it is recommended that psychosocial and other benign options should be employed before considering medication, pharmacological treatment such as antipsychotics has been more widely used in recent times. Though there are few benefits of second generation antipsychotics over first generation antipsychotics in efficacy in treating early-onset schizophrenia and schizoaffective disorder, the former is less likely to cause side effects of extrapyramidal symptoms but at the same time are associated with weight gain, metabolic problems and risk of diabetes, as part of the findings from the treatment of early-onset schizophrenia spectrum disorders study (TEOSS).26 As such, it has been recommended that lifestyle and dietary advise should be given in addition to side effect monitoring when initiating an antipsychotic medication.27 Though antipsychotic medication is effective in reducing positive psychotic symptoms, with a modest effect size of 0.2 to 0.3, there is limited evidence for antipsychotic treatment of psychosis and schizophrenia in young people, with only minimal differences in efficacy found among the different antipsychotics but with large differences in side effect profiles.28 A Cochrane review of antipsychotic medication used in children below age 13 years with childhood-onset schizophrenia found inconclusive evidence regarding the effects of antipsychotic medication for early-onset schizophrenia, with clozapine showing benefits over haloperidol in treatment resistant schizophrenia but were offset by risk of serious adverse effects.29 Another meta-analysis on the efficacy, safety and tolerability of antipsychotics in adolescents aged 13 to 17 years with schizophrenia demonstrated that antipsychotic treatment with risperidone, olanzapine or aripiprazole resulted in significant improvement in sympt omatology, and that treatment with 10mg daily dose of aripiprazole was associated with the lowest incidence of extrapyramidal symptoms with no significant weight gain.30 However, most antipsychotic medications have not been approved to treat early-onset schizophrenia as they have not been tested in the younger individuals. In Europe, aripiprazole and more recently paliperidone which was approved the use in adolescent schizophrenia, while aripiprazole, olanzapine, paliperidone, risperidone and quetiapine are approved by the Food and Drug Administration (FDA) in the United States for the treatment of early-onset schizophrenia in individuals aged 13 to 17 years old.31 Antipsychotic treatment was started for MLS due to the severity of the psychotic symptoms as well as the risk of harm to self and others. As he had developed side effects of sedation with a low dose of risperidone, it was changed to aripiprazole, which was then switched to olanzapine when he did not respond to aripiprazol e at a dose of 10mg daily. His symptoms improved with olanzapine and had maintained well with this medication, but he would need to be regularly monitored for weight gain and metabolic side effects. As he had started to experience weight gain, dietary advice was given and continuation of active lifestyle and exercise which he was beginning to engage in was encouraged. Psychological interventions such as cognitive behavioural therapy have been studied and found that cognitive behavioural therapy can be possibly used to reduce the strength of delusional beliefs as well as to reduce the likelihood of relapse among young individuals with first episode of psychosis. In addition cognitive remediation therapy, art therapy as well as structured employment approaches are being developed and evaluated.19 Family intervention adapted for the developmental needs of adolescents aiming to reduce criticism and hostility towards the adolescent may also be helpful.31 In MLS’s case, a lesser overinvolvement by his mother was encouraged as overprotection and emotional overinvolvement are associated with high expressed emotion, which are in turn associated with a high relapse rate among patients with schizophrenia. More importantly for MLS is the return of functioning and continuation of schooling as this is his final year of secondary education and also the year in which he is bound to sit for the Sijil Pelajaran Malaysia examinations. It may be a stressful situation for MLS going back to school after a duration of 2 months of not attending school, in addition to the stress of catching up with studies, preparing for exams as well as possible stigma from others in school. It is important for school staff to support young individuals with psychosis or schizophrenia in school as they may feel distressed by their psychotic symptoms which may be worsened by responses of those around them, particularly if they get mocked or bullied by others. In addition, exposure to environments or classes with high levels of expressed emotion should be minimised as they are known to increase the risk of relapse but at the same time provide opportunities for social interaction with others.19 As there is a risk of future relapse with ongoing stressors such as sitting for examinations, expanding academic and career capabilities as well as undergoing the transition from adolescence to adulthood, ongoing follow-up is recommended for MLS. Among the factors contributing to a poorer prognosis in child and adolescent-onset psychosis include premorbid social and cognitive impairments, prolonged first psychotic episode, prolonged duration of untreated psychosis and negative symptoms. Schizophrenia in young individuals typically run a chronic course, with only 12% found to be in full remission at discharge and those with full recovery most likely recover within first 3 months of onset of psychosis.19 Nevertheless young individuals who do not undergo complete recovery from the illness may still be able to maintain an acceptable quality of life with adequate support as recovery is a personal process involving finding a sense of self and hope. As for MLS, regular follow-up and assessm ent of treatment needs in addition to return to functioning, prevention of a future relapse as well as continuous support from family members are crucial to ensure a good quality of life as an adolescent and a smooth transition to adulthood.

