Lack of Communication Essay

When you join together and form a relationship you become part of something greater. You must work together as a team if either partner disregards the relationship suffers. Given a desire and will to make things better it takes communication. Lack of communication in a relationship can make a person feel lonely and isolated. This could come from being busy with life, lack of love, and word vs. actions. Lack of communication only results in unsuccessful human alliances which cause grief not only to you as an individual, but to others as well. Many couples stop communicating with each other because each they are caught up with doing his/her own thing in life. Whether it is work hobbies, children, and school, among other things there is always an excuse. Just as you budget how you spend your money it is important to remember that budgeting in time for your relationship is important as well. Lack of involvement and communication increases distance in any relationship. If you don’t have quality time and communication your relationship and understanding will start to vanish. When you are no longer in love with your spouse then more than likely you are not communicating with each other. When you are not in love anymore it is a horrible feeling because you become unhappy and negative about the relationship. It’s difficult to realize that you just don’t feel the same way about the man/women you thought you wanted to spend the rest of your life with. Falling out of love is inevitable. So much of how we perceive love is what we have seen or read. Whenever you stop communicating you destroy the love that you have for one another. Moved by emotions and excitement of the situation, you can get carried away with words saying things that later will not be backed by actions. Actions speak louder than words. A person who wants to be in a relationship with you will show you with their actions consistently over time. Words are powerful and they can hurt, heal, build up or tear down, comfort or curse the relationship without the action behind it. Sometimes you come to a point where you may not have anything to talk about. Speaking from experience and research it is because you know each better than you did before. Now a days people believe in personal space, but sometimes too much space widens the gap between people. Express yourself to your mate talk about your problems, share your feelings with each other and cherish those moments of life together. When you take a close look at your relationship communication is the foundation that will strengthen your bond. Without this, your relationship will definitely not be a lasting one.