Spiritual Emptiness in Hemingways A Clean, Well-Lighted Place Essay

Ernest Hemingway's short story, "A Clean, Well-Lighted Place," first published in 1933, is written in his characteristic terse, unembellished style. The definition of "Style" is "the characteristics of language in a particular story and . . . the same characteristics in a writer's complete works" (Gioa and Gwynn, "Style" 861). Short words and a curt tone are so characteristic of Hemingway's style that writers frequently parody them in "International Imitation Hemingway" contests (Gioa and Gwynn, "Style" 861). But Hemingway could only his express this story's theme -- that there is nothing beyond the here and now of daily existence, no God to embellish our lives -- in an unembellished style of writing. The somewhat empty style of this short story is not "Imitation Hemingway"; it's consistent with the story's theme of spiritual emptiness. Almost thirty lines of "A Clean Well-Lighted Place" are pure dialogue with few clues, other than what is said, about who is speaking. In the rest of the story, the percentage of words with more than two syllables is very low. Some biographers point out that Hemingway learned his rules of writing working for the Kansas City Star, whose style-book admonished reporters to "Use short sentences. Use short first paragraphs. Use vigorous English, not forgetting to strive for smoothness" (qtd. in Desnoyers 2). Was the curt style of "A Clean, Well-Lighted Place" caused only by Hemingway's having learned writing from a newspaper style-book? He later said about those newspaper rules, "Those were the best rules I ever learned for the business of writing. I've never forgotten them. No man with any talent, who feels and writes truly about the thing he is trying to say, can fail to write wel... .... "One True Sentence." The Longman Masters of Short Fiction. Eds. Dana Gioia and R.S. Gwynn. New York: Longman, 2002. 375-376. Desnoyers, Megan Floyd. "Ernest Hemingway: A Storyteller's Legacy." The Ernest Hemingway Collection. 12 December 2002. John F. Kennedy Library and Museum. 20 August 2003. . Gioia, Dana, and R.S. Gwynn. "Ernest Hemingway." The Longman Masters of Short Fiction. Eds. Dana Gioia and R.S. Gwynn. New York: Longman, 2002. 370-372. Gioia, Dana, and R.S. Gwynn. "Style." The Longman Masters of Short Fiction. Eds. Dana Gioia and R.S. Gwynn. New York: Longman, 2002. 861-862. The Hemingway Resource Center. "Ernest Hemmingway Biography>Key West." The Hemingway Resource Center. LostGeneration.com. 20 August 2003. .

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When John Browne set in motion the strategy that put BP on its course to become a â€Å"green† oil company, his plans seemed ripe with promise. Despite criticisms of â€Å"green-washing,† the company enjoyed recognition and admiration from the media and non-government organizations, and rose in the public esteem as an advocate for investments in renewable energy technology and responsible energy use. For years, the move looked to be good strategy: the benefits of the decision seemed to offset the costs incurred to implement it, some of which included: †¢ Risk of minimal benefits if policies or requirements do not change †¢ Foreclosing on future non-green opportunities †¢ Impacting the company’s portfolio of non-green products †¢ Committing to future green investments †¢ Creating a â€Å"higher bar† for ongoing business practices †¢ Increasing the cost of blunders or accidents on the company’s credibility and public standing BP might have understood the price it was paying for its green personality, but the company seems to have underestimated the latter two cost descriptors. Its newfound environmental acclaim and the public awareness that came with it brought closer scrutiny to the company’s ongoing activities and much higher expectations for how it would conduct its business moving forward. The Texas City tragedy in 2005 and the Prudhoe Bay spill of 2006 should have been lessons to the company: unless it can get the basics of corporate responsibility right, drawing public attention to its business is inviting trouble. Disaster at the Macondo Well On April 20, 2010, a BP exploratory well at Macondo exploded, causing 11 deaths, sinking Deepwater Horizon and starting a massive oil leak, that persisted for weeks. The event highlighted BP’s inability t... ... the industry and the multitude of spills occurring since the Deepwater Horizon events point to a much lesser impact on the industry’s performance. Alas, large-scale environmental abuses such as the repeated spills in the Niger Delta, where spills are responsible for degradation equivalent to the Exxon Valdez disaster yearly, are not widely discussed, and much information is still obscured from the public. As non-market pressures increase for corporations around the globe, the hope is that companies will learn from the longer-term de-valuation effect suffered by BP and take its economic value into account. There is hope for responsible behavior; bright will be the day when instead of being more than marketing campaigns, environmental and social responsibility outreach by major companies will exist to maximize social objectives, subject to profitability constraints.

Factors Influencing Family Physicians Prescribing Health And Social Care Essay

Due to turning international concern about the quality of ordering in primary attention, research workers and policy shapers have made interventional schemes to better prescribing. Drug outgos are large load and threaten of wellness attention budgets. It is disputing undertaking to better ordering form in medical pattern. The ordering wont by general practician is a complex activity and depends on the interplay of many factors. In recent decennaries, these factors have been shown to act upon household doctor prescribing form ( 1 ) . ( 1 consequence of advertisement ) Analyzing factors associated with household doctors ‘ prescribing is considered to be of high value since high per centum of drugs are prescribed by primary attention doctors. These factors interact in non additive and unpredictable ways ( 2 ) . ( 2 factors act uponing GP Allan ) . As consequence of assorted influences, ordering wont alterations of the single doctor normally occur easy. ( 3 ) ( drug prescription forms Bjerrum ) . For the range of this reappraisal we classify factors associated with household doctors ‘ ordering into four classs. The first class includes factors related to doctors ; age, sex, old ages of experience, and uninterrupted medical instruction. The 2nd class includes factors related pattern scenes ; size of pattern, figure of patients, guidelines and usage of drug pharmacopeia. The 3rd class includes factors related to drugs: advertizement and cost. The 4th class includes factors related to patients ; age, sex, comorbidity and multiple health care suppliers. Therefore, the purpose of this reappraisal is to place and to measure factors impacting household physician ordering behavior. The research inquiry formulated to province, what are the factors impacting household physician ordering behavior.MethodsIn this literature reappraisal we chose loosely inclusive hunt scheme with two phases. In phase one, a hunt has been conducted utilizing the undermentioned cardinal words: â€Å" prescription † , â€Å" prescribing † , â€Å" prescribing forms † ordering attitudes † , â€Å" ordering factors † , â€Å" ordering indexs † , primary attention ordering † and â€Å" GP prescribing † . In 2nd phase, after calculating out the factors associated with doctors ordering forms based on first phase, a 2nd hunt has been conducted utilizing the undermentioned footings â€Å" guidelines and ordering † , â€Å" drug cost † , â€Å" drug advertisement † , â€Å" drug formulary † , â€Å" polypharmacy † , repetition prescriptions † and â€Å" new drug † . We searched midplane, Pub med and Eric from 1990 to 2009. From articles fulfilling preliminary inclusion standards, the mention lists were reviewed. Based on the initial reappraisal our concluding inclusion and exclusion standards were determined. Study Selection The inclusion standards are: a ) articles assessed ordering in primary attention scene, B ) article recovering information from prescription database. We excluded articles written in linguistic communication other than English, surveies that assessed specific drug group or drugs for specific disease. There were no geographic restrictions.ConsequencesWe found 31 surveies that met our standards. All surveies used a database for informations aggregation, 12 and 13 prospective and retrospective surveies severally ( table 1 ) .Factors related to doctor:It has been found that there is a important relation between certain primary attention physician features and their prescribing behaviour. Younger primary attention doctors have higher rates of new drug use. Female sex and recent graduation i.e. less old ages in pattern are associated with high drug use rates ( 4,5,6,7,8,9 ) ( 1, 4,18, 19,31,32 ) .One survey showed that no influence of physician age or figure of old ages in pattern on polyp harmacy in peculiar ( 6 ) ( 18 ) . High prescribers did non differ significantly from low prescribers in age, figure of old ages in pattern, average pattern size or patient age. ( 9 ) ( 32 ) Gill et Al has found no effects of doctor ‘s ethnicity and topographic point of graduation on ordering forms ( 10 ) . ( 2 ) , However, two surveies demonstrated that doctors who were foreign trained tend to hold high prescribing rates and cost ( 9 ) ( 28,32 ) . Besides medical school found to be a factor associated with higher new drug use ( 7 ) ( 19 ) . Continuous medical instruction ( CME ) has an consequence acceleration of new drug acceptance ( 5 ) ( 4 ) . An educational intercession plans improve ordering forms and may ensue in important clinical benefits ( 11,12 ) ( 3, 25 ) . It is besides noticed that ordering wonts are influenced by scientific documents, specialist recommendations and meetings ( 3 ) ( 14 ) . Financial inducement found to hold a impermanent consequence on altering prescription behaviour ( 13 ) ( 26 ) . One survey showed that guidelines had a small consequence on antihypertensive drug usage. ( 14 ) ( 13 ) Adoption of new drug is of import ordering factor. Among five drugs studied Steffensen et Al found hapless understanding between early, intermediate and late prescribers. Late prescribing was associated with female doctors. ( 5 ) ( 4 )Factors related to patternThere is a additive correlativity between the figure of prescribed drugs and figure of general practicians in the pattern ( 15, 16 ) ( 12, 15 ) . Physicians with big pattern prescribed more drugs than those with little pattern ( 4, 16 ) ( 1, 15 ) . In footings of polypharmacy, one survey showed 56 % of ordering fluctuation between general practicians could be explained by forecasters related to pattern construction, work load, clinical work profile and ordering profile ( 17 ) ( 6 ) . It has been noticed that high work load patterns tend to hold a high prescribing rates. ( 4,18 ) ( 1,27 ) , However in patterns with big figure of listed patients, doctors prescribed fewer drugs per patient compared to patterns with low figure of listed patents. ( 6 ) ( 18 ) McCarthy et Al found a important correlativity between the figure of drugs prescribed and the figure of physician working in the pattern. ( 15 ) ( 12 ) The diffusion clip of new drug after its release is longer in