Research Methodology, Design and Process: Dementia Care

Abstract The ability to critically analyse literature is an important skill for evidence-based practice. This literature review aimed to critically analysed literature on dementia care. A search of literature was conducted on academic databases such as Pubmed and CINAHL. Three studies were finally retrieved for this literature review. Each of these studies was critiqued using the Critical Appraisal Skills Programme (CASP) tool for qualitative studies and the critiquing framework of Long et al. (2002). Findings of this literature review could be used to inform current and future community nursing practice. Specifically, this review revealed that music therapy could improve the mood of individuals with dementia and show evidence in improving memory function. While findings could not be applicable to a wider population, nurses could utilise findings and tailor these to the individual needs of their patients. Introduction Evidence-based practice (EBP) is heavily promoted in the NHS since this helps nurses and other healthcare practitioners apply findings of recently published literature to one’s current and future practice. The Nursing and Midwifery Council’s (NMC, 2008) code of conduct also emphasises that healthcare decisions should be evidence-based and supported by published literature and current guidelines. Developing the ability to critically analyse literature is essential when developing evidence-based care (Greenhalgh, 2010; Aveyard, 2014). There is a wealth of information from published literature and current guidelines. Determining the relevance and quality of these findings will help inform nurses whether findings are credible and valid before they are applied to current practice. As part of community nursing, I am interested in improving my current practice in order to deliver quality care to my patients. The recent policy on community care from the Department of Health (2013a) emphasises the importance of allowing patients with chronic conditions and their carers to self-manage their conditions, achieve self-efficacy and lessen admissions in hospital settings. This policy, â€Å"Care in Local Communities-District Nurse Vision and Model’ (Department of Health, 2013a) emphasises the role of nurses in supporting patients and their carers to improve their health outcomes. While it is acknowledged that patients with chronic illnesses may never recover from their condition, nurses have the responsibility to help patients or their carers manage signs and symptoms of the chronic illness. As a nurse in community setting, I have cared for patients with dementia. I saw how this condition impacts the patient’s quality of life and even increase the risk of depression amongst their carers (Talbot and Verrinder, 2009). I always had an interest in caring for patients with dementia. However, I noticed that most pharmacologic treatments have little effect in delaying the progression of cognitive impairments amongst these patients (Miller, 2009). These treatments are also costly and place a considerable burden on the family members and the NHS (Department of Health, 2013b). Hence, I thought that familiarising myself with non-pharmacologic interventions and their effects on cognition or memory of the patient would be important in my role as a community nurse. A number of non-pharmacologic interventions to preserve memory or delay cognitive decline have been developed in the last two decades. Studies (Spector et al., 2010; Hansen et al., 2006; Vink et al., 2004; Teri et al., 2003) show that these interventions range from motor stimulation, exercise programmes, sensory stimulation and cognitive training. Amongst these interventions, music therapy has been suggested to be least harmful and relatively effective. Some investigators (Fornazzari et al., 2006; Cuddy and Duffin, 2005) have shown that even in patients with severe dementia, music memory seemed to be preserved. However, some studies (Menard and Belleville, 2009; Baird and Samsom, 2009) suggest otherwise and explain that some patients with Alzheimer’s disease (AD) suffer from impaired music memory. One study (Baird and Samson, 2009) however, explained that procedural memory, specifically for musical stimuli are not affected in persons with dementia. With the acknowledgement tha t most pharmacologic interventions have limited ability to treat the symptoms associated with dementia, it is essential to consider how non-pharmacologic interventions, such as music therapy, alleviate symptoms of this condition. In order to enhance my current and future nursing practice and to increase my understanding on the relevance of music therapy to dementia care, I have decided to research this topic further. Literature Search A search of literature from academic databases such as the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Pubmed was done to retrieve relevant studies. CINAHL indexes more than 5,000 nursing and allied health sciences journals and contains almost 4 million citations. The depth of research articles indexed in this database makes it a database of choice for research on the effects of music therapy on patients suffering from dementia. Meanwhile, Pubmed was also used to search for academic literature. This database also contains millions of citations and indexes nursing and allied health journals. A quick search for ‘music therapy AND dementia’ was done in Pubmed since this database focuses on nursing and allied health journals. This search yielded 20 articles, most of which were available as full text journals. The same keywords were entered in the CINAHL database. The search yielded 14 articles, with almost all articles available as full text articles. A review of the abstracts of all articles was done to select only primary research studies conducted in the last five years. Polit et al. (2013) state that retrieving journal articles in the last five years will ensure that the most recent evidence is used to inform current and future nursing practice. Literature older than five years old may be outdated. However, this also increases the risk of excluding landmark studies (Aveyard, 2014). For the present review, the selection of studies was only restricted to the last five years to ensure that more recent evidence on music therapy were evaluated and critiqued. The re was also no restriction on the place where the studies were conducted since dementia affects people of different ethnicities. Learning from the experiences of other nurses or healthcare practitioners on the use of music therapy for dementia patients would also help improve nursing practice in the UK. The following articles were chosen for critique and evaluation: Simmons-Stern et al. (2012) ‘Music-based memory enhancement in Alzheimer’s disease: promise and limitations’ Sakamoto et al. (2013) ‘Comparing the effects of different individualized music interventions for elderly individuals with severe dementia’, Dermot et al. (2014) ‘The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists’ As previously stated, I am interested in how music therapy could help me assist my patients delay the progression of dementia and help them and their carers self-manage the signs and symptoms of dementia. Hence, all articles are relevant my work as a community nurse. To critique these studies, the Critical Appraisal Skills Programme (CASP, 2013) tool for critiquing qualitative studies was utilised. For the quantitative studies, Long et al. (2002) critiquing framework for quantitative studies was used. Both critiquing frameworks are easy to use and help researchers investigate the quality and rigour of research articles. Study 1: Simmons-Stern et al. (2012 A review of the title of the study shows that it reflected the main aim and objectives of the study. The title was concise and provided information to the readers that the study aimed to present the limitations of music-based memory enhancement as well as its possible application to nursing practice. Polit et al. (2013) emphasise the importance of creating a concise and clear title in order not to mislead readers and to inform stakeholders if the article is worth reading. A review was also done on the author’s background and shows that all had extensive background on dementia research and healthcare. This was essential since credibility of the authors’ background could increase the reliability of the findings of the study (Long et al., 2002). However, Hek and Moule (2011) emphasise that the authors’ background is not the sole criterion in assessing the credibility of the findings of the study. The abstract of the study failed to mention the type of study design used. While the abstract summarises the aims and main findings of the study, it did not follow the usual structure of an abstract in a journal article where the methodology or methods used are explicitly stated. Ellis (2010) reiterates that an abstract should provide a brief summary of the study’s background, aims and objectives, methodology, results and conclusion. Although it was difficult to determine why the researchers of this study failed to present the methodology in the abstract, readers of the study could have benefited from an abstract that states the methodology of the study. Reading of the body of the article would show that the quantitative study design was used. The study aimed to investigate the effects of music on the memory of patients suffering from Alzheimer’s disease, one of the diseases grouped under dementia. Simmons-Stern et al. (2012) made excellent use of literature and related findings from previous studies with the current study. Apart from the excellent use of literature, there was also a very good review of the previous studies and a gap in literature was clearly presented. Hence, the literature review of the study was well written and provided the readers with good background on why there is a need to carry out the present study. Polit et al. (2013) emphasise that a well-written review of literature should be able to provide context to the study’s aims and objectives and argue why there is a need to address the gaps in literature. Importantly, Simmons-Stern et al. (2012) avoided the use of jargon when writing the paper. Burns and Grove (2013) explain that the use of jargon should be avoided since this excludes readers of the article that have no nursing or medical background. A good paper is one that is written for a general audience and not only for a scientific community (Burns and Grove, 2013). A total of 12 participants who were diagnosed with Alzheimer’s disease and 17 healthy controls g ave their informed consents to participate in the study. Brown (2009) states the importance of obtaining the informed consent of participants before commencing the study. This would not only protect the rights of the participants but also ensure that the nurse researchers are observing the Nursing and Midwifery Council’s (NMC, 2008) code of conduct in protecting the patients or participants from harm. Part of obtaining an informed consent is the presentation of the study’s aims and objectives, possible side effects or benefits when participating in the study (Brown, 2009). An informed consent will also ensure that debriefing is provided to the participants to avoid any harm and psychological distress to the participants (Oermann, 2010). Apart from getting the informed consent, it was also crucial that an ethics committee has evaluated and approved the study protocol. An evaluation of the study reveals that this was observed and an ethics committee approved the study. On reflection, the study has a very small sample size (n=12 experimental group; n=17 control group). This would have taken a randomised controlled study design since a control group was used to compare the effects of music therapy on the patients with a healthy control. However, the investigators specifically state that this study was comparative. An inclusion and exclusion criteria were used when recruiting the patients, suggesting that participants were not randomly selected. Since the study was quantitative and employed the experimental study design, random sampling of the participants who have been more applicable (Crookes and Davies, 2004). It should be noted that it would also be difficult to randomise participants since this study was only conduc ted in one healthcare setting and it was crucial that participants have developed AD. While randomisation of participants was not observed, it is noteworthy that the investigators stated how many of the participants were excluded from the study and the reasons of their exclusion. This was essential since failure to explain why participants who gave their informed consents to participate in the study but were later excluded in the actual experiment would make the data collection process unclear (Moule and Goodman, 2009). Despite the small sample size, the demographic characteristics of the two groups were not significantly different when t-test was done. There were no significant differences in prior musical training, formal or informal, years of education and age between the participants of the two groups. This allowed the investigators to determine if there were differences after the study, this might have been due to the intervention employed. After informed consents were taken, the authors of the study declared that they paid the participants for the hours spent during the study. Compensating the participants for the time is considered as ethical since considerable time has been taken away from the subjects for their participation in the study (Hek and Moule, 2011). The interventions were clearly stated. This increased the rigour of the study since a clearly stated research method would help other investigators replicate the methods in future studies and verify whether similar findings are obtain ed (Hek and Moule, 2011). Simmons-Stern et al. (2012) also specifically outlined the lyrics used and where these were obtained and how music memory of the participants was tested. Results section of the study clearly presented the main findings of the study. Appropriate statistical tests were also utilised to test the hypotheses of the research. Polit et al. (2013) emphasise that statistical tests should be appropriate to the study’s aims and objectives and should rule out any biases in interpretation of the findings. Despite having a small sample size, the researchers were able to establish that music in patients with AD enhances memory in terms of familiarisation of sung lyrics but not in spoken stimuli. This suggests that in patients with AD, they can enhance their memory when familiarising with the lyrics or listening to music but not when they hear spoken language. There