partnership pattern compared to individual handed pattern, the average diffusion times are 41 and 119 yearss for partnership and individual handed patterns severally. ( 5 ) ( 4 ) Fee-for-service type of pattern was considered to be associated with higher rates of new drug use. ( 7 ) ( 19 ) . Doctors practising in rural countries and holding high proportion of aged have lower new drugs use rates than those practising in urban countries. ( 7 ) ( 19 ) . Use of drug formulary and agreed verbal prescribing policy had no important association with the figure of drug prescribed. ( 15 ) ( 12 ) . Computerized reminders have some consequence on physician ordering behaviour. ( 19 ) ( 24 )Factors related to drugsDoctors ‘ interaction with drug industry found to get down every bit early as medical school. ( 20 ) ( 373.26 ) .It has been found that every bit many as 80 % of GP ‘s in both partnership and individual handed patterns had prescribed new drug 6 hebdomads and 21 hebdomads after its release severally. ( 5 ) ( 4 ) Tamblyn et Al addressed that the new drugs have 8 to 17 fold differences in use rate, and were prescribed by 1.3 % -22.3 % of doctors. ( 7 ) ( 19 ) . There is a additive relationship between polypharmacy and underprescribing. The higher the figure of the drugs, the higher the estimated chance of underprescribing is. ( 21 ) ( 23 ) . Provision of drug cost information in a computing machine based patient record system was found to hold no consequence on overall prescription drug cost to patients, nevertheless there was differences in single drug categories. It besides has been found that doctors are unfamiliar with the costs ofA medicines they normally prescribe. ( 22 ) ( 33 ) One survey has indicated that a important proportion in volume and costs is straight affected by hospital-initiated prescriptions. ( 9 ) ( 32 ) Repeat ordering accounted for the huge bulk of all points every bit good as prescribing costs. It accounted for 75 % and 81 % of all points and ordering costs severally. ( 23 ) ( 7 ) Among aged patients, the mean prescription was 99.4 % per 100 general practician contacts ; 72.1 % were repeat prescriptions. ( 24 ) ( 17 ) . Ashly et Al has found that ordering and professional behaviour appear to be affected by the present extent of physician-industry interactions. ( 25 ) ( 29 ) Reducing interactions between doctors and pharmaceutical gross revenues representatives has resulted in improved prescribing. ( 8 ) ( 31 )Factors related to patientsThe drug use rate additions with patient ‘s age. Patient ‘s age has more important consequence on drug use rate compared to patient ‘s sex ( 26, 27 ) ( 11, 16 ) . Repeat prescriptions significantly increase with patient ‘s age. It has been found every bit high as 72 – 90 % for patients aged 85 and over ( 23,24 ) ( 7,17 ) . In footings of patient ‘s sex, female patients were found to be given more drug points but less repetition prescription than male patients ( 27 ) ( 16 ) . In aged population, more than 60 % of perennial prescribing was for female patients. ( 24 ) ( 17 ) . Among patients aged 79 and under, female patients were pre scribed to significantly more times than males ( 28 ) ( 9 ) . Buck et Al found that female sex was associated with potentially inappropriate medicines ( 29 ) ( 22 ) . Patients with greater figure of chronic conditions, multiple health care suppliers and multiple clinic visits have higher hazard of developing polypharmacy and relentless polypharmacy ( 30 ) ( 8 ) . Ordering rates every bit good as costs increase with morbidity. ( 31 ) ( 10 ) .DiscussionIn this literature reappraisal we observed that doctors ordering behaviours are affected linearly or reciprocally by many factors. Doctors A important relation has been found between certain physician features and ordering behaviour. The findings that younger male doctors had higher ordering rate may be related to a causal nexus between some physician features, ordering behaviour and patient results. It is non clearly known why sicker patients would seek immature or male doctors, but these doctors may prefer more aggressive intervention than female doctors and older co-workers. ( 4 ) ( 1 ) Higher rates of drug use among younger doctors may be related the leaning for aggressive intercession, more established ordering behaviour in older doctors or targeted selling patterns. ( 32,33 ) ( 19 — -47,48 ) The determination that male doctor had higher rates of new drug use was supported by other surveies. ( 34 ) ( 19 — -8 ) Female sex, little list size, lower diagnostic activity per patient and restrictive attitude toward pharmacotherapy tantrum into topology of conservative doctors. Supported by some surveies, con servative doctors described as being light users of drugs. ( 35, 36 ) ( 4 — -9,19 ) It is surprising that for those doctors who qualified from different states, their ethnicity had no consequence on their prescribing behaviour. ( 10 ) ( 2 ) This could be related to secondary socialisation which occurs in approximately 5 to 6 old ages. ( 37 ) ( 2 — -2 ) Socialization through graduate student preparation and practicing in group pattern alterations ordering behaviour. ( 38 ) ( 2 — — -3 ) There was no direct nexus between postgraduate preparation degree and ordering behaviour. The degree of postgraduate preparation can be a factor in finding how readily physicians accept commercial beginnings of ordering information. Handouts from pharmaceutical companies were rated as really of import or of import beginnings of CME by significantly fewer certified members than non-certified members of the College of Family Physicians of Canada. ( 39 ) ( presc by can — — 59 ) Interventional CME for intervention of chronic diseases for illustration bronchial asthma resulted in some betterment in ordering behaviour. ( 11 ) ( 3 ) CME and other societal facts have been found gas pedals for new drug acceptance. ( 40, 41 ) ( 4 — -9,19 ) It has been suggested that there is a nexus between increasing age, non-attendance at CME classs, and inappropriate prescribing. ( 42 ) ( presc by can — 24 ) . But there was no adequate information, nevertheless, to research this hypothesis farther. Other surveies do non back up this account. ( 43,44, 45 ) ( presc by can 44-47 ) The intent of the execution of clinical guidelines is to better quality of attention. However, surveies have showed that the US National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure ( JNC ) guidelines apparently had small consequence on the form of antihypertensive drug prescribing. ( 14, 46, 47 ) ( 13, 13 — — 21 ) Two possible grounds, foremost is that doctors may be loath to alter drug therapy because of already good controlled blood force per unit area. Second ground may be that ordering behaviour was influenced by pharmaceutical maker promotional activities. ( 14 ) ( 13 ) Practice Puting Practice puting features have been shown to act upon ordering behaviour. The informations clearly demonstrated a relation between polypharmacy and pattern puting features. Practices with big figure of patients have fewer drugs prescribed per patient compared with patterns with low figure of patients. ( 48, 49 ) ( 18-22,23 ) This determination was consistent with other surveies. ( 6 ) ( 18 ) Busy working doctor were more inclined to order multiple drugs than doctors with low work load. ( 50, 51 ) ( 18 — — 24,25 ) It has been noticed that new drugs have been adopted by partnership patterns faster than unassisted patterns. ( 5 ) ( 4 ) The type of pattern besides influences doctors ‘ usage of drugs. Salaried physicians practising in government-funded community wellness centres had better ordering forms than doctors in fee-for-service group patterns. ( 52 ) ( pres bycan 5 ) Free-for-service patterns were associated with higher rates of new drug use. ( 7 ) ( 19 ) the ma gnitude of this association was non big plenty to anticipate major cost salvaging related to new drug use. ( 53 ) ( 19 — -52 ) . It has been noticed that fee for service patients were more likely to follow JNC guidelines than the patients with wellness care organisation insurance. Therefore, the patients with wellness care organisation insurance had no penchant for promoting their doctors to choose more cost-efficient drugs. In contrast, fee for service patients appeared to hold more penchant for choosing lower cost drugs. ( 14 ) ( 13 ) Although, fiscal inducements represent a non-voluntary scheme to implement alteration in medical pattern, it had a limited, impermanent consequence on the prescribing behaviour. ( 13, 54 ) ( 26, 26 — — -18 ) Working in rural countries influenced ordering behaviour. Lower rates of new drug use among doctors working in rural countries may be due comparative isolation of rural doctors from co-workers who may hold influence in the determination to order new intervention. ( 55 ) ( 19 — — 22 ) Merely one survey concluded that there was no important difference in figure of different drugs prescribed by patterns runing a formulary from that found among patterns with no formulary. This could be due to, that all doctors in those patterns may non follow with the formulary, or pharmacopeias contained a narrow scope of drugs. ( 15 ) ( 12 ) However, this determination was non supported by other surveies. The usage of pharmacopeia has been found to act upon ordering behaviours and cut down costs. ( 56, 57 ) ( 12 — -1,3 ) Drugs There are many factors related to drugs that may act upon physician prescribing behaviour. Early usage of new drugs may non be compatible with appropriate prescribing. Newness should non be seen as a virtuousness in a pharmaceutical merchandise and that it is important that physicians think more carefully before ordering a new drug. ( 58 ) ( presc by can ) Small proportion of doctors prescribed new drugs even for drugs that were known as supplying significant betterment over bing intervention. ( 7,59 ) ( 19, 19 — -8 ) Costss of wellness attention are escalated by increased disbursement and usage of prescription medicines. There was no adequate grounds that physicians ordering behaviors affected by consciousness of drug cost ( 60 ) ( 20 ) . It may be that physician ordering behavior isA insensitive to be information. other factors such as drugA efficaciousness, , patient conformity, side effects and peer recommendationsA may be more of import. ( 61 ) ( 20 — -5 ) Particul arly for chronic attention medicationsA that have proven to be effectual for an single patient, A cost may be a minor factor. However, several studiesA have shownA that instruction of doctors about drug monetary values can alter prescribingA behavior and cut down cost by bettering selectionA of cost-efficient drug intervention. ( 62,63,64 ) ( 33-18,19,20 ) In qualitative surveies drug monetary value was a perennial subject and was mentioned as the chief ground for taking first line intervention. Price was besides mentioned as the ground for drug switch. ( 2 ) ( factors Allan ) It has been noted that when doctors were cognizant that patients would hold to pay out of their ain pockets for prescriptions, or they learned from patients ‘ ailments to them, they modified their prescribing behaviour consequently. ( 58 ) ( pres by can ) At primary attention degree, every bit high as two tierces of all prescriptions were repeated. One possible ground may be the impact of infirmary prescribing in volume was most obvious with repetition prescriptions for patients with chronic upsets. ( 9 ) ( 32 ) Second possible ground is that big proportion of repetition prescription issued during indirect contact. ( 24 ) ( 17 ) In UK survey, it has been found that 23 % of the patients had been having repetition prescriptions for more than a twelvemonth without seeing their household doctors. ( 65 ) ( 17 — -2 ) Practices with high figure of patients on repetition prescriptions were found to hold an increased hazard of polypharmacy. It has been noticed that patterns utilizing a broad scope of different drugs had a high prevalence of polypharmacy. ( 66 ) ( 18 — -31 ) Doctors ‘ beginnings of information about pharmaceutical agents are likely to be a major factor in ordering behaviour. The drug representatives visited doctors on frequent bases utilizing a broad assortment of promotional techniques including drug samples, gifts, and educational stuffs. Accepting drug samples was associated with penchant and prescription of new drug ( 25,67 ) ( 29, 29-40 ) In one survey, it has been found that 85 % of medical pupils believe it is improper for politicians to accept a gift, whereas 46 % found it improper for themselves to accept gift of similar value from a pharmaceutical company. ( 68 ) ( 29 — -9 ) All educational stuffs sponsored by pharmaceutical industries including support for travel or lodging to go to educational symposia, industry-paid Meals, pharmaceutical representative talkers, CME sponsorship and honoraria, research support influenced prescribing. ( 25 ) ( 29 ) The determination that advertising on clinical package had small consequence on ordering behavior was similar to other surveies consequences when analyzing the relationship between ordering and advertising in diary. One survey found no relation between the advertisement and for a drug and the sum and prescribing by doctors. ( 69 ) ( 5 — -11 ) Patients It is sensible that patterns with high proportion of aged patient had high rates of drug use. The observation that some of patterns had sicker patients than others ; this observation may be due to that sicker patients chose specific patterns or physician ordering behavior may hold made their patients sicker. ( 4 ) ( 1 ) It is non clear why sicker patients chose peculiar patterns. One survey has found that patterns with high proportion of aged patients were associated with greater likeliness of prescribing of new drugs, but lower new drug use. It has been suggested that doctors faced patients with coexisting disease. ( 70, 71 ) ( 19-53,54 ) The determination that patients in the distant parts had low prevalence of drug prescribing may hold been because of limited entree to medical services. ( 72 ) ( Quesinable presc ) Females were prescribed more medicines than males. When gender-specific medicines are excluded the differences are less marked. ( 73 ) ( 9-16 ) When female-specific cura tive groupings and interventions are removed, differences still exist between male and female prescribing.DecisionsDoctors ordering behavior appears to be influenced by multiple factors. Majority of surveies in this reappraisal retrieve their informations from wellness database. However, these comprehensive wellness databases have no information on the indicants for drug intervention or ascertainment of comorbidity that may hold affect ordering behaviour. Therefore, properties of the pattern population demand to be considered as possible prejudices. Data is missing on combination of each factor to patient outcomes, this spread in the literature needs to be addressed. Therefore, it is hard to mensurate the rightness of doctors ordering. Physicians ordering behaviour can be improved by execution of easy progressing alterations. Finally, ordering is a clinical determination ; surveies ; of clinical determination devising are about people, behaviour and contexts. They need both quantita tive and qualitative attacks. Davidson et al. , 1995 Canada 336 general patterns Gill et al. , 1997 United kingdom 310 general practicians Denig et al.,1998 Nederlands 181 general practicians Steffenson et al. , 1999 Danmark 95 general practicians Handerson et al. , 2008 Astralia 1336 general practicians Bjerrum et ak. , 2000 Danmark 173 general practicians Harris et al. , 1996 United kingdom 115 general patterns Chon et al. , 2009 Taiwan 11338 prescriptions Mortin et al. , 2002 Newzeland 31 general patterns McGavock et al. , 1988 United kingdom 23 general patterns Fernandez et al. , 2008 Spain 5474274 prescription McCarthy et Al 1992 United kingdom 362 general practioners Guo et al. , 2003 USA 7.3 million prescriptions Bjerrum et al. , 2002 Danmark Bjerrum et al. , 2001 Danmark 173 general practioners Rberts et al. , 1993 United kingdom 90 general patterns Straand et al. , 1999 Norway 1677 prescriptions Bjerrum et al. , 1999 Danmark 173 general patterns Tamblyn et ak. , 2003 Canada 1661 general practicians Omstein etal. , 1999 USA 22883 prescriptions Grimmsmann et al. , 2009 Germany 730 general patterns Buck et al. , 2009 USA 61251 patients Kuijpers et al. , 2008 Nederlands 150 patients Martens et al. , 2007 Nederlands 53 general practicians Straand et al. , 2006 Norway 600 general practicians

Managerial Level and Skill Essay

1. DESCRIBE THE MANAGERIAL LEVEL & MANAGERIAL SKILL IN HOSPITAL ADMINISTRATION MANAGMENT. Management is an art of getting things done through others. It is organized efforts so as to achive the predeterminedgoal. It is continuous process made up of various functions like planning , organization , controlling , directing. A manager is person who is responsible for getting work done through people so he must have some skill â€Å"managerial skill†and levels â€Å"managerial levels â€Å" Managerial levels : In management there r three broad levels they are 1. First line or junior management 2. Middle management 3. Top managment First line management : This is lowermost level which directs non managerial employers in other word called â€Å"supervisors† Middle management : This level is important and responsible level which direct activities of junior managers and employee. Top management : Overall management of organization is take care by this level. They are referred as chairman, president , vice president , chief executive officers , managing directors . Role of this peoples is to establish policies , strategies co-ordinate activities and guide peoples. Managerial skill : Skill can be defined as an ability to translate knowledge into actions. Henri fayol has define three managerial skill seems to be necessary in managers. Three types of skills are needed by managers, 1. Human relation skills, 2. Conceptual skills, 3. Technical skills. Human skill : Human relation skills are skills associated with a manager’s ability to work well with others, both as a member of a group and as a leader who gets things done. Conceptual skill : Conceptual skills are skills related to the ability to visualize the organization as a whole, discern relationships among organizational parts, and understand how the organization fits into the wider context of the industry, community and world. Technical skill : Technical skills are skills that reflect both an understanding of and proficiency in a specialized field. This is necessary for supervisors or lower level management.