were also no significant differences in the healthy control and experimental groups in terms of memory after hearing the lyrics of a song compared to hearing the lyrics as a spoken stimuli. Since this study has a small sample size, the applicability of the findings to a larger and more heterogeneous population would be difficult (Burns and Grove, 2013). Although a control was used, it should be noted that participants in the experimental group are in the early stages of AD. This could have affected the findings of the study since it is unclear if patients with severe dementia would also yield similar reactions and results. At present, the findings are applicable to the sample population of the study and importantly, only on individuals in the early stages of dementia. While there were several limitations of the study, findings are noteworthy since these show that music therapy is promising as a non-pharmacologic intervention for enhancing memory in individuals with early stage dementia. The conclusion of the study was clearly presented and summarises the key points presented in the study. Although the discussion states future areas of study, there were no clear recommendations in the conclusion. Specific recommendations could have been made at the end to help future researchers identify areas of investigation. There were also no implications for future nursing and other healthcare practitioners’ practices. Despite the lack of clear recommendations, readers can still read through the study and identify areas that need further investigation. For example, there is a need to replicate the study in a larger and randomly selected sample population to strengthen the validity and reliability of the findings. There is also a need to compare findings with patients suffering from moderate to severe dementia to determine if music still has similar effects on the memory of those in advanced stages of the illness. There are a number of implications of the study in nursing practice. Nurses can use music to help enhance memory or prevent deterioration of memory amongst individuals with early stages of the disease. It is essential to consider the acceptability of music therapy in those suffering from dementia. As a whole, the study was of high quality and effort was made to reduce bias within the study. Although the investigators failed to blind assessors to the study, findings were presented objectively. It is also difficult to blind assessors because of the very small sample size (Burns and Grove, 2013). All investigators were familiar with the background of the participants and blinding them to the intervention was difficult since these investigators were also responsible in implementing the interventions. Finally, there were no conflicts of interest (Polit et al., 2013), ensuring the readers that bias in presentation of findings was avoided. Study 2: Sakamoto et al. (2013) An evaluation of the study’s title reveals that it was concise and clearly reflects the study’s aims and objectives. This was essential (Long et al., 2002) since this would present to the readers the main aim of the study. The type of study design chosen to answer the study’s aims was also appropriate. A quantitative study design would help investigators answer the research aims and objectives through experimentation, surveys or a randomised controlled trial (RCT) (Brown, 2009). In Sakamoto et al. (2013), the randomised controlled study design was used. Compared to other quantitative study designs, a RCT reduces risk of selection bias and bias in interpretation of findings (Moule and Goodman, 2009). Selection bias occurs when participants are not randomly selected and do no have equal chances of being assigned to a control or experimental groups (Crookes and Davies, 2004). This is avoided in RCT since all participants are randomly assigned to an experimental or c ontrol group. On the other hand, bias in interpretation of findings is lessened especially if investigators and assessors are blinded to the interventions and standard treatment (Oermann, 2010). A critical analysis of the study shows all participants in the study were randomly assigned to the treatment and standard care groups. However, a major limitation of this study was its relatively small sample size (n=39). It would be difficult to transfer findings to a larger and more heterogeneous group due to the representativeness of the sample population (Ellis, 2010). While it is difficult to transfer findings to other settings due to the relatively small sample size, community nurses may consider the applicability of the findings to their own practice. It is noteworthy that it would be difficult to recruit participants in the advanced stages of dementia since their ability to give their informed consent is severely limited (Department of Health, 2009). Further, their participation requires that their carers or immediate family members are aware of the study’s aims and objectives and should be able to assist the participants during the the study. While an ethics board app roved the study and informed consents were taken from the respondents or their representatives (Burns and Grove, 2013), involving individuals who suffer from severe cognitive impairment would be difficult. This also carries some ethical issues since their ability to understand the procedures of the study is compromised (Hek and Moule, 2011). Although the Mental Health Act in the UK acknowledges that carers can act in behalf of the individual with mental health condition, ethics regarding their participation in research studies remains debatable (Department of Health, 2009). Despite the possible ethical issues surrounding the study, investigators of this study used other means of evaluation to assess the participants’ responses to the interventions. For example, they used the Faces Scale (Sakamoto et al., 2013) to determine the emotions of the participants. A review of the study’s aims and objective shows that these were clearly presented in the beginning of the study. The introduction and review of literature also made excellent use of previous studies. It is also important to note the gaps in practice in recent studies were highlighted in the literature review section (Ellis, 2010). A good literature also argues why there is a need for the new study and how this could be applied to current healthcare practices (Ross, 2012). Methodology and methods used were also appropriate for the research question. Since the study aimed to determine the effectiveness of music therapy, it is appropriate that a RCT is used to compare music therapy with st andard care. Comparing music therapy with standard care is ethical (Ross, 2012) since all patients in the study received interventions. It would be unethical to withdraw treatment or assign participants to a control group that would receive no intervention (Crookes and Daives, 2004). The evaluation tools used to measure the responses of the patients were appropriate and have been previously validated and standardised. This was necessary to convey to the readers that validated measurement tools were used in the study (Moule and Goodman, 2009). A clear description of the research methods was presented. This would allow future researchers to replicate the present study (Oermann, 2010) and determine if similar findings could be observed. This also increases rigour of the study (Burns and Grove, 2013) since it is essential for other researchers to also test the hypothesis of the study and ensure that results are consistent across different healthcare settings. Results of the study were well presented and appropriate statistical tests were used. The discussion section of the study presented the strengths and limitations of the study. Polit et al. (2013) emphasise that presenting the limitations of a study will help inform other researchers on areas that need further improvement and presents areas for further research. Since weaknesses of the study were presented, readers and other healthcare practitioners can determine the extent in which the findings can be applied to current and future nursing practice (Burns and Grove, 2013) . The conclusion of the study succinctly captures the main points raised in the research study. This helped the researchers identify the main highlights of the study (Ellis, 2010). However, recommendations for other researchers and areas of improvement of the study were not cited. While the discussion section presented these limitations and areas for future studies, brief recommendations at the end of the study could have added rigour to the research study. Importantly, there were no conflicts of interest. This assured the readers that bias in reporting of data was reduced (Ellis, 2010). Findings of this study have important implications in nursing practice. All participants received either the passive or interactive music intervention while the control group received no music intervention. There was careful choice of music in the interactive group. For example, healthcare workers assigned to the interactive group helped investigators choose music for the patient participants. Music played during the intervention all had special meaning to the participants. All interventions were given individually for 30 minutes per session at once a week for 10 weeks. Those in the interactive group were allowed to clap, sing or interact with the music. Meanwhile, those in the passive group only listened to the music. The music chosen for the passive group also had special meaning to the participants. Those in the control group sat in silence for 30 minutes during the once a week session. Interestingly, findings show that music associated with special memories led to significant cha nges in the parasympathetic nervous system of the participants. Investigators note that music significantly increased relaxation of the individuals immediately after intervention when compared to baseline data. However, these were not noted in the control group. Significant changes were also seen on the emotional states of the participants in the interactive and passive music intervention groups. Music appeared to elicit pleasant emotional states. However, when passive and interactive groups were compared, the latter was significantly more relaxed following the music intervention. It should be noted that patients with severe dementia are more sensitive to environmental stimuli and may experience stress when placed in a new environment (Morris and Morris, 2010). Further, patients with cognitive impairments may express feelings of stress and fear through disruptive behaviour (Morris and Morris, 2010). The difficulty in verbalising their emotional needs could aggravate their responses to their surroundings (Department of Health, 2009). Hence, the st udy of Sakamoto et al. (2013) may have important implications in nursing care for patients in community settings. Nurses can encourage family members to play music that have special meaning to their loved ones suffering from dementia to illicit positive emotional states. The calming effect of music could be an advantage for patients cared in home or care settings since this would not only prevent stress but also allow patients to enjoy quality of life. Study 3: Dermot et al. (2014) A review of the study’s title shows that it also reflects the main aims and objectives of the study. Readers could easily understand that the study explored the experiences of individuals with dementia, their carers, staff and music therapists when music interventions are employed. The CASP (2013) tool for qualitative studies contains three screening questions that should be used to determine if a study is worth reviewing. The study of Dermot et al. (2014) suggests that music can help maintain the person’s interconnectedness and their quality of life. Findings have important implications in nursing practice since music intervention (Miller, 2009) is not costly and could yield positive results for patients suffering from early to advanced stages of dementia. Further review of the study shows that aims and objectives of the research were clearly stated. The main aim of the study was to explore the meaning of music in the lives of individuals suffering from dementia. Inves tigators of this study state that there is limited knowledge on why or how individuals find music beneficial to their wellbeing. Understanding the role of music according to the perceptions of the patients and their carers will help inform nursing practice on the relevance of music in the lives of people with dementia. A qualitative research methodology was appropriate for the study’s aims since the research aims to interpret the subjective experiences of individuals with dementia. Parahoo (2006) emphasises that a qualitative study allows researchers to explore the experiences and perceptions of individuals in more detail and depth. Since open-ended questions are used, investigators can use probing questions (Burns and Grove, 2013) to help participants articulate their experiences. One of the strengths of this study was the inclusion of participants’ family members, care home staff and music therapists. Individuals suffering from dementia were recruited from care homes and those living in the community. This allowed Dermot et al. (2014) to compare the perceptions of people with dementia living in care homes or in the community and determine if settings of the individuals impact their experiences with music therapy. Recruitment strategy employed was also appropriate for the research ai ms. There was also a clear explanation on the methods of data collection. Semi-structured interviews and focus group discussions were done. In the former, this would allow researchers to investigate perceptions of participants in more detail (Parahoo, 2006). However, this requires more time to complete especially if there are many participants in a study. A focus group discussion, on the other hand, requires little resources and could be completed in one setting (Polit et al., 2013). However, if a dominant member would be included in a focus group discussion, interactions would be limited (Burns and Grove, 2013). This could be avoided with a facilitator who knows how to redirect the discussion to all members of the focus group. A stregnth of the study of Dermot et al. (2014) is the presentation of a rationalisation on why they used a combination of focus groups and in-depth interviews. It should also be noted that participants with dementia might display cognitive impairments, depending on the stage of their illness. Hence, requiring these patients to explain their experiences in more depth might be challenging. However, the investigators tried to mitigate this challenge by including carers of the patients