Improving Performance & Effectiveness of your Company

A year ago, the administration has met the top eight managers of the company for a thorough departmental evaluation. The conference yielded outstanding overviews of where the company is, where it should be going, and how it can get where it should be. Each department head devised a plan on how to contribute to the vision of the company, which each department was able to materialize.A year later and the goals have been met. However, the overall state of the company stayed the same. If it moved forward at all, the move was too little and subtle to affect the company vigorously.This is why the management has decided to create an action plan which will homogenize the departmental plans that were created and now being observed so that the positive effects aid the company in moving forward. EXAMINATION OF THE VARIABLES The initial evaluation made by the managers is sufficient to zero in on department-specific issues and concerns. Initially, these issues and concerns of the individual emplo yees and the small group (departments) were considered the best determinant of the company’s progress meter. From these evaluations, the managers identified the problems and devised ways of solving them.Likewise, they uncovered opportunities that were not used before. Lastly, action plans have been created. While the managers succeeded in their implementation of their action plans, it did little for the company. The company remained stagnant as a whole even if the departments soared at meeting goals and exploiting opportunities. Solving problems, Meeting goals One important aspect of the process was identifying the problems in detail by specifying those which bothers each department. By looking into the details, the managers ensured building a strong foundation for the company.It is also by looking at these minute problems that the bigger ones are avoided. With a better foundation, a company is stronger and small problems are sure to not affect it. The identification of probl ems led to an evaluation for coming up with solutions. This further resulted in slating several goals which will keep the employees focused. Goals are important as it unites all the different activities that happen in the background of the company. The goals of the company became the guide line for the employees and managers alike. Opened opportunitiesThe evaluation also enabled the opening of opportunities which the departments have not identified before. By looking at these opportunities and exploiting them, the company was able to minimize the wastages. The opportunities also helped maximize the advantageous edge that the company already enjoys. Heterogenous However effective the departmental initiatives were, the problem was that the initiatives were definitive. Instead of helping the company as a whole, each department strived at achieving their own goals which were rather specific for their areas rather than focusing on the goals of the company as a whole.Thus, the positive re sponse received upon the action plan of the managers did little to grow the company. CONCLUSIONS The process, recommendations, and actions were good, but they were not good enough. The managers were effective on the task given to them, but putting off the focus on the company and concentrating on the areas was a bad choice. Instead, the vision and mission of the company as a whole should be a chief consideration for all initiatives big and small. With this, every little inch in which the company grows will be monumental and evident. RECOMMENDATIONSIt is worth for the initiatives of the managers to be carried on. Given that they have been effective in their respective areas, they should also be introduced in other departments in which they may also be needed; even though the need might not be obvious or immediate. To do so, another meeting with the managers should be called to order. Then, the managers will be prompted to share to the group the successes of their respective departmen t. From these sharing, the managers will be encouraged to adapt the initiatives of another department that are not yet applied in their own area.However, the initiatives that will be adapted should be fit to the department who is also adapting it. Meanwhile, marketing and advertising should be made available as well to boost sales which is primarily important for the business. EVALUATIONS A twelve-month recourse will be put into place, after which an evaluation will be made as to the progress of the company. If the company improved, the initiatives will be continued and even propagated with new ones. If not, a new proposition should be looked at.One would be evaluating for problems in the company as a while instead of by-area. The managers should also introduce new breakthroughs. Employee participation may also be encouraged later on, where the employees will be given the chance to voice out what they think and feel about improvements that can be made to the company. Employee welfar e will also be considered. With all the follow-up initiatives, a focal vision will give every action plan the effectiveness it needs. In return, it will also give the company the effectiveness it deserves.

Chronicle of a Death Foretold: a Crime Novel? Essay

DECLARATION I, the undersigned, hereby declare that this is my own and personal work, except where the work(s) or publications of others have been acknowledged by means of reference techniques. I have read and understood Tutorial Letter CMNALLE/301/2011 regarding technical and presentation requirements, referencing techniques and plagiarism. EA Swanepoel 48170399 26 March 2012 Gabriel Garcia Marquez’s Chronicle of a Death Foretold is a narration spoken from the different viewpoints of the residents of a river town in Colombia. The novel embarks on an exploration into an unsettling crime to arrive at a solution in order to explain a murder. Many years after the death of protagonist, Santiago Nasar, his close friend returns â€Å"twentyseven years later† (Marquez 1981:1) to question the residents present on the day of the murder. Through analysing into the past, the story turns investigative and portrays elements of a detective novel. A typical crime novel usually portrays the author opening the story with a problem (Sansalvador, G. 2010. Film, Literature and Society. Only study guide for WLL2602. Pretoria: University of South Africa), such as the need to solve a crime and discover the perpetrators, the victim or motives behind the crime. The reader is not kept in suspense to be headed to the crime, but is instead made aware of the crime from the beginning. The rest of the novel usually details the crime, obtains clues and solves the problem. The problem is known to the reader beforehand; it is the development of the problem that the reader is oblivious to therefore, the solving plays a crucial part in a detective novel. Such can be found in Chronicle of a Death Foretold, when the first paragraph sets the crime for the reader. The opening statement, â€Å"On the day they were going to kill him† (1981:1), portrays the crime. The reader realises the offense before discovering how it happened. Thus, it is the duty of the narrator, acting as detective, to examine facts and study reports. The narrator does indeed act as detective. He comes â€Å"back to search out the last pieces of testimony† (1981:87) and tries â€Å"to put the broken mirror of memory back together from so many scattered shards† (1981:5). According to Hannah Wallace and W.C. Miller (2006) the narrator continues to give a journalistic explanation of an actual murder. More details are given in the first