as part of the study participants. Inclusion of carers could provide researchers with more detailed information on how music impacts the wellbeing and quality of life of the patients since these carers are more acquainted with the individuals suffering from dementia (Miranda-Castillo et al., 2010). It is also noteworthy that music therapy was individualised to the patients in the study. Thi s suggests that comparison of music therapy received by the patients was not done. Instead, investigators focused on the impact of music therapy on the patients’ wellbeing. In addition, the study did not take into account the differences in music interventions and whether this shaped the individual’s reaction to music therapy. Despite the differences in music intervention, it was common for the music therapists to use songs that were well-known to the patients. They also supported active music therapy with exploratory improvisation. Dermot et al. (2014), however, failed to explain what is exploratory improvisation or how this was done during music therapy. There was also an explanation on the content of the guides used for the in-depth interviews and focus group discussions. This was essential to demonstrate the coverage of the interview guides and whether each guide reflects the aims and objectives of the study (Moule and Goodman, 2009). However, the relationship between the researchers and the participants was not thoroughly discussed. If the participants knew the investigators, this might lead to potential bias especially if the researchers hold positions of power (Oermann, 2010). Despite this limitation, Dermot et al. (2014) emphasise that only one facilitator guided the focus group discussions. There were changes in the methods used during data collection. For instance, where a focus group discussion was initially decided, this was then changed to individual interviews in the second group of patients and healthcare workers. Dermot et al. (2014) explain that the severity of dementia of the patients was considered in the choice of d ata collection. In-depth interviews were used when patients had severe dementia. There were also sufficient details on how participants were recruited and whether ethical standards were observed. Polit et al. (2013) state that ethics in research is crucial to ensure that the rights of the participants were observed and they were not subjected to undue stress or negative experiences during data collection. Confidentiality was also observed in the study and all participants remained anonymous. Approval was also sought from an ethics board in the community settings. Data analysis of qualitative data could be extensive and time consuming (Parahoo, 2006). Informing readers how data was analysed would help increase the rigour of a qualitative study. Dermot et al. (2014) provided an in-depth description of how data was analysed. Thematic analysis was also used to present the main findings of the study. There was also a clear description on how categories and themes emerged. For instance, the long-table approach was used during analysis of data. Verbatim transcripts wer e used to support the main themes. This ensures validity and credibility of the main themes generated in the study (Polit et al., 2013). Contradictory data were also taken into account. The researchers also critically examined their own roles in the research process and the potential bias that might arise during analysis of research data. While respondent was not done, validity and credibility of the data were observed through constant comparison of categories and themes. More than one researcher was involved in the analysis of data. Professors and doctoral students of the Doctoral Programme in Music Therapy were also consulted during thematic analysis and were involved in identifying categories. Importantly, findings were discussed with reference to the original research question. A discussion was also made on the relevance of the study to dementia care. Findings of this study suggest that music is a medium that is readily accessible to patients with dementia. Many of the patients, their carers and healthcare staff admitted that music promotes mental stimulation and is an emotionally meaningful experience. Almost all participants also remarked that song lyrics with personal meanings helped patients remember their personal history. It is also perceived to reinforce personal and cultural identity. Music is also perceiv ed to promote connectedness and building and sustaining of relationships. In addition, music has immediate effects on the mood of the patients. Most of the staff members who participated in the focus group discussions remarked that agitation of the patients decreased as a result of music therapy. It is also shown to promote a relaxing environment in the care homes. On the other hand, listening to music in the lounge area could be challenging since care home residents might have different music preferences. Hence, it would be a challenge for healthcare workers to address all the music preferences of the patients. Since the study was qualitative, transferability of the findings to a larger and more heterogeneous population is impossible (Polit et al., 2013). However, other healthcare practitioners could use findings to help build a peaceful environment for patients suffering from dementia. A further review of the study also shows that the conclusion summarises the main points raised in the study and provides recommendations for other researchers to consider in similar studies in the future. Implications of Findings in Nursing Practice Findings of this literature review could be used to improve nursing practice when caring for patients with dementia. All three studies (Simmons-Stern et al., 2012; Sakamoto et al., 2013; Dermot et al., 2014) included in this literature review demonstrate the impact of music therapy on patients with dementia. Music therapy could improve health outcomes and quality of life of the patients from early to advanced stages of the disease. In the latter, patients who have difficulty communicating their needs, react positively to music therapy. Many of the patients with severe dementia show less agitation when exposed to music that was once relevant to them before they suffered from dementia. This suggests that music therapy could even not only promote positive mood of the patients but might even reconnect them to ‘who they are’ (Dermot et al., 2014). This holds important implications in nursing practice in community settings. Music therapy could be introduced to families caring for a loved one with dementia and could be used to calm the patient, reconnect with their family members and create an environment that is less stressful for the individual with dementia. The type of music therapy, however, will be dependent on the preferences of the individual (Sakamoto et al., 2013). This is consistent with patient-centred care (Department of Health, 2009) where patient preferences are considered when creating a care plan or introducing healthcare interventions. It is suggested that interactive music therapy (Simmons-Stern et al., 2012; Sakamoto et al., 2013) might be more effective than passive music therapy in improving memory and mood of the patients with dementia. As a community nurse, I need to be aware of the different non-pharmacologic interventions for people with dementia. I can use findings of this review when caring for patients suffering from dementia. Music therapy is relatively easy to carry out and entails very little cost. Importantly, it has positive short and long-term impacts on patient’s mood, memory and quality of life. Hence, considering this type of intervention could also help ease the burden of carers who provide care to these patients on a daily basis. I could use information from this literature when conducting patient education. I can inform my patients and their family members of the benefits of music therapy and the sustainability of this type of therapy over time. I can also encourage family members to consider music therapy to help alleviate the mood of the patients and provide a calm environment. Conclusion This literature review has shown the feasibility and promise of music therapy in promoting wellbeing, improving memory and quality of life of patients with dementia. As a community nurse, music therapy could be employed with the help of a music therapist in community settings. Families and carers could be taught on how to use this type of therapy to improve the mood of the patient or to calm the individual when agitated. This type of therapy holds some promise in long-term care for people with dementia. As shown in the review, individuals with severe dementia still have the ability to respond positively to music therapy. However, consideration should still be made on the applicability of the findings of the three studies to a larger and more heterogeneous population. All studies recruited a relatively small sample size that might not be representative of the experiences of a wider group of people with dementia. Although this limits applicability, findings can be tailored to the needs of individual patients. Considerations should also be made on the preferences of the patients and their family members on whether music therapy is acceptable to them. Since there is a need to practice patient-centred care, nurses have to determine if patients or their family members are willing to employ music therapy. It should ne noted that this literature review is only limited to reviewing three studies. Literature on the acceptability of music therapy was not evaluated. Despite this gap in the present literature review, the positive responses generated after music therapy should help patients and their family members consider music therapy. References Aveyard, H. (2014) Doing a literature review in health & social care: A practical guide. 2nd ed. Berkshire: Open University Press. Baird, A. & Samson, S. (2009) Memory for music in Alzheimer’s disease: unforgettableNeuropsychology Review. 19(1), p. 85–101. Brown, S. (2009) Evidence-based nursing: the research-practice connection. Sudbury Mass: Jones & Bartlett Publishers. Burns, N. & Grove, S. (2013) The practice of Nursing Research: Conduct. critique and utilisation. 7th ed., St. Louis: Elsevier Saunders. Critical Appraisal Skills Programme (2013) 10 questions to help you make sense of qualitative research. England: CASP. Crookes, P. & Davies, S. (2004) Research into practice. Essential skills for reading and applying research in nursing and healthcare. 2nd ed. Edinburgh: Bailliere Tindall. Cuddy, L. & Duffin, J. (2005) Music, memory, and Alzheimer’s disease: is music recognition spared in dementia, and how can it be assessedMedical Hypotheses. 64(2), p. 229–235. Department of Health (2013a) Care in local communities: A new vision and model for district nursing. London: Department of Health. Department of Health (2013b) Improving care for people with dementia [Online]. Available from: https://www.gov.uk/government/policies/improving-care-for-people-with-dementia (Accessed: 5 December, 2014). Department of Health (2009) Living Well with dementia: A National Dementia Strategy. London: Department of Health. Ellis, P. (2010) Understanding research for nursing students. Exeter: Learning Matters. Fornazzari, L, Castle, T. & Nadkarni, S. (2006) Preservation of episodic musical memory in a pianist with Alzheimer disease. Neurology. 66(4), p. 610–611. Greenhalgh, T. (2010) How to read a paper: the basics of evidence-based medicine. West Sussex, UK: John Wiley and Sons. Hansen, V., Jorgensen, T. & Ortenblad, L. (2006) Massage and touch for dementia. Cochrane Database of Systematic Reviews. 4, p. CD004989. Hek, G. & Moule, P. (2011) Making sense of research. 4th ed. London: Sage. Long, A., Godfrey, M., Randall, T., Brettle, A. & Grant, M. (2002) Developing evidence based social care policy and practice. Part 3: Feasibility of undertaking systematic reviews in social care. Leeds: Nuffield Institute for Health. McDermot, O., Orrell, M. & Ridder, H. (2014) The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists. Aging & Mental Health. 18(6), p. 706-716. Menard, M. & Belleville, S. (2009) Musical and verbal memory in Alzheimer’s disease: a study of long-term and short-term memory. Brain and Cognition. 71(1), p. 38–45. Miller, C. (2009) Nursing for wellness in older adults. Philadelphia: Lippincott Williams and Wilkins. Miranda-Castillo, C., Woods, B., Galboda, K., Oomman, S., Olojugba, C. & Orrell, M. (2010) Unmet needs, quality of life and support networks of people with dementia living at home. Health and Quality of Life Outcomes. 8:132 doi: 10.1186/1477-7525-8-132. Morris, G. & Morris, J. (2010) The dementia care workbook. London: McGraw-Hill International. Moule, P & Goodman, M. (2009) Nursing Research: An Introduction, London: Sage Publishers. National Institute for Health and Clinical Excellence (NICE) (2009) Depression: The treatment and management of depression in adults. London: NICE. Nursing and Midwifery Council (NMC) (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. London: NMC. Oermann, M. (2010) Writing for publication in nursing. 2nd ed., Philadelphia: Lippincott Williams & Wilkins. Parahoo, K. (2006) Nursing Research: Principles, Process and Issues. 2nd ed. New York: Palgrave Macmillan. Polit, D., Beck, C. & Hungler, B. (2013) Essentials of nursing research, methods, appraisal and utilization. 8th ed., Philadelphia: Lippincott Williams & Wilkins. Ross, T. (2012) A survival guide for health research methods. Maidenhead: OUP. Sakamoto, M., Ando, H. & Tsutou, A. (2013) Comparing the effects of different individualized music interventions for elderly indivduals with severe dementia. International Psychogeriatrics. 25(5), p. 775-784. Simmons-Stern, N., Deason, R., Brandler, B., Frustace, B., O’Connor, M., Ally, B. & Budson, A. (2012) Music-based memory enhancement in Alzheimer’s disease: promise and limitations. Neuropsychologia. 50(14), p. 3295-3303. Spector, A., Orrell, M. & Woods B. (2010) Cognitive Stimulation Therapy (CST): effects on different areas of cognitive function for people with dementia. International Journal of Geriatric Psychiatry. 25(12), p. 1253–1258. Talbot, L. & Verrinder, G. (2009) Promoting Health: The Primary Health Care Approach. Australia: Elsevier Australia. Teri, L., Gibbons, L., McCurry, S., Logsdon, R., Buchner, D., Barlow, W., Kukull, W., LaCroix, A. McCormick, W. & Larson, E. (2003) Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. Journal of the American Medical Association. 290(15), p. 2015–2022. Vink, A., Birks, J., Bruinsma, M. & Scholten, R (2004) Music therapy for people with dementia. Cochrane Database of Systematic Reviews. 4, p. CD003477.

Perspectives on conflicts and disputes Essay

Legal positivists postulate that individuals are intrinsically greedy, which is the main root of conflicts among them. Thomas Hobbes posits that beings are doomed to dispute because of their primeval nature, which is deduced to selfishness that causes them to struggle to maintain their social status. In this milieu, Charles Darwin furthered this stance by conjecturing that species’ selfish ways are embedded to their genes because life is nothing but a struggle for survival. To curtail this selfishness, law is of necessity because only it provides rules and restrictions to protect the interest and upholds the rights of each individual. The advancement on the epistemological aspect of conflict starts at the ontogenetic condition of the specie and continues in its phylogenetic condition. Ontogenetic state means that the being develops from the conception of its genes up to the end of its life cycle. Conversely, phylogenetic event transpires in between of the beings conception and death, meaning the individual develops throughout the time it exists. Therefore, Homo sapiens understanding of conflict’s anatomy begins at phylogenetic level and its full comprehension happens when Homo sapiens reaches the end of ontogenetic level. The epistemic acquisition of conflicts thrives in human playground or to events and settings that necessitates human actions and interactions. Conflicts undergo a succession that perpetually exists within the life-world of beings such as their surroundings, environment, politics, business, science, etc. Having drawn this conclusion, we can infer that in existing innumerable of conflicts there is a myriad of ways of resolving it. Conflict is impossible to annihilate because of the following reasons: first, it thrives at the very heart of human volition, which is the source of human selfishness, and second, it has been part of human psyche to transfer it from one generation to the other, which resulted to a vicious cycle within the epistemic system of conflict. And throughout history, individuals have learned the art of conflict, and some even mastered the usage of conflict in their everyday lives. Handling conflict is very vital to human existence because it can totally change the landscape of one’s own existence. The coming of twentieth century proved that beings are becoming more and more aware of how to comprehend the nitty-gritty details of conflict, and what are the effective means of handling conflicts. There is no panacea that will medicate continuous existence of conflict, but humans strive to find a better solution to satisfy the needs of a prominent conflict because they are challenged by the difficulty it embodies. It must be noted that conflict is getting more complicated as time passes by, which means that better solution must be concocted to counter-attack more severe problem. The vastness of the universe implies a far more serious condition because the contingency of the world can necessitate an unknown conflict, which greatly needs a novel constructs or to put it simply, man has to go out of the box to resolve a new or unknown prevailing issue. This kind of conflict serves a greater challenge to human reason because it is something that our very reason has not yet encountered. The enigmatic characteristic of such new issues demands transcendence in our rationality. Using Karl Marx philosophical stance, we can infer that conflict has a crisis-response blueprint or a thesis-antithesis pattern. Multiplicity of conflicts has evolved into a more complex manner within the continuum of time, as well as the individual effort to manage and to elucidate it. In order for a human specie to understand the mechanism of conflict, he/she must know its intrinsic values, and in doing so, he/she can decipher appropriate solution for different conflicts. The epicentre of conflict lies on the innate nature of man and its solution lies on the rules that have been drawn to curb the natural operation of human volition. Development is the life-source of conflict, ironically speaking, the more we formulate means to make life easier the more we recognize new conflicts. In the primeval condition of humanity the only existing problem is the source of food, and then it further develops into the issue of territory, and finally when men resolved these issues another conflict sprouted when they realized the significance of property. The birth of science and technology intensified the man’s struggle to annihilate conflicts. Science and technology successfully medicated the prevailing conflicts of our society but it also paved for the birth of novel conflicts, and in some condition aggravated an existing issue. As of this modern day period, science and technology provides a myriad of solutions in human crises in the field of poverty, education and medicine. But it also exacerbates war between nations because technology brings forth weaponry of mass destruction. Man by Nature is Selfish According to Richard Dawkins introduction in his book The Selfish Gene, man’s attitude is greatly affected and designed by our genetic composition. Our genes made us. We animals exist for their preservation and are nothing more than their throwaway survival machines. The world of the selfish gene is one of savage competition, ruthless exploitation, and deceit. But what of the acts of apparent altruism found in nature – the bees who commit suicide when they sting to protect the hive, or the birds who warn the flock of an approaching hawk? Do they contravene the fundamental law of gene selfishness? At the onset of Dawkins book, he clearly stipulated that all species either man or animals are machines fashioned by their genetic design. As mentioned earlier, Hobbes believes that men are naturally born selfish, and it is the same in Dawkins case. According to him, the selfishness of man is deeply embedded in our genes, and due to this we must learn the virtue of generosity and altruism because if we failed to do so, men will perpetually live on catastrophic state. Dawkins stance must not be misconstrued as an ethical justification of human behaviour or a moral treatise that must be followed since his insight is loud and clear; that men are selfish because of their genes, no more, no less. Having said this, it is a challenge for us to control it if not exterminate it because we are the only species who can desired to do it. In the furtherance of man’s selfish genes, Dawkins incorporated Darwin’s biological conjecture that man is doomed for the battle of its own survival. However, the former believes that survival is not controlled by man; rather man is machinated by genes to strive for its own survival. The genes are the building blocks of human existence, it is the one that created us, and these genes even dictates how we should reason out. Men are innately selfish for the sole reason of life preservation or prolongation. They are willing to do everything just to ensure that their interests are satisfied. Satisfaction of interest is tantamount to the validation of one existence. This is the embodiment of human existence, chaotic and full of struggle. The machination of individual is further elucidated by Dawkins through his explanation of gene mechanism. Dawkins adopted G. C. Williams’ definition of genes, which stated that gene any portion of chromosomal material that potentially last for enough generations to serve as a unit of natural selection . The deoxyribonucleic acid (DNA) of man thrives within our body. It must be noted that DNA is not contained in a particular body parts rather it is widely disseminated within our cells. Approximately speaking, a human body is made of a thousand million cells, and each of these cells contains an exact blueprint of all DNA in our body. The significance of the ontogenetic control of genes is its capability of self-continuation and self-propagation, meaning, genes can preserve itself under the condition of numerous struggles. The survival of genes lies on the efficiency and power of our corporeal body, which they inhabit for its own development. The existence of each human species is not everlasting, it is ephemeral. Dawkins uses an analogy wherein each card in a deck represents the genes. According to him, when a deck of card are being shuffled they undergo a process of survival. And this process of survival is exactly the mechanism of genes wherein every time they are shuffled a gene only assumes the position of another gene, instead of being destroyed, and after the shuffling process genes are still genes that continue to march on. Dawkins draws a conclusion from this analogy, which stated that genes are basically the replicators and we are their machinery for survival. And when we have fulfilled our function we are automatically became useless, but gene will perpetuate its existence because it is a denizen of geological time . In view of that, Dawkins also posits that gene is the basic unit of survival because it competes for its own preservation against their alleles for a slot in the chromosome. With this picture, we can infer that genes struggle for survival of future generation in the gene pool in the expense of its own alleles. Therefore, selfishness is indeed the fundamental foundation of selfishness. The genes are the master programmers, and they are programming for their lives. They are judged according to the success of their programs in copying with all the hazards that life throws at their survival machines, and the judge is the ruthless judge of the court of survival . This phrase only strengthened Dawkins claims that man is nothing but a machinery of genes for its own survival. As pointed earlier, man is different from other specie because a human being has a will power and reason, meaning man can go against the dictate of its gene i. e. a person can choose not to reproduce. In addition, reason has its own domain wherein it has the capability to manipulate habitual operation of gene machine, to envisage what lies beyond its own future, and most significantly, to act according to its own course of nature. Because of rationality, gene machinery is able to be in command of outlining what direction individuals must follow. Rationality can curtail the dictate of gene, meaning, a person can transcend his/her selfishness and reach the condition of being generous and altruistic. The emancipation of man from his selfish nature is only possible if and only if he succumb himself to an agreement. Being established that human beings to be innately selfish also indicate that they are self-regulating. But generosity and altruism can only be actualized if the self-regulating beings surrender their self-regulating prowess. Selfishness is the anti-thesis of the said virtues but because of rationality human beings will submit to an agreement to satisfy the insufficiency of self-regulation. The universal antidote for this insufficiency is the construction of law through its rules. In the vein of Hobbes social contract theory, man must give in to an agreement to restrain his natural tendencies, but he must only surrender to a contract if and only if others will surrender to it in equal footing. But in the provision of rules it is a prerequisite to understand the intricate schema of conflict. The Role of Rules In Using Conflict Theory, Otomar Bartos and Paul Wehr claim that in the wide range of epistemic knowledge regarding conflicts there are two guiding principles that must be comprehended: one, to concentrate on general theories, and second, to carry out these theories on a simplified fashion. The former necessitate an application of theories to innumerable types of conflicts. While the latter focuses on the specific arguments or application of the former. One good example of general theories is elucidation of poverty in the third world countries using the framework of dialectical materialism by Marx. If we convert this general theory into a simplified manner, one must look at the specific causes of poverty such as shortage of natural resources, lack of capital, misallocation of funds, graft and corruption, and the likes. If one is successful in outlining the appropriate general theories in an existing conflict, then he/she translates these theories in its simplified form. And if this will be the case, then concoction of rules will be easier. Rules must embody the principle of the entire society and it must cater to the needs of its citizenry. Rules can be perceived in two ways: Kantian or Utilitarian. Immanuel Kant posits that rules must be made in the context of universal imperative, meaning it must not be used as means of advancing one’s interest rather it must be created for its own sake and for the goodness and betterment of humanity. In lieu to this, Utilitarian advocates such as J. S. Mill argues that rules must be conceptualized in the essence of achieving the goodness of the majority and resulting to the production of best consequences. Kant postulates that a rule must be encompassing and must not reside on the band wagon of majority votes because it contradicts the reason of man, and because number of votes does not imply truth. For example, killing another being is morally unjustified is a universal rule because it affirms the importance of life, which is true to all beings. Conversely, J. S. Mill believes that rules are justified if and only if the â€Å"greatest happiness for the greatest number of people† is reached. But it must be noted that utilitarian theory also entails a qualitative measurement through the intensity and duration of happiness, meaning, it must have greater impact to the society and its intensity must last for the longest time if not forever. For example, death penalty can be either permissible or impermissible depending on the context of society, but the point is, morally justifiability of death penalty lies on majority votes since it can serve the interest of more people. There are voluminous conflicting issues regarding these theories because both of them are in extreme opposition. Kant rejects utilitarianism because it does not uphold a consensual quest for universal truth and it only served the interests of the majority of population in a given social context. On the other hand, utilitarian advocates refute the Kantian theories because of its impossibility or tedious system in knowing the universal truth. But in the modern day period, utilitarian theories are more adopted than Kantian theory because it is more feasible in creating rules for present conflicts and for future conflicts. In most cases, before a rule can be ratified it must undergo an election and must meet certain number of votes to quantify its validity i. e. three-fourths of the voting population or majority votes. But it must be noted that most rules fashioned in utilitarian perspective must follow a universal precept so that it will not contradict the constitution of a specific nation. For example, murder is universally not accepted, which one of the reason why death penalty is not easy to endorse because it contradicts a universal precept, though some countries provided an reasonable exemption on the matter, killing will still be universal precept that they must consider. Rules main goal is to promote the interest of every individual as possible as it can, and to restrict the selfish ways of human beings, in order to maintain an ordered society. Because of this guideline, law has delineated the scope of public and private sphere to guarantee the possibility of generosity and altruism. Public sphere is far more superior to the private sphere because the former promotes national interest and the welfare of the entire populace. Law provides countless rules to reinforce the supremacy of public sphere, which is the apparent implication on the significance of reason. Rules are the product of our reason to rebel against the dictate of our selfish genes. In the furtherance of rules, justice must be encapsulated in its formulation to ensure an effective implementation of it.