line of the book. Perhaps like a true detective, the narrator provides little details which otherwise would be forgotten or deemed irrelevant. We learn that the victim is Santiago Nasar; that he â€Å"got up at five-thirty in the morning† and that he had waited â€Å"for the boat the bishop was coming on† (1981:1). As is seen throughout the novel, the narrator often states the time in which certain affairs take place, in order to give the reader a timeline of events. The first line refers to â€Å"they†; the perpetrators of the crime, indicating that the narrator already knows who â€Å"they† are (later to be confirmed on page 14). As an investigative narrative unfolds, the detective finds and reveals clues along the investigative journey. The detective goes forth undertaking various methods of investigation, such as questioning and reading reports. In doing so, he finds evidence that would allow for the consummation of the solution. The detective in Chronicle of a Death Foretold questions numerous people in order to hear their side of the story. It is here where the novel adopts many narrators, each recalling events from his or her point of view. â€Å"All the many people he ran into after leaving his house†¦ remembered him†¦Ã¢â‚¬  (1981:2) and gave accounts of that day. The detective has to sift through the various interpretations in order to find similarities and discover any falsehoods. The narrator interviews Santiago Nasar’s mother, Placida Linero, where she explains that â€Å"the front door, except for festive occasions, remained closed and barred† (1981:10). This is one clue where the narrator slips into the story. It is only later that the reader realises why it was mentioned at all. The narrator continues on suspicions such as Angela Vicario’s purity because â€Å"no one would have thought nor did anyone say that Angela Vicario wasn’t a virgin† (1981:37). Elaine Swanepoel Student Number: 48170399 WLL2602 Assignment 02 Unique Number: 756601 The reader discovers that Santiago Nasar was remembered with mixed reactions by the people in his community. Some thought well of him while others â€Å"recalled [him] without affection† (1981:7). It is also noteworthy that the narrator, although acting detective, relays to the reader his own perspective of Santiago Nasar. Therefore, while the reader hears accounts from various witnesses, the ultimate perception of Santiago Nasar is that of the narrator. As a result, it could be said that the narrator loses the professionalism of a detective. Furthermore, the imaginative detail given by the narrator works against the journalistic style found in a detective novel, and â€Å"sends the reader into several different conceptual areas between reality and fiction that he then has to disentangle† (SparkNote Editors). Another point is brought to attention. â€Å"There is no mystery surrounding the death of Santiago Nasar† (Wallace, Hannah. Miller, W.C. 2006) therefore, the reader questions the intention of the detective. The detective eventually arrives at a solution and thus, completes the investigation. It could possibly be said that the narrator in Chronicle of a Death Foretold wishes to find the reason why no one bothered to stop the Vicario brothers from murdering Santiago Nasar because â€Å"many of those who were on the docks knew they were going to kill Santiago Nasar.† (1081:18). It is also discussed, although chance events proved wrong, that â€Å"no one even wondered whether Santiago Nasar [had] been warned, because it seemed impossible to all that he hadn’t.† (1981:19). As the detective realises that someone did try warning Santiago Nasar by slipping a note under his doorway before the murder (1981:13), he learns and reveals to the reader that it was not found until after the chaos surrounding the murder. The narrator never truly finds out if Angela Vicario was telling the truth about Santiago Nasar, and many doubted because â€Å"no one had ever seen them together, much less alone together† (1981:90). She swore to the judge it was him â€Å"but with no further precision of either how or where† (1981:101). The narrator argues with the validity of the arrest (or the non-arrest) of the Vicario brothers. Nevertheless Colonel Aponte asserts that â€Å"no one is arrested just on suspicion† (1981:57). Whether this was true of the law, it may very well be that Gabriel Garcia Marquez inserted this line to show how Colonel Aponte, and others, tries justifying his actions. The narrator reveals why the Vicario brothers never saw the light in Santiago Nasar’s bedroom go on. â€Å"He didn’t have to turn on any light to reach his bedroom because the bulb on the stairway stayed lit through the night† (1981:64). After finding the solution, typically the detective will give explanations of the murder. Why did no one warn Santiago Nasar? People thought he already knew (1981:19) and â€Å"the people were too excited with the bishop’s visit to worry about any other news† (1981:20). The narrator provides a list of events for the reader (1981:48-69; 10304) along with a summary (1981:84). While explaining the solution though, the reader is taken back and forth to interviews with residents. Therefore the narrator is still in the phase of discovering truths, while explaining solutions already found. This is perhaps not so typical of a detective novel. On the other hand, the â€Å"back and forth† eventually allows for the narrator to bring the information together so that the reader can perceive how events have turned out. He continues to explain other questions such as why Placida Linero locked the door (1981:119). The uncertainty the crime Santiago Nasar committed is never solved but the narrator provides a reason why it was uncertain. It was because the judge did not find â€Å"a single indication, not even the most unlikely one, that Santiago Nasar had been the cause of the wrong† (1981:100). An explanation of the aftermath of the murder is given (1981:84-99); the narrator adding that â€Å"most of those who could have done something to prevent the crime and still didn’t do it consoled themselves† (1981:98), which further proves the residents trying to justify their actions. In essence, Gabriel Garcia Marquez wrote Chronicle of a Death Foretold as an inspired novel (based on true events, Sansalvador, G. 2010) providing a description (or chronicle) of the crime. The narrator and his personal relationship with the victim and the residents, tells the story from his point of view, although he allows others chance to tell theirs. He has read the autopsy report (1981:75) and has scavenged â€Å"some 322 pages filched from the more than 500 that the brief must have had.† (1981:100) Chronicle of a Death Foretold, although not a detective novel, uses elements thereof and turns journalistic as the narrator â€Å"recovered numerous marginal experiences† (1981:43) in order to write up a chronicle based on the â€Å"last pieces of testimony† (1981:87 SOURCES CONSULTED Dictionary.com. [O] Available: http://dictionary.reference.com/ Accessed on 19 March 2012 Marquez, G. 1981. Chronicle of a Death Foretold. Spain: Penguin Books. Sansalvador, G. 2010. Film, Literature and Society. Only study guide for WLL2602. Pretoria: University of South Africa SparkNotes Editors. â€Å"SparkNote on Chronicle of a Death Foretold.† [O] Available: http://www.sparknotes.com/lit/chrondeath/ Accessed on 19 March 2012 Wallace, Hannah. Miller, W.C. ed. *Chronicle of a Death Foretold Study Guide : Summary and Analysis of Chapter 2*. [O] Available: http://www.gradesaver.com/chronicle-of-a-death-foretold Accessed on 19 March 2012 Elaine Swanepoel Student Number: 48170399 WLL2602 Assignment 02 Unique Number: 756601