The Microsoft trial the Pro an Cons Essay Example | Topics and Well Written Essays - 750 words

The Microsoft trial the Pro an Cons - Essay Example Microsoft countered that innovation and competition were not unlawful, and that the browser and the operating system were inseparable as the browser was not a separate product but a feature of the operating system. Microsoft purported to demonstrate this in court by showing a video of the sluggish performance and increase in errors that would occur if the browser was removed from the product. The DOJ submitted evidence to show that the browser and operating system were separable. They also pointed out that it was possible to obtain a standalone version of the browser, for example for the Macintosh operating system. Although Microsoft argued that the browser was being provided free, the DOJ adduced that the costs of the browser's development were incorporated into the cost of the operating system, and was partly responsible for the relatively high cost of the operating system. Microsoft further argued that the fact that the industry was unregulated had meant faster development, lower prices and more choice for consumers. This argument was echoed by other commentators (see Browne, 2001). However the manner in which the browser is integrated with the operating system means that even when a consumer prefers to use an alternative product the default browser would be Microsoft's. It was not possible for the consumer to backward engineer this, firstly because of the restrictions in the end user license agreement and secondly because most consumers would not know how to go about doing so. Hence in reality they were being forced to use Microsoft's browser whether they wished to or not (Chin, 2004). Judge Thomas Penfield Jackson held that Microsoft were in breach of both sections 1 and 2 of the Sherman Anti-Trust Act and ordered that Microsoft should separate the browser and other applications from the operating system. However Microsoft appealed and Judge Jackson's decision was overturned by the DC Circuit Court of Appeals on the basis that since the Judge had given media interviews he had not retained his objectivity. The DC Circuit Court of Appeal remanded the case to be reheard on a reduced scope of liability. Ultimately the DOJ and Microsoft agreed to a settlement whereby Microsoft would provide its Application Programming Interfaces (APIs) to third parties and set up a Technical Committee of 3 persons to oversee this for compliance. Despite opposition that this was no more than a slap on the wrist, the US Appeals court unanimously accepted this settlement and Judge Colleen Kollar-Kotelly directions. In an interview after the ruling a disappointed Massachusetts Attorney General Thomas F. Reilly said Microsoft "not only has been ruled a monopolist, they are now a protected monopolist. That's a very dangerous thing." Reilly said the case demonstrates that "our antitrust laws are not effective in protecting consumers," especially in the realm of high technology (quoted in Krim, 2004) All software companies benefit from Microsoft's 'victory' to the consumer's

Reading response and discuss question Essay Example | Topics and Well Written Essays - 250 words

Reading response and discuss question - Essay Example ies remains extremely authoritative in establishing interpretive strategies for increasing audience acceptance and influencing their view of a masterpiece film. In exploring cultural construction of masterpiece films, Luckett critically evaluated Fantasia during its original release and reissues by examining the film’s publicity, reviews, and marketing. According to Luckett’s analysis, the film produced by Disney starred mainly due to its open publicity in road shows, use of modern technology including home theater appliances, and its receptions based on culture. For instance, based on application of new technologies, Disney decided to help the audience construct a home culture by establishing home theatre systems and video libraries as opposed to watching films in cinema theatres (Luckett 233). It is indispensable to note that the technique increased sales (Luckett 231). There exists an imperative culture and social context behind acceptance of a new film by audience. Reception studies remains authoritative in understanding particular social and historical aspects associated with audience interpretation and consequent response to a film. In publication and review of a film, it is domineering for a production company to establish public culture in relation to their interpretation and understanding of films. Representing audience interests in relation to gender questions, culture, and social expectations is imperative in construction a public culture that would assist in making a film masterpiece. Therefore, does publicity and review of a film inherently a film affect its consequent audience

Rhetorical Analysis of MLK Jr's Letter from Birmingham Jail Essay

Rhetorical Analysis of MLK Jr's Letter from Birmingham Jail - Essay Example The letter is King’s response to the public statement issued by eight white religious leaders of the South. All throughout the letter King emphasizes that the demonstration conducted at Birmingham was quite non-violent in nature and he warns the authorities that the injustice, segregation and racial discrimination shown towards the Negroes can be overcome only through non-violence and civil disobedience. The letter clearly demonstrates that Martin Luther King was quite aware of the nature of his audience or readers. Thus, he consciously stresses the Judeo-Christian tradition of the liberation of the oppressed and propagates democratic human rights (Ess). The Negroes are referred to as oppressed, segregated, robbed and suppressed. One can find King addressing his audience as ‘my Christian and Jewish brothers.’ The recurrent references to the Holy Bible, Jesus Christ and Apostle Paul are quite meaningful and he also draws parallels between the experiences of early C hristian martyrs and the demonstrators. At the very outset of the letter king makes it clear that he supported the Alabama Christian Movement for Human Rights as he wanted to propagate the gospel of freedom beyond his own particular hometown just as St. Paul preached Christ’s gospel to everyone. Towards the end of the letter King expresses his disappointment toward the white church and its leadership. Even though King expected Christian brotherhood and support from them, it is quite misfortunate that many of the white Church have proved to be opponents of the movement. He exhorts the church authorities to react against the injustice shown to the blacks and to express moral concerns over the status quo. He also warns that if the Church shuts its eyes towards these injustice believers would move away from it. King also pays special attention to appeal to the logos (use of reasoning to appeal to the reader) of his audience. He vividly portrays the segregation, injustice and raci al discrimination experienced by the Negro community and purports that it was reasonable for the demonstrators to engage in non-violent protests. King, in his letter, stresses on the ‘interrelatedness of all communities and states’ and he postulates that â€Å"injustice anywhere is a threat to justice everywhere† (King 2). Thus, he makes it clear that he cannot shut his eyes to any sort of injustice whether it is in Atlanta or Birmingham. While the white religious leaders of the South regarded the demonstrations in Birmingham as unfortunate King admits that the Negro community in Birmingham had no other alternatives but to fight against the white power structure in the city. He repudiates that the actions of the demonstrators would never precipitate violence. He exhorts the society to ‘protect the robbed and punish the robber’ (King 3). He believes that only through tireless non-violent efforts and hard work the dreams of the black man could be cheri shed. King’s next focus in the letter is to convince his readers/audience of the various reasons as well as the non-violent nature of the demonstration. King goes on to explain the four basic steps of any nonviolent campaign: â€Å"collection of the facts to determine whether injustices are alive, negotiation, self-purification, and direct action†

Applicationof nursing process to delivery cultural competent care to Research Paper

Applicationof nursing process to delivery cultural competent care to Haitian Americans - Research Paper Example The immigrants faced a huge test of survival in the new lands. Most of the Haitians, however, had fled to France. This was because of the French policy of assimilation, which saw most educated Haitians go to France. Over time, the number of Haitians living in the US has increased. According to the 1990 census conducted in the United States, there were more than 290,000 Haitians in the United States (Zephir, 2004). This figure, however, does not include the tens of thousands who live in the US illegally. Being of the black race, and with the historical racial segregation of the US, the Haitians have always faced a huge task of being accepted into the community. Like most other Blacks, they have faced political as well as social discrimination from the whites of the United States. This made survival for the Haitians a very difficult endeavor. Today, however, the Haitian Americans as well as other ethnic groups from the black race are a strong part of the American

Establishment of a Public Relations Department within a Holiday Resort Essay - 2

Establishment of a Public Relations Department within a Holiday Resort in the Flinders Ranges Promoting Eco-Tourism - Essay Example This paper illustrates that the goal of PR by a corporation is to persuade the investors, public, employees, partners, and stakeholders to uphold a point of view about public relations, its products, leadership or political decisions. Â  Activities involving public relation include speaking at conferences, working with the press, employee communication and winning industry awards. According to Danish Public Relations Association, PR is a management function that tabulates public attitudes; define the interests, procedures, and policies of a company followed by implementing a program of action to win public acceptance and understanding. An establishment of PR department is critical in building the relationship that advance, benefit and promotes the reputation of the Holiday Resort. Being an eco-tourism sector, gaining the confidence of its clients is key, and this is facilitated through marketing the company’s services and product. Improving reputation is a fundamental objecti ve of most organizations. As such, a PR department creates an industrial partnership and strong community translating to increased productivity. The public relation will be vital in maintaining the Holiday Resort’s image and conveying its information to the general public, investors, and customers. A positive perception of Holiday Resort is likely to increase the number of tourists both locally and internationally as it improves its bottom line. The public Relation professionals will work closely with the CEO to craft an overview of how the Holiday Resort will be perceived and assist in planning to design a positive image. Unlike in marketing, the public relation professionals aim at organizing interviews with clients, writing the press release and providing information on the company’s achievements.

Case study Essay Example | Topics and Well Written Essays - 750 words - 12

Case study - Essay Example and Hasan, H., n.d.) At the outset, the environment although polite and formal, breeds division between management and employees. This is shown by the set up of physical structures, by not inviting employees to participate in management’s plan, with a notion that there is nothing more to learn from them. Result of this environment showed that while it was a good design of operational efficiency and control, there was no flexibility that resulted in loss of motivation and trust that led to unsatisfied performance in the long run. Because there is no chance of communication, even the best intentions could be clouded with suspicions as in what happened to John who failed to see the good intention of training and further development. If the democratic leadership is adopted, as initiated by new manager, there is a fair chance that employees will be more motivated in the work performance, John will not quit as things are communicated well, and system will lead to a collegial system whose basis is teamwork. Sundarasadula, D. and Hasan, H., Closed system and organizational theories, Chapter  11.  A unified open systems model for explaining organisational change Retrieved 15 2010 from http://epress.anu.edu.au/info_systems/mobile_devices/ch11s02.html This case describes a situation of job satisfaction and organizational commitment. Interestingly, it is related to career opportunities, work life policies and job characteristics as could be seen with the problem of Suzanne Chalmers. Money, benefits and stress on the job are out of the question since these are not the reasons for her resignation. But why would she quit, along with other IT professionals who quit to later joining start-up software firms that give lesser benefits? In my analysis, management failed to see that job satisfactions among professionals has something to do with †upward mobility† as they are seeking for higher status and

Job Analysis and its Role in Human Resources Essay

Job Analysis and its Role in Human Resources - Essay Example The importance of job analysis to HR managers is very crucial that it has been called the building block of everything their personnel does. Wright and Wexley (1985) reasoned out that the fact is that almost every human resource management program requires some type of information that is gleaned from job analysis. An appropriately executed job analysis could be beneficial for the company. This is because an organization will be able to undertake: Work redesign-Often an organization seeks to redesign work to make it more efficient or to improve quality. The redesign requires detailed information about the existing job (s). In addition, preparing the redesign is similar to analyzing a job that does not yet exist. Human resource planning-As planners analyze human resource needs and how to meet those needs, they must have accurate information about the levels of skill required in various jobs, so ... Training-Almost every employee hired by an organization will require training. Any training program requires knowledge of the tasks performed in a job, so that the training is related to the necessary knowledge and skills. Performance appraisal-An accurate performance appraisal requires information about how well each employee is performing in order to reward employees who perform well and to improve their performance if it is below standard. Job analysis helps in identifying the behaviors and the results associated with effective performance. Career planning-Matching an individual's skills and aspirations with career opportunities requires that those in charge of career planning know the skill requirements of the various jobs. This allows them to guide individuals into jobs in which they will succeed and be satisfied. Job evaluation-The process of job evaluation involves assessing the relative dollar value of each job to the organization in order to set up fair pay structures. If employees do not believe pay structures are fair, they will become dissatisfied and may quit, or they will not see much benefit in striving for promotions. To put dollar values on jobs, it is necessary to get information about different jobs and compare them. Moreover, job analysis is also important from a legal standpoint. This is because the government imposes requirements related to equal employment opportunity. Detailed, accurate, objective job specifications help decision makers comply with these regulations by keeping the focus on tasks and abilities. These documents also provide evidence of efforts made to engage in fair employment practices. For example, to enforce the Americans with Disabilities Act, the Equal Employment Opportunity Commission may look

Sole Trader Companies Essay Example for Free

Sole Trader Companies Essay Sole trader companies are the ones which are opened individually. For example, there is one person and he fascinated about doing business so he can invest money into the business and he has to do it by himself. It means he has to find out where can sources of finance come and how to control it because he must work by himself without shareholders. There are some sources of finances as follows: * Retained earnings: this is profits of a company after removing taxes, salaries and expenses or something like that and this source should be applied after few months from the beginning. For example, after removing all of expenses like sundry costs, training courts costs we have the balance in our savings account about 9500 pounds. Pizza hut can use that money actively to purchase for their raw materials it is also an advantage of them when they can control their expenditure and save some money so that they can use their money without thinking about charging fees or interests. However, if they base on the money which is saved too much they are going to meet problems because the situations of company will be different depends on different economics phase so they need to think of some ways to make sure that saving money will not take a lot of place in their account. * Selling assets: in case the entrepreneur set up their business but they have problems in capitals so they should sell some products to get money to invest and getting profits. For example, pizza hut can sell their old machines, equipment, or even their own logo. This is seemed to be a risk way because after selling assets they will be lose their control in their business a little and it can lead to situations of having not enough assets to support for producing. * Personal capital: The owners can invest their own money into business for expansion. This will prevent him from the burden of interests from borrowing and he or she can control their business by himself or herself without depending on others one. * Debt finance: it is often used when people start to set up a business, entrepreneurs will ask for borrowing money from their families and friends  first and finally then they will ask for borrowing from others business’s helps. In short, debt finance is used for subscribing the borrowing action of a business to report for their productions. In case Pizza hut is a Public Limited Company Public Limited Companies is the ones which are created from 2 or more than 2 persons. And those persons are called shareholders and each shareholder will own a part of the company which is depends on their financial ability by the ones called shares. The more shares you owned the more donation you have in control of company. By this way the company can mobilize capital easily and there are some sources of finance as follows: * Issuing shares: business can collect money by issuing shares to stock exchange and outsides the business there are going to be some people want to invest money to make profits for themselves so they can use their money to buy the shares and by that way the business can get money and for the person who invested money they will have a position in the business and they will receive dividend each month. * Venture capital: venture capital is becoming increasingly important sources of finance for growing business. This can be done by individuals or groups of shareholders, they have to look for a lot of potential companies or projects and making decisions exactly is not being lacked of. Otherwise, they can easy to meet debts for dividends for example or they can go to bankrupt because they are lost a lot of money for failure projects. * Bank loans: Business can raise their fund by borrowing money from banks and this is seemed to be a good way to get money immediately. However, the business has to think a lot about the interest rate and the repayment ability in case they don’t want to go to bankrupt because of debts. And, business consider loans as long or short term plans to support their business and the considering is depended on the purposes and the amount of money the business want to borrow. For instance, if the business had 1 billion and they borrow 100 million, it would be considers as short – term loans because the amount of money they borrowed is not main money for projects because it too small compare to 1 billion. 1.2 Advantages and Disadvantages * Debt finance: Advantages: everyone when they want to set up a new business so borrowing money is very necessary because it will help the entrepreneur feel more confident and they are going to be stronger in doing business. Disadvantages: besides, they have to think about ways of repaying loans to others. The reason is that they will create a trust and increase their reputation so that they can borrow in next times easily. So, doing business is not always favorable so it requires businessmen to think about ways of existing a lot and when they go to bankrupt there will be not easy for them to face with creators and in the worst case they can be a prison. * Issuing Shares: Advantages: businesses can raise their funds easily by issuing shares and they can expand their business as well. This mobilization capital will not create a debt which the business has to repay. Besides, issuing shares can help business attract and keep good force of staff and the business can connect to potential partners. Disadvantages: The businesses have to accept high fees of issuing. Issuing shares can disperse the ownerships, controllerships and revenues as well. * Bank loans: Advantages: Bank loans are seemed to be a good resources for a business to raise their funds because the business can get mortgages from bank easily and the mission they need to complete is that try to earn profits as much as possible to repay. Disadvantages: In case, the business make lost so that will be a really big issue because if they did not repay on time they will lost their assets but the thing is they have to delay the debts and that’s the reason for interests are going to be increased immediately and the delayer the more interest. Finally then, the more money cannot be paid the more risks of bankrupting.

Interpretation and delivery of language Essay Example for Free

Interpretation and delivery of language Essay I am writing to congratulate you upon being chosen to play the part of Richard in our forthcoming production of Richard III. This letter is a guide for you for how I would like the part of Richard to be acted. This shall be primarily based upon two key scenes in the play, which are Act 1 Scene I (opening scene) and Act 5 Scene VII (eve of battle scene). This guide covers 3 main aspects of playing the part of Richard. These are: Your interaction with other characters, your interpretation and delivery of speech within the play and your physical representation of Richard. The reason why these two scenes have been concentrated on is because they occur at key moments within the play and at opposite ends as well. Not only do they appear at opposite ends of the play but they also occur when Richardss confidence is at opposite ends of the emotional spectrum. This enables us to see Richard from multiple perspectives and it shows us his multi-faceted mental and emotional states. As I am sure you are aware, Richard is portrayed as an Evil and conscience free king as well as being physically deformed. Although elements of this are based upon the truth, it is appreciated that Shakespeare made many of these descriptions up. Due to limited other historical reference this is how Richard is portrayed nowadays. Shakespeares reasons for, perhaps, making up these facts are to please the Queen at his time, who was Queen Elizabeth I. This would please her because it was her grandfather, Henry Tudor (later Henry VII (Richmond in the play)), who became King after Richard III was killed in battle. Obviously this made Richmond and Richard enemies, so portraying Richard as both evil and deformed would put Queen Elizabeth and her ancestry in better light. Richardss evil is very evident from his very first speech (a soliloquy) in the first scene of Act 1. This solo speech to the audience sets the tone for the nature of Richardss evil worlds and actions throughout the rest of the play. This supreme malignity is evident in the quote that I will shortly send thy soul to heaven, when referring to his Brother Clarence who he has sworn to save from imprisonment. This is remorseless in its extreme form considering that he has pledged to his brother to have him released form the Tower, which Clarence believes, but in truth he is going to have him killed. This means you must portray an immense feeling of evil and remorselessness to the audience. This could be done by snarling and almost spitting when speaking of what you plan to have done as well as making angular and jerky motions rather than smooth rounded ones. However Richardss evil is often matched by his intelligence and an example of this is in the quote To set my brother Clarence and the king in deadly hate, the one against the other. This shows how he is manipulative and again you must get the audience to believe this about you as well as making them in awe of your intelligence and scheming. It is obvious that Richard is aware of his intelligence, so portray this to the audience with a swagger and self confidence of a man who knows of his large capabilities. A lot of the reasons behind Richardss hatred for all things jovial is due to his physical deformities and his hatred of his own appearance. He knows of his own deformities, obvious in the line Nor made to court and amorous looking glass. He does however use this to focus himself on his intentions. An example of this is apparent in the line And therefore, since I cannot prove a loveri am determined to prove a villain. These abnormalities should, at first, appear to displease you and annoy you; however within in an instant this should be changed to relief when he realises that his peculiarity can work in his advantage making him focused and more determined to achieve his goals. To make these deformities appear powerfully they must be exaggerated to let the audience know, although his abnormalities are making him more focussed, that they are still a physical weakness and therefore a hindrance. This can be achieved by appearing dependant on a cane that you shall be carrying. This is to give the impression that physically you are dependant upon other people or objects. This will also provide opportunities for people to attack you and taunt your disabilities, such as the cane could be kicked from beneath you and you could use it to regain your feet, again showing physical dependency. The focus that has stemmed from these disabilities must be showed prominently also. Richards focus is clear in the quote For then Ill marry Warwicks youngest daughter. This shows us what lengths he is willing to go to get and then keep the crown in his family after his death. His efficiency and preparation must be extravagant to give the audience reason to believe Richards apparent relief that his deformities can focus him on success. This means also that, regardless of the situation, you appear in control and assured, particularly in the earlier scenes of the play. From this scene where Richard is efficient, assured and organised, we move onto the other key scene. This is the eve of battle scene where both Richard and, his enemy, Richmond are preparing themselves and their army for battle. The scene starts with a quote from Richard saying Why, out battalia trebles that account; besides the Kings name is a Tower of strength. I for one believe that this act of confidence is one where the speaker, in this case Richard has very little faith in his comment so I would appreciate you saying this line with a distinct lack of conviction in your own remark. It seems to me also that with this comment he is not only trying to convince those listening of his armys strength, but he is also convincing himself. His apparent lack of confidence is than compounded by the appearance of the ghosts. There are many quotes from the ghosts to Richard. A typical example of this would be And fall thy edgeless sword; despair and die! which was said by the ghost of Clarence. These quotes must appear to affect you now as perhaps they wouldnt have done in the earlier scenes. These effects include paranoia and further dents to your confidence which can be acted by adjusting your posture and body language. Then when he awakes from this dream he is convinced he has awaken from battle. Evidence of this is in the line Give me another Horse! Bind up my wounds and following this he begins to question his conscience for the first time which is present in the quote O coward conscience, how dost thou afflict me. This shows us that he is no longer invulnerable and that the atrocities he has committed are beginning to take effect on him.

Underwriting Process in Insurance

Underwriting Process in Insurance Underwriting Process In order for the insurance companies to make profit and charge the appropriate rate for an insured, they undergo the underwriting process. Underwriting is the process in which an insurance company determines if an applicant is eligible for insurance and the rate they should charge if the applicant is eligible. In simpler words, it is a process of risk classification. The purpose of insurance underwriting is to spread risk among a pool of insured in a way that is both profitable for the insurer and fair to the customer. Insurance companies need to make a profit like many other businesses. Therefore, it doesnt make sense if they sell insurance for everyone who applies for it. They may not want to charge an excessive high rate to the customer and also it is not good for them to charge the same premium to every policyholder. Underwriting enables the company to weed out certain applicants and to charge the remaining applicants premiums that are commensurate with their level of risk (Conra d, Clark, Goodwin, Morse Kane, 2011). The underwriting process consist of evaluating several sources of an applicant and the use of complex pricing models developed by actuaries that help the insurance companies set prices. I will focus on the risk classification along with some of the factors that help the underwriters classify each applicant and the use of insurance credit scoring that allow the insurance companies to price the premiums. Factors An insurance company usually looks at various factors during the underwriting process in order to evaluate a potential customer in terms of risk. These factors enable the insurer to determine whether or not the potential customer is insurable. If the potential customer is determined to be insurable, then these factors will help to place them in the appropriate risk group. Some of the factors considered are age, sex, health history, current health/physical condition, personal family health history, occupation, personal habits/character, financial condition, and hobbies (Clark, et al, 2011). Some people believe that any characteristic over which we have no control, such as gender, race, and age, should be excluded from insurance underwriting and rating practices (Baranoff, Brockett, Kahane, 2009, p.157). This argument reflect the idea that the factors used by insurance companies should be based on the behavior of the people instead of the quality on which they are born. Risk Classification Risk classification plays an important role in the pricing of the policy. The premium that the customer pays will depend on the category he/she belongs to. Underwriters classify the applicants into four types of risk groups: standard risk, substandard risk, preferred risk and uninsurable/declined risk. Standard risk. Individuals who have a likelihood of loss or the probability of filing a claim that is not significantly greater than the average are classified as standard risks. Based on the underwriting standards of the insurance company, the people in this group are given a term of insurance without being charged for any extra fees or be subjected to any policy restrictions and they are charged with the standard premium rate (Clark, et al, 2011). Most individual life and health insurance policies are issued at standard premium rates. Substandard risk. Insured that are classified as substandard risk or rated risk, are those that have a greater chance of filing a claim. Applicants are classified in this group because of their health and/or other factors that makes them more likely to die earlier than those who dont possess these kinds of risk factors (Clark, et al, 2011). They are usually charged a higher than standard rate because of the added risks that they possess. Examples of people that may be in this category are those who possess a history of high blood pressure, diabetes, drugs and alcohol. Or maybe they engage in some dangerous activities like skydiving or rock climbing. Preferred risk. Applicants classified as preferred risks are those who are expected to have an above average life expectancy (Clark, et al, 2011). People in this group are preferred by the insurance companies because of their health history and good habits. They are usually offered a lower rate or preferred rate. Applicants that may belong to this group are nonsmokers or people that have a good health history. Uninsurable risk. Individuals categorized as uninsurable or declined risk are those that pose a risk that is too great for the insurance company to cover. The applicants conditions are so rare or unique that the company may not be able to arrive at a suitable premium (Clark, et al, 2011), so their policies are generally declined. Examples of this category include people who have a serious illness and people who conduct illegal activities. Insurance Credit Scoring in Pricing After classifying the applicants into one of the risk groups, the insurance company needs to set price for the policies. One of the tools used by the insurance companies for pricing is the credit scores that help them determine the adequate premium for each consumer. Insurance scores are confidential rankings based on credit history information. Insurance scores are used to provide insurers with a snapshot to provide service to consumers. The score is derived from the consumers previous credit history. This data allows the insurers to price insurance premiums/rates more accurately. (Almarshary, Erbek Reddic) Insurance scores estimate the probability of having insured file a claim. The variables commonly used to estimate insurance scores include measures of performance on credit obligations, credit-seeking behavior, use of credit, length of credit history, and types of credit used (Powell, 2009). They do not include race, color, religion, national origin, gender, marital status, sexual orientation, age, address, salary, disability, occupation, title, employer, date employed or employment history for scoring purposes (Anonymous, 2009). Insurers have found a strong correlation between insurance claims and credit scores. People with low scores are more likely to file claims than people with high scores (Lankford, 2007). They also discovered that people who made late payments tended to have more claims (Almarshary, et al). Improving credit score can certainly make a big difference in the premiums. More insurers now are considering credit scores when setting premium rates. Credit scoring enables insurers to better assess the risk of future claims. In fact, insurance credit scoring helps insurers to differentiate between higher and lower insurance risk (Almarshary, et al). Therefore, insurers will charge a premium based on the information provided by the credit score. When insurers use insurance scores to improve the accuracy of predicted losses, it benefits individuals and society (Powell, 2009). Premiums are closely related to consumers risk of loss on average, so insurance scores increase the fairness in insurance pricing outcomes. Insurance scoring also adds value to insurance transactions. Because insurance scores are accurate and inexpensive rating variables; it reduces the overall cost of providing insurance and this reduction in cost is applied to the premiums of the customer (Powell, 2009). Many people may not be familiar with the underwriting process, but knowing the factors that affect the decision of the insurers of placing you into one of the risk groups, is very useful. In this way, you can easily know if you can be chosen as a potential customer based on your personal information and even if you are not chosen as a potential customer, you might at least know what to avoid in order to decrease the chance of your policy being rejected. Finally, we have to notice the importance of the credit scores, because many insurance companies used it nowadays to price the premiums. Having a good credit history is a key factor to get a lower premium rate in the policy.